24 August 2015

Following Petite Trotte à Léon PTL 2015 from the bench


One year ago Otto and I was in Chamonix and if I remember correctly was on our way to the pre-race briefing for Petite Trotte à Léon (PTL) when I write this. The start was then later in the afternoon. This year I will be on an airport heading for a business meeting in Münich when the race starts at 5:30 pm today and will have to follow the teams the coming week online at UTMB Livetrail. Quite illustrative of how my priorities have been this lost season – I have already started to plan for next summer’s adventures and races. Regretfully there are no Swedish teams participating this year - Tobias Lindström is this year running Tor des Geants later in September for instance. We will surely miss what looks like an amazing course. Of course, there appears this year to again be a really tough race with some challenging, but beautiful, passages. The weather forecast for the week is quite uncertain, as always in the mountains, but it looks like they will have a rough start with strong winds and perhaps even snow. Strange how quickly one forgets how painful it was – really longing to participate again now. Perhaps next year?
 
Map of PTL 2015

Profile of PTL 2015

Timetable of PTL 2015
 


18 July 2015

Mont Blanc 80 km 2015 race report

It has gone three weeks since I ran Mont Blanc 80 km and it feels definitively too late for a race report. If it had been only about my experiences and learnings I would probably have skipped writing this altogether, I do not need to write this either to prove to others or myself what I achieved or give an account of what went right or wrong. However, I think the race itself was so great, with an absolutely superb course, that it deserves some pictures and words.

The race started at 4 am from central Chamonix and as my hotel literally was 50 yards from the starting line I had set the alarm for 3:15. As always before a morning race I woke up earlier, but still felt quite rested. This was my first “shorter” race in a while after Tor des Geants in 2013 and Petite Trotte a Leon in 2014 and mistake number 2 was probably that I really tried to stuff myself full with food and fluids before the race and ate as much as I could both before I went to bed and immediately when I woke up. What about mistake number 1? Well, I woke up with a slight headache and realized that my first mistake was that did not arrive in Chamonix until late afternoon the day before the race and therefore had no time to adjust better to the altitude and surroundings. Still it was great to be back in the Alps and listening to the same speaker voice as when starting PTL last fall.
 
Early morning start in Chamonix
Mistake number 3 was that I decided to wear a technical compression T-shirt from Compressport – certainly looked really cool, but as it turned out a risky, and probably not the best, choice as I paradoxically both got really hot in it and at the same time got really cold over my stomach due to the sweat.  Mistake number 4 was a real beginner mistake, a mistake mentioned as the first one in Joe Uhan’s excellent listing of “Six Things That Elite Ultrarunners Are Doing That You Are Not” – not running slow enough during the first ascent up to Brevent. It felt as I was hiking slowly, but as I climbed the 1426 meters up to Brevent at 2461 meters altitude in less than two hours and was among the first 200 runners out of 1000, when I normally starts much slower and is somewhere in the middle of the field, I am certain I started too aggressively. It felt great, however, and even more so during the first descent down to the first food control when watching to sun rise over the Mont Blanc massif.

Sunrise from Brevent over the Mont Blanc Massif on the other side of the valley
When stopping at the control to eat and drink something I realized suddenly that I was quite nauseous. I tried to eat some bread, only to almost get it up immediately, so the only thing I could tolerate was some coke and orange wedges. I was not too worried and decided to continue the descent to Flegere to see if I felt better at a lower altitude. I still tried to keep a good pace and was just thinking how fun and technical this path was when I fell headlong off the trail. Luckily, I fell on some stones and could arrest myself with my hands before falling down the slope into the forest below the trail. I got an adrenaline rush and was up and running in less than a second as I was not even passed by the runners just behind me and did not realize until some minutes later that I was bleeding quite profusely from my right hand and left knee. As I had full moments in both the hand and knee and it did not hurt too much I just continued running.


Descending worked fine all day, except when I fell
When the adrenaline left the body I felt very weak, however, and slowed down my pace when starting the small ascent to Tete Aux Vents. Here I also took one of the liquid Enervit gels I was carrying – I was happy to be able to tolerate those and should probably have carried more than 5, my planning had been to have one at each major climb, and mistake number 5 was too not have more of those with me. It was really frustrating to feel strong and lively in the legs and muscles, while at the same time very weak and nauseous and not able to go run as normal. I still hoped it would get better coming to the second major food control in Buet after 26 km, but during this time I was started to get passed by more and more runners and this is never good for the morale, in particular as I normally is almost never passed when ascending. Still, I was among the first 300 runners when reaching Buet after 4 hours and 37 minutes.
 
Heavy feet while ascending
Here I really became worried as I had to suppress vomiting as soon as I tried to eat anything. I looked for soup or broth, but they did not have any at this station and I had to resort to only Coke and some orange wedges again before setting of after a short stop. I noticed that it now had started to get really hot and I was happy that the ascent up to Col de la Terrasse through Loriaz started off in a quite dense forest in the shadows. Soon, however, we came to sunny meadows and clearings that started much earlier than the normal altitude for the tree lines of 2000 meters. There were plenty of small steams and I started to fill my head cap with water and wet my arms and legs each time I passed in order to cool down. I do not know if it was this that caused my ears to feel as they were filled with water, or if this ear clogging was caused by some infection or something else, but it did not help my nausea.  Mistake number 6 was clearly one of the major ones and that was to not train properly in heat before this race; it became incredibly hot during the day and I was not at all prepared for it. During this painfully slow ascent I also became increasingly irritated with my new running poles. Mistake number 7 was to bring new poles to the race – I had never really tested the Mountain King Carbon Trail Blaze Poles I had decided to run with, mostly due to their low weight while still being Carbon poles, and they were clearly not up to the job in the Alps. I guess they might be really good on the British fells, but in the more stony and technical terrain around Chamonix they were too weak and not absorbing the shocks when climbing. I also quickly developed blisters in my hands – something I have never experienced with my regular Black Diamond Ultradistance Poles. I will post a more comprehensive comparison here soon.

Rather quickly during the ascent up to Col de la Terrasse I definitely realized that I would not meet my target time and that this would be a very long day even though I still I hoped to be able to arrive in Chamonix in time for a late dinner. I was now so weak that I had to stop frequently to rest, something not entirely bad as I then could enjoy the view more and the passage up to the Col at the highest point of the race at 2645 meters through the glacier was really spectacular. If it would have been a cold day it would have been impossible without crampons, but now the snow was almost too soft even for holding the steps that had been formed.

