THE RUNNING SHOE Why a Special Shoe?

A special running shoe is essential for anyone who is going to run long distances. The proper shoe will provide cushioning for the foot and leg, and support to the feet. SNEAKERS WILL NOT DO!

Every sport places a different type of stress on the foot and leg. The proper shoe for another sport is inappropriate for running, just as a running shoe should not be used when participating in other sports. For example, tennis shoes and basketball sneakers are inadequate for running because they offer no cushioning for support. In contrast, wearing running shoes for other sports may lead to an increased risk of ankle sprain.

Each foot of the runner hits the ground at an estimated 800 times during every mile of running. The forces generated are about five times the body weight and must be absorbed and distributed evenly, enabling the runner to continue without putting undue stress on any one area of the body. The proper shoe assists the body's shock absorption and distribution mechanisms.

What Should The Proper Shoe Look Like?

The proper shoe should feel slightly spongy when the runner walks on a hard surface. The shoe should bend easily in the area of the ball of the foot. To avoid excess twisting of the foot, the shoe must have a firm heel counter, a wide heel (approximately 21/2"), and a slightly raised support under the arch. A heel lift of about 3/4" should be present in order to allow the runner to maintain good posture.

The shoe laces should only be drawn firmly about the instep, NOT across the forefoot. Sometimes, it may be necessary to use two sets of laces. The set for the forefoot is left loose, and the set for the instep area is firmly laced.

The type of sole on the shoe is relatively unimportant to most beginning and intermediate runners. The waffle bottom has become the fad, but there are numerous shoes available with assorted tread designs. These designs attract the eye but do not enhance running. The life of a shoe is accepted to be approximately 400-600 miles. Try to avoid holding onto a "favorite pair" for too long as the padding will become less absorbent of impact as the shoe wears out.

STRESS TESTING

Stress testing is "in" these days, and it's a good thing. Any previously sedentary prospective exerciser over 35 should have a thorough check-up before beginning an exercise program.

At NISMAT, this evaluation is unique because it includes not only a graded exercise stress test with oxygen consumption measurement, but also a blood analysis and an orthopedic examination.

Before the Test

Before coming to the Institute, you will be expected to complete a medical and orthopedic history about your health and activities. You will need to bring:

• a list of physical activities you want to pursue, how often and for how long; - any old ECG's or chest X-rays you can obtain; - appropriate clothes for an exercise workout.

If you are interested in this type of testing, call NISMAT at (212) 434-2700.

NEW RUNNER'S TRAINING PROGRAM

It would be irresponsible to decide "Okay, I'm going to be a runner" and just head for Central Park at top speed. There are four prerequisites to a successful running program: good health, a commitment to run, additional exercises, and a training program which will help you get into shape gradually.

1. GOOD HEALTH People who are physically active one or more times a week and do not suffer from a chronic medical condition, such as high blood pressure or heart disease, can begin a training program. However, if you are over 35 and have been sedentary for a few years, a physician's examination and a stress test are recommended. While the stress test is not an exclusive indicator of a healthy heart, it will highlight some serious heart problems which might modify a running program. Also, an orthopedic exam may reveal problem areas before they arise.
2. COMMITMENT TO RUN If you are going to run, you should do it regularly, at least 3 days a week, on an alternate day basis. 'Mat's why it's best to schedule a specific time each day for running. Make it a normal activity of your everyday life. Initiate a running program slowly over several weeks.
3. ADDITIONAL EXERCISES Strengthening and stretching exercises are important to prevent injury and help increase your ability to run. Stretching should be done daily, and strengthening exercises every other day.
4. RUNNING FOR YOUR HEART To produce an optimal conditioning effect on the heart, your exercise must bring your heart to 50% to 85% of your maximum heart rate. To calculate your maximum heart rate: subtract your age from 220; multiply the result first by .75, then by .85. The result is the heart rate range which should be maintained while exercising. Here's how it would work out for a 30-year-old:

1. - 30 = 190 (predicted maximum heart range) .50 x 190 = 95 (low end of range) .85 x 190 = 162 (high end of range)

   This runner's heart rate should range between 95 and 162.

   More precise target ranges are possible following oxygen consumption testing. To produce a training effect, you must function at 50% to 85% of the maximum heart rate at least three times a week, preferably on alternate days, for 30-45 minutes each day. Exercise prescription is best determined by performing a stress test such as the one provided by NISMAT. This type of test helps identify the zone of effort you are most likely to derive benefit from.

