Food As Fuel: How Triathletes and Marathoners Eat in Between Work and Working Out

This  article is Part II of my report on the eating habits of 141 triathletes and marathoners I surveyed in the Fall 2008 during my first year of graduate school in applied cultural anthropology. At that time I was still new to the various theoretical perspectives in anthropology that strive to explain why people do what they do.

Like any interpretation of behavior, my survey results are contextual of a particular place and time with biases per the questions I asked and the perspectives of my respondents. That being said, I still find that trying to figure out "why people do what they do"  is not only interesting, but has  obvious practical implications. From altruistic societal goals such as creating more effective and long-lasting peace initiatives and changing consumer behavior to more environmentally sustainable norms and  to more mundane things such as marketing a local business, figuring out why people do what they do is many practical applications. 

My initial interest in the sport sub-cultures of triathlon and marathon running came from participating in both sports when I was younger and watching both cultures evolve from serving smaller groups of "core" participants and mostly elite athletes and become more conventionalized and commoditized with participation mass-marketed to anyone with the  time and money who wants to look like an "Ironman" or lose weight.

The eating habits of my sample of triathletes and marathon runners generally followed the working and break hours of an 8-to-5 office culture with the demands of training one to two workouts a day.  Food consumed during the day was usually taken as regular snacks or a quick meal in between working and working out until the, generally, larger and main evening meal. Or, in other words, eating food was less about the sensual (as in tasting, smelling, etc.) and social bonding aspects of a communal meal and more about the utility of food to serve as a fuel.

What follows is what my respondents said via their survey answers about what they ate, when they eat (lunch was rarely at noon), and how much they ate. Finally, I end this report with a symbolic interpretation of the survey results about what consists of a “perfect” meal according my surveyed triathletes or marathoners.

Methodology

I surveyed 108 marathon and ultra runners of two local running clubs and 33 triathlete members of a local triathlon club. In addition to the online surveys, I interviewed several race participants about their food ways at the Carpinteria Triathlon, September 28, 2008 and Santa Clarita Half-Marathon and Marathon races, November 2, 2008. Details on demographic composition of the survey sample will follow in Part III.


 My sample of respondents was purely convenience based. However, they represent “typical” triathletes and marathon runners per the demographic information from online media kits for Triathlete and Runner’s World magazines (Triathlete 2008; Runners World 2008). And, full disclosure, they were also my friends and friends of friends who self-reported their eating habits. Their self-reported food intake may not be totally accurate but was about their most recent period training for and during their last triathlon or marathon.

Results

Eating Alone and Together: Social bonds and individualism

Each of the triathletes I interviewed told me that he or she usually ate alone during the day and shared a meal with others only in the evening. Eating alone can connote ascetic values, spiritual purity and a social separation from others according to anthropologists (Goody 1982 ).   Eating alone rather than with others also reflects the dominant individualist mores in America where the nuclear familial household is the most common kind  (Triandis 1995). And, like people who live in other industrialized or urban communities, there is trend towards de-socialized eating habits as snacking has replaced sit-down meals by people who demand convenience due to their  busy work schedules and the availability of prepared foods, packaged snacks and "fast" food (Mintz 1985). Sharing a meal with others is symbolic of social ties and is often practiced ritualistically before an important race (in the form of a “Pre-Race Pasta” or “Carbo Loading” dinner) by long-distance triathletes or marathon runners and after a race (such as an organized awards dinner such as at an Ironman Triathlon or at an informal celebratory meal among friends who raced together). The commensality of these meals enforces the social bonds within the group of athletes and friends as they experience a spirit of communitas (a feeling of egalitarianism and connection)  with each before a race and celebrating afterwards (Giulanotti 2005:6). 

