Aches and Pains as You Train-The Runner’s Roadside Repair Kit

The “Race to be Ready,” a 5K/1K  Walk-Run and a FREE one-of-a-kind Emergency Preparedness Expo which I am the Race Director of, will be held at the Rancho Mirage High School on March 30th.  This will be an event certain to be a fun and easy way to be better prepared.  You will be able to experience an 8.0 earthquake and…. survive!!  Go to racetobeready.com and be part of this momentous event endorsed by Senator Boxer, The Great California Shakeout and many other politicians and governmental agencies.  We will show you how to live longer and safer the easy way!

Many of you who started your New Year’s resolution recently may now be experiencing some of the common running-related symptoms.  Here’s your prescription for less pain and continued training.  In case you did not know, when you exercise muscle fibers tear that can result with pain and stiffness.  Lactic acid and other pain producing chemicals are common side effects of running and exercise.  Since running can equate to 3-6 times your body weight, the pain level can reach a point where even a good night’s sleep does not allow your body to recover from all those healthy intentions.

I want to share some of my steadfast rules of self-care.  Listen to your body and try to avoid the use of synthetic anti-inflammatories and painkillers. We have always known these drugs have their caveats; never take on an empty stomach and their use can cause your stomach to bleed.  The recent link of acetaminophen to liver disease is just another reason to avoid depending on these over-the-counter drugs.  Advil use caused a pro football player’s death in 1984!  A female high school runner died from Bengay use on her shin splints in 2007!  Try to use natural anti-inflammatories instead like white willow bark, bioflavonoids and essential fatty acids, unless you cannot sleep due to pain or discomfort, as sleep is probably the best recovery aid our body has.  Calcium and magnesium supplements can reduce muscle tightness and cramping (my favorite is Bone-Up).  They are the “spark plugs” necessary for muscle contractions and without them muscle spasms in the hamstrings and calves, especially in the evening can be excruciating for runners and walkers.  These should be taken after lunch, dinner and at bedtime for optimum absorption and benefit.  Epsom salt baths provide a valuable magnesium source to help relax those sore tight muscles.  A cause of muscle cramping from excessive sweating during exercise can be due to excessive sodium loss.  This is why the sports drinks Gatorade, Powerade, and Accelerade can be valuable in preventing muscle cramps.  If you sweat a good amount when you are exercising, sore muscles that are not tight could be crying out for more potassium (a banana daily can help keep this pain away).  Dr. Paul’s adage for specific exercise related pain treatment is crushed ice in a zip lock plastic bag wrapped with a paper towel for 15-20 minutes 2-4 times daily.

My most common recommended self-care tool for many of the most common running related symptoms is the foam roller for tight and sore hamstrings, quads, calves and ITBs.  If the foam roller creates pain when you roll on it, you definitely need the treatment.  Our Olympic athletes roll their legs and calves out on a PVC pipe the same thickness as the foam rollers! I also promote and show low back, hamstring and calf stretches in “Ask Dr Paul.”  The traditional quad stretch of pulling the ankle and foot backwards to the buttocks is still indicated.  The current recommended time to maintain a stretch is between 5 and 15 seconds, repeating 3 to 6 times, gradually increasing the stretched position.  Easy does it!  We recommend more stretching after than before exercising.  UCLA volleyball players measured how high they could jump before and after stretching. Which way produced higher jumps?  Right, minimal stretching before jumping produced higher jumps.

My special foot taping technique can immediately reduce the nagging morning just out of bed “stepped on a rock” heel pain from plantar fasciitis and even help shin splints and achilles tendonitis.  The point of pain shin taping technique can give immediate relief to shin splints.  Kinesiology tape can be applied to the achilles, hamstrings, quads, ITBs and groin pains. Other effective products to treat and prevent these common running symptoms are the compression socks, calve sleeves and leg products like those from the company 2XU.  Custom orthotics are shoe inserts used by 80% of serious marathoners and probably the most important part of a runner’s tool kit.

Cross training on a running day with aerobic activities like swimming, biking, or the elliptical machine are excellent alternative aerobic exercises to help reduce running overuse conditions and boredom.  My three favorite longevity strength exercises in “Ask Dr Paul” are the superman, hip flexor scissors and the glut/hamstring ball exercises.  These can be done on your non-running days 2-3 times a week.

A visit to your sports chiropractor, physical therapist, or massage therapist is always beneficial in helping you recover faster and continue to improve your overall fitness level.  These treatments can be paramount in your life-long pursuit to staying active and maintaining longevity.  Only 95% of our Olympic athletes use these types of treatments to recuperate quicker and perform at their best!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

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New Year, New Race, How to Run a 5K

With the start of the New Year comes a lot of excitement!!  I want to thank all of you who have visited the blog for the last two years as we now have over 650,000 visits.  I pledge to continue learning and sharing the latest in sports injury prevention and treatment.

January 1, 2012, I started this blog with marathon training for the LA Marathon.  This year brings the traditional 5K race to the topic table, especially of my decision last year to create a 5K road race with a special theme, “Emergency Preparedness.”   This unique event is the City of Rancho Mirage’s “Race to be Ready,” a 5K/1K Run-Walk and Emergency Preparedness Expo.  It will be held March 30, 2014 at the new Rancho Mirage High School where our participants will start and finish inside a stadium.  Other than competing in the Olympics, this may be your only life opportunity for this one-of-a-kind experience.  Not to mention the wealth of information and hands-on types of experiences to enjoy along the race course and especially in our expo, which will be filled with 10 or so big trucks and trailers giving everyone the opportunity to experience an 8.0 earthquake (The Quake Trailer), a building fire (The Smoke Trailer), or how to extricate someone stuck under fallen debris (cribbing demonstrated by a CERT team).

Race To Be Ready

Race To Be Ready

Whether you’re a rookie or a seasoned veteran at this running thing, its always good for a refresher and/or getting up to date with the latest running research.  First, we start with the footwear, “how to choose running shoes” and “how to lace your running shoes.”  Your feet are the wheels under your chassis and their primary job is absorbing up to six times your body weight running, so be nice to them and give them plenty of support.  This means no barefoot or minimalist shoe training runs.  My favorite running shoes are the stability and motion control shoes which I recommend for most peoples’ training runs.  Lightweight racing flats and cushioned shoes are acceptable on race day for a 5K, 10K or half marathon if you are a competitive athlete or one with no physical injuries or limitations.  Otherwise, I recommend running a race in the same type shoes you have been training in, just a newer pair rather than an older pair.

Let’s get you moving now and start with an easy 3-5 minute warm up either walking briskly or jogging at your 50% of max or so level.  This gets the blood circulating throughout your body, especially to your legs and feet.  I suggest initially lacing your shoes to about 80% of their max tightness and after the warm up, tighten them close to 95%; 10-15 minutes later, you can pull laces to 100% if desired.  The best running surfaces are well manicured grass (parks, green belts, golf courses), flat dirt paths, trails and fire roads.  The absolute best surface is along the shoreline at low tide in ½” to inch of water, but most of us will have to seek alternate running surfaces.  The treadmill is also an excellent training tool; just be sure to pay attention.  When all else fails, hit the street (pavement) and as an absolute last resort, the sidewalk.  Consider my article, “What side of the road to run on.”

For rookie runners, once you have done your few minute warm up, consider increasing your output from 50% to 75-80%, an exercise level you can still talk to someone, “Hey look at me; I’m a runner.”  Try to maintain this for 1-5 minutes, then walk for 1-2 minutes.  Try to spend 10-20 minutes total time running for the first few runs, gradually increasing your running time and remaining close to the 80% of max effort level for the first week or two.  Your 2-3 month goal to run a 5K race is to get to the point where you can run continuously for 30-40 minutes.  Worse case scenario, you run and walk during your first race, but FINISH IT!  The trick is gradually increasing one run per week, either in intensity and/or distance, usually no more than 20%.  For instance, when you are able to run for 15 minutes a few times, increase one of the week’s three runs by 2-3 minutes, i.e. 15,15,18 minutes, following week 15, 15, 20 minutes, next week 15,15, 22 and so on.  After 2-4 weeks, increase the shorter runs 2-3 minutes, i.e. 17, 17, 25 or so, gradually increasing the short and long runs.  This is how you can get to the 5K race distance within 2-3 months.

I’ll be glad to field some questions; otherwise I’ll get back to you next month for a follow up blog.  As I always say, “Be sure to have fun; moderate exercise definitely helps you live longer!”   So easy does it, take your time and enjoy the ride.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Race To Be Ready Flyer 1

Race To Be Ready Flyer 1

 

Race To Be Ready Flyer 2

Race To Be Ready Flyer 2

 

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Clinton Health Matters Initiative

We are starting a great 2014 with a healthy atmosphere!  Please join me at the Clinton Health Matters Initiative Codeathon!

Screen Shot 2014-01-10 at 8.48.53 AM

http://codeathon.splashthat.com/

 

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Loren Nancarrow – R.I.P.

Loren Nancarrow, RIP

Loren Nancarrow

Loren Nancarrow

When Susie saw me before paddling out to say goodbye to Loren she said, “Those were the good ol’ days!”  As I watched her paddle out to say goodbye to the consummate husband, father and friend, I thought of Don Henley’s song, “The end of the Innocence” and rephrased it to Loren:

Now we’ve come so far, so fast
Who knew how long this was to last,
But somewhere back there in the dust
That Lone Jack time’s in each of us
I just need to remember this,
So Susie give him one last kiss
And let me take a long last look
Before we say goodbye

Loren and Paul

Loren and Paul

Stay Strong Susie, Graham, Hannah and Britta.  We love you. Our hearts ache with you.  The Copeskeys

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The Santa Monica 5000

I ran in my favorite LA race October 6th, The Santa Monica 5000, even though I did the 10K.  I was able to see family, friends, patients, coaches and professional colleagues.

Dr Paul Santa Monica 5000

Dr Paul Santa Monica 5000

It was a special day because I was helping introduce a 14 year old young man just starting his competitive running career in his first 10K road race.  Even though he had won every cross country race he had been in and is an excellent HS and collegiate running candidate, he was humble and eager to learn more about running and how to improve his performances.  I kept reassuring him days before that he could use his music source in this race and not be penalized, even though music is restricted during his school competitions.

He arrived to the race on a warm fall southern California morning that was 80 degrees at 8 AM with a long sleeve compression top under a loosely fitted T shirt, baggy running shorts to his knees and wearing a baseball hat turned  slightly to the side.  My only suggestion was improving the lacing of his running shoes.  Like so many young runners these days, I usually notice their shoes are not laced properly.  He had tied multiple knots in each shoe.  A technique I recommend in my “How to lace your running shoe” involves using every eyelet in the shoe and a special loop that secures the shoe better than other lacing methods, leaving less lace leftover and need for additional knots.  I shared this method and some of my alkaline water with him, explaining how this unique type of water, explained in “Water, Water Everywhere,” stays in the body longer and that I would not need to drink any water during the entire race since I had been hydrating with alkaline water the few days before the race.  That really surprised him!

We did 10-15 minutes of easy warm up strides followed by some faster strides just before the race started.  Lastly, I showed him how to slither in between some of the PVC barriers at the starting line a few minutes before the race started where we were standing next to the elite athletes.  Once the race started and he was off with the elites; I just merged with the other 1000 runners.

Dr Paul's Results

Dr Paul’s Results

My young friend finished six minutes before me, first in his age group and I third in mine, so we both had podium performances, his obviously more noteworthy.  My time was slower than last year’s, as I spent the prior few months preparing for the 10 degree uphill grade Palm Spring’s Tram Race in late October by running up and down the intense “Bump and Grind” desert run four days a week.  That mountain training obviously did not help prepare me for this flat race course.  Another faux pas I committed for this race was using a spray on sunblock.  Yikes, when my forehead sweat migrated south, I developed the burning eyes syndrome that menaced me throughout the race.  I hope that’s my last sunblock blunder.  One thing that’s for sure is my young friend and I will have many more fun, productive and satisfying training runs and races!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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A Lesson In Peace Making

I am a competitive runner who is a doctor, or maybe I should phrase, I am a doctor who is a competitive runner/athlete.  I write about health and how to keep your body healthy and in motion.  I write about competing and how to do it well without cheating, as many athletes have lately.  I love winning and/or placing in races; I train hard, keep fit, eat well and work to win.

One topic I have not addressed is sportsmanship in how we compete and how we live our lives, day to day.  I witnessed an example of the ultimate in sportsmanship a couple days ago on of all places, the tennis court.  Carole, a friend of ours was playing with a partner against another couple.  She happens to be the President and CEO of The Peacemaker Corps, a global company helping children spread peace around the planet.

Carole and her partner were having a rally against their opponents when she successfully struggled to reach a ball and returned it for a game-winning point.  Her partner yelled out just as she hit the ball, “great shot!”  The opponent, who would not have been able to return Carole’s shot, suddenly stopped and responded, “Oh, I thought you were referring to mine as the winner.”  It was obvious to all that he could not have returned Carole’s ball and that his team lost the point and game.  However, he insisted that he could have returned her shot if he had not been interrupted, so he demanded a re-serve for this important game point.

There was a moment of bewilderment by Carole and her partner (the teaching pro at our tennis club), but they conceded with grace and agreed to re-serve the point.  Unfortunately, she and her partner lost the next two points and the game.

The Peace Makers Corps

The Peacemakers Corps

However, in my eyes, Carole won the highest honor of sportsmanship by not contesting the opponent’s justification for not returning her shot.  What an ultimate sportswoman and peacemaker!!!  She not only talks the talk, but she walks the walk!!!