Ascent through the glacier up to Col de la Terrasse.
Felt almost like being in a lemmel migration with all runners sometimes
The last few meters up to the Col involved some light scrambling and it was almost ridiculous how many guides that were waiting for us runners and the top and literally directed each step we took. A nice gesture, but I think the following descent through some lingering snow fields were actually more dangerous.


Mountain guides babysitting runners at Col de la Terrasse
The descent was really fun, however, as some of the snow fields were so steep and the snow so soft that running or walking down was really difficult, in particular with poles without any basket at all. So, the only option was really to just sit down and glissade down. It was really cold for the buttocks, and I was not particularly fast as I clearly had not practiced this as some French runners who swiftly passed me, but it was fun.

The descent through snow fields requiring glissading skills
That it was not without risk was however evident when I just after the last snow field was stopped as a rescue helicopter was picking up a runner with a broken or twisted ankle.

Rescue helicopter picking up an unfortunate runner
The last distance into Emosson, the next “ravito complet” after 39 kilometers was clearly runnable, but it felt like I was more stumbling than even walking. At Emosson I finally vomited after eating some bread and after that I felt better and could have some soup in addition to the Coke and oranges I now was quite tired off (I have not had Coke now for three weeks since the race – probably a personal record for me). I also finally changed the hot dark black compression T-shirt for my favorite white Better Than Naked T-shirt from North Face – and as soon as I had done that I realized that mistake number 8 clearly was that I had not stopped for 2 minutes before and done it earlier. I also made mistake number 9 and stayed way too long at Emosson, but it felt like it did not matter any longer. Just exiting the station a photographer took some of the mandatory race pictures and I look surprisingly strong considering how I really felt.
 
Looking surprisingly strong - finally with a new T-shirt and finally having been able to tolerate some soup.

The descent from Emosson down to Chatelard was really fun and not too slow, it was a quite technical descent through the forest with several sections with chains as aids for the steepest parts and I could easily just keep my place in the single-track line that had formed of runners waiting for those in front of them. Too always have other runners around me was a new experience for me after TDG and PTL and quite frustrating sometimes, in particular as I throughout the day only was passed by others and almost never passed another runner. In Chatelard village, at the lowest altitude during the race so far of 1155 meters, there was a check of the mandatory equipment – a good thing I have not experienced in other races before.

It was now mid-afternoon and over 30°C (high 80s in Fahrenheit) in the shadow, but as the descent to Chatelard and the first part of the ascent up to Les Jeurs went through quite dense forest it was not too bad. However, as soon as the meadows started during the ascent it became incredibly hot. The water in my ear had also returned and I had now in addition to feeling quite dizzy also got quite bad tinnitus and when I was greeted by another runner at the next food station I could barely hear that he was speaking Danish (which is similar to Swedish and thus at least partly understood by Swedes) and complaining of the heat. He must also have been suffering horrendously this day as I passed him in the climb up to Catogne and Tête de l'Arolette and then did not see him further despite my crawling pace. At Les Jeurs I again had some broth soup, Coke and oranges – trying to eat some more just made me sick again and I left in the heat without any new energy. The few afternoon hours I spent in going up the relatively gentle slopes to Tête de l'Arolette at the, for the Alps at least, moderate altitude of 2322 meters, were some of the longest in my life. I was completely exhausted and had to focus in order to take each and every step in order to not stumble of the trail. I also had to focus on my breathing as exhaling through partly closed lips was the only way I could somewhat quieten the storm in my ears. I have never experienced anything similar and when searching for similar experiences in the literature or the net I do not find much.

It was somewhere during this climb that I finally made my decision to not finish the race. It was not an easy decision as it would be my first DNF in an ultramarathon and I have previously written a blog post about the negative things of a DNF. One contributing factor to the DNF was that I had to leave Chamonix already 6 am the next morning for a job conference in Salzburg, and I realized that I with the current pace would finish sometime during the early morning hours – more than 6 hours slower than my target finishing time. This was clearly mistake number 10 - I will never again compete in a longer mountain ultramarathon trail race without having proper recovery time after a race and having to think about finishing before the cut-off time just too be able to recover sufficiently. Nevertheless, this was not what made me decide to quit the race at the next aid station. I think it was a combination of realizing: 1) that the experiences I would miss by not running the last 25 kilometers of the trail during the evening and night were not worth the suffering I felt due to the weakness, nausea and tinnitus; 2) that I already had missed my target finishing time and that for this shorter race a good finishing time was actually more important from a personal competitive standpoint than just finishing – I had nothing to prove to myself just by finishing the race and I did not need any UTMB points or anything else by just finishing; 3) that my medical condition was actually quite bad and that I should have been taken off the course if there only had been a medical check-up during the race; and 4) that I would not risk a scary descent in a dark forest down to Chamonix during the night similar to the experience I and Otto had during PTL last year. So, immediately when I made the decision just before reaching Tête de l'Arolette I knew it was the right one and it still feels so three weeks after the race.

Everything felt much easier as well after making the decision to DNF, like a heavy burden had left my shoulders, and I could actually enjoy the stunning passage on the ridge over to Tete de Balme and the passage of Col des Posettes up to Ardoisieres with beautiful views over the Chamonix valley in the afternoon sun.


The ridge between Tête de l'Arolette  and Tete de Balme  
I took good time to descend, but now the field of runners was finally more spread out and I could run long parts alone down to Le Tour. When I stopped I had completed 4713 D+ meters out of a total 6077 and it was only one major climb left so it still had been a fairly long day.

When I said I would stop at Le Tour I thought that there would be some kind of transport to the finish line, or at least some medical check-up, but I soon realized I was in France and unless you are dying you will not receive any attention. I was told that there was a public bus stop 500 meters away  where there might be buses going down to Chamonix and that I could go for free if I just showed my race bib. I had to wait 30 minutes for the bus and then that took another 30 minutes down to Chamonix center. During the waiting time and the bus ride I had felt quite fine, but as soon as I stepped out of the bus it was like my body finally erupted. I barely had time to reach a waste basket in a park before I started to vomit and found myself standing there doing that for the next 20 minutes. Quite painful, as I already after 5 minutes had nothing else to empty, but it would not stop despite that and I could not leave. When the attacks started to thin out some I managed to walk to the hotel, only to continue vomiting and spending the night in a miserable state continuing to vomit all I tried to drink or eat. On the good side, I had no chaffing despite the heat and was very happy with the Salomon S-Lab Sense Shorts in that respect. I had neither any blisters or pain in my Achilles tendons or calves and extremely satisfied with running this race in Salomon S-Lab Sense 4 Ultra shoes and Dry Max Trail Socks.