When they eat: Fueling up and recovery

The triathletes and marathon runners I surveyed spaced their meals and food intake around their daily and weekly workouts (Appendix A:12, 13; Appendix B: 12, 13). Many of them reported the foods they have had to “give up” in order to live what French anthropologist Pierre Bourdieu terms the “ascetic exaltation of sobriety and controlled diet” of an upper-middle class lifestyle (Bourdieu 1984: 213).  Living a disciplined and ascetic lifestyle and stoically enduring physically arduous endurance training and racing gives legitimacy to their membership within the triathlon community (Atkinson 2008). 

 Surveyed triathletes and marathon runners generally eat according to their daily training schedule and the professional 8 am to 5 pm work hours (Appendix A: 18, 19; Appendix B: 18, 19). The eating times of triathletes often reflected their multiple daily workouts (Appendix A: 12). About 81% of surveyed marathon and ultra runners ate more often than three times a day (Appendix B: 18). Triathletes seem to eat more often with 92% of surveyed triathletes claiming that they ate more often than three times a day (Appendix A: 18).

“Sports nutrition is a practice as much as a science,” according to Sports Nutrition: Handbook of Sports Medicine and Science (Maughan 2002:140). Triathletes and marathon runners are exhorted by sports nutritionists to eat the same foods as they normally do (in the evening and morning before a race or long workout) before an important race so as to not jeopardize their race outcome (Ryan 2007). Both the triathletes and marathon runners I interviewed and surveyed commonly practice eating these foods as one of their  “pre-race rituals” (Appendix A: 23, 24; Appendix B: 23, 24).

Structure of the "Perfect" Triathlete or Marathoner Meal

The traditional British meal, made up of a meat dish plus two side dishes, preferably one a vegetable and the other a starch. The British meal has influenced much of the dominant American food culture according to Anthropologist Mary Douglas (Douglas 1975). According to Douglas, the proper British meal includes an entrée of meat (A) that is accompanied by two side dishes (2B):  one that is a starch and the other that is a vegetable. Douglas encodes this meal structure as A+2B (Douglas 1975).

Triathletes and marathon runners seem to have their own “proper meal” structure that is based on the different proportions of macronutrients (protein, carbohydrates, fats) and includes carbohydrates of some form  (Appendix A: 23; Appendix B: 23). The macronutrient proportions are different if the meal is consumed before a workout (or race) or after. Hence, according to my surveyed respondents their "perfect" meal could be generally denoted by this formula: CHO+xMacro. The letters “CHO” is the sports nutrition chemistry denotation for carbohydrate (Maughan 2002).  The denotation ”xMacro” is my own endurance athlete denotation that stands for "x" times the proportions of macronutrients ("Macro")  (USDA 2008). According to endurance athlete sports nutritionists, a good meal for a triathlete or marathoner can be either in a solid or beverage form but it must include carbohydrates (Applegate 2008; Fitzpatrick 2006, Ryan 2007).  It's interesting that the surveyed triathletes and marathoners categorized food by their macronutrient type and the food's perceived functional attributes to create a physically fit athlete. These functions were perceived to be based on the current sports nutrition and scientific research on exercise physiology in both these sport sub-cultures as well as in the mainstream the health and fitness trend in American culture. Unlike abstaining from eating pork or eating turkey on Thanksgiving, these food habits are perceived to be based on nutrition science (and even use scientific terminology) rather than on religious identity or national or ethnic traditions.

My next post about eating habits of triathletes and marathoners will explore some cultural reasons why they eat this way according to interpretive anthropological theory. The working title for Part III of this series will be something like  “Food As Fuel: Why Triathletes and Marathoners Eat So Weird Compared to Non-endurance athletes". Or, something like that.

In the meantime, bon appetit and happy training!

 Note: I don't benefit from mentioning any products or brand names mentioned in this post.
Resources

Applegate, Liz

   2006  “The Best Food For Runners”, Runner’s World, retrieved on September 24, 2008, from http://www.runnersworld.com/article/0,7120,s6-242-301--10200-2-1X2X3X4X6X7-7,00.html

Applegate, Liz

   2008  “Liquid Diet,” Runner’s World, June 9, retrieved on September 24, 2008, from http://www.runnersworld.com/article/0,7120,s6-242-302--12702-0,00.html

Atkinson, M.