I would like to thank you Carole for this poignant example of peace making!  You may not have won that game, but you are the real WINNER!!!   Thanks for refreshing my memory that it’s not whether you win or lose, but how you play the game!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Our Golden Girl, Alexis Faulknor

Alexis Faulknor

Alexis Faulknor

Dr. Paul, I want to take this time to say thank you for playing such a significant role in my life and the life of my daughter, Alexis.  For many years you have played a key role in our success and we truly appreciate you.  As the founder and head coach of the Southern California Running Cougars youth track club and the Head Track and Field Coach at Serra High School, I want to thank you for keeping my athletes strong and injury free.  Some of my greater athletes such as Bryshon Nellum, Duane Solomon and Joey Hughes who were top runners at USC, Khalfani Muhammad and D’Anthony Thomas, Oregon’s top running back just to name a few, could not be where they are today without your consistent treatment.
I am pleased to say that at age 49, I am ranked among the top US Masters in both the 60 meters and the 200 meters.  I am performing at my highest level because of your advice, treatment and your knowledge of sports injuries.  Thank you for being a friend and family doctor.  We will continue to be successful and perform at our best because we have the perfect person in our lives.

Thanks Doc,

Chris Faulknor
USA Master Athlete, USA Track and Field Official SCA High School Track

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Best Running Shoes for 2013

Dr Paul Recommends Saucony Omni

Dr Paul Recommends Saucony Omni

Where did all the strength and longevity in running shoes go?  I can remember shoes lasting 500-600 miles 15 years ago.  Nowadays, if you get more than 300 miles, you probably weigh 125 pounds or have excellent running mechanics.   All the running shoe companies used to make some models that were “board lasted.”  That means when you pull out the shoe’s insole, a board (cardboard-like material) would be located from the heel to the midfoot area of the shoe to make the shoe stronger and last longer.  Today’s running shoes remind me of the Wendy’s commercial where the little old lady said, “Where’s the beef?”  Are you getting the message?  Yes, the shoe companies are motivated to sell shoes and the more the better, especially for the finance department and stockholder.

Dr Paul Recommends New Balance 940

Dr Paul Recommends New Balance 940

The “Run Free” book and subsequent minimalist shoe movement became a huge opportunity for all the shoe companies to get into this current trend and “fad.”  Remember just a couple years ago when Skechers and Reebok had their hands slapped for false health claims about their Shape-Ups and Tone Ups?   I do enjoy the financial benefits from the injuries caused by this quasi-science, but am looking forward to future running shoes that can enhance shock absorption and increase the longevity of the shoes.  If you visit How to Choose a Running Shoe and see some examples of Dr. Paul’s favorite running shoes in The Right Running Shoe, you will probably be able to stay off the disabled list and out of my office.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Hitting V02 Max with RunKeeper on the Bump

The Bump By Runkeeper

The Bump By Runkeeper

I ran “The Bump and Grind” at noon today at 90 degrees in between some monsoonal rain showers; reminded me of Hawaii.  Ironically, it was almost as difficult as a typical 105-degree desert evening “Bump” run.  Hard to believe I was the only person on the trail; love the dust and people absence.  I ran with a frozen bottled water for the first time.  It was invigorating to roll on my chest, neck and even armpits.  The ice starts melting immediately and I still had some left at the end of the 40-minute run.

Keep running!

Dr Paul R. Copeskey, D.C., C.C.F.C.

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How to Increase your VO2 Max Running

Dr Paul Desert Running at 105F

Dr Paul Desert Running at 105F

The most important measuring stick of optimal physical fitness and human performance is VO2 Max.  VO2 Max is basically the maximum ability or heart rate for someone doing an aerobic activity, i.e. running or riding a bike as fast as possible.  It’s a measure of a person’s maximum heart and lung function.  The higher heart rate a person can achieve exercising and not pass out or die doing it usually means better cardiovascular health and higher VO2 Max.  Recent research has now shown track sprinters can have a greater VO2 Max than marathon runners.  This science is supported with recent high intensity interval training (HIIT) results, revealing that short bursts of maximum physical effort for 20 seconds to a few minutes followed by 10-60 seconds rest is healthier than uninterrupted continuous easier efforts for much longer time periods.  See June’s NY Times article, 4-Minute Workout.  The positive changes from HIIT are not only measurable in the heart and lungs, but also in muscles, blood vessels and even evidenced with improved pancreas function related to glucose regulation for many hours after the exercise event.  I’ve always said, “You never see an overweight track sprinter.”

Many of my patients do weekly workouts doing HIIT on a track where, after warming up for 10-20 minutes, they may do 200-400 meter repeats and longer at 90-100% effort with 30 second to 2 minute rests or longer in between.  Other HIIT workouts gaining popularity now are circuit-training classes that turn up the VO2 Max a notch with some resistance training as well.  Be sure to get the OK from your family doctor before ramping up your exercise regimen with these advanced workouts.  Start out 1-3 times a week with 5-10 short sprints of 5-10 seconds at 75-80% effort, gradually increasing over the course of a month or two.  You will be amazed how quickly you will be able to get to 30-second sprints.  Easy does it!

The Bump and Grind

The Bump and Grind

My favorite VO2 Max workout is a 3 to 4 mile advanced mountain trail run called the “Bump and Grind” in the California desert near Palm Springs.  It’s a challenging trail run up and down a barren desert mountain landscape mimicking the moon’s surface.  The early part of the trail is only a couple feet wide and passing people involves at least one person turning sideways.  The trail is littered with intermediate size rocks, hence the name “Bump,” and for the first half mile a vertical drop of a few hundred feet keeps one focused on every foot strike.  The “Grind” part of the run is a steep 1 mile climb that can quickly establish everyone’s VO2 Max within a few seconds, or the heart rate basically when one can no longer run or even walk up the mountain.  I try to continue running in this “Grind” phase close to my 90-95% VO2 Max for intervals of 2-4 minutes with 10-20 second rests.

A tool I frequently use to increase my VO2 Max by only 20-25% on this trail run in 100 degree heat is crushed ice in a small ziplock baggie under my hat.  The top of the head is like the car’s radiator and ice can last up to 30 minutes in this heat.  Another boon for heat running are salt tablets (“Salt Stick Caps”) and energy aids like Powergel and Gu products.

Once at the top of the “Bump and Grind’s” nearly 1000 foot climb, its time for the breathtaking views across the valley floor, the 8,000 foot snow-covered mountains directly above Palm Springs and Big Bear’s snow cap as well to the northwest.  One might get lucky as I did the other day and see a Bighorn sheep and its offspring.  My descent includes novel challenges to primarily increase propioception and coordination, i.e. skipping from side to side and doing 360’s.  It’s difficult to challenge my VO2 Max on the way down, other than a few ‘bumpless’ stretches of 300 yards or so that I can push the pedal on and then later through a rolling bumpy stretch for a few minutes, all the time also checking for rattlers, scorpions, tarantulas and sidewinders.  My special preventive ankle sprain taping technique keeps my confidence high running down the “Bump.”

Top of the Bump and Grind

Top of the Bump and Grind

The name of the game in athletics when it comes to exercising and pushing the body to higher physical challenges is, “you have to be able to repair what you tear.”  Exercise involves predictable stresses and strains on our skeleton, starting in the feet.  I have specialized for the last 35 years in sports medicine on the feet and lower extremities as they relate to the entire skeleton.  My most important revelation has been that almost everyone has one leg actually longer than the other by almost ¼” and correcting this abnormality with custom orthotics helps the entire skeleton’s function and performance throughout life, whether you are a Ferrari, Hummer, or a Volkswagen.   As the intensity of exercise increases, the workload on the skeleton does as well, magnifying the body’s imbalances.  Running down the “Bump and Grind” could be up to 10 times one’s bodyweight.  This is when new symptoms may eventually start appearing, or a minor symptom may increase to a point of concern.  Getting to a sports specialist health care provider can help identify, correct and even prevent a mechanical problem before it becomes an exercise ending issue.  This is why “easy does it” is my mantra to athletes when they challenge their bodies with more exercise intensity, frequency or duration.

Of course, how to choose the right running shoes and how to lace your running shoes are imperative.  Other important factors to help the body perform better are compression apparel, along with natural anti-inflammatories like White Willow Bark and Bioflavonoids.  Take good care of your body; it’s the only one you have and you want to get 300,000 to 500,000 miles out of it.  That’s why I always make time to see my body mechanics, especially the chiropractor and occasionally the massage therapist.  Sleeping on a supportive mattress without an alarm clock will also help you recover faster.

Keep Running!!

Dr. Paul R. Copeskey, D.C.,C.C.F.C.

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Pleasures of the Golden Years

Dr. Paul and Scott Tinley

Dr. Paul and Scott Tinley

Started 2013 with a terrific 5K race experience in what I initially thought would be just a small local event for the Palm Desert Charter Middle School’s Science Department with a few hundred 12-14 year olds and their parents.  At the starting line I chatted with a fit and friendly 68 year old British bloke.  We realized we had both been in Hawaii almost 30 years ago when he was competing in the Ironman Race and I was there treating 2-time Ironman Champion and long-time friend from San Diego State University, Scott Tinley and others.  He then asked me, “Did you know Scott was at this 5K race today?”  I thought this guy’s a little looney, too many endurance events. To my chagrin, Scott was definitely there!  Turned out his wife, Virginia, went to this same school and they were there in support of the event.  Small, Small World!  Got 2nd in my age group-22:16. Guess who was 3rd? Looks like the tortoise passed the hare! Glad I was able to support Virginia’s Alma mater. Great healthy post-race food! By the way, the 10 year older Brit beat both Scott and me.

5-K Race Results

5-K Race Results

I have been running on a treadmill recently at race pace and it definitely helped! The ability to run this way forces you to remain focused on technique and to maintain a fast cadence, which can be difficult to duplicate when leisure running. Even though I’ve always been an outdoor runner, the forgiving surface of a treadmill, combined with an escape from nature’s weather challenges, offers a terrific alternative. See you on the treadmill!

I look forward to helping this terrific event grow.

Keep Running!

Dr Paul Copeskey, D.C., C.C.F.C.

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Foot Pain Taping

Steve Ambrosi
February 2, 2013
Dear Dr. Paul,
Steve Kalalau Trail

Steve Kalalau Trail

So, we were out here hiking Na Pali coast’s Kalalau Trail and my achilles starts acting up severely. So I thought back and used your foot taping method around my forefoot and heel. It was awesome. I said Dr. Paul would be proud of me!! HaHa!

Thanks,

Steve

Dear Steve,

So glad my foot taping technique could be of help during the hike.  I remember the trail’s stretch climbing 800 feet in one mile.  The best thing about being a fit runner is the ability to see firsthand so many of this world’s treasures. Thanks for sharing this experience.  best health and hiking,

Keep Running!

Dr Paul R. Copeskey, D.C., C.C.F.C.

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Kinesiology Taping on Race Day

Gracie Padilla Photo  Diana Hernandez

Gracie Padilla Photo Diana Hernandez

Hi Dr. Paul,

It was great seeing you today! I hope your race went well! Here are the cool pictures with the awesome tape job you did on me! Totally loved it! If you want to use these pictures please credit Diana Hernandez.

See you soon,

Grace Padilla

 

 

Dear Gracie,

I’m so pleased that my care and custom orthotics over the last 18 years have enabled you to stay healthy, competitive and recently attain world status in the global running community.

Gracie Padilla Photo Diana Hernandez

Gracie Padilla Photo Diana Hernandez

Thank you for your continual willingness to allow me to introduce you to new technologies like kinesiology taping for your hamstrings and achilles muscles and tendons for performance enhancement and faster recovery from races and hard training sessions.  You are a gold medalist person in life whose personality and friendship have left a permanent impression on me forever!  I look forward to sharing more sports science, memorable events and experiences with you.

Keep Running,

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Santa Monica 5000

Santa Monica 5000

Santa Monica 5000

Had a blast running in the Santa Monica 5000 this past Sunday seeing  family, long-time friends, patients, teachers, coaches, world class athletes, USA Track and Field staff, other doctors, their staffs and making new friends!  Missed 3rd place in my age group by 5 secs.  Might have to fire the 8 yr old who was pacing me!  Yes, he beat me and was 1st in his age group!  I even ran in minimalist shoes, but fortified them with my orthotics, a special 1/8” cardboard shoe insert, foot taping, achilles kinesiology taping and compression legs.  Still content with 4th place-22:27.  Because you know I practice what I preach, here is a breakdown of Dr Paul’s race day tool kit:

Shoes:  Choosing the right shoe is important; I ran in the New Balance Running Course MR1400s.  They were awesome!  Thank you Garrett for the recommendation, manager at Toptotop running specialty store in Santa Monica.  I used a special insert to embellish the shoes’ strength, an 1/8” thick cardboard from the heel to mid foot part of the shoes.  This is similar to the boards most shoe companies last century used to include in many of their running shoes.  Today, I know only two running shoes that have them, Brooks Adrenalines (#1 shoes sold in running specialty stores) and Brooks Addictions.  Shoes can be classified as board lasted or slip lasted (no boards).  The boards make the shoes stronger and last longer.  Stump your local running shoe sales clerk by asking to see their board lasted shoes.  Don’t be surprised if they look bewildered.  Of course, I used my how to lace your running shoe technique to optimize shoe fit and prevent lace loosening.

5K Race Shoes

5K Race Shoes

Orthotics:  I needed to enhance my running custom orthotics to remove a little metatarsal pain I developed recently training in lighter shoes and also a result of this century’s trend of less strength provided in most running shoes, even stability and motion control shoes.  10 years ago we could get 500-600 miles out of running shoes; today its only 200-400 miles.  Remember, shoe companies are primarily in the business of selling more shoes, not less.  The new thicker metatarsal pads really absorbed the forefoot pressure and my race was pain free.

Compression Gear:  Legs are a must for me.  I did not need arm sleeves or a compression gear top during our beautiful warm and sunny California day.

Taping:  Kinesiology taping  is a constant for me, as I always tape on race day, but also reflects where I am personally in my running/training and the specific race defines the areas to focus on.  At this race, I taped my feet and achilles primarily for performance and recovery.  Running on the forefeet on pavement produces extra lactic acid in the calves.  The foot taping and achilles kinesiology tape can prevent this by 50-100%!  Crazy, but just the science!!

Nutrients:  I did not eat or drink immediately prior to this race.  I do this for 5K and 10K races, as shorter, high intensity level races can irritate the stomach.  Longer races such as half and full marathons require more fuel and are run at a slower pace and intensity.  I always pre and post race hydrate with alkaline water, Kangen water at 9.5 pH.

