Podcast, Running

Run training load, biomechanics, and injury risk with Max Paquette, PhD | EP#321

 January 17, 2022

By  Bernardo Gonçalves

LISTEN TO THE EPISODE HERE:

Max Paquete - That Triathlon Show

Associate Professor Max Paquette of the University of Memphis joins us to discuss training load in running, as well as running biomechanics and injury risk

In this Episode you'll learn about:

  • Training load in running: how should we approach it, and the issues with commonly used methods
  • Neuromuscular load or mechanical load: what is it and which factors impact it
  • The impact of ground surface on mechanical load and injury risk
  • Uphill running vs. running on the flats and injury risk
  • Intensity control and the impact of intensity on mechanical load and injury risk
  • Injury risk and recovery times for the aging runner
  • Footwear, shoe rotation and shoe replacement

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Shownotes

Max's background

03:14 -

  • I am Max Paquette and am an associate professor at the University of Memphis, USA. I am originally from Canada. (Eastern Ontario region).
  • I did running in high school, and during my science degree, I understood I would merge both passions. (athletes and science). I did a doctoral degree and had a faculty position in Memphis. Thus, I have been doing running science research ever since.
  • I am continuing to run. My training program is not optimal or ideal. (I run when I feel I want to do it)
  • However, I can do some "crazy things" sometimes. (For example, on the weekend of the recording, Max was going to pace a marathon)
  • Nevertheless, I run enough to maintain my fitness and build from that if I want to do it. But it is not the best approach or some I would recommend.

Evaluating training load study

What led Max to write the review

05:04 -

  • The article is a commentary on the area of reviewing.
  • My research group and I have thought of sharing our opinions based on the current evidence on "quantification of running training load." The reason is that distance/mileage is the method often used to evaluate training volume.
  • Therefore, we thought it was worth spending some time writing a paper to discuss other options. And explain why those could be better.
  • The goal was to educate people on other methods to think about training monitoring. It is not to say that there is the only way of doing it. We only want people to think differently about the topic.
  • We should not focus only on distance but also on other parameters involved.

Potential issues when monitoring running volume with only distance

06:47 -

  • Sometimes, we want to make things simple. It is why most people do it like that. (take a GPS watch. and that's it)
  • When coaching athletes of different levels, there will be some differences in paces and abilities between distinct athletes. There are also daily variable exertion levels for dissimilar athletes.
  • Assuming that athletes run 10 miles together, the stimulus on the athletes will be individual to each one.
  • Some people can complete 10 miles at slower paces. If you run that distance at 8min/mile pace, you spend more time than someone that runs a 7min/mile pace.
  • Of course, the pace is different, but it is relative to each person's ability.
  • Using only distance does not consider individual responses to training.

Alternative methods to monitor training load

08:42 -

  • It is where the physiological parameters are handy. (RPE, heart rate or others)
  • There is not a specific answer to the best choices. (there is not a method that does not have limitations)
  • What we want is that people think differently about athletes' training monitoring. (consider other factors)
  • If you can achieve that, we will help coaches and athletes to improve and get better.
  • If we only think about one variable, we will miss many other things. (stuff that contributes to the training outcome)
  • You make 20 athletes do a certain distance per week for several weeks.
  • Over time, some will do well, and others will not. (some will improve and stay healthy, others will get worse and injured)
  • Then, a coach might ask the reasons why athletes did not improve. And that is the primary issue. All athletes were doing the same things and evaluated in the same way.
  • Regarding other factors, triathlon is easier to grasp. The reason is I have to consider swim and cycling training. These will affect the outcome of the running workouts.
  • In students, you will have other problems like peer pressure, social relationships or academic work. Professional athletes will have financial stress or relationship ones.
  • Coaches need to be communicative and open with athletes to understand their lives. I read a tweet from a legendary coach stating: "Elite sports is all about pushing boundaries".
  • The best form to manage athletes is to manage risks.
  • We cannot prevent anything, but we can do risk management. Therefore, if we think outside of only distance, we can understand other factors. (Performance improvements, injury risks - something like gambling safely)
  • Factors like RPE, pace, HR or HRV are measurements easily obtained. (by most, but not for everyone)
  • There are also other things like an athlete's mood. (their expression and how they move)
  • Most coaches that know their athletes can understand when they are feeling fatigued. You do not need to ask athletes too many personal questions. However, you get a good gauge if something is not right on the day.
  • With more information, we can manipulate some factors in training and, for example, increase recovery time.
  • It is not only about technology. It is also focusing and observing what is going on with the athlete.
  • People search for one parameter/value/threshold that will tell them what to do. Despite all disciplines in triathlon being so different, I believe a good coach can juggle between all three sports.
  • They can prescribe an intense swim session in the morning and a difficult bike workout in the afternoon. (without seeing numbers) Our aim is for coaches to have some method to quantify their training consistently and be reliable. Reliability is essential because you want to access performance over time instead of comparing it to other athletes.
  • Good athletes and coaches have procedures to evaluate training load that make sense for them.