Was it worth it? Yes, the time when I jogged from Tête de l'Arolette to Col des Posettes, when I knew I was going to finish there, was actually one of my best “running” (my speed was really too slow to be called running) experiences. I could not have sunk deeper than I did physically and mentally during the previous climb and that probably made the experience so much stronger.

This view made it worth it and why I would recommend this race
Could I have avoided the DNF and the disastrous outcome of this race? I do not know, but probably my biggest mistake, mistake number 11, was done already long before I was standing on the starting line in that I had not accumulated enough running miles during the spring. I was probably in my best ever shape for 10 km, I had in a training run the weekend before the race, after a large dinner with coffee and cognac, fairly easy run 10 km in low 38, but that was probably not worth much for a race like this. I should have spent more time logging miles and doing hill repeats as previous seasons I guess. The only thing I regret is that I in the aftermath of the race got a strange pain in the upper part of my right calf – it came five days after the race and lasted for almost two weeks and it is just the last week I have been able to start running again. This prevented me from starting in Ice Trail Tarentaise, the race I most had wanted to run this year. If I do not regret the DNF in Mont Blanc 80 km, I certainly regret the DNS in ITT and mistake number 12 was to not plan my race schedule for the year better. I will now have to think carefully about what races to run during the rest of the summer.

25 June 2015

Back in Chamonix

I am back in Chamonix for this year’s first race – Mont Blanc 80 km. Feel quite unprepared for the start 4 am tomorrow morning, in five hours, as I flew in today. No drop-bag for this short race, which makes the bag quite full at least in the beginning of the run. The weather is great and looks to stay the same tomorrow – will be almost too warm down in the valleys I fear – and the course amazing. Testing some gear and will report later here.

Mont Blanc and Lac Leman viewed from the flight. Great summer weather.

The feet are prepared for tomorrow morning.

Too much gear for a day´s run


15 June 2015

I am a runner…

…and not a cyclist. And neither any longer a swimmer, somewhat to my surprise. And, I have clearly during the last few years focused on long endurance training for mountain ultramarathons and not shorter distances. So, afterwards, it is almost funny to think that I had quite high expectations before my first triathlon. Uppsala Triathlon was an Olympic distance competition, for those like me who until recently do not know what this is it is 1500 meters swimming, 40 kilometers cycling and 10 kilometers running. Certainly not Ironman distance, but a good beginners distance I thought. The race was in my backyard in central Uppsala where I live and perhaps that was what made me sign up for the race. Or perhaps it was the fact that my wife had tricked me into believing I was a better cyclist than I really am. 

Or perhaps it was the fact that I now in fact finally had a road racing bike for the first time in my life and during the past weeks put in some serious mileage in cycling that made me sign up for the race. If someone had said to me that; ”Hey, I have bagged some serious mileage and vert during the last few weeks and now I am ready for a mountain trail run” I would probably silently, but kindly, have laughed and given the advice to come back next year with at least months instead of weeks in the legs. And swimming; “Hey, I swam a lot in my youth, so I certainly know how to crawl and now I have been to the gym much lately so what could be the problem – I do not need to train at all”. “That it is open water swimming upstream in a freezing cold river? No problems, I just have to get a wetsuit”. What was I thinking?? Well, I guess I this weekend learned that I am still one of those boys who do not learn that the plate is hot until I have been burned. I also learned that my mantra of race specific training is even more true when talking about biking and swimming.


The swim has started. I am still over the surface, but not for long. Picture from UppsalaTriathlon Facebook page

So, starting with the good experiences:

·       The event was excellently organized and for a beginner it felt extremely safe all the time. There were plenty of volunteers out this early Sunday morning in rain and 12°C (53.5°F) to make sure in particular the road crossings were free from cars when cyclists arrived. The race was held in central Uppsala with a lot of logistics and I am really impressed by the organization – hats off!

·       My secret recipe of carbohydrate loading worked extremely well. The fundaments are, among other things like pre-loading gels, blueberry soup and peanut butter sandwiches, and despite cold weather and rain my stomach worked perfectly the whole race.

·       I have switched to liquid drinkable gels and when I in a race like this did not have to carry them over some mountain summits they were perfect. Together with the carbohydrate pre-loading and some sips of sports drink during the running I could not have been better fueled and I am happy my muscles did not complain either.

·       Biking is fun. I felt really strong going uphill and either passed or could keep the same pace as other, much better, cyclists, during the climbing sections. I also got gradually better, or more daring, during the steep downhill sections on the wet slippery asphalt and towards the end of the race during the last two laps out of five I was quite fast there as well. It is fun to go fast.

·       Not considering the swimming where it felt like I struggled to even stay over the surface of the water from my first stroke I am clearly more trained for longer distances as both the bike and cycling events felt way too short and I could have continued in the same pace for much longer.

·       I am a runner. Despite literally not feeling my feet for the first 3.5 kilometers of running as they had frozen cold during the previous events and despite feeling excruciating pain in my feet for 1.5 kilometers after that when the blood returned it felt really good to run. It felt like I was going slowly the whole run, but I passed numerous runners all the distance and looking at my watch I was at my target speed of 4 min/km most of the time. I was surprised it went so fast each time I looked at my watch as it felt that I was going much slower. I am therefore quite happy with my time of 41.50 as it really felt like I had been running conservatively and had much more to give, both in terms of speed and as it felt like I could have continued for at least twice the distance at this still very conservative speed. I had neither done any taper whatsoever for this race as my first “real” race of the season – Mont Blanc 80 km, is less than two weeks ahead.

But there were certainly some bad experiences:

·      The first time you swim in a wetsuit, ever, should never be in your first triathlon race, at least not on an Olympic distance swim of 1500 meters.