Keep Running,

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Custom Orthotics and Sesamoid Fractures

Dear Dr Paul,
Oh my, I am a Crossfitter regularly jumping running lifting, etc. i was diagnosed last week with fractured sesamoid and am so curious to know about these orthotics? Who can I contact in the Chicago area about this?
Thank you,
Royce

Dear Royce,

The most important person to get to is an orthotic specialist and one who understands that your true anatomical leg length difference (probably a 1/4”) is almost always related to why you broke the sesamoid in one foot and not the other foot. I would sidestep over the counter orthotics.

The correction of your feet and leg length abnormalities is best done with custom orthotics. That said, a custom orthotic is not a custom orthotic. The best way to make orthotics is from non-weight bearing foot impressions usually done with plaster casts of each foot. Weight bearing foot impressions, i.e. stepping into a foam box, walking or standing on a footplate system allow the foot deformities to become magnified. Orthotics made from these methods are less corrective and beneficial.

The best materials orthotics are made out of are usually a flexible plastic that can be easily modified if needed for best comfort and function. This is where the experience and art of making orthotics can result in boon or bust! Its definitely advisable to get to someone with medical and biomechanical experience and preferably an athlete as well.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Broken Sesamoid Bone Question and Answers

Hi Dr. Paul,
This is a follow up to my sesamoid questions! I have followed all of your advice and have been running on the treadmill in Saucony Omni 10’s with no pain at all! I also forgot to mention previously that I do have custom orthotics for the fracture and they have definitely helped but my sesamoid was still bothering me in the old shoes. But the new shoes have been great!

My question is what is your opinion on speed training in soft sand? To give you a reference to where I’m at with my running, I ran a 6:45 mile on the treadmill yesterday.

Thanks so much for all of your help!
Tess

Dear Tess,
Congratulations on rejoining us in the active running community! Lets keep you there. Choosing the right running surfaces is especially important after an injury.  Running on soft sand is an excellent choice for both speed work and sesamoid protection. The sand is my favorite running surface, especially the hard packed sand of low tide, or my absolute favorite, running in a 1/8” to 1/2” sheet of water at low tide.

Beach Running Low Tide

Beach Running Low Tide

I’m sure you are aware that speed work in deep sand will require rest days in between workouts due to the increase in work on your legs’ muscles and tendons. Running in deep sand could also be a surface where you could eventually get into a lighter or even a minimalist type of running shoe, as long as your broken sesamoid doesn’t talk to you, or you don’t develop any of the common conditions related to running like achilles tendinitis, shin splints and plantar fasciitis.

An important tenet of mine is to always be able to repair what you tear. If you pay attention to your body, eat and sleep properly, using the information I recommend on my website, your ride through life will continue to have you less on the sideline.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Barefoot Running Commentary

Dear Dr Paul,
We have been living barefoot for 1000′s of years while shoes are a relatively recent invention. How did our bodies manage when there were no shoes? Is it possible that all the injuries are due to incorrect running technique or unnaturally high mileage and insufficient rest in between runs or over-training?
Saurabh

Dear Saurabh,

Pronated Feet

Pronated Feet

Without a doubt many sports injuries are a result of unnaturally high mileage, insufficient rest, over running -training and trying to run into your 50‘s, 60’s, 70’s and 80’s.  As far as early man who ran barefoot for 1000’s of years, he was about three feet tall, weighed 60-70 pounds and lived to 30.
 

Collapsed Arch

Collapsed Arch

The point in my writings is how to improve health and run realistically 60 to 80 years beyond early man’s lifespan.  It is also important to point out that early man was not running for pleasure, but to eat and survive.  We do not know if he ran without injury, only that it was a necessity of safety and supplying food.
 

Foot Alignment

Foot Alignment

As man evolved he became smarter and made choices not available to our predecessors such as living in houses, driving cars, going to school, using hospitals and having children vaccinated.  Early man “managed” without these things.  That doesn’t make it the better choice today to dismiss modern technology.  My personal belief against barefoot running is based on my 35 years of medical experience.  Even though I choose not to do it and preach against it, it benefits me personally, as those who choose to run this way fill my treatment rooms and feed my and other doctors’ bank accounts. That being said, the choice is yours.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Running Surfaces and Endurance Exercise

Runners, coaches, sports scientists and doctors vary in their opinions about the best surfaces runners should run on and how each affects the body.  Most are focusing on athletes’ short-term ability to perform better.  I feel they may be missing the mark on the long-term effects of some of their recommendations and might consider what consistent extensive exercising and especially running does to the body over a lifetime.  This aspect of exercise has been overlooked because the evolution of ultra running and other endurance sports is relatively new with the longstanding effects just now surfacing.

Beach Running

Beach Running

The perfect example of this endurance exercise issue is the Ironman Triathlon.  We are just beginning to learn the toll of this event and what the required training to compete can inflict on the body.  As my long time Ironman patient, Scott Tinley, said in 2007 of his femur prior to hip resurfacing surgery, “My hip looks more like a pumice stone than the shiny, well-lubed and smooth piston of my past.”  No matter how much treatment Scott received, the years of running on pavement and the amount of miles he ran could never be completely negated.  So, as a runner, sports scientist and doctor myself, I have had a unique perspective and set of tools (my hands) with which to evaluate 1,000’s of athletes’ bodies and their physical responses to exercise.  Over the last 35 years I have performed more than 400,000 treatments; you might say I’ve been a human Ferrari mechanic.

In science we say for every action there is a reaction.  We know gravity is compressing us constantly, which is why the average person shrinks 2 to 4 inches by the time their 70.  We have no control over gravity, but we can control how the forces are absorbed by the body from the ground up.  These forces start at foot strike in a chain reaction of predictable interdependent actions throughout the body’s 206 bones, 600 muscles and 1200 ligaments.  Add to this our average lifetime mileage is 250,000 to 350,000 miles.  The vertical forces can generate 3 to 6 times a runner’s body weight with each foot strike.  This translates into absorbing more than 440,00 lbs, or 220 tons per foot per mile.  It does not take a rocket scientist to understand that any reduction of these forces whenever and wherever possible will be beneficial in the long run.  Excuse the pun.

Trail Running

Trail Running

I have discussed the body’s need to be balanced from left to right already in custom orthotics and what side of the road to run on articles.  These excessive forces are much easier for runners to absorb and avoid injury from if they are balanced and their weight distributed equally from the feet upward during the running gait.  This is very important as unbalanced forces, over time will cause everything from bunions, stress fractures, knee tracking issues, hip socket pain to degenerated hips and spines with a lifetime of fixing.  I have also written about the need for proper running shoes and the need to maintain the normal 40 degree angle of the heel bone (calcaneus) to prevent and treat plantar fasciitis, shin splints and achilles tendinitis.  Stability and motion control shoes provide the body’s best shock absorption system.  Much like a car, you could drive one with bad shock absorbers, but do you really want to?  I look at barefoot running much like driving a car without shocks, which would definitely wear the car out prematurely.

A critical component in the life prescription for pain free running are the surfaces you run on.  Different surfaces offer different shock absorption rates.  Our inability to negate these forces as well on harder surfaces accelerates degeneration.  It may not be realistic to always run on softer surfaces.  As a marathoner,  I only run on pavement when I have to.  I recommend running on softer surfaces whenever and wherever you can.   Even in my marathon training guide, I recommend training on softer surfaces.  The only time I pavement run by choice is during a road race.  To allow yourself the ability to run into your 50s, 60s, 70s, and 80s comfortably and injury free, you need to be smart when you are younger.  Running on softer surfaces adds the benefit of reducing the vibratory forces throughout the body.  I saw a young woman the other day running barefoot on the sidewalk, not even in Vibrams!  My thought was, “Yikes!”

Manicured Grass Running

Manicured Grass Running

Ideally, beach running at low tide near the water’s edge in compact sand is the optimal surface.  This surface makes you use your leg muscles up to 20% more, so it can be used as a speed work enhancer.  It provides the best shock absorption and spring action to protect our body during impact giving you more bang for your buck.  Yes, not all of us are in a geographic location that makes this type of running possible.  Next on the list of the best running surfaces are DG (decomposed granite) paths and manicured grass.  There are many articles written about running injuries that occur on grass and I agree that, like trail running, if grass is not cut short to allow level passage, twist and turn injuries like strains and sprains can occur.  Running on trails and fire roads have been my staples for the last 30 years.  I love the hills as they enhance runners’ endurance, although down hill can be a challenge generating 4-8 times the body weight, but is so much fun!  I have also spent many years recommending and preventatively taping my ankles for those Baja 1000 type trail runs to avoid the infamous ankle sprain.  See my ankle sprain taping.  Getting to run on a track at your local school is another running surface that trumps the pavement and asphalt experiences.  Treadmills, especially the non-motorized ones, offer a good alternative to the road and in-climate weather as well.

When all else fails, or it is mandatory because of a race, I will run on the street.  Most marathons and road races are going to require this anyway.  They will have a dramatic physical impact on your body no matter what you do, but if you have used some of the other surface choices to lessen the impact during your training runs prior to the race, you will recover faster and have much less potential long term symptoms and degeneration. There is rarely a reason to run on cement, unless you are in a city and pavement running is too dangerous and not an option.  It is the most rigid and least forgiving surface.  The young may get away with it for a time, as they forget that this one chassis must last for at least 80 years and 300,000 miles.   Even though it may be hard to find a beach, park or dirt road to run on, it should be feasible to limit your asphalt and cement running.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Sesamoid, Shoes and Running Surfaces

Hi Dr. Paul,
I recently was browsing the Internet looking for advice on the best type of shoe to get when running with a sesamoid fracture. I saw that you recommend stability and motion control shoes. Currently I am recovering from a fractured sesamoid, though my x-rays indicate the bone is still in half, it feels significantly better than when I broke it in February. I have been doing Step class, biking, jogging, basketball and lifting heavy weights with little pain. However, in my running shoes, Asics Gel Nimbus, I notice significant pain in my ball of my foot.

Altra

Altra

I have not begun running on the streets as I would like to, and I was wondering if there is a specific shoe that you recommend?  My basketball shoes are very wide and I wear those almost all of the time with little pain, and I was thinking the wider the shoe the better, which is why I have been looking at the Altra Instinct Running Shoe which has zero heel drop, and is extremely wide. I was wondering your thoughts on getting this type of shoe or looking into a different shoe?

Thank you so much for your time,
Tess

Dear Tess,
After seeing your doctor, I would advise a three part plan to achieve running without pain after a broken sesamoid.  First, is offloading the forces putting pressure on the big toe with proper shoes. These include stability and motion control running shoes and avoiding your cushioned (Asics Nimbus) and minimalist (Altra Instinct) shoes.  Second, is foot pain taping which promotes landing more towards the outside of the foot, supporting the arch of the foot, heel, big toes and broken sesamoid bones.  Third, is custom orthotics that correct abnormal foot alignment and uneven leg length differences, why most foot, leg and musculoskeletal symptoms are rarely symmetrical.

Addiction

Addiction

For shoes, consider Brooks Ariels and Addictions,  the Asic Evolutions and Foundations or Saucony Omnis.  These all keep you from pronating and putting more forefoot and big toe pressure on the break. Just to be clear, offloading the forces from the broken sesamoid comes from lifting the arch, not just getting a bigger toe box.  Lifting the arch straightens the toes, reducing the foot width and forcing normal foot strike to the outside of the foot.

The right running  shoe is very important!

Lastly, you mentioned another factor that I believe needs to be addressed as well, street running.   I would avoid running on the pavement and sidewalks for now.  This running surface topic is an important enough issue to address in a new article I will post very soon.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

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Can I Run in Vibrams with a Broken Sesamoid bone?

Can I run in Vibrams with a broken sesamoid?

Sesamoid Bones

Sesamoid Bones

Yes, many of my patients are running with broken sesamoids, but No, not in Vibrams.

Here’s how to get from a broken sesamoid to running without pain. There are two free floating bones under the big toes in our feet called sesamoids.  These bones are vulnerable for anyone walking extensively or running barefoot.   The primary cause of a sesamoid injury is due to inadequate support in the arch area of the foot.  This collapsing arch problem is called pronation.  Running in Vibrams, Skechers and minimalist shoes are also more likely to injure these bones because they are not strong running shoes.  Cushioned shoes and sometimes even motion control shoes may not provide enough support for an over pronator, resulting in arch pain, heel pain, achilles tendinitis or sesamoid pain.  Sometimes experienced runners provoke sesamoiditis by putting too many training miles on their feet, running on hard surfaces and even a road race can trigger sesamoid pain or brake a sesamoid.

Broken Sesamoid Bone

Broken Sesamoid Bone

The good news is that these broken bones rarely need surgery, since many of us have already broken one of ours.  Frequently, young athletes break a sesamoid as teenagers when their natural endorphins are abundant causing symptoms to usually be no worse than being described as “hot.”

There are a few techniques to minimize foot pain even with a broken sesamoid or reducing the sesamoid pain if it is caused from overuse or misuse.  Broken sesamoids can best be treated by off loading the forces putting pressure on the big toe and sesamoid bones when walking or running.  The first factor to consider are the shoes; stability and motion control running shoes are a must! Now is the time to definitely avoid cushioned and minimalist shoes, including Skechers and Vibrams like the plague!  The second factor in pain free running with broken sesamoids is using my special foot pain taping technique for immediate pain relief.  This foot taping is also good for other over pronation symptoms including plantar fasciitits, achilles tendinitis and shin splints.  This foot taping works because better arch support is an essential part for foot pain relief.  Along with stability and motion control shoes, it promotes landing more towards the outside of the foot when walking or running, reducing the forces on the arch of the foot, heel, big toes and broken sesamoid bones.  My foot taping is actually better than most of the over the counter orthotics like Superfeet, Sole Insoles and Dr. Scholls.

Broken Sesamoid Bones

Broken Sesamoid Bones

My most important recommendation to continue walking and running with a broken sesamoid or sesamoiditis is with custom orthotics.  These orthotics work two to three times better than my foot taping technique by supporting the feet, forcing the person to toe off the 2nd, 3rd and 4th toes when running and walking and allowing the big toe to basically float during normal gait mechanics.  A reality rarely discussed by professionals in the foot and shoe industry is that feet gradually get flatter through life as we put thousands of miles yearly on them and average 200,000 miles in our lifetime.  My custom orthotics correct abnormal foot alignment and uneven leg length differences, which is why foot, leg and most musculoskeletal symptoms are rarely symmetrical.