Accessing risks

17:57 -

  • There are many tests we can do to monitor fatigue or training response. However, it is easy to make the mistake of measuring many things and creating correlations.
  • The most crucial thing athletes and coaches need is to communicate how the athlete feels. (and their response and feedback)
  • It is tricky for tech to measure all these signs.
  • When I am tired, coffee does not keep me awake. (e.g.)
  • Or when I am exhausted, I drop things when I walk.
  • Several factors can pop up with fatigue. Thus, I think education is fundamental. Data is beneficial, but you also need to listen and understand your body.
  • Despite all these metrics, we do not know how to manage risks. (sometimes) So, that is the question about technology. What matters is its implementation, not what we can take from it. How do we affect change?
  • You get some numbers on a test, and the primary problem is understanding the next move. Do you back off the training session? Do you make it harder?
  • We do not have these answers yet. (especially from an injury risk prevention standpoint)
  • From a performance view, we are better at understanding what to do. However, the decision making is still not evident in the short or long term.
  • All athletes want to improve their PBs and finish higher in the classifications. Therefore, slowing down because you are tired can be good. However, you can back off too much that you will lose fitness.
  • In my opinion, I prefer to stay on the side of caution.
  • At the moment, I coach primarily junior/high school athletes. In these cases, there is no second thought. When in doubt, we pull back.
  • At the professional level, there are times you need to take that risk. (even if at times it does not feel quite well)
  • We are pushing boundaries, so it depends on the athlete and coach.

Do people struggle more in a particular core principle?

18:46 -

  • The more beginner athletes are to swim, the more principles athletes will need to look into in their training.
  • Beginners struggle with breathing and balance.
  • More experienced athletes will need to look into their equilibrium and rotation.
  • The more advanced swimmers need to focus more on the "Catch and Pull".
  • In conclusion, it will depend on your experience with swimming. However, even those experience athletes pick up things from the first principles.
  • There are always minor details we can work on and improve.

Running neuromuscular load

22:59 -

  • It is a term that we use as an example in the commentary.
  • It is a term that encompasses many factors. It consists primarily of mechanical loading for me. Any mechanical stress will have a neuromuscular response from the body.
  • Contact time, the number of steps are some factors you can combine. With them, you can obtain time under tension. If you take 1000 steps and each takes 100 ms, you will spend 100 seconds under "tension".
  • It is one way of looking at it. (in terms of demands on the body)
  • If we go for a run and have different contact times, we will have distinct times under tension. One of us will have to put more muscle output.
  • The concept allows us to compare athletes and even on the individual level. If we are fatigued, we may spend more time on the ground. (the lower limbs are not as stiff)
  • These factors would follow under muscular load.

Accessing forces and factors like bodyweight's influence on the training load

26:55 -

  • We regularly report metrics relative to body weight and not in absolute terms. (e.g., force, newtons)
  • If we run with three times my body weight and have different masses, our weights are different. (but they are relative to the individual)
  • Therefore, we need to be careful when addressing body weight and training volume. If training progresses over time, you will adapt.
  • Muscle tendon tissues and skeleton muscles adapt to that load you are going through. It is one reason why we take time to build running volume.
  • Another aspect is body composition. An elite triathlete has a high percentage of lean mass. (muscle mass)
  • These athletes carry functional weight, especially for cycling. (legs will be muscular)
  • We do not know if more muscle mass might protect against muscle skeleton injuries. The reason is that there is more muscle, but most of it is doing work to absorb energy.
  • Therefore, we need some caution around body mass.
  • Generally, mass does not correlate with injuries across the board. (all populations of runners)
  • It can be for beginner runners that start because they want to lose weight. Concerning performance, it is different.

