Do Asthma Inhalers Make You Faster?

As most of you may - or may not? - know, I race with asthma, and am also part of "Team Asthma" here in Toronto: TEAM ASTHMA BLOG.

I admit I am not very diligent at using my inhalers properly, but lately, especially with the epic cold spell ["f u, polar vortex"], I have been had to use them in order to stay healthy. I actually need the bloody thing - just last week, in the middle of a heinously difficult swim set at the pool, I ended up on the side of the pool barely able to get a breath down, and without the puffer I carry with me, that could have been ugly..

Anyway, last week before my 3000m race on the indoor track, I took a couple of puffs as per my doctor's directions - only to have a guy beside comment "hey - isn't that cheating...?".

My first reaction was:

 But, all I said was "Ya, 'cause I really feel the need to suck back meds in order to take the massive - MASSIVE! - cash prize at the end of the race". Oh, wait - there is NOTHING awarded at these races (and for what it is worth, regardless of what is on the line at each race, aside from hoping to race my best...I WOULD NEVER USE A PED!! Maybe a little blue pill when I am old and grey but that is a different blog - haha).  

But his comment did get me thinking about whether people actually understand what an "asthma puffer" does, or, does not do. So, to that end, I write this blog for the guy whose snarky aside left me, pardon the pun, huffing and puffing:

Q: Will using an asthma inhaler make you a better athlete? Some athletes believe the answer is yes — but science says no.

The asthma medications of interest in terms of performance are the bronchodilators (such as salbutamol, albuterol and formoterol), which open closed airways and relieve the symptoms of asthma, including shortness of breath and wheezing. However, some athletes obtain bronchodilators for off-label use, believing the medications will further relax the muscle linings of their healthy lungs and provide an advantage over other competitors.Such logic is fallible, says Dr. Michael Koehle, a sports medicine researcher with the University of British Columbia. In a 2012 study performed by Koehle’s team, cyclists were given either salbutamol or a placebo inhaler before performing two 10-kilometer time trials. Though lung function did improve in the salbutamol group, it did not have any effect on time trial performance.“Numerous studies from a variety of research groups (including ours) can show no definite advantage for these medications,” says Koehle. A 2011 review of 26 studies on asthma inhalers found that the medications did not improve “endurance, strength or sprint performance in healthy athletes.”

sucking air after the Binbrook triathlon 2013

What’s more, the off-label use of bronchodilators can come as a cost — side effects such as tremor, palpitations, and jitteriness can derail an athlete’s training or racing efforts. Overuse of these medications in asthmatics may also, under certain circumstances, render them less effective when they are needed. As inhalers are a delivery system that can be used for the administration of a variety of drugs, it is important for asthmatics utilizing an inhaler to check the status of their medication on the WADA Prohibited List. Some medications administered by inhaler are prohibited, some are not, and some are considered threshold medications on the WADA Prohibited list, which means they are allowed in certain quantities, but prohibited in excess of that quantity. If an athlete has a legitimate medical need to take a prohibited medication, a Therapeutic Use Exemption (TUE) may be requested, which, if granted, allows them to take the medication in a therapeutic dose.“A substance or method will be considered for the WADA Prohibited list if it meets at least two of three criteria: It has the potential to enhance or enhances sport performance, it represents an actual or potential health risk to the athlete, and/or it violates the spirit of sport,” according to the U.S. Anti-Doping Agency (USADA). The independent organization is responsible for managing the anti-doping program including testing, results management, education and scientific initiatives, for all U.S. athletes in Olympic, Paralympic, Pan American and ParaPan American sports, including USA Triathlon.

So - bottom line? If an athlete has asthma, see your doctor and don't worry about a puffer giving you an unfair advantage; in fact, to the contrary, it may even save your life. And to the fellow athlete who questions your use of meds (and thus, implicitly, your integrity)? Just take them down hard at the line.

see ya on the track

Mellow Johnny

Old Runners and Great Knees

I donneed no stinkin' draft...

So, I have run a couple of indoor track meets so far this year - racing 3000m on the boards is like returning to an old, but fierce, friend - and while I am definitely not dropping down times like I used to a few years back, I am still having a blast.

And yet when "non jock" peers (as in like 99% of those I work with) hear about our crazy exploits, one of the first things I tend to be asked, aside from "are you nuts?" is: doesn't running wreck your knees?