Many doctors are not willing to say they are against barefoot running and minalimist running shoes; the patient flow from their use is very profitable.  I prefer my patients to be informed, not in pain and live without foot fractures or other disabling injuries in the first place.  A broken sesamoid with symptoms usually results in an orthotic patient for life, but as Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

 

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Knee Kinesiology Taping

Patella Kinesiology Taping From Above Knee:

Patella Kinesiology Taping Upper Knee Pain

Patella Kinesiology Taping From Above Knee

 

Patella Kinesiology Taping From Below Knee:

Patella Kinesiology Taping Lower Knee Pain

Patella Kinesiology Taping From Below Knee

This Patella and/or Knee Kinesiology taping techniques will help alleviate pain in the patella and the bursa behind it, whether coming from above, below, outer or inner knee.  Patella and/or Knee symptoms are almost always due to faulty biomechanics, especially over pronation of the feet and commonly referred to as “runner’s knee.” Patella femoral syndrome, chondropatella malacia and knee tracking issues are other common knee conditions caused from foot over pronation. They are usually improved with this taping technique, also with foot pain taping, custom orthotics or Dr. Pauls VS orthotics. 

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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My Definition Of A Spectacular Day!

Third Time Across The Line

Third Time Across The Line

My Definition Of A Spectacular Day:

Finished Santa Monica Heal the Bay 10K, 4th in my age group.  One of my favorite patients, Laura Conley, won the race and I went back onto course and crossed the finish line 2 additional times to help 2 first time racers!
Love to Run!!
 
Dr. Paul
P.S. Sorry PrimeTime Timing
 
 
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The Olympics, A Competition Between Athletes or Chemical Androids?

What is the price of winning?

As I walked and ran the fields of Olympia, Greece that hosted more than 250 ancient Olympic Games, I felt a palpable sense of reverence. This beautiful valley city is located about 200 miles west of Athens and 40 miles inland from the Ionian Sea.  The first Olympic games were held there in 776 BC as a tribute to the Greek god Zeus.  Events included foot races of various distances, wrestling, the discus, javelin throws, long jump, horse-drawn chariot racing and a type of boxing called pancratium.

Steroid Abuse, Muscle and Strength

Steroid Abuse, Muscle and Strength

The Olympic Games were so important that every four years, for some 850 years, all wars or armed disputes were suspended throughout the lands so that athletes and spectators could travel to Olympia and participate in the Games in peace.  More often than not, those wars did not resume afterwards.  The ancient Olympic Games were bigger than today’s Soccer World Cup and football’s Superbowl combined. The Games went on for months, not weeks, and included festivals for artisans, sculptors, poets, speeches by religious and cultural leaders sharing their philosophies and ideas,  At today’s Olympic Games, spectators and athletes continue this long standing cultural exchange by trading special collector pins that represent their different countries and sports.

In ancient Greece, cheating at such a revered event as the Olympics was punishable by a life-time disqualification of the athlete and his sponsoring state.  This was followed by the creation of a larger than life-sized statue of the disgraced athlete, which was placed at the entrance to the Olympic Stadium to immortalize his corruption for eternity.  Spectators were reminded each Olympiad of these cheaters and spat on their statues as they entered and exited the Olympic Stadium.  Those original 13 statues remain at the stadium entrance today. (No, I did not spit on them.)  Our sports world today is in need of this ancient Olympics’ reminder to the consequences of cheating, especially how they took action against their cheaters.  Present day abuse of blood doping, anabolic steroids use, human growth hormone, stimulants, and other illegal performance-enhancing drugs (PED’s) have mocked the importance of sports’ ethics.  How many statues would we currently have to errect to reflect all our PED cheaters?  Do you know their faces?  How many countries would still have the privilege to compete?  Additionally, every athlete, coach, doctor, or chemist who supplies these substances, are modern day disgraces to professional sports, motivated by the desire to win at all costs regardless of the ethics of their methods.  Today, most Olympic sport athletes have to test positive three times before they are banned for life!   Additionally, the short-time gains of using PED’s are sorely outweighed by the long-term major health risks.  These risks are undeniable and much more is being uncovered and understood about them as I write.

Athletes or Androids

Athletes or Androids

I have personally observed the gamut of these risks, from the tragic fall of a historic Olympic athlete who was stripped of her Olympic medals, to knowing a professional colleague who suffers from the long-term effects of having used anabolic steroids as a collegiate athlete.  His affects include having advanced cardiovascular disease, multiple surgeries for abnormal breast growths (gynecomastia) and premature balding.  Many of the drug cheats I have known over the last 20 years also now suffer from what I call Post-Steroid Rage.  Clinically, I do not know if they are depressed due to their present health challenges and/or to the consequential changes in their lifestyles due to their past doping.

At long last, both Olympic and professional sports have finally begun to address many of these doping issues.  However, pharmacists of some of the drug-cheats seem to still be one step ahead of the testing done by the anti-doping associations, USADA (US Anti-Doping Association) and WADA (World Anti-Doping Association).  That said, mandates by the International Olympic Committee (IOC) and international sport federations and enhanced testing techniques have helped.  It should be the responsibility of every professional involved in sports to promote a drug-free philosophy to our youth…from doctors, to coaches, to trainers.  If we all help to teach our present day athletes to understand that victory achieved by illegal methods has no worth or significance, we all win.  What value do sports really have if they are denigrated into competitions amongst chemical androids?

Just Say No

Just Say No

I believe that running is a life-time sport and our body is our machine.  We have just one body.  We must take care of what we put into it and how we take care of it, to be able to live long and well.  Most of us will probably get at least 200,000 miles out of their bodies, and many of us will hit the 500,000 mile mark in our lifetimes.  A true athlete is someone who maximizes his or her best qualities to allow their body to perform at its best without jeopardizing its future.  As a chiropractor, I primarily maintain the structural and functional integrity of the body through manual, non-surgical manipulation of the joints, tissues, muscles, and connective tissues.  My graduate studies and clinical experience include nutrition, X-Ray and other diagnostic studies, physical therapy modalities, prevention methods, movement analysis and conditioning—rather than focusing on surgical remedies and pharmaceuticals as most medical doctors do.  I support using invasive medical procedures and prescription drugs when needed, especially to correct dysfunction and to save lives.

I do not believe we are yet at the end of this era of artificial athletic enhancement; like cigarette smoking, it will take longer to eradicate.  There is no question that steroid abuse and the cost burdens that the performance-enhancing drug era will have on our national health care system during the next 25 years will be alarming.  Yes, we will get old, and yes we have this one body to live with.  But I believe it is very important to not cheat at life or in life.  That includes all the ways in which we care for this body of ours, whether we are Olympians or runners, young or old, today or tomorrow.

Lance Armstrong

Lance Armstrong

The father of western medicine, Hippocrates, said, “The doctor of the future will educate his patients in the health of the human skeleton.”  I believe this is my calling and I will continue to carry the baton to share the important things I’ve learned over the past 35 years.  I run daily, do marathons myself and have treated some of the fittest professional athletes on the planet—from athletes with the endurance to swim, bike, and run for 8 continuous hours while doing the Ironman Triathlon in Hawaii, to Olympians sprinting 100 meters faster than anyone has before.  I love the challenge of helping these superior athletes maximize their physical potential.  But I get the biggest reward from the work I do with young athletes.  I always tell them, “99% of our Olympic Track & Field athletes receive regular chiropractic treatments and massage therapy.”  My goal and mission in life is to stay closely connected to our future through these aspiring future Olympians while promoting fair drug-free competitions and global peace via the original Olympic mandates.

Let’s see how we can all help achieve these goals!

Keep Running!

Dr. Paul R Copeskey, D.C., C.C.F.C.

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My 18th Year at Mt Sac Relays

Race Day Track Meet Treatments

This past weekend I worked my 18th annual Mt Sac Relays.  It is my favorite weekend in the track and field season.  You track junkies do not need to be told Mt Sac is short for Mount San Antonio College, or that it is the premier track event in the southwest United States.  It is where the elite meet athletes from high school, college, other professionals and aspiring Olympians.  It is where Olympic dreams are formed or renewed, scholarships cemented and records redefined.  This track is fast and has been scrutinized as to why.  It is considered the fastest all weather track in the world and a long distance runner’s best forum.

Mt Sac Relays 1

Mt Sac Relays 1

The Mt Sac Relays is a non profit meet that is successful due to hundreds of volunteers and supporters, of which I am one.  My perspective on the event comes from the medical tent.  I am not a spectator in the audience or an aspiring Olympian.  I am a technician to these elite participants and rarely ever see a race even though I am less than a 100 meters from the track at all times.  My joy comes in helping the athletes’ dreams come true primarily with the skills, techniques and therapies I have honed throughout my entire 35 year career.

At the medical tent you see 20 tables with global competitors side by side from 50 local and distant high schools, an equal number of national colleges including UCLA, USC, University of Wisconsin, UNLV, BYU, University of Houston, LSU, University of Tennessee and many countries including Mexico, Nigeria, Egypt, Trinidad, Jamaica, England, Spain and even Latvia to name a few, all getting therapy, taped, stretched, massaged and adjusted.  Rival high schoolers and Olympians are all pursuing the same extra edge to help get them to their goals.  This is what I love and why I love donating my time being an instrumental part of this unique and special athletic experience.  

As I move into my fourth decade as a treating sports doctor, researcher and educator, I work in my practice to be able to donate this time at the track meets.  Someone once asked me what it is like at the Mt Sac Relays?  My response was, “It’s like the Ringling Brothers & Barnum Bailey Circus.”   Imagine 300 pound gorilla strength shot putters, gazelle like hurdlers, lanky cheetah like long distance runners and muscularly ripped powerful locomotive Rhodesian Ridge Back sprinters.  Yet, they all need basically the same thing from me.  They all need their bodies to be physically fine tuned from the feet to the head for that one race or one event.  Ironically, some of these athletes are so talented they do multiple events, different distance races and are part of relay race teams.  These truly unique athletes need repetitive treatments before and after these multiple events, many times 3-6 treatments over a 6 hour time period.  I  did 75 or so treatments Saturday in 11 hours, with a constant waiting line five deep!

Mt Sac Relays 2

Mt Sac Relays 2

On race day my cell phone and text messages start beeping before dawn, “Are you here yet, Doc?”, “Can you see me at 11:00?”, “Can’t you make it here any earlier?”  These athletes at this caliber have more than likely already experienced the lows of defeat.  They have a better understanding of their bodies.  I liken them to Ferraris and I am their race day pit stop mechanic.  It is an awe inspiring thing to be part of intense euphoria and sometimes agonizing disappointment.  Many times their bodies can be treated, altered, fixed, tuned up or relaxed, but some injuries are game stoppers and we may have to ‘shut them down.’  This is when I am glad to be a D.C. and not an M.D.  I like to usually leave the blood, dehydration symptoms, dislocations and snapped achilles tendons to others.  I prefer helping the athlete gain the extra .01 seconds and inches achieving personal records (PRs) and personal bests (PBs).

Many of the philosophies and techniques I use in my everyday practice to help my patients apply at the track meets.  I look at everyone from bottom to top, starting at the feet.  I am 100% confident that foot alignment is the most important issue to be discussed because without it, optimum balance and weight distribution vertically from the foot up the tibia (shin bone), function and performance can not be possible.  The abnormal foot pronation at foot mid stance causes the tibia to rotate inward.  Improper foot and tibia alignment can cause stress fractures, patellar tendinitis (runner’s knee), knee tracking issues, groin strains, iliotibial band symptoms.  Any misalignments or asymmetry in the feet and legs can even cause hip pain and increased pressure on spinal joints, or create bulging low back disc issues.  These abnormalities can continue up the spine to create havoc with the upper back and shoulders or neck and can ultimately lead to headaches.  This confirms and substantiates my focus on the need for balance from the bottom up.  The biomechanical forces need to travel equally throughout the human chassis to avoid degeneration.  

This is where the power of orthotics comes in.  Orthotics are the stabilizing tools allowing a more balanced transfer of weight in the gait cycle.  Without correcting the foot and leg imbalances, most therapies or treatments have limited longevity and probably at best last only temporarily.  This is why many of these high level athletes who do not have corrective orthotics need almost daily care to offset the physical demands on their bodies.  When my patients and athletes ask, “Why do you think my back or knee pain can be corrected with orthotics?”  I might reference the old child’s nursery rhyme, the foot bone is connected the leg bone, the leg bone is connected to the hip bone and so on.  Athletes usually experience and learn this much sooner than non athletes.  In fact, most people take many years to feel the body’s physical imbalances. The reality is, many of these track athletes push their body to 50 different gears of physical effort, where most of us only have a few to maybe six gears.  By pushing the body intensely, athletes are essentially condensing years of effort into days!  One question I always pose, “Have you ever seen a fat track sprinter?”

Mt Sac Relays 3

Mt Sac Relays 3

I am appreciative to have had the opportunities the last 20 years in track and field treating many race day athletes and record holders to include Santa Monica TC athletes like Carl Lewis, Mike Marsh, Jon Drummond, Johnny Gray and many other world champions and Olympians, including disgraced Marion Jones.  In the end, I gain much more satisfaction working with the young and emerging athletes of the future, trying to promote not only good physical conditioning and training habits, but germinating friendships and experiences that will have lasting positive effects on future Olympians and role models.

Keep Running!

Dr. Paul Copeskey, D.C., C.C.F.C.

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Back Pain, Inflammation and Weather

Back Pain,  Inflammation and Weather

Barometric pressure is the measure of the pressure of the air exerted onto the earth. The weight of this air or its pressure on us is measured by a barometer. Generally speaking, low pressure weather systems begin with changes to the barometric pressure. They usually bring winds accompanied by a rapid air pressure drop as the front arrives. The center of the front continues with a rapid air pressure reduction and increased humidity, followed by an equally rapid rise in air pressure and decreased humidity after the front passes. So low pressure weather systems, especially rapid moving ones, bring extreme changes in temperature, pressure, humidity, along with gusty winds. Add several storms back to back and you have what I call inflammatory weather and all the triggers needed to bring out some of your body’s physical weak links.