Impact of terrain and footwear on muscle loading

29:40 -

  • I say "yes", despite lacking scientific evidence.
  • Concerning footwear, there is not a specific shoe that improves injury prevention. However, it is a "grey area" in our field. There are some concepts around "comfort". (more comfort reduces injury risks)
  • Nevertheless, that bubble burst because people would buy comfortable shoes and get injured.
  • There is also pronation shoes (motion control), but that does not work either.
  • The most accepted idea about footwear is using different types of footwear in training. (a high rotation of shoes)
  • You may wear different shoes on separate days of the week. It is an accepted idea.
  • Evidence is not strong but exists.
  • There is no evidence of cushion for injury reduction. If you compare different shoe types, you do not find any differences.
  • Based on some research and experience, there are some strategies to manage load around the foot. (especially for rehab and short term niggles)
  • We can reduce impacts on inflamed tissues to help with the rehabilitation process.
  • I am not saying to use a specific shoe when injured. Depending on the injuries, you might shift loads from the inflamed tissue. (while rehabbing)
  • Aside from that, footwear and running injuries literature are weak.
  • Regarding terrain, I spoke with Brad Beer on the "Physical Performance Show" on this topic. (surface interactions when running)
  • There are two primary points to takeaway.
  • First, as with footwear, there might be some value in altering running surfaces. The aim is to change the mechanical stimulus on various tissues. (not only muscle tendons but also bones)
  • One misconception with running surfaces is that softer surfaces are better for injury prevention.
  • However, there is no evidence of this. When you run on a softer surface, your lower limbs stiffen. When you run on surfaces that compress easily, your lower limb "spring" becomes stiff. (running on grass, sand, dirt)
  • It means you put more stress on your Achilles and patella tendons. (the muscle strain is lower)
  • On a hard surface, that does not happen.
  • You still have some stiffness, but your body is more compliant.
  • If you maintain a running speed on grass and pavement, the grass is not as responsive. (soft surfaces)
  • Therefore, you have to generate more muscular work to run at the same speed as on pavements.
  • When you do that, it increases the stress on the muscle-tendon tissues.
  • Running on soft surfaces might be detrimental for those that suffer from tendon injuries. If you slow down, it might not be a problem. However, the demands are higher if you maintain speed.
  • It might be helpful to run on soft surfaces when having bone injuries. (only if you slow down)
  • The forces applied to the body are lower. If you go fast, muscles will pull and compress bones. (what can lead to more damage)
  • My recommendation is to use softer surfaces to slow down. I run on trails on easy days to force myself to run slower. (even if I feel good) It is tricky to run fast on a soft surface.
  • I am not talking about a technical trial. But one with soft grass or gravel.
  • We have to slow down on trails because going faster can lead to injuries. There is also the problem of unpredictability.
  • When you stiffen the lower limb, you limit the mobility to joint motions.
  • You will also stiffen the lower limb at night when you cannot see the surface.
  • When you cannot predict what is on the ground, you will stiffen the lower limb. (even if the surface is not as soft as grass)
  • I think that the variability of the surface contributes to this concept as well.

Intensity and injury risk and muscle skeleton stress

39:41 -

  • Pace and speed are relative to the person. If you have someone that runs 12 min/mile, it will lead to different stresses applied to the body. (compared to someone running 5:30 min/mile pace)
  • Therefore, it matters how fast you go on absolute terms as well.
  • Faster speeds increase mechanical loading on the body. (peak vertical force, how quick the force loads on the body and demand on the calves increase)
  • However, it is also individual to each athlete. At faster speeds, some elite runners can produce less force. (on optimal mechanical velocities) Once you pass this, the load increases.
  • For others, a slight increase in speed leads to a significant increase in muscle load. You even have athletes where muscle load remain constant, regardless of the velocity.
  • It happens because runners adjust their technique as they gain speed.
  • If you watch Kipchoge jog, it is different from when he is doing 4:33 min/mile. You would not even recognise the person.
  • And it happens to everyone. Your running mechanics are different at distinct speeds. (we try to adapt your running style to produce the least energy possible)
  • Therefore, speed is a complex topic to address. It is why I recommend biomechanical running tests at different running speeds.
  • A physiological evaluation is accessible because you only need to measure heart rate or RPE. But we need to understand what happens when a specific runner increases speed concerning biomechanics.
  • A coach can monitor training loads better with this information. (if they prescribe faster workouts more often)
  • Thus, I would encourage people to evaluate how athletes respond to speed variations.