   2008 “Triathlon Suffering and Exciting Significance,” Leisure Studies, April, Vol. 27, No.2, pp.165-180.

Blanchard, Kendall

   1995 Anthropology of Sport: An Introduction, Westport, CT: Bergin & Garvey, pp.31-224

Bourdieu, Pierre

  1984 Distinction: A Social Critique of the Judgment of Taste, Cambridge, MA: Harvard University Press, pp.200-230

Burke, Louise M., Gregoire Millet and Mark A. Tarnopolsky.

  2007  “Nutrition for distance events, “ Journal of Sports Sciences, Dec. 15, 25,  Vol. 18, no. 3, pp. 281-300.

Csikszentmihalyi, Mihaly

   1990 Flow: The Psychology of Optimal Experience, New York, NY: HarperCollins Publishers, p.77

Brownell, Susan

   2000  “Why Should an Anthropologist Study Sports in China?” Games, Sports, and Cultures, New York, NY: Berg

Douglas, Mary

   1975 “Deciphering a Meal,” Implicit Meanings: Selected Essays in Anthropology, 2nd Ed.,, New York, NY: Rutledge Classics

Fishpool, Sean

   2002 Beginner’s Guide to Long Distance Running, Hauppauge, NY: Barron’s Educational Series, Inc., pp.30-31

Fitsgerald, Matt

   2006 Performance Nutrition for Runners, Boston, MA: Rodale Press, pp. 1-151.

Giulianotti, Richard

   2005 Sport: A Critical Sociology, Malden, MA: Polity Press, pp. 4-165

 Goody, Jack

   1982 Cooking, Cuisine and Class: A Study in Comparative Sociology, Cambridge, England: Cambridge University Press, pp. 119-190

Hab, Mark D.

   2008 “Sports Nutrition: Energy Metabolism and Exercise,” JAMA: Journal of the American Medical Association, [J. Am. Med. Assoc.]. Vol. 299, no. 19, pp. 2330-2331.

Larkin, Duncan

   2007  “Interview with Scott Jurek”, Elite Running, February 22, retrieved on October 13, 2008, from http://www.eliterunning.com/features/54/

Leslie, Charles

   2001 “Backing into the Future,” Medical Anthropology Quarterly, Vol.15,No.4,

Maughan, Ronald J., and Louise M. Burke

   2002 Sports Nutrition: Handbook of Sports Medicine and Science, Malden, MA: Blackwell Science, Inc.

Mintz, Sidney W.

   1985  Sweetness and Power: The Place of Sugar in Modern History, New York, NY: Penguin Books.

Prebish, Charles S.

   1993 Religion and Sport: The Meeting of Sacred and Profane, Westport, CT: Greenwood Press.

President’s Council on Physical Fitness and Sports

   2004, Research Digest, Series 5, No. 1, retrieved on October 12, 2008, from http://www.fitness.gov/Reading_Room/Digests/Digest-March2004.pdf

Runner’s World

   2008  “Media Kit: Demographic Profile, Runner’s World, retrieved on November 26, 2008, from http://www.runnersworld.com/mediakit/rw/audience/demos.html

Ryan, Monique

   2007 Sports Nutrition For Endurance Athletes, Boulder, CO: Velo Press.

Scott, Dave

   2008 “Nutritional Fueling for an Ironman, “ Active.com, retrieved on September 25, 2008, from http://ironman.active.com/page/Nutritional_Fueling_for_an_Ironman.htm

Triathlete Magazine

   2008 “Print Media Kit”, Triathlete Magazine, retrieved on September 25, 2008, from http://www.triathletemag.com/Assets/2008PrintMediaKit.pdf

Triandis, Harry C.

   1995 Individualism and Collectivism, Boulder, CO: Westview Press, pp. 14-80.

Turner, Victor W.