·       I do not know anything about wetsuits, but I would not recommend a quite thin wetsuit designed for swimrun when it is 14°C (57°F) in the water and 12°C (53.5°F) in the air. Looking around me at the start I noticed that all other athletes had long and thick suits and some even had extra clothes under and two swimming caps. I guess I was tricked by the word “swimrun” that was on the outside of the suit as it appealed to me as a runner. I also got it cheaply on sale two days before the race.

·       That you were a reasonably good swimmer 20 years ago does not mean that you are a good swimmer today, at least if you have not trained swimming at all during the past 20 years.

·       Training your upper body and core in a gym does not help you in the water.

·       It is different to swim in open water in the form of a dark cold river than in a 50 meter pool. I quickly realized this when looking down to try to orient myself and just saw murky water and occasionally, at least in the beginning of the swim, a foot from a competitor, and occasionally, in particular towards the end of the swim when I was really tired, some slimy water vegetation when I drifted off too close to the riverbank.

·       Surprisingly, despite being a river through central Uppsala, you appear to be able to drink the water of Fyrisån without getting sick as I inadvertently drank plenty of its water during my swim.

·       Your feet risk freezing after spending close to 40 minutes in cold water and, surprisingly, they will stay frozen during over one hour of biking.

·       A short triathlon is different from an ultrarun and it is not OK to spend over 4 minutes at the base station between the swim and bike section. You will never make up that time during 10 kilometers of running.

·       Having owned a road bike for three weeks does not make you a road cyclist – neither in terms of technique nor in terms of physique.

·       Unless you are in the leading group, in a triathlon lap race with 5 bike laps, and with a mix of competitors on different distances, you will never know your position and might be misled to think that you are going fast when you pass other cyclists, but in fact you are still going miserable slow. It is most likely the mind rather than the muscles or lungs that inhibit you.

·       Finally, I now know for sure that I regretfully are not, and newer will be, Peter Oom. Perhaps it is easier for a long-distance triathlete to become a really good ultrarunner than vice versa as it is more difficult to add sports to your training and skill set than focusing on one thing after being good in several sports. Whatever, if I had admired his accomplishments before I understand now even more fully that he is one of the best athletes in Sweden. At the age of 40.

Overall, my first triathlon was however a good experience and the best thing about it is that I have a very good starting position for improvement. It should come quite effortlessly I hope as I only need to swim once before my next race and I will have trained 100% more than I did before this race. Joking aside, will I try this again? Yes, probably, and I am still dreaming to sometime try one of the mountain triathlons like The Norseman, Swissman and Celtman. However, before even having such dreams I realize painfully now that I need to be a swimmer, again, and a cyclist, and not only a runner. And for now it still is so much more fun to run in the mountains than to swim in murky waters.

08 June 2015

Massage and foam rolling in mountain ultramarathon running

For an ultramarathon runner it is obvious that training is damaging for muscles, soft tissues and bones and that it is necessary to balance the training with the right amount of recovery in order to improve the muscle strength and endurance. This balance quite often, at least for me, feels like walking on a knife-edge or a very thin ridge and by just losing the balance a little bit you could end up with a more serious injury like a stress fracture, a muscle strain or a more severe inflammation in a particular tendon or soft tissue. On the other hand, too little training for a period of time is also risking to fall of the knife edge or ridge as it not only mean less improvement, but also that the risk of injury might increase when ramping up and trying to catch up the lost training later on.

The past month I have been on the wrong side of the edge as I have had problems with my left leg. It started with the usual ankle and Achilles tendon pain I have had repeatedly the past few years – nothing worrisome and even though I hesitated a little bit I took the decision to run two back-to-back 20 mile trail runs on a weekend in the beginning of May – the last of those two runs with Hokas with a slightly more drop than usual. As I often have experienced my Achilles pain actually disappeared after these runs, the first time this happened I was quite surprised, but now I have learnt that this certainly could happen. The following week, when I focused more on hill repeats combined with strength training in the gym and some quite long road bike rides with my wife, I instead started to feel a numbing and pain in my left hamstrings. As always, it was initially quite difficult to distinguish “real” pain caused by some kind of stress or injury from muscle soreness, but after a while I realized that this probably was something more serious. In the middle of all of this I, quite embarrassingly, sustained a fall with my new road bike as I was not used to the pedals and cleats – it is indeed amazing how much you could damage yourself just by falling of a standing bike and I can still two weeks after the accident show some quite impressive abrasions on my left arm and knee. I might also have landed on my left buttock as I had a bruise there as well. The following days I referred the pain I felt, in particular after downhill running, in my left hamstrings and gluteus also to this fall. However, the past few days the pain in the hamstrings has finally subsided, but I am instead now feeling quite intense pain in my left buttock. Not the best thing to experience when sitting on numerous flights as I have been doing the past week. A few days ago I tried a foam roll for the first time in my life with the guidance of my PT and I could clearly feel that I have some kind of trigger point in my gluteus. It is likely only a slight muscle strain and it felt much better after releasing by the massage by the foam roll. But, I think it still too early to rule out the possibility of a more serious injury like a bone bruise or a pelvic stress fracture. As I do not have an MRI machine in my living room I will continue to walk on the knife edge until the pain has subsided or gotten even worse and when that happens I am quite sure I will instead have pain somewhere else, perhaps in my knee – it was a long time since I had that now when thinking about it.



This was a long introduction to the topic I was going to write about and that is massage and foam rolling for mountain ultramarathon running. I have actually never been had a massage and I have not until now used a foam roll, so clearly I am probably personally biased against the benefits of these activities as I otherwise would have used them. The reason I decided to write about them anyway was that I read a new article about massage during Tor des Géants (TDG) and those who has followed my blog knows that I have covered all scientific articles written on this race since I ran it myself in 2013. The article actually covers the year when I ran and I remember being offered to receive massage as part of the study at the life base in Donnas close to halfway around the 330 km tour of the Aosta valley. The article entitled “Effect of massage on DOMS in ultramarathon runners: A pilot study” is written by Lorenzo Visconti and colleagues and is in press in Journal of Bodywork & Movement Therapies. In the study, a total of 231 patients (210 males and 21 females; >45% of subjects were between 40-50 years old) were enrolled and treated with a 20-minute massage in the area that the subjects were complaining of symptoms. The area where the symptoms were most common was, not surprisingly, the lower extremities, with 60% of subjects complaining of leg problems, 23% complaining of thigh problems and 8% complaining of knee problems. The most common symptom of the delayed onset muscle soreness (DOMS) in >95% of participants was pain. To measure the effect of the massage the participants scored the degree of perceived pain intensity before and after treatment on a numeric pain rating scale (NPRS) from 10 to 0. Another scale, called the Patient Global Impression of Change scale (PGIC), which has been used in previous studies on massage effect, was also administered. Not surprisingly, immediately following the massage the level of pain measured by both scales were significantly reduced. This decrease in NPRS averaged 3.6 points (Standard deviation 2.1) and there were no cases that showed an increase in the NPRS scale after treatment. The PGIC values also improved after massage with values greater than the “much improved” in 80% of cases and was unchanged following treatment in only one case.