Running slower to easy runs for elite runners

43:59 -

  • Overall, running easy is always positive. However, "easy" is relative to runners.
  • Most elite runners do the slower runs at 6:20-8:00 min/mile pace.
  • People need to realise that those paces are slow compared to their racing speeds.
  • Consider you have a female runner that does 15 minutes on 5 km. It is 4:48 min/mile. If she runs at 7:00 min/mile, it is three minutes slower than the race pace.
  • Now, looking at a high school runner that does 19 minutes for 5 km. (around 6:00 min/mile pace) The "slow pace" would be 1:30 minutes lower than the race pace.
  • What you see is many slower runners doing their sessions at those "easy" paces that professionals do.
  • Those "easy days" are more intense for slower runners than for professionals.
  • The 6min/mile athlete operates at a higher percentage of race intensity than the 4:48 min/mile athlete.
  • Sometimes, the pace is not the best indicator. It will feel the same for all these athletes. Therefore, it is tricky to recommend a training pace.
  • Concerning run mechanics, most runners experience the same forces as when running at the race pace.
  • However, it does not mean we can run fast all the time. I have many problems coming up when applying that approach.
  • It is more common to see athletes that always run fast to burn out or get injured. (even though the science might not be there to prove it)

Is it ok for slower runners to run slightly faster on "easy runs"?

49:28 -

  • Focusing on the mechanical training aspect is more important for younger athletes. (more than the metabolic side of training)
  • Young athletes recover fast from sessions. The risks of their careers focus more on injury management. (avoiding bone stress or tendon injuries)
  • In those cases, I would agree that mechanical loads will be higher when running at faster relative speeds. So, I would tell them to run slower.
  • However, it is a too general statement. Some runners are not efficient at slower speeds.

Running uphill vs running on flat roads

51:11 -

  • Assuming the paces are similar, the vertical forces you experience are lower. However, the metabolic demands will be higher. Heart rate will go up.
  • Nevertheless, you experience less impact, and the speeds at which the forces are applied are lower.
  • On the one hand, it is positive. (experience less force) Therefore, you can do some good work uphill. And It is helpful to work on biomechanics and technique. The foot hits the ground sooner than on flat terrains.
  • However, when you run uphill, you increase the demands on the calves and Achilles tendons.
  • Even though the forces are lower, you use the calves more. So, the tension forces muscles generate will compress the tibia. (so the stress on this bone could be higher)
  • It will depend on running technique, but you need to keep the speeds low. (to decrease the forces applied and not the opposite)
  • If you are recovering from muscle injuries, uphill intervals could be beneficial. However, it depends on the problem.
  • Running uphill requires more hip flexion. When you flex the hip, you lengthen the hamstrings.
  • Therefore, you might put more strain on hamstring tendons. From that perspective, uphill running might be riskier.
  • But, I do not know if there is some benefit when running uphill. If you do it progressively, the muscles and tendons will adapt.
  • If you introduce uphill training, do not run with long steps. Many people try to increase their step length to get faster.
  • However, I would tell to keep the run steps tight and compact to avoid hip flexions. (especially early in the session, where you are trying to progress an athlete's resilience over time)
  • So, be careful with the time of the season and how you cue athletes to run on the hills.
  • The beauty of biomechanics is that you can progress. First, you can focus on short and tight steps. As they get stronger, you can increase the step length. (and putting more stress on the hip flexors)
  • It is a way to progress when running uphill instead of running on a steeper climb.
  • You can change the mechanics of a hill by changing running biomechanics.

Running injuries and age

57:42 -

  • As you age, you will take more time to recover. However, you also tend to do less as well.
  • Therefore, you might recover slower because of this point.
  • Ageing is not as a factor as we might think. It is the increase in inactivity that speeds the perceived performance decline.
  • Concerning injury risk, my investigation group did a lot of work on this topic and what to do.
  • We could say ageing athletes have a higher risk of lower leg injuries (Achilles tendon and calf injuries).
  • As we stop doing high intensity (less jumping/sprinting), we lose some function on smaller muscles.
  • "Use it or lose it" concept.
  • Therefore, it is crucial to maintain some intensity to maintain the function of our calves. (jumps/hops/faster running)
  • However, a warning for podcast listeners is you might not do plyometrics or uphill running in years. Now, you might decide to do these things.
  • As it is a new stimulus, make sure you do it progressively.

Differences between genres

1:01:34 -

  • Although we have much research on the topic, it is too broad. We do not know much about younger, middle age or older runners.
  • More research on female athletes will fill the void and knowledge maps. But there are some biomechanical differences between genres.
  • Often, we might see more motion at the hip joint for women. (especially on frontal and transversal planes). More movement in hip adduction and more internal rotation. (when the femur rotates inwards)
  • We also see more knee abduction on female runners. (and potentially more drop in the pelvis)
  • However, it is not consistent across the board.
  • There have not been many studies on elite runners comparing men and women.
  • And we can almost conclude that differences will not be as high as for novice runners.
  • Differences will also depend on the athlete's background. If you compare women who played soccer/volleyball and sedentary men, the differences can favour female athletes.
  • There are no controlled studies yet to answer that question.
  • However, some factors seem to be different.
  • And those differences might lead to increases in injury risks. (patella femur pain syndrome - often associated with motions at the hip more prevalent in female runners)
  • To address these issues, the focus on form is something people could focus on in their training.
  • The outcome in terms of success is not well understood. (in terms of scientific literature)
  • Strength training could help with this as well. Most physios will want to strengthen the glutes. It seems to be the cure for all injuries.
  • A few years ago, an English marathon runner said something like: "Calf injuries, knee pain, migraines solution is glute strengthening." It seems that if you have a problem with your body, all you need to do is strengthen the glutes.
  • However, there is no scientific evidence making your glutes stronger will alter your biomechanics. The primary outcome of working your glutes is that you will become good at doing those exercises.