I hate that question - and this is generally what I hear when "over the hill desk jockey's" start blathering about the horror and evil of running, doing Ironman, etc:

 blah blah blah blah 

                             However, in the interests of continuing on my Zen like path to enlightenment, I will answer their query as best I can:to wit [more law jargon - it always adds to the general high brow tone of The Blog]: Is there any scientific study to substantiate the claim that older people (over 45) should limit high impact exercises such as jogging, sprinting, etc.?

Much of the recent science about high-impact exercise by “older people” like me — I prefer the term “seasoned,” by the way — reaches the opposite conclusion, suggesting that in many cases high-impact exercise can be beneficial for those middle aged and beyond. A seminal 2003 study of people aged 30 to past 70, for instance, found that while sedentary adults lost about 10 percent of their maximal endurance capacity every decade, young and middle-aged athletes who regularly engaged in intense and high-impact exercise, such as running intervals, experienced a much slower decline, losing only about 5 percent of their capacity per decade until age 70, when the loss of capacity accelerated for everyone.

There is also little evidence to support the widespread belief that high-impact exercise speeds the onset of arthritis. In a 2013 study, adult runners, including many aged 45 or older, had a lower incidence of knee osteoarthritis and hip replacement than age-matched walkers, with the adults who accumulated the most mileage over the course of seven years having the lowest risk, possibly, the study’s author speculated, because running improved the health of joint cartilage and kept them lean as they aged. Similarly, a 2006 review of studies about jogging and joints concluded that “long-distance running does not increase the risk of osteoarthritis of the knees and hips for healthy people who have no other counter-indications for this kind of physical activity,” and “might even have a protective effect against joint degeneration.”

my home running turf

                   Running and similar high-impact activities likewise have a salutary effect on bone density, wrote Dr. Michael Joyner, an exercise physiologist at the Mayo Clinic in Rochester, Minn., and an expert on aging athletes, of whom he is one. Over all, he concluded, he is “skeptical” of the idea that older people should avoid high-impact activities. “A lot of concerns about age-appropriate exercise modalities have turned out to be more speculative than real over the years,” he said, adding that during his research and personal workouts, he’s seen many seasoned adults pounding the pavement without ill effects.

So, no excuses; as the dreaded corporate hydra Nike once sagely adverted: Just Do It.

see ya on the boards,

Mellow Johnny

the Death of a Running Legend: Chris Chataway

Chris Chataway, the British runner who helped Roger Bannister achieve 

the first sub-four-minute mile, then broke world records himself and 

became a member of Parliament and a cabinet minister, died last

Sunday in London. He was 82.

Chataway was best known for helping Bannister, 

his fellow Oxford graduate and good friend, 

break the supposedly unbreakable barrier in the mile. 

For months, Bannister, Chataway and Chris Brasher 

trained together to prepare for the attempt.

It came on May 6, 1954, at the Iffley Road track in Oxford, 

an hour outside London. According to plan, Brasher, 

a steeplechaser, led for the first two of the four laps. 

Chataway, primarily a 5,000-meter runner, led for the third 

lap and a little beyond. With 300 yards to go, Bannister 

raced past and finished in 3 minutes 59.4 seconds, 

an achievement that made the front pages of newspapers

 around the world.

The three ran a victory lap together, and Bannister 

subsequently said many times, “We had done it, the three of us.”

                 Chataway congratulating Bannister on the 1st sub 4 min mile

While Bannister’s record was monumental, it was also fragile. 

In June that year, John Landy of Australia lowered it to 3:58.0 

in Turku, Finland. He gave much credit to the runner who 

pressed him for most of the race — Chris Chataway.

That summer, Chataway set a world record of 13:51.6 for 

the 5,000 meters. In a 10-day period a year later, he set 

world records of 13:27.2 and 13:23.2 for three miles. He also

 ran a mile in 3:59.8.

Chataway was not as successful in the Olympics. In 1952 

in Helsinki, Finland, he was leading on the last lap of the 

5,000 meters, fell back to second, tripped on a curb alongside 

the track and fell and finished fifth. In 1956 in Melbourne, 

Australia, he finished 11th. After that, he retired as a runner.

For years, Chataway was unhappy with the path the Olympics 

had taken, and what he saw as a shift from the Olympic ideals. 

In 1959, he wrote in The New York Times Magazine:

“Are the Olympic Games a force for good or ill in international 

relations? The answer is probably that they are not much of 

a force at all. They are worthwhile for what they are: 

the best sports meetings in the world.”

“In my experience,” he added, “the average athlete does not run, 

jump or throw for the greater glory of his country. He does 

it to satisfy himself, to meet his own competitive urges, to prove 

something to nobody but himself. My motive force was purely 

personal, never patriotic.”