All of this is of course fine and might on a first quick (really quick) glance support the use of massage, but regretfully, this is not telling us anything about either the efficacy or the safety of massage during a mountain ultramarathon as obviously this study has major flaws. First of all, the selection of participants is greatly biased as it was done based on symptoms and willingness to try massage for those symptoms. I would personally have done anything to relieve my muscle soreness at the lifebase in Donnas, but as I did not believe massage would help me more than a short while I elected not to receive it. Quite interestingly, but in line with all other placebo effect research, the belief in massage has been shown to influence the perception of benefits also in running (Moraska “Massage efficacy beliefs for muscle recovery from a running race” Int J Therap Massage Bodywork 2013; 6: 3-8). Secondly, the study did not use a comparison with subjects not receiving massage. Thirdly, the effect measurement was done by the same persons performing the treatment. Fourth, the effect was measured immediately after treatment and there is no indication whether the effect was sustained even after the next climb up to Refugio Coda. Fifth, the massage was given after long downhill section of the race which had been relatively fast and easy to run with some road sections so the muscle soreness was probably at its peak at this point. Sixth, no information is available on the use of NSAIDs or other pain relieving medications. Seventh, no information is available on the previous use and experience of massage. Eight, no objective measurement of DOMS such as biochemical or other laboratory parameters were used.  I could probably find even more flaws with the study, but will stop here. I am not too concerned by the author’s statements that the massage had some positive immediate effects on DOMS, but I am more disturbed by the fact that they are claiming that the massage was completely safe without following the outcome of the runners for the rest of the race.

The study is interesting as a pilot experiment, however, and shows that it would be possible to do a proper prospective randomized controlled scientific study during this long race with a large number of participants. It is also an interesting study as it discusses some of the current knowledge in the area. However, also in this aspect the study has some major flaws as it leaves out plenty of the negative studies indicating lack of effect of massage for DOMS and performance in association with running (for instance Dolgener & Morien “The effect of massage on lactate disappearance” J Strength Cond Res. 1993; 7:159-162; Dawson et al. “Evaluating the influence of massage on leg strength, swelling, and pain following a half-marathon” J Sports Sci Med. 2004; 3: 37-43). A good, but somewhat old, review article is Brummit “The role of massage in sports performance and rehabilitation: Current evidence and future dirction” North Am J Sports Phys Therapy 2008; 3: 7-21. More recent review articles about massage for DOMS are Nelson “Delayed onset muscle soreness: is massage effective” J Bodyw Mov Ther 2013; 17: 475-482; Torres et al “Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis” Phys Ther Sport 2012; 13: 101-114; Tejero-Fernandez et al “Immunological effects of massage after exercise; A systematic review” Phys Ther Sport 2015; 16: 187-192. I will not review all of this literature here, but just point out that 1) there exist to my knowledge no other studies of massage for ultramarathon running; and 2) that most of the studies of massage as a treatment for DOMS and for improvement of running performance has the same design flaws as the study by Visconti and colleagues and more and proper research is clearly needed.

In summary, the question whether massage and foam rolling is effective and safe in reducing muscle soreness and other issues in association with mountain ultramarathon running is still unanswered and open. However, personally, since I started to write this post it has passed some days and the pain in my left buttock is markedly improved so at least I will give foam rolling more of a try in the future now.

18 May 2015

Monday morning movie


 
The perfect short film to watch on the Monday morning commute on the way to a new work week. I found it on Fossil Alpinism, one of my absolute favorite blogs.

17 May 2015

Strength training for mountain ultramarathon runners and foot strike patterns

This spring I have spent considerable more time in the gym compared to past seasons. This is of course time I rather should have spent out on the trail running – I am sure that there are no shortcuts and to be good at running you need to run. Hence, I am rather skeptical to the more or less bold statements about the importance of strength training for runners and how you by attending some training classes with exercises to improve core strength and strength and flexibility of the muscles involved in shaping the running stride. So, when I started to add indoor strength and agility exercises in January it was more for laziness and time constraints – it was so much easier to go to the warm gym during lunch than to go out in the rainy and cold winter for a run. However, I quickly realized that the strength training at least did something as the muscle soreness I had in particular in the gluteal and adductor muscles after each training session was tremendous. Gradually, however, my strength has improved and I have now less and less soreness after each time at the gym. Importantly, I have not built muscle mass and gained weight, but the question is whether I have gained speed and endurance when running. One good thing I think is that I have varied the training and also complemented the running specific training with more general strength training, including training also for the upper body, with a personal trainer. In this experiment to include more strength training I think this is going to benefit running speed on more technical trails with some more challenging scrambling.

As I wrote in a blog post almost two years ago there are no good scientific studies of the efficacy of strength training programs for mountain ultramarathon running so my belief in variety in strength training is highly personal. My belief is also in opposition to most “running specific” strength programs, such as the “Runner’s Strength” program by Urban Tribes at SATS that I have attended, and the POSE method and Chi methods, both of which have become very popular in Sweden recently. These programs are all strong proponents of pure forefoot running and makes very bold claims of effectiveness not only in improving running ability over just a couple of months, but also in reducing injuries. Again, the scientific evidence behind the methods is in my opinion almost non-existent and a very good overview of the science behind the methodswas written four years ago by Dr Henderson at the Irunfar website. I do not know the current situation in the US and if these training methods are more or less popular today, but I am not surprised that something which at least was popular a couple of years ago in the US now has become increasingly popular in Sweden as there usually is a lag-time in when things spread here.  Since Henderson’s overview in 2011 no significant studies has been published about Pose running and only one study of Chi running by Goss and Gross showing what was already know that forefoot running may reduce vertical loading rates and knee extensor work, but instead may increase work of the ankle plantar flexors (Goss & Gross. A comparison of negative joint work and vertical ground reaction force loading rates in Chi runners and rearfoot-striking runners. J Orthop Sports Phys Ther. 2013; 43: 685-692). The balance between knee and ankle stress is something I personally have experienced over the past years as my long-standing knee pain abated when switching to shoes with a lower drop and more of a forefoot running technique, only to be replaced by Achilles tendon and lower calf pain. Not surprisingly, this spring I have experienced more pain from in particular my right Achilles tendon, most likely as a result of the running specific strength training as mentioned above mostly focusing on forefoot running.