Why is strength training a prescription so often used to "prevent injuries"

1:05:59 -

  • The theory is that tissues become more "resilient". So they can handle more load. However, we do not know if that is the case.
  • In the past, I believed in that concept. And I had some conversations with colleagues about this topic.
  • However, things are not as linear as the theory. Thus we do not know the reasons for preventing injuries.
  • Improving strength and reducing injury risks might be as simple as becoming more athletic. Maybe you change how you step and move.
  • This topis is still blurry because the methods cannot give us definite answers yet. (increasing strength and glutes reduces injury risk, which it does not seem to do)

When to replace running shoes

1:07:30 -

  • There have been some studies evaluating biomechanical changes in different shoes. (with distinct wear time)
  • People say that after 300 miles, you should change shoes. However, this comes back to the topic of quantifying training load.
  • If you only use mileage to know how good your shoes are, it does not consider the number of steps you gave.
  • If you are light and tall, you take fewer steps per mile. If you have less weight, it means you have less stress on the material of the shoe.
  • So, those shoes might last longer for one individual than for others.
  • I do not like the idea of shoe mileage. I have had shoes for about ten years.
  • And I will run in those old shoes sometimes. (but, of course, I only run like 12 times per year in those shoes)
  • For me, I would feel when it was time to retire a pair of shoes. (and I did not count the mileage)
  • It is hard to describe, but it comes with experience. If you know how it feels, you will understand the period to do it.
  • The evidence on shoe wear and injuries is not substantial either. You might feel better in new shoes, but it does not mean you will get injured.

Common mistakes made by runners

1:11:01 -

  • There are many mistakes to point out.
  • We have alluded to the "easy runs".
  • For example, I prefer youth runners do less volume and make recovery sessions relatively slow. (30-35 minutes)
  • I use minutes there because the distance will depend on the speed travelled.
  • Another aspect is that runners like to do too much at once. They finish the season and take some time off.
  • After, you hear or read some information on socials. It is good to learn about different options, but athletes implement everything at once.
  • Strength training, plyometrics, hill running are some, and they become too much for the athlete to handle.
  • If you incorporate new things, do it by blocks. Start with strength training (e.g.) and add other aspects slowly.
  • The third point is for coaches. They assume athletes respond to training as they think. It is one of the most prevalent mistakes I see with coaches.
  • They do not communicate or evaluate things as they should.
  • Therefore, they miss opportunities to back off training.

General questions

1:13:29 -

What is one thing within coaching or training you are now learning/curious about or fascinated by and why?

Everything that is related to running. We have some studies looking at coaches believes and strategies for injury prevention. It will be interesting to see how that correlates with what we know from the literature. One of my studies is finishing a thesis on strength training for middle-aged runners. We looked at how distinct sessions affect the economy and biomechanical running parameters. We are also doing a lot of footwear work. (its impact depending on the athlete's running experience) By experience, we mean lifetime exposure to running. When you present novel footwear to athletes with distinct experience levels, the response might be different. The hypothesis is those beginner runners have more malleable biomechanics. While more experienced runners might not show any changes in biomechanics. (they are so used to run, that their shoes will not affect their "running style"). I am also learning a lot about the psychology of injuries and how it changes behaviours. It is an area I have not focused a lot on in my career.

Rapid fire questions

What is your favourite book, blog or resource?

Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance Hardcover by Alex Hutchinson

What is an important habit that benefited athletically, professionally or personally?

Patience

Who is someone you have looked up to or who has inspired you?

Personally, most of my coaches, but primarily my high school coach. Professionally, Trent Stellingwerff.

LINKS AND RESOURCES:


Bernardo Gonçalves

Bernardo is a Portuguese elite cyclist and PhD student in the field of aerodynamics at the University of Coimbra. He writes the shownotes for That Triathlon Show, and also produces social media content for each new episode.

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