Run for Your Life

by Mark Cucuzzella

  It’s simple: after you have worked out comfortably—avoiding exhaustion and cooling down slowly—you are set up for optimal recovery. No need to do anything more. But remember: if you return to the chair immediately after a workout, you’ll sabotage the range of motion that just nourished your body. Your muscles and joints and fascia will cool down and “set” in that sitting position, and you’ll have to start over the next day. This is similar to spending good time and money on massage or deep tissue work to alleviate positional pain and tightness—then immediately resuming the damaging posture that necessitated the treatment. I witness this daily.

  MINIMALIST GOLF? (NO, NOT MINIATURE GOLF.)

  Many runners are also golfers, and golf qualifies as a type of full body movement—when done “old school.” One of my mentors, Dr. Phil Maffetone, wrote a book called The Healthy Golfer, which doesn’t prescribe the best grip for your club nor demonstrate the correct swing plane. Instead, it shows you how to lower your score by becoming the healthy, flexible, focused, and relaxed person that the sport demands. As with running, a good golf game requires listening to and caring for your body. Maffetone starts by encouraging golfers to wear shoes with flat, flexible, spikeless soles, and to go barefoot during the day and eat the right foods.

  Part of my early aerobic base for running was built on golf. During the summers, beginning at age eleven, I walked eighteen (or more) holes of golf each day with my brothers at our local course. Our golf shoes were Keds and Converse sneakers, and the bag I carried weighed almost as much as I did. We couldn’t afford to lose golf balls, and routinely climbed across rocky terrain and forded creeks to retrieve them. We never took lessons, and played with blade clubs—old wooden and steel clubs with tiny sweet spots. As a result, we developed natural swings. Now golfers rely on oversized titanium clubs like the Big Bertha driver, and often don’t get the full feel of the ball and club.

  My wife, Roberta, and I continue to play, and when in Colorado we found a little-known course called Perry Park that is tucked into the red rocks of Colorado. Walking is encouraged there, and we were allowed to bring our dog. Eighteen holes took us three hours, and we finished more refreshed than when we set out. The grounds crew even allowed us to go on morning runs.

  Later, we experienced golf at its purest on a trip to Ireland. The terrain was impassable for a cart, and the elderly caddies were the healthiest and strongest seniors I have met. Most courses in the United States now require that golfers ride carts. Walking is prohibited! I tried a cart once, and found that in addition to feeling lethargic, I couldn’t concentrate on my form or the game. I’m a minimalist golfer, and love it that way. I carry six clubs, each more than twenty-five years old, and still play a decent game. My favorite “golf” shoes are FiveFingers or running sandals. Our local course in West Virginia still encourages walking, and they allow me to run there during the early morning hours, too.

  My father-in-law is in his nineties, and he walks the course (with four clubs). A few years ago, a group of young players in carts came upon him.

  “How old are you?” one young man asked.

  “Ninety,” he replied.

  “Wow. I hope I can still get out on the course when I’m ninety,” the young man said.

  “Then get out of the cart,” my father-in-law responded.

  Golf can be a source of health and fitness for anyone. But the modern version of it—the electric carts, stiff shoes with spikes, and heavy bags with too many clubs—robs golfers of the experience of mastering the game from the ground up. In golf, as in running, the feet and their connection to the earth greatly affect what happens to the rest of the body, and how you perform.

  DRILLS

  The drills here are all about expanding mobility and range of motion. Each of these movements should leave you feeling refreshed and ready to go again the next day, not sore and unable to move. The quality of your movement is more important than how much weight you lift or how fast you perform a task or a drill. Three years from now, no one will care how well you performed in today’s workout, but injuring yourself is an event you’ll likely remember.

  Whether you are a competitor or exercising for fun and fitness, train the pattern, not the part. The brain and nervous system do not recognize individual muscles; they recognize patterns of movement.

  Exercise snacks between meals

  “Exercise snacks” can help break up the day and get the blood flowing. I spend much of my hospital workday walking. Between patients, I often stretch and do gentle lunges and trunk twists. If you work in an office, exercise snacks such as these will keep you healthy and flexible. You can stand while chatting with a colleague or student, and phone conversations offer more opportunities to stretch and move.

  When working from home, interrupt your day by going outside and completing chores, especially those that demand some physical effort. When you return to your desk (preferably a stand-up variety), you are physically and mentally refreshed, and noticeably more productive.

  In the following drills, we are going to work on movements, not muscles, and progress from very simple to more complex. You need not do all of these, but they can populate the menu that you select from, depending on the level of challenge you desire, and how it fits in your day.

  Let’s start with some mobility assessments.