But, has the strength training done something good? Obviously I think so as I have continued. Using the new gadget Garmin Fenix 3 in doing an analysis of my cadence, vertical oscillation and ground contact time my running stride has improved. Also, my muscle soreness after longer training runs is much less pronounced, rather surprisingly as there has been considerably less such runs this spring, and I therefore contribute it to the strength training. I still think I have much to improve, however, and it was quite humbling to run a very technical trail path, named a “wilderness path” with my 8-year old son Carl last weekend. Despite my attempts to convince him of the joy of running he is much more into downhill skiing during winter and soccer during summer and this was one of the first times we were running together. Obviously, it was entirely a fun run, but when racing downhill on stony and technical terrain Carl was much faster than me - he just flew down naturally without thinking about either having the ride stride, cadence or being afraid of falling. I am sure he had no thought whatsoever whether he was using a forefoot or rearfoot running stride.
 

Uphill slope section of one of my favorite trails. What foot strike pattern would you use? At least when it has rained at least I need to use both my hands here in scrambling up.

Part of the "Wilderness trail" I ran with my son. What foot strike pattern is best to use here? And in what frequency? This is clearly a section of the trail which looks quite strange afterwards when analyzing the run. The ground contact times are indeed quite long when hauling the raft over the water.
There have been several studies published in the last few years of the stride type and gait parameters of mountain ultramarathon runners and the theory that a natural stride is beneficial seem to at least have some support. A video-analysis of gait parameters at level ground was done by Kasmer, Wren and Hoffman of Western States 100 mile (161 km) mountain ultramarathon runners and found no correlation between a particular foot strike pattern and performance (Kasmer ME et al. Foot strike pattern and gait changes during a 161-km ultramarathon. J Strength Cond Res 2014; 28: 1343-50). Rear-foot strike (RFS) was most common used by 79.9, 89.0, and 83.9% of the runners tested at 16.5, 90.3, and 161.1 km, respectively. There was a significant decrease observed for stride rate and length over distance for the whole population, but not among the top 20 finishers who were able to maintain a stable stride rate and length. The top 20 finishers had also a greater use of a non-RFS pattern at 161.1 km than the remaining finishers. There was a trend toward greater post-race blood creatinine-kinase CK (a blood marker for muscle damage) values among non-RFS runners compared with RFS runners, reaching significance at the 90.3 km site (p < 0.05).

Western states is a comparable fast and flat ultramarathon with the biggest challenge compared to other mountain ultramarathons not the altitude difference and technicality of the terrain as I have discussed in a previousblog post. It is perhaps therefore not surprising that a similar analysis of stride and gait parameters of the 100 mile Ultra-Trail du Mont Blanc (UTMB) with more altitude difference yielded different results (Morin JB et al. Changes in running mechanics and spring-mass behavior induced by a mountain ultra-marathon race. J Biomech 2011; 44: 1104-7). In this study, running mechanics was analyzed in 18 male UTMB runners with a finishing time of 37.9 ± 6.2 h (range23.5-46 h) by running at 12 km/h over a 7 meter long electronic pressure walkway pre- and 3h postrace.  In this study, the stride rate was significantly increased post-race (5.9±5.5%), associated with a reduced aerial time and no change in ground contact time. Overall, the results show that 3h post-UTMB, subjects ran with a reduced vertical oscillation associated with an overall lower impact during the braking phase of each step, perhaps as this smoother running pattern might be caused by the need to attenuate painful eccentric (braking) at each step. An analysis of gait parameters following the 65 km long Vigolana Mountain ultramarathon in Italy with a high altitude difference also showed a significant increase in the stride rate post-race, as I noted in my last blog post (Vernillo G et al Energy cost and kinematics of level, uphill and downhill running: fatigue-induced changes after a mountain ultramarathon. J Sports Sci 2015; 9: 1-8 Epub ahead of print). Also a shorter 5-hour hilly running bout induced an increase in stride rate and similar other gait changes, but in a lower amplitude, as in the studies by Morin and Vernillo and colleagues (Degache F et al. Changes in running mechanics and spring-mass behavior induced by a 5-hour hilly running bout. J Sports Sci. 2013; 31: 299-304).

A very recently published, but already very much quoted, study of foot strike pattern analyzed Kilian Jornet’s technique during the 2013 Kilian’s Classik 45-km mountain ultramarathon with 1627 meters D+ (Giandolini M et al. Foot strike pattern and impact continuous measurements during a trail running race: proof of concept in a world-class athlete. Footwear Sci 2015; E-pub ahead of print). One good summary of the article was written by Alex Hutchinson in Runner’s World and we are both fascinated by the possibilities of the new technique using wireless accelerometers to measure the foot strike pattern in real time and to link the findings to synchronized measurements of the environment by a GPS. Unfortunately, in the experiment on Kilian the battery to the GPS died mid-race so only data from the first 20 km, which were predominantly uphill resulting in an average speed of 10.9 km/h by Kilian, could be used. A total of 5530 steps were analyzed  with ~18% of the steps rear-foot strike (RFS), ~33%  mid-foot strike (MFS) and ~49% fore-foot strike (FFS) (see figure below).
 