   1964 Betwixt and Between: The Liminal Period in Rites de Passage. In Magic Witchcraft and Religion: An Anthropological Study of the Supernatural, Seventh Edition, Pamela A. Moro, Arthur C. Lehmann, James E. Myers, eds. Pps: 91-100. New York, NY: McGraw Hill.

USDA

   2008 “Nutritional Goals for USDA Daily Food Intake Patterns: Goal for Macronutrients”, Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, retrieved on September 27, 2008, from http://www.health.gov/dietaryguidelines/dga2005/report/HTML/D1_Tables.htm

Food as Fuel: Food Beliefs of Triathletes & Marathoners

The post-race party has started

With the current food movement extolling the health benefits of whole foods, organic foods, home cooked or slow foods, gluten/fat/sugar/salt-free and 100% natural foods, I thought it was curious that many endurance athletes, self-described health and fitness conscious folks, who even believed themselves that home cooking with natural ingredients was better for their health, regularly processed and fast foods on the go. 

Instead of eating meals and snacks made of local farm fresh ingredients, the marathon runners and triathletes I interviewed regularly gulped down processed, packaged and pre-made convenience foods chock full of artificial ingredients known only to food chemists with PhDs. And forget about sitting down to a meal with friends or family around the table. Many of the athletes I surveyed frequently ate alone– taking their meals in the front seat of a car, under a tree on a trail or from their bike jersey’s back pocket. Finally, they don't even think of a meal in the same way. Instead of meal made up of a variety of ingredients found in nature, they're computing food calories and ideal proportions of macronutrients to optimize their athletic performance. What’s the deal?

By looking at the dietary habits of nearly 150 triathletes and marathon runners in my area—what they eat, when they eat, how they eat and their food-related rituals and beliefs—I hoped to explain why they are “a little different” when it comes to their eating habits. The following report is an edited down version of a research project I did for a food anthropology class in the Fall of 2008. I edited out most of the social science lingo, methodological details and references to old dead French social theorists to spare you.

Methodology: 

To figure out why triathletes and marathon runners are preaching, but not necessarily practicing the whole foods/slow food trend, I surveyed 108 marathon and ultra runners of two local running clubs and 33 triathlete members of a local triathlon club. In addition to the online surveys, I interviewed several race participants about their food ways at the Carpinteria Triathlon, September 28, 2008 and Santa Clarita Half-Marathon and Marathon races, November 2, 2008.

 My sample of respondents was purely convenience based. However, they represent “typical” triathletes and marathon runners per the demographic information from online media kits for Triathlete and Runner’s World magazines (Triathlete 2008; Runners World 2008). And, full disclosure, they were also my friends and friends of friends who self-reported their eating habits while training for and during their last “important” triathlon or marathon race. Their self-reporting may not be entirely accurate due to poor memory and potential social embarrassment. For example, my eight time Ironman athlete and personal trainer friend may not have come clean about his weekend beer and gummy bear consumption. In other words, the results should be taken with a grain of salt (ouch, bad pun).

The eating habits and dietary beliefs of the interviewed athletes seemed to mimic the ideals of sports nutrition within both sport sub-cultures of triathlon and long-distance running.  These ideals are represented in sports nutrition articles in both peer-reviewed research journals and popular triathlon and running magazines such as Triathlete, Runner’s World and Marathon and Beyond.

However, this is with the one significant exception: post-race binging. Very often, after a major race, my surveyed endurance athletes threw out everything they knew about performance enhancing nutrition and recovery and did the exact opposite. Basically, it seems that these normally sports nutrition disciplined and solitary eaters found their inner post-finals college party selves and went crazy–dietarily speaking. Many of the triathletes and marathon runners surveyed went on a post-race communal consumption binge: drinking enough beer or margaritas to make a fraternity guy (or sorority girl) wobbly, and happily consuming normally what they considered to be "bad foods" foods such as burgers, French fries, pizza…But I am getting ahead of myself.