  Ankle mobility assessment

  Place your right foot forward with your toes about four inches from a wall. With heels on the floor, try to bring your knee to the wall. Switch and assess the other side.

  Hip extension assessment

  Lie flat on a table and hug your knee (as your other leg hangs over the end of the table). When you hug your knee, does the other thigh elevate off the table? Assess both sides.

  Quad length test (affecting hip mobility)

  While lying prone (on your belly), bend the knee of one leg and bring your heel to your butt. Assess both sides.

  Prone

  Upright

  Range-of-motion drills

  Six-position foot walk

  This simple exercise snack works the small muscles of your feet and ankles, and assists with balance and foot strength. Barefoot, preferably, walk in the following manner whenever you can (for instance, when walking the dog), initially for short distances. Walk:

  On the outsides of your feet (inversion).

  On the insides of your feet (eversion).

  Toes pointing outward (Charlie Chaplin style).

  Toes pointing inward (pigeon-toed).

  On the balls of your feet, backward.

  On your heels (you may need shoes, if not barefoot adapted).

  The squat—rediscovering one of the most basic positions

  Kids squat naturally and easily. Adults typically say, “I’m not built like a child anymore, and can’t get into that position.” It’s true that your body geometry is different, but to reclaim your flexibility and mobility, you still need to be able to squat.

  The prime movers in squatting are the muscles around the hips and knees, but all joints below the belly button (hip, knee, ankle, foot) and most of the spine need stability and mobility for a proper squat.

  Looks perfect! Just do your best to rediscover this.

  Align your feet comfortably under your hips (or slightly wider). Then move directly to a full squat. As you do so, try to maintain a good, flexible posture, with your:

  Head and thoracic spine upright.

  Lumbar spine neutral, not hyperextended.

  Arms in front and shoulder blades “tucked.” (Think of putting your shoulder blades into your back pockets.)

  Hips mobile, sitting back as if tapping a chair behind you with your glutes (but not sitting).

  Knees tracking directly over the toes. Use a resistanc
e band around the knees, and apply outward pressure.

  Shins close to perpendicular to the ground. (Your knees shouldn’t extend over your toes.)

  Weight on your heels, and heels remaining on the ground.

  Which does your squat look like? Aim for the picture on the left.

  Progress to a deep squat (“ass to grass,” as they say). If your heels come off the ground, place a book or two under the heels and work on gradually removing them. This will help the mobility of the ankle. Vary the foot position. The goal is to hang out comfortably in a deep squat for a few minutes. But if you have any discomfort, restriction, or tightness in the knees, stop when your thighs are perpendicular to the ground. It may take time to work into a full squat.

  or load yourself with a kettlebell, in an exercise called the goblet squat.

  The wall squat

  To further assess the mobility of the thoracic spine, stand with your toes close to the wall (or, ideally, right up to it). Raise your arms high overhead, and try to drop down into your basic squat. Can you get your thighs to a level parallel with the ground? Can you drop your bottom all the way down? Do this routine especially if your upper back is restricting you.

  By working on upper body, hip, and ankle mobility, you’ll be able to do a wall squat.

  Floor sitting

  We should all be exploring the ground whenever we can. We can do this (without spending extra time in our day) by sitting on the floor. Here are five floor-sitting positions, in addition to the deep squat, that will greatly boost your flexibility and range of motion:

  Kneeling. Lost from most Western cultures, this requires quad and ankle mobility. Use a pad for your butt and knees if you’re uncomfortable. As an interim measure, try kneeling on one leg while doing some of your work. This will build hip and core stability.

  Long sitting. Sit with both legs extended, straight out. This builds hamstring mobility. Tuck one leg in for variation.

  Cross-legged, or “Indian style.” Tight IT bands and piriformis will cause the knees to elevate. Work to keep the knees lower. As a variation, place the soles of your feet together.

  Side sitting. Place one leg in internal rotation and the other in external rotation. Change sides, and assess tightness and symmetry. This can be challenging.

  Upper body mobility

  T-spine foam roll

  Move into these positions slowly, with diaphragm breathing, to open up your thoracic spine.

  Move slowly up and down each segment, while deep breathing.

  Move shoulders and arms as if making a snow angel

  Supple hips

  The windshield wiper progression

  This exercise generates good internal and external rotation of the hips, with glute firing and hip extension. It’s especially good for golfers, who need at least 25 degrees of internal rotation of the lead hip on the backswing, and the same on the other hip on follow-through. (The average PGA golfer has 45 degrees of internal rotation.) If you don’t have this range, you’ll end up compensating elsewhere in the kinetic chain.

  Lie on the floor, with back flat, arms stretched straight out, knees bent at 90 degrees, and heels on the floor.