From Giandolini et al 2015. Foot strike pattern of Kilian Jornet at the first 20 km of Kilian's Classic 2013. Altitude (black line) and speed (grey line). Bar charts represent the repartition of foot strikes (RFS, MFS and FFS) within eleven analysed sections

 
The stride frequency was correlated to slope and speed. The RFS pattern increased towards the end of the first 20 km, perhaps due to increased strain of the calf muscles in running uphill with a FFS. Still, the frequency of RFS was low compared to the studies referenced above. Another interesting finding was that the anterior-posterior and resultant components of tibial acceleration appeared important for impact magnitude and stress, much in line with the changes in postural control in the anterior-posterior plane following the longer ultramarathon Tor des Geants (TDG) as I have written about before in another blog post (Degache F et al. Alterations in postural control during the world's most challenging mountain ultra-marathon. PLoS One 2014; 9: e84554. doi: 10.1371). In summary, Kilian appears to be able to adapt his running stride to both extrinsic (e.g. slope, surface) and intrinsic (e.g. fatigue, pain) factors and that it might be this adaptability which partly creates his advantage. This is far from the strict adherence to a certain stride pattern and encourages me to continue to make sure I have variety in both my strength and running training.

30 April 2015

The importance of downhill training for mountain ultramarathon trail running

Winter has passed since my last post and spring here in Sweden has finally arrived after a long period of “in between” the seasons. The winter was unusually mild, but I anyway managed to get over 30 downhill ski days together with my family, much due to the fact that my 8-year old son is very much into downhill ski racing and we went to training camps both in Sweden and the Alps. Skiing, together with functional strength training as I have switched gym and started taking lessons from a great personal trainer approximately once a week, have made me more fit overall than during several years. It was a humbling and painful journey to start to rebuild some of my core strength after several years neglect, although also very fun and I will write more about this later on here. I have managed to build my core without gaining too much weight and loosing running speed, which is great, and I think the new strength will be important for the more technical skyrunning races I am planning this year. The worrisome thing is that I have not logged nearly enough running miles in my legs due to my new job where I now commute to office by train and not by running any longer, but also travel very frequently. I am just recovering from a late season bout of the flu and running for in a very flat Rotterdam earlier this week was indeed humbling. But, still, it feels reasonably good and I have at least logged a lot of vertical meters up and downhill as one of my most common training runs now consists of nightly laps up and down the castle hill in Uppsala.

Writing this I do not know exactly why I have taken this long break in blogging. Partly I guess it has to do with the fact that I had run out of subjects to write about for a while. Looking at what I want to write about now, however, where a number of subjects are in line to be covered, I realize it cannot be the main reason. I guess sometimes you have to just take a break to become motivated again. Also, switching work has forced me to rethink my priorities and I guess most running parents with demanding jobs can relate to the difficulties in getting the right balance in their lives. I view the lack of blog posts in the past months as a clear sign that I did not get this balance right, not only for my blogging of course, but also for life in general. Anyway, this is the first post again of many. I thought it best to start easy, however, and the first topic is going to be one of my favorite ones, and something I have previously written about in for instance this post – the importance of training downhill running when preparing for mountain ultratrail running.

This winter I read with interest a new article about the subject by Vernillo and colleagues from the universities in Milan, Verona and Bologna in Italy entitled “Energy cost and kinematics of level, uphill and downhill running: fatigue-induced changes after a mountain ultramarathon” published in Journal of Sport Sciences.
 
 
In this study, they analyze whether the fatigue induced by the Vigolana Trail mountain ultramarathon (MUM) in Trento in Italy in July 2014 led to changes in energy cost and kinematic during level and graded running in 14 healthy male runners. The Vigolana Trail course is taking place at an altitude of 725 to 2100 meters and is 65 km with a total positive elevation of 4000 meters (D+/km = 61.5). The runners were all experienced with, on average, 11 ± 4 years of training in running and 4 ± 2 years of ultra-endurance experience. Their pre-race training consisted of 3–4 weekly sessions in which they ran for 8.0 ± 5.0 h/week and 58.5 ± 28.0 km/week. The experiment in the study consisted of a pre-and a post-race analysis of the energy cost of running (Cr) of running at a speed of 10 km/h for 5 minutes each at a level, moderately uphill inclined (+5%) or a moderately downhill inclined (-5%) motorized treadmill. Kinematics and spatiotemporal gait parameters were also measured using a photocell system. The runners performed the pre-race experiment the week before the race and the post-race experiment within 5 minutes of finishing the race. 

The time of the winner of the race was 6 h 40 min 07 s and the average time of the study participants was 9 h 45 min 41 s (range, 6 h 58 min 34 s to 14 h 12 min 32 s). Body mass decreased by 3.8% during the race and, as expected, the respiratory exchange ratio (RER), measured using the gross VO2 and VCO2 during steady state in the last minute of 5-minute running condition, decreased significantly. This corroborates previous studies on ultrarunning events where RER decreased by 15.6%, 11% and 7.3% between pre and post 24-h treadmill exercise (Gimenez et al 2013), a simulated 60-km ultramarathon (Schena et al 2014) and a 65-km MUM (2500 m D+) (Millet et al 2000), respectively. It is in contrast to findings in the extreme ultrarunning event Tor des Géants, where the same authors found that RER did not change, likely because of the multistage nature of the competition in which the runners were allowed adequate energy intake throughout the race, thus maintaining the efficiency of so called ATP aerobic resynthesis without having to completely switch substrate utilization from carbohydrates to fat as the glycogen stores never become so depleted (Vernillo et a 2013). However, the main finding in the study was that the energy cost of running (Cr) only increased, by a significant 13.1%, in the downhill condition and not after level or uphill running. Another major finding was that albeit there were no statistical changes in the total group, the individual changes in Cr in uphill and level running seemed to correlate well with running performance time with the slower runners having the largest changes. Altogether the authors interpret these results as supporting evidence for a role of Cr as a determinant for ultra-longdistance running performance.

Not surprisingly, the runners of the Vigolana Trail MUM had biomechanical changes in their running gait immediately after the race. Duty factor and stride frequency increased, whereas swing time, cycle time and stride length were significantly decreased in all conditions. Contact time was increased and the rate of force generation was decreased only in the uphill and downhill conditions. Interestingly, the stride frequency was increased only in the downhill running, probably indicating the highest muscle fatigue and thus at least partly explaining the highest increase in the energy cost of running (Cr) in this condition.