Superman

Superman

In terms of the human body, barometric pressure changes can exacerbate or trigger bulging discs, joints, old chronic injuries like sprained knees and ankles, back pain, radiating nerve conditions, prior surgeries, even migraines and cluster headaches. A low barometric pressure system affects the body by having less gravitational forces exerted on it; it feels as if the air is definitely heavier. When the barometric pressure is low and the humidity is high, this extra weight impedes our mobility and irritates our joints. Rapid and repeated changes in the air pressure prevent our bodies from proper repairing and recovering from our workouts. Patients with bulging discs, our spine’s water filled shock absorbers, are especially vulnerable to these rapid changes in barometric pressure. Even the fluid capsules surrounding the joints of our hands and knees, as well as those in our spine, become inflamed with low barometric pressure, many times causing almost intolerable levels of pain. These rapidly changing weather patterns, or what I refer to as the ‘yo yo effect’, many times are similar to repetitive stress injuries that are significantly reticent to improve until the erratic weather pattern changes.

My experiences in the hyperbaric chamber have allowed me to feel the immediate benefit, especially for my low back disc pain, from a forced high pressure system. Almost everyone has friends, parents or grandparents who do not need the weather man to tell them a storm is approaching; they feel it coming!! How about all those grandparents who love the high atmospheric pressure and increased warmth living in Arizona?  After a couple months of these low pressure systems coming through Los Angeles recently, many of my patients, not previously in pain, needed more care. My own February flu stint, in conjunction with heavy marathon training, reminded me of my own low back bulging disc. I enjoy keeping my patients better and I am always there to help, but I prefer them well and just needing periodic maintenance care and semi-annual or annual orthotic updates. So now, lets discuss how to prevent and treat these pain episodes, focusing especially on low back pain due to a bulging disc.

Hip Flexors Strengthening

Hip Flexors Strengthening

Knowing, understanding and listening to your body’s triggers is an important lesson. During weather fluctuation conditions pay attention to your body’s weak links. Mornings are especially problematic for bulging discs in the low back. The discs, 70% water, swell like sponges during the night, and many times in the morning are pressing up against the spinal cord in the low back. This is why bending forward to wash your face or put on your shoes can be difficult and send you to the chiropractor or sometimes to the neurosurgeon for a cortisone injection (epidural). I like to do some easy morning push ups and press ups (“Cobra” yoga position) to decompress the low back discs. Even standing and gradually arching and looking upwards will do. Another favorite yoga move I do primarily for low back decompression is the “Salutation.” This is basically a standing forward lunge with your hands over your head and is also a great hip flexor stretch.

More important than last century’s outdated passive low back stretches (pulling knees to chest), low back disc pain is best prevented and treated in the 21st century by strengthening the muscles in the low back, legs and hip flexors; refer to my superman, glut/hamstring and hip flexor strengthening in “Ask Dr Paul.” I also recommend, as similarly for pain conditions in other body regions, natural anti-inflammatories: white willow bark, bioflavinoids and essential fatty acids. As always, 20 minute zip locked crushed ice pack applications covered with one paper towel help reduce the pain. The bulging disc causing low back pain can be reduced by limited sitting, avoiding bending forward at the waist, including standing toe touches, pulling the knees to the chest, traditional sit ups and the Yoga position, “Downward Dog.” If experiencing a bulging disc episode, extra caution when coughing and sneezing are this doctor’s orders. A good rule of thumb is to look upwards when coughing/sneezing and do not hold the sneeze in, as this increases the disc pressure; just remember to cover your mouth and nose.  I treat bulging low back discs in my office primarily with ultrasound physical therapy, passive extension maneuvers (McKenzie Protocol) and chiropractic adjustments. I usually assess the lower extremities for any anatomical leg length difference and abnormal pronation of the feet, which usually are connected to the cause of the low back pain and best corrected with custom orthotics as seen in “The Orthotic Difference” under Custom Orthotics.

Weather conditions are a part of life we can not change, other than where we choose to live. Many times inflammatory conditions in the physical body can be prevented by strength work, sound body biomechanics, moderation, ample sleep and nutritional supplements. Just like our cars, regular maintenance care can prevent breakdowns.  For many people avoiding some foods like gluten can reduce inflammation in the body. Try to avoid or reduce your gluten intake for a week to decide if this helps your pain condition. This includes most beers and soy sauce.

Always consult a physician when you are not able to find relief on your own.

Otherwise, keep running!

Dr. Paul Copeskey, D.C., C.C.F.C.

 

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Adductor Kinesiology Taping

Kinesiology Tape Adductor

Kinesiology Tape Adductor

This Kinesiology taping technique helps alleviate pain from the most common adductor strain and from groin pulls and strains.  This running injury usually causes pain either at the origin in the groin area, in the middle area of the leg, or at the insertion near the inner knee.  Adductor strains are commonly due to tissue overload starting with faulty biomechanics in the feet and over pronation, causing muscles of the inner leg to work beyond their normal limits.  Adductors should never be a major source of power during running, even though they are common running injury.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

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Your Post Marathon Plan

Your Post Marathon Plan
Congratulations you did it!!   It may not have been in the time you wanted, but you are done!! Now What?   If you have been keeping up with my posts,  I reminded you previously how taking care of your body is similar to maintaining your car.   It is your only one, so keeping it going throughout this last race was important, but so is your need of it for hundreds of thousands of future miles and running many more races!  If running is one of your life’s addictions, you should look ahead, assess what you did and take from it what worked and remember what did not, so you learn from this experience and progress.   Self assessment is important and so is moving on to the next goal.  This week we reflect, recharge and get back to running.   Lets talk about how we go about these new goals.

Father and Daughter

Father and Daughter

My quads were pretty sore Monday and especially Tuesday.   This is definitely normal up to a week after the marathon.  lt’s normal to not want to run sometimes for a week or longer after a marathon.  Yes, I myself ran two days after LA Marathon, but I’m what they call mostly a “seasoned veteran” with 35 years of daily running experience.   My two favorite alternative aerobic activities to use and recommend post marathon for the first few days to a week or so after are biking and swimming.   I resumed daily running in the park with my dogs this week,  20 easy minutes Tuesday, 30 easy Wednesday, Thursday and Friday.  Their joy in running inspires me; they are my secret motivators to increasing my speed, endurance and they bring me great satisfaction as my running team. This week especially, we stayed on running on soft surfaces during our runs.  I like to primarily use low tide at the ocean’s waters edge and manicured grass at the park.   Easy runs, bike rides, elliptical workouts or swims are important to start to stretch out our bodies, releasing the painful lactic acid in our muscles, free radicals and other biochemical debris produced in our muscles from the marathon.   I  got a light massage and chiropractic adjustment on Wednesday, three days post race.   On the LA Marathon day, after I finished running the race, I worked at our USA Track and Field Pit Stop at Mile 22 with many runners still on the course.   I found this inspirational, to see these marathoners persevering and for them to see me with my medal on, working after the race.   It was an affirmation to me and  I realized I was motivating them to go get that medal too!!  Really Special and Cool!!  Physically for me, this extra standing and walking at a slow pace allowed my body to come down gradually and not crash and spasm by just stopping abruptly as others normally do.   At the end of my marathon day,  I worked on getting a good protein packed dinner, hydrated my body with ionized alkaline water, took my salt stick, calcium and magnesium for my muscles, white willow bark for pain and enjoyed a hot Epsom salt bath to sooth my sore legs.  All this allowed me a good night sleep and my body definitely was well on the mend.

Tuesday,  I reflected on what I did wrong during my race.  Since most of you don’t know me, I’m a big kid enjoying what he does and who he is with.   I allowed my youthful exuberance and enthusiasm to get the better of me at about mile 14.   When I saw some of the Beverly Hills Police Officers cheering me on,  I did a partial “touchdown goal dance” as I passed them and ended up tweaking my hamstring.   I should have remembered that the motion of a marathon needs to stay forward and victory dances should be kept for the end of the race if you are able.  My faux pas resulted with a hamstring cramp and my 9 minute mile pace was now a race casualty.   Thanks to the great 10 minute massage I and over 50 other competitors received at our USATF Mile 22 Pit Stop, I finished better than I would have without it.  Another lesson learned!  Oh well, there will be many other races, as this was only my 5th marathon.   I definitely have 100’s more marathons and races to do, including Boston, New York, Honolulu, London, Chicago and Berlin marathons.   A marathon is only a measure of a day; getting out to run everyday with my dogs is a measure of my life!

At race start the temperature was in the 40’s, headwinds a wicked 20 miles an hour with showers forecasted.   Although this might be normal for all you Bostonians and Chicagoans, for me a 155 lb., 57 year old ectomorph from Southern California, warmth was imperative!!  It was better for me to be too warm on a cold day than too cold.   I chose to keep warm with compression gear and some special long underwear legs, considering these abnormal weather conditions for Los Angeles.   I wore gloves, even had an outer layer of both wind breaking legs and a jacket with a hood, all of which I kept on for most of the race.   I have learned my light frame helps me in many ways, but not in cold.   A higher BMI or body fat level is a major safeguard from losing heat.  This is because runners with a higher BMI hold their core body temperature longer and it doesn’t drop as fast or easily.   This allows them to tolerate cold better.   I did well with my marathon footwear, relying on the Dr Paul lacing technique, no blisters due to my break in program and Vaseline application, no plantar, Achilles, shin splints, ITB issues due to my orthotics and kinesiology taping.  Experiencing no problems with footwear and lower extremity injuries was our goal in our prior weeks of instruction together; practice and self evaluation did the job!  Kinesiology tape is a terrific compliment to compression apparel.  Every kinesiology taping technique I previously demonstrated on the blog I did on myself the night before the marathon.  That means I taped both achilles, ITB’s, adductors, quads and hamstrings.  This tape was especially helpful when I tweaked my hamstring being a kid, as it was a tremendous support for the injured muscle.  It did exactly what it is designed to do, giving another 10 to 20 per cent support to muscles and tendons.  So as a sports injury specialist what I told you to do prior in the blog to treat injuries I was able to use to prevent those symptoms.  This same taping prevention philosophy I recommend to do and personally use for ankle sprain prevention when moderate to extreme trail running.   
 
LA Marathon 2012

LA Marathon 2012

My race day  fueling plan included a morning smoothie made from almond milk with frozen fruit, peanut butter and protein powder, followed by running with Cliff shots, jolly ranchers, salt sticks and ginger candy.  I had some coconut and ionized alkaline water at Miles 13 and 22.   I took water and electrolytes at all aid stations and ended the race with the provided peaches and pineapples fruit cups along with and a couple Odwalla protein bars. This too was a successful post race refueling program, considering my commitment to get to the Mile 22 Pit Stop to help other marathoners still on the course.   My one surprise was my desire for a flat coke at Mile 22.   I am not a coke drinker nor believer in its health properties or lack of, but I am willing to say there may be a time and place for it and it definitely helped me 4 hours into this physically demanding day.  Since I was running with my cell phone, I phoned ahead to have it ready for me at the Pit Stop.  Seeing my wife and kids at the finish line was also a great motivator to get there in good shape!. Loving smiles are a welcome site at the finish line, yet I was moved by the strangers around them waiting for their own marathoners who were equally supportive and enthusiastic to me and many other unknown finishers.

Over the course of the next week or two it should be your realistic goal to gradually resume your running to at least every other day, if you were at that frequency during your marathon training.   If you were running daily as I was, a week to three might be needed to get you back to this running frequency.  Luckily, I have run daily since two days after the marathon, even though gently.   For the first two weeks or so post marathon the mileage of your runs should be relatively the same distance, without doing a longer run.   After two to four weeks of this consistent similar running distance, you have the green light to resume your longer runs, starting at one to two miles longer than your other runs during the week.  Remember, this is a time you are vulnerable, not only for overuse sports injuries, but for those microbes that can make you sick.   Please refer back to and re-read my article, “No I Cant be sick, I need to Run,” so EASY DOES IT!
Keep Running!
Dr. Paul R. Copeskey, D.C., C.C.F.C.
 
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Ready, Set, Run!!!

LA Marathon

LA Marathon

The LA Marathon is due to give us 49 degrees and 15 mile per hour head winds!
Lets make it a great experience!
Keep Running,
Dr. Paul R Copeskey, D.C., C.C.F.C.

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USA Track And Field at The Los Angeles Marathon

Marathon Running

Marathon Running

USA Track and Field’s Medical Group will be staffing a special Pit Stop at mile 22 of the LA Marathon. This is GREAT NEWS for those marathoners with screaming hamstrings, ITBs, calves and quads. Whole Foods will be donating oranges and Kangen will be donating ionized alkaline water. So between the USATF Medical Support Group, Freemont College’s sports massage group, Whole Foods and Kangen, we will help get you to the finish line down the street.

See You There!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

3/16/12

Thank You To:

Whole Foods

Kangen Water

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Water, Water, Everywhere!

Why Runners Need Ionized Alkaline Water?

As I have mentioned earlier, as a daily runner, I have been drinking and training with alkaline ionized water for the last 3 years.  Since our body is 70% water, this is a topic of significant importance, especially for a successful marathon experience.   Just as our body has an optimal temperature of 98.6 degrees Fahrenheit, our body’s optimal pH is 7.36; pH is the liquid measure of acidity or alkalinity.

Kangen Water Clusters

Kangen Water Clusters

Alkaline water ionizers work by using a electric process that gives the water three distinct  properties that are not found in tap or most bottled water: micro-molecular, alkaline and anti-oxidant. The first process of these ionizers is to pass the water through an electrical current and as a result, the water molecules are converted into small molecule clusters.  These smaller clusters are now 4 to 6 water molecules per cluster instead of the average of 10 to 20 clusters.  They can even be up to 40 to 100 molecules per cluster in extreme examples, many times what is found in ordinary water.   The smaller clusters lead to much easier, faster and better water absorption and hydration.  This is because the smaller molecules pass through our cell walls faster and easier than the larger molecules.  So, the ionized water delivers oxygen and nutrients easier than tap water into our cells.  An example of this enhanced hydration is how an average person taking a spinning or aerobic class will probably drink half as much alkaline water during the class compared to the amount of regular bottled water needed during the same class because of this increased absorption of the alkaline water.