Chataway started running again in his late 50s. At 64, he ran a 5:48 

mile on the Iffley Road track, his first race there since Bannister’s 

sub-four-minute mile. John Hartley, Chataway’s television 

colleague, said Chataway had told him that as he stood on 

the starting line this time, he calculated that in the 41 years 

between those two miles, he had absorbed 400 pounds 

of tobacco and 7,000-plus liters of wine.

Chataway, Bannister and Brasher remained close until 

Brasher died in 2003. In 2004, at age 73, Chataway ran a 

10-kilometer race in 49:08. The race was the Chris Brasher Memorial.
The starter was Bannister.

January 19th: a sad for running...

see ya on the roads, Chris.

Can Rotating Running Shoes Reduce Injury Risk? – New Study Suggests Yes!

Shoe geeks rejoice! If you’ve been looking for a good reason to convince your spouse or significant other that you need a new pair of running shoes, look no further than a new studythat suggests that runners who rotate among more than one pair of running shoes are significantly less likely to get injured than those who wear the same model of shoe on every run.

The abstract of the study arrived in my inbox a few days ago, and I do not yet have access to the full text, but Craig Payne at Running Research Junkie and Scott Douglas at Runner’s World have both covered it in some depth.

Here’s the abstract:

Scand J Med Sci Sports. 2013 Nov 28. [Epub ahead of print]

Can parallel use of different running shoes decrease running-related injury risk?

Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, Theisen D.

Abstract
The aim of this study was to determine if runners who use concomitantly different pairs of running shoes are at a lower risk of running-related injury (RRI). Recreational runners (n = 264) participated in this 22-week prospective follow-up and reported all information about their running session characteristics, other sport participation and injuries on a dedicated Internet platform. A RRI was defined as a physical pain or complaint located at the lower limbs or lower back region, sustained during or as a result of running practice and impeding planned running activity for at least 1 day. One-third of the participants (n = 87) experienced at least one RRI during the observation period. The adjusted Cox regression analysis revealed that the parallel use of more than one pair of running shoes was a protective factor [hazard ratio (HR) = 0.614; 95% confidence interval (CI) = 0.389-0.969], while previous injury was a risk factor (HR = 1.722; 95%CI = 1.114-2.661). Additionally, increased mean session distance (km; HR = 0.795; 95%CI = 0.725-0.872) and increased weekly volume of other sports (h/week; HR = 0.848; 95%CI = 0.732-0.982) were associated with lower RRI risk. Multiple shoe use and participation in other sports are strategies potentially leading to a variation of the load applied to the musculoskeletal system. They could be advised to recreational runners to prevent RRI.

© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

I’ve long advocated rotating running shoes since I think that one of the major causes of repetitive overuse injury in runners is that many of us run on the same type of uniform surface (road/sidewalk) in the same model of shoe on every single run. In other words, we hammer ourselves in the same way every time we head out the door (trail runners excluded).

I believe that wearing shoes that vary in sole geometry and the amount of cushioning and support provided results in forces being applied to the body in different ways and thus reduces the overall repetitive load to individual tissues. This, in turn, reduces injury risk. I’ve employed a shoe rotation myself for several years now, though mine may be a bit larger than necessary given that I review them (perhaps to the point of actually being too big a rotation!). My thoughts on the benefits of rotating shoes until now were just a hunch based on knowledge of how footwear can alter mechanics and force application, but the study reported above seems to lend some scientific support to the practice.

In his article on the study, Scott Douglas reports the following regarding the researcher’s explanation for the mechanism behind the benefits of a shoe rotation:

“The researchers wrote that this could well be because different shoes distribute the impact forces of running differently, thereby lessening the strain on any given tissue. Previous research has shown, and runners have long intuitively felt, that factors such as midsole height and midsole firmness create differences in gait components such as stride length and ground reaction time.

As the researchers put it, ‘the concomitant use of different pairs of running shoes will provide alternation in the running pattern and vary external and active forces on the lower legs during running activity. Whether the reduced [injury] risk can be ascribed to alternation of different shoe characteristics, such as midsole densities, structures or geometries cannot be determined from these results and warrants future research.’”

This hypothesis is thus right in line with my own belief that mixing up force application is a plausible explanation for why a shoe rotation might reduce injury risk. However, we can’t confirm the mechanism for certain yet.

In any event, it’s nice when science supports a practice that I and many people I know have long advocated. It’s OK to experiment with footwear, and in fact it may be a good thing.