   PRELIMINARY TRAINING PROGRAM

   Below is a preliminary progressive training program. Upon completion of the first day at stage one, immediately count your pulse. If your pulse is below the heart rate at which you should be functioning, go to step two the next time you train. Continue "stepping up," if needed, until you find the correct stage to produce the desired heart rate. Then, progress in the time intervals indicated.

   PACE WEEKS

   1. Walk 30 min/mile x 20 min. =.67 miles 2 2. Walk 20 min/mile x 20 min. = I mi. 2 3. Walk 15 min/mile x 20 min. = 1.33 mi. 2 4. Alternately walk 50 steps, jog 50 steps x 20 min. = 1.40 mi. 2 5. Alternately walk 50 steps, jog 100 steps x 20 min. = 1.48 mi. 2 6. Alternately walk 50 steps, jog 200 steps x 20 min. = 1.57 mi. 2

   PROGRESSIVE TRAINING

Once you reach this level, you must always do stretching exercises before and after the workout. Do NOT progress more rapidly than what is indicated.

RUNNING PACE TIME DISTANCE WEEK

1. 12.0 min/mi. x 20 min 1.67 mi. 3 8. 11.5 20 1.74 2 9. 11.0 20 1.82 2 10. 12.0 25 2.08 2 11. 11.5 25 2.17 2 12. 11.0 25 2.27 2 13. 10.5 25 2.38 2 14. 10.0 25 2.50 2 15. 9.5 25 2.63 2 16. 8.5 25 2.94 3 17. 9.0 30 3.33 2 18. 8.5 30 3.53 2 19. 8.0 35 4.37 3 20. 8.0 40 5.00 3 21. 7.5 35 4.67 3 22. 7.5 40 5.33

Level 22 is a maintenance level. However, some people may not be able to exceed the pace of level 17. If this is your situation, just add time to your running session. If two or more days of running are missed consecutively, go back to the previous level for at least one week.

TAKING YOUR PULSE

It's easy to take your own pulse. First, find your radial artery, located on the inner side of your wrist, below the thumb. (See diagram.) Place the index and middle fingers of your other hand lightly over the radial artery. Count the number of beats for 15 seconds. Multiply this number by four. The result is your heart rate.

BASIC STRETCHING EXERCISES

Stretching exercises are vital to every runner's program. These exercises stretch the muscles in the leg and back that are tight. Maintaining flexible muscles in the legs and back is desirable as it allows the muscles and joints to work more efficiently and decreases the frequency of muscle injuries.

These exercises will stretch the muscles in the calf, thigh and back. They should be performed on a daily basis. On running days, do stretches before and after your run. On non-running days, do stretches at least once.

Each exercise should be performed in a slow, sustained manner, until a stretching or "burning" sensation is felt. When this happens, hold the stretch for 30 seconds, relax for 15 seconds, and repeat the stretch for another 30 seconds. This is a minimum amount of stretching.

STRETCHING EXERCISE #1 - POSTERIOR THIGH

Starting position: Sit lengthwise along a table and place your right leg on the table. Rest your left leg on the floor or on a footstool (Fig. IA).

Action: Lean forward over your right leg until you feel a stretch behind your knee and in your calf. Hold that position by grasping the right leg (Fig. I B). Repeat with the left leg.

Note: Stretch the calves by pointing your toes upward and toward your chest.

STRETCHING EXERCISE # 2 - CALF STRETCH

Starting position: Stand 2-3 feet away from a wall. Put your hands against the wall at about shoulder level to support your weight (Fig. 2A).

Action: Lean in toward the wall by bending your elbows until you feel a stretch in the back of your calves (Fig. 2B). Keep your body erect, your knees straight, and your hips forward. DO NOT bend at the waist. Make sure your heels remain on the ground. Alternate foot position by turning the feet outward, stretching, then inward, and repeating the stretch. If you run a great deal, do this repeatedly throughout the day. To increase stretch, a book can be placed under the "ball" of the foot, letting the heels hang down.

STRETCHING EXERCISE #3 - ANTERIOR THIGH

Starting position: Stand with one arm holding onto a chair or wall (Fig. 3A).

Action: With the free hand, grasp the instep of the foot and pull the heel behind you toward your buttocks. KEEP YOUR KNEE BACK (Fig. 3B). Do not let it come forward.

Note: You should be standing erect throughout the entire stretch. DO NOT LEAN FORWARD. If you can touch your heel to your buttocks, slightly extend your back while doing this exercise.

STRETCHING EXERCISE # 4 - INNER THIGH

Starting Position: Sit on the floor. Place the soles of your feet together and bring them about two feet away from your body (Fig. 4A).