Second, the ionizers put a higher pH (alkaline) into the water; a higher pH means less acidity. This helps our body neutralize the acids we are constantly absorbing.  The acidity found in our body is the result of simple food digestion and even from the air we breathe.  The more we consume highly acidic things, the harder our bodies work to maintain a balance of 7.36 pH.  This is why switching to a diet high in fruits, vegetables, certain types of fish, and drinking plenty of alkaline water helps our body function better.   Alkaline ionized water also helps reduce from the inflammation created by the high amounts of lactic and pyruvic acids due to heavy exercise.

Kagen Benefits

Kangen Benefits

Third, the ionizers put a negative charge on the water giving it an abundance of negatively charged  ions.  These negative ions actively seek out and neutralize positively charged free radicals which cause cancer  in our bodies.   Twenty percent of the air we breathe contains free radicals as well.  Our oxygen demand is increased five times during heavy exercise, so our bodies free radical production goes up five times as well.  By consuming millions of these negatively charged ions in every glass of alkaline water we  drink, we can provide our bodies with a fresh source of antioxidants to neutralize these harmful free radicals.

As we approach the LA Marathon in a few days, now is a good time to start hydrating your body with alkaline water.  Whole Foods has a few different 8.5 pH products available in quart size plastic bottles.  Try to drink a half gallon to a gallon daily for these days prior to the race.  Think of your body’s water needs being like the water coolant system in your car and alkaline water is the special coolant additive.  The water system in your body helps to promote and ensure the proper function of the electrical (nervous) system which controls your musculoskeletal system, something we’ll be taxing doing one of our life’s most arduous tasks.  The alkaline water you’ll fuel your body with is definitely more efficient in cooling and regulating the body’s temperature than regular water.

USA Track and Field’s Medical Support Group will be staffing a special Pit Stop at mile 22 of the LA Marathon.  This is GREAT NEWS for those marathoners with screaming hamstrings, ITBs, calves and quads.  Whole Foods will be donating oranges and Kangen will be donating ionized alkaline water.  So between the USATF Medical Support Group, Freemont College’s sports massage group, Whole Foods and Kangen, we will help get you to the finish line down the street.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Our Special Thanks to:

Kangen Water

Whole Foods

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Pre Mararthon Pampering

The U.S. has been in an odd weather pattern this year and here in Los Angeles as well.  We have experienced low pressure systems roaring through the city every other day, combined with daily temperature gradient changes of 45 degrees in 12 hour time periods.  I have spent the last 3 weeks with many of my patients feeling these changes.  It is normal for weather pressure changes to bring out your weak links, especially if you are involved in marathon training, excessive training, training the wrong way, or some other excessive physical activity.  For me personally, my last long run a week ago, preceded by flu 3 weeks earlier, provoked my low back bulging disc symptoms and left me wanting to be more proactive in my own low back care for these two weeks pre marathon.   As healthy as I am, the last 30 days left me feeling a little vulnerable.  So what’s the doc to do?

As I have advised all of you, this is the pre marathon period and time to invest in the fortification of our own bodies.   I would like to share with you exactly what I did recently to counteract the weather fluctuations, long runs, over worked weeks and even getting hit with the flu a month ago.   I practice what I preach and I believe this is why I can continue to almost always run daily, injury free at 57 and am readily available to keep up with my busy schedule of treating patients in three offices, while donating my time for our local USA Track and Field track meets, athletes, teams, high schools, businesses, Baker to Vegas Law Enforcement Relay teams and educational forums.  The Dr Paul’s personal health plan starts with the chiropractor getting regular chiropractic adjustments from Dr. Michael Cooper.  I have previously discussed with you how chiropractic improves the body’s neurological and biochemical functions, but especially its biomechanical system.

Hypoxico Chamber

Hypoxico Chamber

I followed my recent chiropractic treatment with a 20 minute treadmill running session in an altitude chamber at 9,000 feet.  The altitude chamber trains your body to use oxygen better at sea level for a few days after your altitude training session by 10-20%. Following the altitude chamber, I  visited  my favorite personal physician, Dr. Bill Stuppy, MD, for a hyperbaric chamber treatment (HBOT) simulating 50 feet under water.  I am a firm personal believer of this unique therapy.  It is great for low back disc decompression, healing muscle tissue damage from heavy exercise and the repair of destroyed red blood cells from crushing them under your feet thousands of steps each running session.  On marathon day you will take 40,000 steps.

HBOT Chamber

HBOT Chamber

That’s why I’ll be especially sure to get a hyperbaric treatment the day after the marathon.  This restorative therapy increases the amount of oxygen in the blood stream, accelerates healing in your body, as oxygen is essential to optimum healing in all the body tissues, whether it’s skin, muscle, blood vessel, disc, bone, ligament, tendon or nerve.  I entered Dr. Stuppy’s 2″ thick clear chamber with the echo that you’re in a space capsule, but without the claustrophobic feeling of a MRI or Cat Scan unit.  I descended within a couple of minutes to 50 feet, except without being in water.  I definitely got the feeling in my ears of going underwater, but 3 or 4 times of blowing my nose released all the ear pressure and voila, normalcy of ear pressurization.  I was closely monitored and able to even listen to music, watch a movie or simply close my eyes, meditate or just rest.  Of course, I chose to watch the Doctors Show and then Dr. Oz.  The chamber super saturates the body with oxygen, decreases inflammation, restores circulation and reduces pain.   My hyperbaric treatment goal was to decompress the discs in my low back, help heal and re-energize my body.  HBOT is now even being used to treat neurological disorders including diabetes, traumatic brain injury, cardiovascular disease, stroke, cerebral palsy, and autism.

To complete my health care day my personal sports massage therapist, Dora,  massaged my legs and lower back for a hour.   I slept a whopping 8 and a half hours (normal for me is usually 6 and a half hours to 7).  The day after the triple therapy day, my energy increased 20% and I am still feeling the bump a few days later.   Obviously, you do not need to do all these aforementioned therapies to have a successful marathon; its just important to take care of the only machine you have in every way you can, as you need this machine to last you, not only through this one race, but for hundreds of thousands of future miles on your feet and running many more races!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Your Last Long Run Before the Marathon, Now What?

Rundocrun Shoe Selection

Rundocrun Shoe Selection

The time has arrived to be purchasing your race day shoes.   I ran in the 13.1 LA Race January 15th and the Super Bowl Sunday Redondo Beach 10K in my signature stability shoes, the Brazilian designed triathlon shoes, Asics Noosas (DS Trainers).  This marathon will be the Adrenalines.  Most of you rookie marathoners will probably be in the same style, make and model shoes you’ve be training in for the last 3 to 4 months.  Your new shoes should be used on a long run of a minimum two hours, followed with 3 to 6 shorter runs before the race.

Your last long run for the LA Marathon in 14 days should probably take place this weekend or within another few days and then its all about rest and recovery mostly for the following two weeks or so before race day.  No need for daily runs unless they are 30 minutes or less in length.  Running shorter distances at faster clips will be more beneficial now than any more longer runs at this stage of the game. You have already done all the endurance training and any more protracted runs will difficult to recover from in time for the race day.  Remember the moderation discussed in the last blog article about distance training and getting sick.  This is where some track work can even have merit.

Dr Pauls Marathon Shoes

Dr Paul's Marathon Shoes

You’ve done all the hard work.  Now you’re ready for some good rest, massage therapy, chiropractic, acupuncture, hyperbaric treatments, 20 to 30 minute altitude chamber training, friends and family time, even a movie or three.  Choosing your music, especially for your second half of the marathon race day is also on the list to do now.

Congratulations on all your diligence and hard work.  You’re about ready to experience one of the best “highs” you’ve had in your physical conditioning life.  Hang in there.  There will be both physical and emotional challenges for you to overcome on race day.  The best is yet to come!  As always, have fun, enjoy the ride and smell the roses!
Keep Running!
Dr. Paul R. Copeskey, D.C., C.C.F.C.
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No, I Can’t be Sick? I Need to Run?

Too Sick to Run

Too Sick to Run

So lets start from scratch.  I am an admitted baby when it comes to getting sick and when I am under the weather, I spend most of my time in denial.   It is a good thing it rarely happens.   I can safely say I miss a day of work once every 2 to 4 years.   But I am human and we humans, even those of us in the health care delivery business, have to listen to our bodies and take proper immune boosters when exposed to illness.   I find it a blessing that it is so rarely happens to me, considering I am continually exposed so many people throughout my workday.   However, I do get regular monthly chiropractic adjustments, known to activate the immune system.

We have spent most of our time together on this blog discussing the biomechanics of the human frame.   As runners we have a good understanding of our musculoskeletal system.  We have chosen the best shoes, laced them properly, self-massaged ITBs, taped Achilles tendons and hamstrings,  taken our natural anti-inflammatories and done our long runs so far.  But sometimes we need to take stock of our immune system in a greater light than before, especially as we call upon it more in the coming days.  We need to look at our immune system as it relates to long distance running now.  Since all the training, taping and lacing will not protect us from the flu, lets take the time to talk about it.  Sometimes we face circumstances that mean more running or cross training may do more harm than not exercising.

Running  can boost your overall  health and send those endorphins we discussed earlier throughout the body, but heavy training is not possible with the flu and  taxes those systems that are normally so strong.  If you are like me, you don’t take notice until a cold or headache settles into our head a few the days before a long run and/or the marathon.  Too much running can have an adverse effect on your body, sometimes manageable and sometimes not.   Your window of compromised immunity usually lasts from three to 72 hours after an intense, prolonged event, meaning after your marathon or long run.   This is when there is an opportunity for viruses and/or other pathogens to plan their “sneak attack” when you least expect, especially since you have been feeling soooo good!

Our stronger than average immune system routinely defends us against these common illnesses.   It is our fortress, but does not operate in a vacuum; it is interconnected with the physical, nervous and endocrine systems.   As a marathoner the benefits we understand in our sport pertain to moderate running.   There is nothing moderate about a marathoner or the training it takes to get to the starting line.   David Nieman, head professor at the the Human Performance Laboratory of Health from Appalachian State University and marathon runner says, “Running a marathon and beyond is a huge stressor.  What you put your body through is beyond what’s good for it,” as he promotes the “neck rule.”   Symptoms below your neck, chest cold, bronchial infection, body ache, require time off, while symptoms above your neck, runny nose, stuffiness, sneezing, usually  don’t pose a significant risk to runners who continue their workouts.   I mostly agree with his philosophy unless there is fever involved in that situation.  Under no circumstances should you run with a fever!  “No running for three days,” advises the allergist, immunologist, and ultra marathoner Jeffrey Hall Dobken, M.D. of New Jersey.   Running with a fever could raise your body temperature even higher, causing undo strain not only on your immune system, but even on your heart.

Help When Sick

Help When Sick

We have discussed fluids and nutrients to prevent the release of stress hormones, which in turn suppress the immune system.  Your post run meals of protein are important here as an even moderate protein deficiency can result in impaired immune function.  You need your immune system to be able to defend against the infections and pulverize them when needed.   The immune system needs the protein building blocks to do this, like those found in fish, soybean, walnut, flax seed oils and mother’s home made chicken soup.  I’m a big fan of oregano, especially a product named, “Oregano Spirits,”  but have always found liquid formulas of echinacea effective against most viruses.  I am certain there are other successful alternatives from Asian practitioners and even acupuncture may offer some benefit.   My other fail safe treatment is getting to the chiropractor, as spinal adjustments will activate the body’s immune system and is why most people who see chiropractors regularly say they rarely get sick in the first place thanks to their chiropractic care.  Remember the vitamins previously mentioned, A, E, and C, and the minerals zinc and iron, are essential for normal immune function.  Vitamins C and E, in particular, are also powerful antioxidants.

You need to be real about the need to rest.   I believe the power of sleep for the human body cannot be taken for granted.   So during periods of illness, heavy training or marathon time, get more sleep.   Since my standard is that I never nap, if I need to, it is an obvious sign my body is talking to me.   Listen, nap, take a break and recharge.  The flu can keep you out of the exercise loop for a week or more.  Don’t hit the ground running as soon as you feel 90 per cent better.   “When your fever’s gone and the worst of the symptoms have pretty much left, just take an easy walk, then a brisk walk and see how you respond,” says Nieman.   After a symptom-free week of moderate exercise, start easing back into your routine until you’re back to where you were before you got sick.  Probably running every other day if you were daily running before a setback would be a good first week exercise return routine.  Remember Dr. Paul’s rule of thumb, have fun, enjoy the ride and smell the roses!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Posted in Running a Marathon | Tagged , , , , , , , , , | 15 Comments

One Month Pre Marathon, Are You Ready?

Time to Take Stock and Fine Tune 4 Weeks Before Marathon

If you have been following my training tips, you have completed 2 or 3 long runs of  2 1/2 to 4 hours by now.  This is not the point to make major changes in your marathon plan, just assess where you are.  My marathon training tips should have you running without a major injury and with most of your aches and pains already dealt with on earlier posts.  Now is the time and place you evaluate where you are and need to be to complete a successful marathon.  A successful marathon should not mean injuring yourself to get through the race, but to have a good race and not pay for the experience after.  Your long runs should be your barometer of where you are and what you need to tweak.  Run for your life, longevity and joy, not just for the day.

la marathon course map

la marathon course map

Lets start with your shoes. This is the most important component in your tool kit to a successful race day and experience.  I recommend the shoes, including brand and style, you’ve been doing your long runs in should be your race day shoes.  How has the lacing been working for you?  If you have had some issues, try How to Lace Running Shoes before and/or during your next long run.  These new shoes should have about 20 to 30 miles on them by marathon morning.  Never use a new pair on race day, even if it is the same brand you have been using during your long runs.  Now or a week from now is a good time to purchase your race day shoes so you can get that one long run and a few other shorter runs in them before you do the marathon.  I can’t tell you how often I hear the scenario of out of control blistering due to shoe issues!  Don’t be afraid of using too much Vaseline. You can put gobs of it around the perimeters of your toes and and on the tops of your feet to reduce friction.