There are of course limitations of the study and the authors discuss them also in the paper. Firstly, running on a motorized treadmill is never going to measure the same gait as overground running in particular over more technical terrain outside. Secondly, the low gradient of the uphill and downhill running clearly does not reflect conditions when crossing most slopes during trail MUMs and the authors explain this as a compromise to be able to achieve metabolic steady state in a fatigued state after the race and to not force the participants to switch locomotion from running to walking. Lastly, as all studies of this nature the number of participants were rather small and perhaps not representative of other groups of MUM runners. Nevertheless, I clearly think the study enough generalizable to support the authors final conclusion that their data “show the importance of incorporating downhill locomotion in the training programmes of ultratrail runners to improve the various physiological and biomechanical parameters relevant to ultraendurance performance”.   

29 December 2014

Ridge running

We got a white Christmas in Uppsala after all and the past days have been absolutely stunning with snow and temperatures down to - 20°C (- 4°F). The time between Christmas and New Year is a time for reflection – reminiscence of the year past and envisioning of the year to come.  For me 2014 was a great running year with everything focused on Petite Trotte à Léon (PTL) in August. Both the training and planning before the race were great and, even though there of course are things I would change now knowing how the race went, I think I was as prepared as I could be. The race itself was an experience of a lifetime, as I have written in a previous blog post, and I am immensely grateful to have done it together with Otto Elmgart. Otto is still writing a story, in Swedish, about our long voyage around Mont Blanc, and it is very interesting and educating to relive the race through the eyes of a friend and fellow runner. As with Tor des Geants in 2013, there is not a single day when I do not think about the race. The initial nightmares I had of the bad moments have gradually transformed into good dreams about the challenging moments in the beautiful mountains. I recently got the courage to look through the photo material from PTL again. My skills as a photographer are regretfully indeed limited, but I at least attempted to clip together a short movie of ridge running when we after around 48 hours in the race passed the ridge to Pointe de Chaligne above Aosta in the Aosta Valley in Italy and when we the last evening after 120 hours ran along the beautiful ridge of Mont Jolly (see maps below). The runner in front of me in a yellow jacket is Otto. It is moments like those that make nightly runs in mid-winter freezing temperatures so much easier.
 
 
 
The ridge to Pointe de Chaligne

The ridge to Mont Joly
 

18 December 2014

Snowfall, running, skiing & mountains

This morning we had the first real snowfall of the year in Uppsala. Regretfully, the snow will likely disappear to Christmas as it is going to be warmer and rain already tomorrow. Until then I am really enjoying the shining bright light from the white ground – it has been incredibly dark without snow the past two months. I also very much prefer to run in snow rather than in slippery icy and freezing water as I have been doing during many runs the past weeks. It is not only the traction that is better; there is something about the softness of snow for the feet that is very pleasant. I have previously written about running in snow and sand from a physiological perspective, and even though there are no direct studies on running on snow specifically, I am convinced that it is a good training form just as running on sand. And, it is indeed quite fun, at least during the early winter season when the snow is new.

The first real snow of the season in Uppsala
There are no mountains in Uppsala and when I am in more mountainous terrain, as the coming weekend, I rather ski or go on snowshoes on snow. It is definitively more efficient and also more fun. It is however clearly different and it is interesting to see how much the biomechanics of walking with snowshoes differ from normal overground walking at a similar speed (Browning et al “Biomechanics of walking with snowshoes” Sports Biomech 2012; 11: 73-84). It is more energy demanding with a higher metabolic rate to walk/run on snowshoes, probably as the snowshoeing gait is characterized by a more flexed posture during stance and a greater degree of plantarflexion during swing. This ‘shuffling’ gait suggests foot position is controlled during this novel task and likely contributes to the increased metabolic rate.

Needless to say, also ski mountaineering (Skimo) has a very different biomechanics than walking or running (see for instance Tosi et al “The energy cost of ski mountaineering: effects of speed and ankle loading” J Sports Med Phys Fitness 2009; 49: 25-9; Tosi et al “Energy cost and efficiency of ski mountaineering. A laboratory study” J Sports Med Phys Fitness. 2010; 50:400-6; Duc et al “Physiology of ski mountaineering racing” Int J Sports Med 2011; 32: 856-63; Haselbacher  et al “Effect of ski mountaineering track on foot sole loading pattern” Wilderness Environ Med 2014; 25: 335-9). If snowshoeing is strenuous, ski mountaineering is extremely demanding and requires extremely high energy demands, which sometimes are difficult to fulfill as shown in a new interesting study of athletes competing in the Patrouille des Glaciers racecourses (Praz et al “Energy expenditure of extreme competitive mountaineering skiing” Eur J Appl Physiol 2014; 114: 2201-11). From a physiological perspective I can understand why mountain ultra trail runners such as Kilian Jornet and Emelie Forsberg appear to thrive and benefit so much from ski mountaineering during large parts of the year – it is simply one of the best endurance training forms there is.

Ski mountaineering also makes the middle and high mountains accessible not only during some short summer months, but for a much larger part of the year. I have become more and more interested in spending more time in the mountains also during the winter, and then not only in the pisted slopes but also backcountry, but my problem up until now has been my rather limited technical ski proficiency. While I virtually grew up with running shoes on my feet, it is not until a couple of years ago when I started with downhill skiing. I have greatly benefited from having a son who became interested in downhill skiing already when he was two years old and who now when he is eight is training and racing in alpine skiing (his favorite discipline is super-G), so I am spending a lot of time in the mountains now also during winter with my family, and this season I am hopefully good enough to at least start to train ski mountaineering. In contrast to running it is however a quite expensive sport in that there is so much more equipment needed – leaving the pisted slopes there will be a need of for instance different skis and ski boots and avalanche safety equipment. The latter is something essential as the objective dangers in the mountains during winter is so much higher than during the summer – if there is less than five runners dying each year on summer trails in the world there are over 150 people dying in avalanches in North America and Europe each year (a good recent review about avalanches and evidence-based guidelines about treatment is Brugger et al “Resuscitation of avalanche victims: Evidence-based guidelines of the international commission for mountain emergency medicine (ICAR MEDCOM). Intended for physicians and other advanced life support personnel” Resuscitation 2013; 84: 539-546). However, I am convinced that as with summer mountain trail running the risks can certainly be reduced greatly by proper training and preparations and it will be really fun to start doing this.
 
And, lastly, the mountains are almost more beautiful with snow – I just love the movie "The Ridge" below by Anson Fogel for Camp4 Collective  It was filmed in the Denalin National Park on June 25, utilizing Brain Farm Digital Cinema’s Cineflex technology. Completely amazing.