Action: Place your hands on your knees and gently push downward toward the floor. SLOWLY bend forward, trying to touch your nose to your feet (Fig. 4B).

STRETCHING EXERCISE # 5 - ILIOTIBIAL BAND AND LATERAL THIGH

Starting Position: Sit comfortably on the floor with your legs out in front.

Action: With your left leg straight, put your right foot flat on the ground on the opposite side of your left knee. Reach over your right leg with your left arm so that your elbow is on the outside of your right leg (Fig. 5). Slowly turn your head and look over your right shoulder and, at the same time, turn your upper body toward the right ann. Keep your hips flat on the floor at all times. Repeat on the opposite side.

Note: If you do not feel a stretch, bend your left knee, placing your left foot next to the right hip. The more you run, the more you need to do this stretch.

STRETCHING EXERCISE # 6 - SOLEUS

Starting position: Stand next to a chair and place your left foot flat on the seat. Hold onto the chair for balance (Fig. 6A).

Action: Keeping the left foot flat, lean over the chair until you feel a stretch in the back of the left calf (Fig. 6B).

BASIC STRENGTHENING EXERCISES

Strengthening exercises should be an integral part of every runner's program. Strong muscles control joint motion and stability. They also promote proper function of the knee, as well as the entire body, when in motion.

These strengthening exercises will improve muscle strength in the thigh and stomach muscles. They should be done every other day. Some of these exercises can be performed with or without weights. Do not lift weights before running. If you wish to use weights and are unable to purchase them, a hand bag with soup cans in it can be used.

Exercise both legs according to these directions. If one leg is weaker than the other, exercise the weak one only. When both legs can lift the same amount of weight, exercise both legs.

EXERCISE #1 - SIDE LIFTS

Starting Position: Lie on your side on a table or firm mattress, with your body and top knee straight, and with the bottom leg bent behind your back (Fig. IA). The top leg is to be exercised. If using weights, put the cloth or velcro strap or shortened leather belt around your instep with the weights secured. The weights should remain steady and not slide down your foot as long as you keep your foot parallel to the floor.

Exercise: Lift the leg slowly to a maximum height of 12 inches. Keep the leg and body straight. Do not move your hips from side to side (Fig. I B). Hold the weight up for one second. Slowly return to starting position. Repeat 10 times; rest 30 seconds and then do another 10 repetitions. DO NOT CAUSE PAIN.

EXERCISE #2 - HIP FLEXION

Starting Position: Sit on a high desk or table with the legs hanging over the table edge at a 90 degree angle so that the weights are hanging above the floor. Grasp the front edge of the table with both hands (Fig. 2A). Secure the weights around the instep while keeping the ankle bent upwards.

Exercise: Keeping the knee bent, slide the thigh about eight inches off the table without taking your hands off the table (Fig. 2B). Hold for one second, then return to the starting position slowly. Repeat 25 times. Rest one minute, and then do another 25 repetitions. DO NOT LEAN BACKWARDS OR LET GO OF THE TABLE. DO NOT CAUSE PAIN IN ANY JOINT. It is normal for the muscle to feel fatigued.

EXERCISE #3 - STRAIGHT LEG RAISES: HIP FLEXORS AND QUADRICEPS

Starting Position: Lie on your back on a table or firm surface. THE LEG TO BE EXERCISED IS STRAIGHT AND IN COMPLETE EXTENSION. THE OTHER LEG IS FLEXED (bent) at the hip and knee so that the foot is planted on the surface of the table (Fig. 3A). Secure the weights around the ankle to be exercised.

Action: KEEP THE LEG TO BE EXERCISED COMPLETELY STRAIGHT. SLOWLY raise the leg until the ankle is approximately 12 inches off the ground (Fig. 3B). SLOWLY lower the leg back to the starting position. Perform the exercise and repeat again 25 times, for a total of 50 repetitions.

NOTE: 1. When raising the leg, the knee must be kept STRAIGHT. 2. NEVER touch the table with the weight.

EXERCISE #4 - PARTIAL SIT-UP

Starting Position: Lie on your back with the hips and knees comfortably bent (Fig. 4A).

Exercise: Bring the chin towards your chest and slowly lift your neck and shoulders off the floor until the back of the shoulder (scapula) is off the floor (Fig. 4B). Hold this position for one second, then slowly bring the shoulders, neck and head backward to the starting position. Relax for 5 seconds, then repeat the exercise again for a total of 10 repetitions. Increase the repetitions as you become stronger.

NOTE: For beginners, the hands can be placed at the side of your body to assist you. After a week or o, place your arms on your chest, and finally, after another week or two, place hands clasped behind your neck.