Fine tune and decide your clothing gear.  You can start to assess the weather expected for the day and what works for you.  Most marathoners know their gear and what works for them in most conditions already.  You know I am a proponent of Running in Compression Gear.  If you have an injury, refer to my Kinesiology Tape For Runners and athletic tape tutorials.  If you still have any reservations about the effectiveness of Kinesiology taping, consider the 2012 U.S. Master Swimmer’s Rule Book bans its use under the speed enhancement rule.  Use the appropriate compression apparel that will cover the area to minimize repetitive stress, tissue overload, increase performance productivity and hasten recovery time.   Kinesiology tape and compression apparel in conjunction are very effective tools of mine!  I would suggest you first timers even think about all of the body’s friction points, not only in your legs, but in your arms as well, including nipples.  On race day preparing by layering and tossing is a tool for warmer days and good wind break effective for wind and rain.  If major rain is expected, a second pair of shoes or jacket is helpful at a 2/3 race point by a loved one. The compression gear really helps with warmth in this scenario too.

You should also now be fine tuning your nutritional needs on the long runs.  How did you do digesting all the food?  Did you get enough in to avoid bonking?  I addressed some tools for this in my blog Doing a Long Marathon Training Run.  Please remember to work this out on the long runs prior to race day!  Did you get enough electrolytes to avoid  quad, hamstring or calf cramps?   Was the insertion of the ITB near the knee talking to you?  If so, maybe my article, Do You Know What Side of the Road You Should Run On? can help you.

Define your fluid needs?  What and when did you drink and how did it work?   I have been using ionized alkaline water which helps me stay supersaturated, neutralizes the painful lactic and pyruvic acids formed in muscles during exercise and even combats the free radicals caused from intense exercise.  Start using this as soon as you can.  Try to load your body with this water days prior to the long run and especially prior to race day.  Your water demand could be diminished by 25 to 50%!  Seems crazy, but it’s just the science.  Next, I’ll get into this special water.

You want to fuel your body to not only perform well, but not to pay for it after.  You need to do this by fueling your body with supplements to succeed the days and nights before you head out on a long run and on race day.  This includes the fish oils (EFAs), white willow bark and/or bioflavonoids for their anti-inflammatory benefits, along with good calcium and magnesium sources for natural muscle relaxation in the evening such as Bone-Up and Epson salt baths.

Dr Paul Tunes

Dr Paul Tunes

Did you need more motivation?  Were you struggling near the end of your long runs?  Pretty environments and LA Marathon will offer entertainment along the way, but sometimes you’ll need a little more help.  Now is the time to create your marathon sound track, knowing you’ll use it mostly during the second half of the race.  Create the music log that increasingly stimulates and pushes you depending on your music likes to hurdle you to the end.  This is a uniquely personal list, but should be thought out.  Work on this during your long runs.  Practice with it and see how it works.  Know your musical equipment.  I lost 4 places (from 4th to 8th) by .2 of a second in the Redondo Beach Superbowl 10K fumbling around with my music source during the race.  Also, know the battery life of your music equipment.

This is also the time to get your body tuned up as well with chiropractic adjustments, sports massage, physical therapy modalities ultrasound and electrical stimulation and even hyperbaric chamber treatments.  The strengthening exercises and stretches I recommend in Ask Dr Paul are now even more important to consider as you wind down your mileage.

Remember to have fun, enjoy the ride and keep running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

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Running in Compression Gear

The use of compression gear has been a staple in my own personal fitness apparel for the last few years.  Neoprene knee, ankle and elbow sleeves, along with neoprene shorts were some of the early applications of compression science.  Compression apparel compliments the use of Kinesiology tape, as it reinforces and magnifies the compression of the area taped.  Although Kinesiology tape is a more exact application of compression science with a specific treatment to a particular muscle’s origin and/or tendon insertion, the use of the two are synergistic.  The use of compression products have definitely helped me recover faster from my daily runs and especially after the recent long LA marathon preparatory runs.

Dr Paul & Dr Popkow Chat Compression Gear

Dr Paul & Dr Popkow Chat Compression Gear

In January while running the Los Angeles 13.1 Half Marathon, Dr Steven Popkow and I chatted about the benefits we both have had with the use of compression apparel while running.  Isn’t it interesting that the picture shows three people in a row wearing some form of this popular exercise gear?  My own professional anecdotal experience with the compression apparel started with the treatment of the highest level American track and field athletes in the mid 90’s.  The reduction of muscle strains (spasms) experienced by these athletes, along with their faster recovery times after exercising, reinforced my confidence in these products.

One of the most significant benefits of compression apparel is the reduction of excessive tissue vibration, which guarantees less tissue tearing, overload and fatigue while increasing muscular strength and power during exercise.   A 5 year Penn State study revealed an average of 12% improvement in both power and strength with compression apparel use.  Research studies done by the American company Dupont in the 90’s displayed 8-10% less tissue vibration and fatigue with compression Lycra material.  Benefits of circulatory improvement with compression and reduced venous pooling in lower extremities dates back to the late 70’s when the medical use of compression stockings for heart patients with compromised lower extremity circulation was first introduced.  Another valuable advantage of this gear is the ability to keep muscles warmer and less likely to get cold and cramp.

 

Dr Paul's Half Marathon Tool Kit

Dr Paul's Half Marathon Tool Kit

The compression products with graduated pressure, more in the feet and less comparatively in the knees and hips, help improve recovery and circulation better than the compression products with equal pressure in all areas of the same garment.  This variation in compression helps push the blood, lactic acid and other by-products created during exercise from the feet and lower extremities upward toward the heart.  My three favorite compression product companies are: 1. 2XU, 2. CWX and 3. Sugoi.

The compression socks that also cover the calves as well are helpful for shin splints, achilles tendinitis and plantar fasciitis.  The compression legs will also help these lower leg conditions and reduce symptoms of iliotibial band syndrome, glute, piriformis, hamstring, quad and groin symptoms.  People with no lower leg symptoms may use the half legs to focus on the waist and upper leg areas such as glute, ITB, hamstring, adductor and quad regions.  I have continued to use both compression socks and legs during all of my daily runs.  I even use the long sleeve compression top, as it helps me maintain better posture, while reducing strain on the shoulders, arms and upper back muscles. The arm sleeves facilitate ease of arm movement and help maintain upper body circulation and warmth.

Now that we know there are obvious benefits to the body with compression products during exercise and even after to hasten recovery, the emergence of compression sleep apparel is just beginning to surface.  In fact, the use of  “posture apparel” is also going to continue to gain in popularity over the next few years, so stay connected to this blog and website for the latest research and products for your physical longevity.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Achilles Kinesiology Taping

Laura Conley Says:
February 11th, 2012 11:18 pm
Many Thanks go to Dr. Paul for taping my legs (see achilles pic) and working on me prior to racing! I won first place and ran my fastest race of 2012 so far! Looking forward to many more PR’s with your help!!!

Dear Laura,

I’m glad my orthotics and care are helping you continue to reach your goals. Thanks for being part of my Achilles Kinesiology taping article. Go Girl!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Kinesiology Tape Achilles

Kinesiology Tape Achilles

 

Posted in Running a Marathon | 2 Comments

Achilles Kinesiology Tape

Kinesiology Tape Achilles

Kinesiology Tape Achilles

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Ankle Sprain Taping


Ankle Sprain Taping


Once an ankle is sprained and there is pain and/or swelling, ligaments have been at least partially torn, but it doesn’t mean you’ll have to even stop running. This ankle taping technique immediately gives your ankle the necessary support to shorten the partially torn ligaments and allow expedient healing of the ankle. Ankle sprains are rated as mild, moderate and severe. Both mild and moderate should benefit significantly with this taping and allow you to resume at least forward walking and running movements within 20 mins after the injury to 1 to 2 days with the RICE method of self care: R for rush to treat, I for ice 20 mins, C for compression and E for elevation.

This ankle taping technique is also a terrific preventive ankle sprain tool to use with trail running and sports involving lateral movements, i.e. tennis, basketball, soccer, football, volleyball. I use it also with track and field athletes who need more foot and ankle support during their particular event, i.e. high jump, long jump, pole vault, hurdling, steeplechase and throwing events. Even running straight ahead or around corners can be improved with this ankle taping technique as it reduces the wobbling affect inherent in walking and running, as we normally land on the outside of our foot every step we take due to the shape of our hip and subsequently role inward ever so slightly.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Kinesiology Tape For Hamstrings

Kinesiology Tape Hamstrings

Kinesiology Tape Hamstrings

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Kinesiology Taping for the Iliotibial Band

Kinesiology Tape IT Band

Kinseiology Tape IT Band

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The Skinny on Kinesiology Taping for Runners

As an experienced sports doctor and scientist I have used Kinesiology tape on my patients since 2007.  As a daily runner I have personally used this tape for years and extensively in my 2010 LA marathon preparation.

Kinesiology Tape

I have even used kinesiology tape on my two Weimaraners who log about 4-6 miles daily with me and occasionally come up lame. To say I believe in this tape is an understatement.  Whether on patient, personal use or on animal, its effectiveness has always been noticeable.

Kinesio Tape therapy was invented in 1979.  Although this is a relatively new taping philosophy primarily used by chiropractors in its infancy, it is universally recognized now.  Anyone who has used this therapy modality, doctor, therapist, trainer or athlete, understands its immediate benefits and efficacy.

The primary running conditions I have a high success rate with the flexible kinesiology tape are: Achilles tendinitis, hamstring tendinitis, patellar tendinitis (runner’s knee), patella femoral syndrome, iliotibial band syndrome, glute tendinitis, piriformis syndrome and adductor strains.  I have found Kinesiology tape more effective for lower ITB pain, patellar femoral syndrome and outer knee pain than the “McConnel” taping technique.  Also, shin splints and plantar fasciitis actually respond much better with the stronger less flexible white athletic tape because it gives much more support than Kinesiology tape does.  I use this white athletic tape in my “point of pain shin splint taping,” “plantar fasciitis taping,” and “ankle sprain taping.”

Reef with Kinesiology

Kinesiology tape’s primary attribute is almost always providing immediate pain reduction in addition to improving athletic performance from 5 to 10%. This can represent a huge aspect of injury prevention and recovery. Have you noticed the increased use of compression apparel legs, calves and socks?

Kinesiology tape is a more exact application of compression science, with a specific treatment to a particular muscle’s origin and/or tendon insertion. It also helps reduce pain from a strain in the middle of a muscle and works 24/7 for days.

The science behind the tape is multi fold.  Muscles have a cover over them called fascia. Kinesiology tape is able to slightly separate the fascia from the muscle, allowing blood vessels underneath the fascia to dilate, improving circulation.  The tape also reduces pressure on pain receptors in the skin surface by this same process.  Kinesiology tape’s benefits are:

1. Increases the amount of effort that a muscle and tendon can exert

2. Increases a muscle’s lymphatic and blood flow circulation

3. Increases range of motion

4. Reduces muscle fatigue and cramping (spasms)

5. Reduces tissue overload from repetitive use

6. Reduces swelling and inflammation

Now lets get down to Kinesiology taping basics.  The tape is usually found at running specialty stores; check with Dr Paul’s Favorite 3.  It is best applied to clean, dry skin without hair, although I have never shaved myself or rarely had any patient taped with issues.  The tape has an additional 10 per cent elasticity built in to it, so there is no need to pull it aggressively.  Apply with very little tension for best results.  Once applied, I prefer to lightly massage the tape onto the skin for a minute or so to insure better contact.  You might feel an initial tension on your skin, usually coinciding with pain reduction.  The tape can be left on, as long as you are comfortable, for a few days up to a week or so.  It should not cause discomfort or keep you from sleeping.  If so, remove the tape.  I cut off the corners to reduce fraying.   Often, I will split the tape, as you will see.  You can remove the tape by rubbing with baby oil or with soap and water.  By the way, I apply all of these taping techniques to my own legs and feet and you can to.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Super Bowl Sunday 10K

Dr Paul
Had a great experience at Redondo Superbowl 10K.  8th place age group finish, 46.28.  Can you believe 2/10 sec seperated 4th thru 8th place? Should have sprint finished.
Keep Running!
Dr. Paul R. Copeskey, D.C., C.C.F.C.
 
Posted in Running a Marathon | 1 Comment

Doing a Long Marathon Training Run

If you are preparing to run the LA Marathon, this weekend you may be doing a long run of 15-18 miles, or 2 1/2 to 4 hours, depending on your pace.  Another approach could be doing two runs in one day totaling your goal mileage and/or time.  Beforehand, it is a good idea to rest for a day or two and not engage in any strenuous exercise, or at least try to limit yourself to non-ballistic activities like swimming or biking.

While the marathon will be run on the pavement, you don’t have to do your long training runs on it.  Doing that run on a dirt trail, at the beach near water’s edge at low tide, or on a well manicured grass park surface will be much more forgiving on your legs while still being the extended aerobic workout it needs to be.  Take your time and make it a long, fun run.

As I mentioned earlier in my marathon training blog, these type of runs should be done wearing shoes that provide stability or motion-control…unless you are an experienced distance runner without foot/leg pain symptoms, or you’ll be finishing the marathon in less than four hours.   I also recommend you use the proper shoe-lacing technique I described in the blog.

As I suggested in my article “Taking on the Marathon,” running a few days a week with one run substantially longer than the others is the best strategy to be have positive results on race day.   Continue to extend the length of those long runs by 2-3 miles every other week, rather than weekly, as you approach the marathon date.  This will give you ample time to recover from those long runs while still increasing your mileage.

Before your long runs, providing your body with the proper fuel should be a priority.  Have you heard of the saying, “Breakfast like a king?”  Research shows that people who have bigger breakfasts eat less throughout the day, compared to those who have smaller breakfasts.  My pre-long run meal will probably be a peanut butter and jelly sandwich without the bread…aka a small tub of raw peanut butter from Whole Foods and a pint of blackberries and/or a banana.  Some people eat a couple “Breakfast Jacks” and an orange juice for their pre-race or long-run meal.  I’ll also bring a few salt sticks, 2 to 3 gel packs, and some jolly rancher candies with me.