  In a slow, smooth motion, sweep your knees back and forth, to the right and then to the left, in a windshield wiper motion. Keep your shoulder blades on the floor, with arms extended. Repeat ten to fifteen times.

  Heel raises

  Foot control is essential to running, and helpful in all activities. Simply balance on one foot, raise up on the ball, and finish by loading weight onto the big toe and rotating the lower leg slightly toward the big toe (to get maximum plantar flexion). This is the full range of motion employed when walking and running correctly. Slowly lower yourself, with control, to the start position. If you can, knock off fifty to one hundred of these on each foot daily. Progress from the ground to lowering from a step.

  Single-leg sit-to-stand

  This simple and revealing exercise can be done while sitting in your office chair:

  Sit on the chair with your feet flat on the ground.

  Select one leg, and elevate slowly on that leg, with arms extended overhead. Pause on the ball of the foot, then lower yourself slowly, in a controlled manner. Don’t let your knee collapse inward.

  Single-leg hop

  Another simple (but somewhat challenging) stability drill is to simply hop on one foot ten times. If you’re unable to do this without pain, or are wobbly, return to the single-leg sit drill above, and progress to this.

  Fire hydrants

  This move assists hip mobility and strength in both extension and abduction, which are essential for running. On all fours, elevate and extend one leg, and draw large circles with it, clockwise, then counterclockwise. For an additional challenge, extend the opposite arm directly forward into the “bird dog” pose.

  There are three tests of hip, glute, and core stability. Hold each of these positions for one minute:

  Bridge single leg

  Lying on your back, tuck one knee to the chest and tighten the glutes. Then “bridge” (elevate) your core upward.

  Plank

  Lie prone on a mat or the floor. Place your forearms on the mat, elbows under shoulders. Place the legs together. Elevate your body into a straight line. Hold for thirty to sixty seconds.

  Side plank

  Lie on your side on a mat or the floor. Place your forearm on the mat, perpendicular to the body. Place the upper leg on top of the lower leg and straighten your knees and hips. Raise your body up until it is rigid. Hold for thirty to sixty seconds. Repeat on the opposite side.

  Video assistance

  My colleague Jay Dicharry and I demonstrate some excellent assessments and corrections for improving range of motion and stability in “Are You Ready to Go Minimal? 3 Self-assessment tests with Jay Dicharry,” on the videos page of runfo­ryourli­febook.com.

  Once you have progressed by mixing these movements into your day, the final exercise is the Turkish Getup, which incorporates nearly all of the preceding exercises. This sequence (see the video by this name) will help you visually piece together this timeless exercise.

  Turkish Getup up move

  Reverse to slowly go down

  CHAPTER 9

  Eating to Go the Distance: Nutrition and Health

  People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.

  —WENDELL BERRY, author and sixth-generation Kentucky farmer

  MYTH: Eating fat makes you fat.

  FACT: Sugars, processed carbohydrates, and a “low-fat” diet can lead to bonking, inflammation, and weight gain. Healthy fat, by contrast, provides long-term stamina and health, curtails hunger, and aids in weight loss.

  By now, your running form has improved, you have better footwear, and you’re on the path to building your endurance engine. In order to maintain and optimize that engine and boost performance, it’s time to check on the quality (and quantity) of your fuel. You might even want to consider a fuel upgrade.

  We’ll explore the specific implications for our diet in the next chapter, but first let’s take a look at what happens when food enters our bodies and begins its long and complicated transformation into fuel, body fat, waste products, and sometimes even forward movement.

  The units of energy that power us are commonly measured in calories. The conventional wisdom of “energy balance” says that if calories in equal calories out, then your body weight remains stable.

  But this deduction is flawed. Clearly, it takes more energy to maintain vigorous work than to rest or to sleep. But not all calories going in are identical, nor are all of those consumed calories digested,
stored, or drawn upon for combustion in the same way. And food has an annoying tendency to morph and migrate to unexpected places, and park itself where we don’t want it.

  OVEREATING AND UNDERNOURISHED

  Part of the problem is that our food isn’t delivering the nutrition that we really need.

  In medical school, I believed (as many doctors still do) that a high-carbohydrate, low-fat diet was essential for athletic performance and health, and that exercise was the key to weight control. That’s what we were taught, and what the world believed. Like other young, near-tireless athletes, I began each day with a huge bowl of cereal and skim milk for breakfast, an energy bar or bread for a morning snack, and more carbs for lunch. After meetings, I hoarded any energy bars or muffins left behind on the conference table. Then I gobbled up a pound of spaghetti for dinner, devoured more cereal before bed, and awoke at two in the morning for an expedition to the kitchen to eat more cereal.