If you are sweating a lot during your long run, a good rule of thumb is to eat one salt stick  every hour.  This will replace those valuable electrolytes lost in your sweat, especially the sodium and potassium.  The gel packs and jolly ranchers keep you from “bonking” or losing valuable glucose, the first sign of which is becoming light-headed.  Your fluid intake should also be every hour or so, so either carry some on you, or plan ahead for where you will be able to get some.

I personally prefer to drink both ionized alkaline water and coconut water days before the long run.  Alkaline water helps your tissues retain fluid longer and coconut water is a rich source of potassium.  If your stomach has difficulty digesting your fuel supply during the run, a very small piece of sugar-coated ginger candy that you just chew for a minute or so and not even need to swallow, or a peppermint pill or two, should quell any nausea and/or regurgitation feeling.

During your long run, you may need to walk for a few minutes occasionally.  During the marathon itself, walking thru the aid stations is an excellent way to help you avoid those disabling calf, hamstring, quad and ITB pains.  Taking  brief walking breaks is no problem.  Take your time and realize that even most people finishing in 4 hours or longer do some periodic walking.

Be sure to get some good quality protein within an hour or two after your long run.   A good rule of thumb is 70% of your body weight in grams of protein if you’re out there 2 to 4 hours.   I’m  155 pounds and will eat the equivalent of two large chicken breasts after my 2 1/2-3 hour run.

www.joniscoffee.com

If you are sore after your long run, please refer to my earlier blog entry, “Are you sore from running?”   This will give you some suggestions to hasten your recovery, keep you in the game and focused on the longer runs to follow on your way to a successful marathon experience.

Remember that job #1 is to ALWAYS HAVE FUN!!

Keep Running,

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Feel free to send me any questions you might have regarding your marathon preparations.

Coconut Water, Purchased at Whole Foods

http://amyandbriannaturals.com/coconut.html

Salt Sticks, Purchased at Rundocrun recommends top 3 running stores

http://www.saltstick.com/

Ginger, Purchased at Whole Foods

Post Long Run Meal

http://joniscoffee.com/

 

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Are You Sore From Running?

One week ago, following the LA 13.1 half marathon, my web site spiked with requests for IT Band Massage and Foot Pain Taping for Shin Splints.  Additionally, this past week as most of you are starting to take on longer runs with the LA Marathon 8 weeks away, I also had a spike in hip flexor strengthening requests.  From this information, I am able to see the areas our followers are interested in.

For those of you who are not able to run the first day or two after a half marathon or after a long marathon training run, don’t fret.   I endorse, encourage and personally use cross training methods of exercising.  My sports medical career originated treating the early Ironman champion triathletes Scott Tinley, Mark Allen, John Howard and Tom Warren.  From working on these unique athletes who were putting enormous constraints on their bodies, training 6 to 8 hours a day to stay on top of their sport, I learned the benefits of cross training.  Walking, swimming, biking, or using the elliptical machine are excellent alternative aerobic activities.  Working the upper body with some strength exercise is a good alternative as well.

Stretch, Tape and Treat

A visit to your sports chiropractor, physical therapist, or massage therapist is always beneficial in helping you recover faster.  Only 95% of our Olympic athletes use these types of treatment to recover faster and perform at their best!

This is the point I find the need to remind my patients of some steadfast rules of the game of self care.  Listen to your body and try to avoid the use of synthetic anti-inflammatories and pain killers.  Use natural ones instead like white willow bark, bioflavinoids and essential fatty acids, unless you can not sleep due to pain, as sleep is one of the best recovery aids our body has.  Even calcium and magnesium supplements can reduce muscle tightness and cramping.  These should be taken after lunch, dinner and at bedtime for optimum absorption and benefit.  Epsom salt baths provide a valuable magnesium source to help relax those sore tight muscles.  Dr Paul’s adage, ice for pain, except for menstrual cramps.  Remember, there is always another day for more fun and longevity producing activities, so…..take your time, enjoy the ride and smell the roses!!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Thank You for Visiting!

“Thank you all for the more 21,900 visits to my website www.rundocrun.com over the last month.  I pledge to continually share my training and longevity tools I’ve gleaned over the last 35 years, along with keeping you informed of the latest, most valuable and credible information from the sports science and medicine community.

 

Rundocrun Beach Run

Rundocrun Beach Run

My goal is to help you achieve your health and longevity goals and avoiding time on the sidelines due to injuries. Have FUN!!

Keep Running!!

Dr. Paul R. Copeskey, D.C., C.C.F.C. 1/21/12

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Do You Know What Side of the Road You Should Run On?

As crazy as it may seem, this is often one of the most important things I tell my patients. As the saying goes, “the devil is in the details.”  I have been able to collect some valuable information from 4,000 patients who have come to me over the last 32 years.

Leg Length Measurement

During that time I have been responsible for ordering, evaluating and the computations of more than 4,000 X Rays of my patients’ legs, their femurs and tibias.  I, along with other medical researchers, have concluded that 95% of us have about  ¼ inch or 5 to 6 millimeters difference in the longitudinal length of our legs.

If this abnormal difference is more in the femur (the thigh bone), the difference in the weight of an average adult male’s longer femur could be 5 to 20 pounds more than the leg with the shorter femur!  This is because of the extra body mass, more bone mass, including the bigger and stronger muscles in the buttocks and upper leg of the longer femur, especially the glutes, quads and hamstrings.  Ever wonder why one glute, hamstring, quad, and/or calf always gets tighter or is more symptomatic than the other one?  This is probably because of this elementary imbalance.  Some dedicated runners, hikers and walkers have noticed they feel better exercising on one side of the road more than the other side and consequently use one side more to their benefit.

The only way to know for sure what this finite leg length difference number is with a special life size X Ray of the femurs and tibias—what is referred to in medicine and sports science as a scanogram or orthoroengtenogram of the femurs and tibias.  A bone scan of the bones can be done as well, but I feel lacks the accuracy of a scanogram.

You might say this leg length difference number is the answer to the $40,000 question.  But in the case of a professional athlete, it could be the security of the team owner’s $40M investment.

Once you know which leg is longer, you know what side of the road to run and/or walk on, depending on whether you’re running on the pavement or the sidewalk.  The longer leg’s foot should always be lower than the shorter leg’s foot.  For instance, if your right leg is longer, running on the right side of a crowned, paved street should feel better than running on the left side… and vice versa if your left leg is longer.  If you’re running on the sidewalk, it is the opposite because sidewalks always slope toward the road.  This means left long leg people should feel better running and/or walking on sidewalk on the right side of the street, or with the traffic if your right long leg is longer.

It should be noted that even if you correct the short leg length deformity with custom orthotics, or place an extra insole in your short leg shoe, the longer leg will still weigh more than the shorter leg.  As a result, you will probably still feel better exercising on the side of the road that addresses your long leg imbalance. This leg length imbalance is also the reason you’ll want to stretch your long leg’s hamstrings, glutes, ITB, calf and quads more than the corresponding muscles on the shorter leg, especially after you exercise.

I believe that this leg length information will help extend your body’s physical longevity. We now know the elderly usually break the neck of their femur bone in the long leg about 90% of the time after putting 200,000 miles on their legs. The fall usually occurs after the femur breaks, and it is not the fall that causes the break in the leg.  This does not discount the fact that any fall may result in a fracture for a geriatric.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

Posted in Running a Marathon | Tagged , , , , , , , , , , , | 34 Comments

Stability and Motion Control Running Shoe Selection

Rundocrun Shoe Selection

Rundocrun Shoe Selection

I am in my sixties @98 lbs., run 3 time a week for 60 min. on pavement without pain.  What is the best running shoe for me to keep me pain free?

Dear Running Grandma,
Congratulations, you must be running on the correct side of the road.  “What side of the road should you run on” will be my blog article later this week.  Sometimes, this is the most important thing I tell a patient.  Your terrific weight, age and lack of pain, along with the best ballistic aerobic choice revealed by the leading longevity studies probably means you could  benefit from a lighter stability shoe more than a heavier motion control shoe.  The 4 best stability running shoes for you and others from 80 to 125 pounds are:

1.  Asics 2170
2.  Asics Foundation
3.  Saucony Hurricane
4.  Saucony Guide

Those of you who are 125 to 175 pounds, try these motion control running shoes:

1.  Asics Foundation
2.  Saucony Omni
Have fun and….. I’ll talk to you on the next blog and tweet later this week!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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13.1 Half Marathon

 

13.1 Half Marathon

I ran in the 13.1 LA race yesterday and found it to be a great, competitive and fun half marathon among the fittest participants I’ve witnessed in a while. I PR’d with a 1:48 at 57 and was still #16 in my 55-59 age group! Like most of us, still room for improvement. Kudos to the 13.1 Team from Brennan Lindner and Generic Events, along with Bob Fox’s clan from the U.S. Road Sports and Entertainment Group. My training equipment and strategy has me ready for an easy couple mile recovery run today and now my focus will be on the LA Marathon in 2 months. Yesterday I was able to visit with one of our patients from the USA Track and Field national team, Lopez Lomong. After the event and we shared a mutually positive 13.1 experience with the compression sock and legs. I witnessed a few competitors barefoot running, one who started the race carrying his Vibrams and finished wearing them. I’ll talk to you later this week with the answer to the $40,000 to $40,000,000 question, “What side of the road should you run on?”

Keep running and …… have fun!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

 

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Motion Control Shoe Selection

Rundocrun Shoe Selection

Rundocrun Shoe Selection

“I am a 250 pounder marathon junky – they come in all sizes – done 9 Honolulu marathons and going for my 10 th at the LA marathon …what the best running shoe for me ?….you gotta help me Doc. At 64 this is really serious biz.”

Dear Marathon Junky,
Keep it up and congrats!! These are my recommendations for motion control shoes to be used by runners over 200 pounds. They should help you in your pursuit to continue marathon training and prevent injury.

1. Asics Evolution
2. New Balance 1123
3. Brooks Beast

These are my motion control recommendations for those of you between 175 and 200 pounds:

1. Asics Foundation
2. Saucony Omni
3. Brooks Addiction

My next post will address motion control shoes for women and men between 100 and 175 pounds.

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Running A Marathon, Lacing Your Running Shoes

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Proper Lacing Technique for Running and Athletic Shoes
Now that we have you in the proper running shoe, lets show you how to lace it up to have the best possible fitness experience and benefit, whether you are marathon training, training for a 5K, 10K, half marathon, involved in a running-related sport, i.e. soccer, basketball, football, baseball or tennis, but even for walking events like hiking, golfing, boxing and bowling and to also use in the gym training, dance studio and aerobic class.

This lacing technique will have a significant beneficial effect on race day. The laces especially need to be secured for a running event, described by a German physicist two years ago at a sports science seminar as a “controlled free fall!” I refer to the lacing technique as, “battening down the hatches, as one would for the Baja 1000.”

1. With the end of 1 lace exit the 2nd to last eyelet from the inside of the shoe and repeat on opposite side of shoe with other lace end.

2. Enter back into the last eyelet of each shoe side from the outside, creating a small loop on each side.

3. Cross over with each lace end and go through each small loop.

4. Gradually pull each lace independently upward and slightly. Easy does it.

5. Pull tightly to your 80-90% tolerance.

6. Warm up at 60-80% for 10 minutes or so, then pull laces to 95-100% tightness.

7. Ready for lift off and FUN!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

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Running a Marathon, Choosing the Right Running Shoe

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Posted in Running a Marathon | 2 Comments

Taking on a Marathon and The Right Running Shoe

Choosing the Right Running Shoe

I want to make sure you have a great experience marathon training and eventually do many more.  You may not realize this, but marathons have a high failure rate.   Only 15% of marathon runners do more than one.  Injuries are the most common reason for this alarming statistic usually due to a poor marathon training plan.   You can begin the new year with Dr. Paul’s marathon training schedule with several updates.  This running educational blog will help those of you who are weekend warriors or others looking to do 5ks, 10ks, half marathons and/or triathlons.   I’ll teach you how to avoid foot pain, shin splints, achilles tendinitis, knee pain and IT band pain from a sports chiropractor who has treated 1000’s of Olympians and professional athletes with 35 years experience treating and preventing sports injuries.  Even if you do not have any injuries, I will show you how to avoid them while running more efficiently and faster with my specialized exercises and stretches.

The most important part of your running gear is your footwear.   Consider that for a 150 pound person, 300 to 600 pounds will be landing on each foot 20,000 times during the marathon and on pavement.  That’s some serious tonnage and why most rookie marathon runners are injured well before the starting line and are praying they can somehow keep it together for the 6 hours they’ll be on the course.

Since most of us have medium to low arches the most commonly recommended running shoes are classified as “stability and motion control” types.   People with high arches or seasoned runners can get away without these stronger shoes and can run in “cushioned” running shoes.  They will probably be finishing their marathon in 3-4 hours.   Experienced marathon runners may even race in racing flats or in some of the popular minimalist shoes.   I have created the Dr. Paul “twist test” where you twist the heel of the running shoe and the toebox area in opposite directions.  The shoe should not bend in the middle.   You do want a flexible toebox, so I suggest you press up on the toebox to check for this flexibility.

Keep in mind that these running shoes will only have a longevity of 300-400 miles, so they should only be used for running and are not to be walked in or used in the gym for other weight-lifting or ballistic activities, especially on the same day you’ve run in them.  Additionally, these shoes should not be run in consecutive days as they have air molecules forced out of the outer sole during the run that need 36 hours to re-aerate.  Thus, 2 pairs of the same shoes are recommended if you run daily or are a weekend warrior, planning to run Sat and Sun.  Most fledgling marathon runners are best off running every other day, rather than consecutively.   Daily running usually takes a year minimum of consistent running to avoid breakdowns and overuse syndromes.

The Right Running Shoe

Remember, the most important thing is to have FUN!  I’ll see you on the next blog or at the next running event!

Keep Running!

Dr. Paul R. Copeskey, D.C., C.C.F.C.

 

Posted in Running a Marathon | 2 Comments