Research Results:

The "good foods" and "bad foods" according to triathletes and marathon and ultra runners

The surveyed and interviewed athletes generally categorized foods as either “good foods” or “bad foods” most consistently by their digestibility (important for consuming foods while training and racing), their functional ability to increase the athlete’s endurance, and their perceived healthfulness. When asked to name “good foods” and “bad foods” triathletes and marathon and ultra runners athletes alike seemed to categorize most foods by the foods’ perceived health and athletic performance enhancement functions.

“Good foods”

Good foods were described as “healthy”, “nutritious”, “high carbohydrate”, “anti-oxidant”, “fresh”, “whole grain”, “organic”, “non-processed”, “vegetarian” and “raw”. Some of the descriptions they used for good foods seemed to be symbolic of the body image ideals of these sport cultures such as “lean”, “in moderation”, “light”, “low fat” and “whole”.

Believing that they are what they eat, triathletes and marathon runners seem to prefer eating “light”, “low fat” and “whole” foods and thereby would imbue their bodies with those qualities and thus they, in turn, would seem to embody their sport cultures.

Moderate amounts of high carbohydrate and micronutrient rich foods were uniformly cited as generally “good foods”, a category which matched the prevailing sports nutrition discourse (Ryan 2007; Maughan 2002 ;USDA 2008). What I didn’t see that surprised me were foods being categorized “good” because they were “organic” or “natural.” Perhaps the mainstream acceptance of those labels have made them no longer differentiating or meaningful or perhaps these are just not as important to these athletes as the foods functional qualities in regards to one’s athletic performance. Though a few respondents did say that they preferred vegan or vegetarian foods.  Also, many foods that were good were noted as “lean” which reflects the dominant fitness trend and embodied culture of runners as lean and athletic (Bourdieau 1984: 214).

 Representative examples of “good foods” from surveyed triathletes are:

“carbohydrate foods like bagels, oatmeal, energy gels, bars like PowerBar.”

 “I find whole foods are best and I also try and avoid a lot of dairy …”

“high carbohydrate foods like bagels, oatmeal, energy gels, bars like PowerBar”.

“fruit and vegetables and juices. Yams/sweet potatoes for high carb content.”

 “WHOLE GRAIN BREAD, BANANAS, PASTA”

Representative examples of “good foods”  from surveyed marathon and ultra runners are:

“lean protein sources, wild salmon, grass-fed beef, veggies, fruits, nuts, fish oil, olive oil, coconut oil, protein supplements, maltdextrin for recovery.”

“whole grains, fruits & veg[ie]s”

“skim milk, yogurt, whey protein, bananas, apples, berries, oatmeal, lots of broccoli, olive oil, chicken breast, salmon, … wheat breads. Water”

“Chicken, fruits, oatmeal, salads, beans, pasta, seltzer water! … fresh, stuff that is lower in fat content, stuff that will fill me but not fatten me…”

“Bad foods”

Bad foods were described as the very qualities triathletes and marathon runners eschew with their active life styles. Symbolic of these “bad foods” qualities are their negative descriptors such as “fake”, “processed”, “high fat”, “fried” (“fried” is also a slang term for “tired”—a state these athletes try avoid when training and racing), “preserved,” “fat” (race times are slower generally the heavier one is), “heavy,” “artificial” and “junk” (term for over-training without a specific performance goal is called “doing junk miles” in the lingo of both of these sport cultures).

The categories of foods are based on their functional role of health and athletic performance enhancement. These functions are based on what many of the athletes believe is scientific research on exercise physiology and sports nutrition as well as the health and fitness trend in American culture. This is a significant departure from food choices based on religious beliefs, flavor and family customs or traditions.

 These “bad foods” generally mirrored the same foods categorized as “bad” in the American media lately. Foods that contain high fructose corn syrup, MSG, too much salt, and trans fats are “bad”. These athletes usually consider fried foods and “drug foods” such as coffee, alcohol and refined sugar are as “bad”. Also, considered “bad” are red meat, processed foods, fast foods.

Representative “bad foods” from surveyed triathletes are:

“simple carbs, alcohol, processed food”

“Alcohol, preservative laden foods, ice cream”

“fried foods, lots of meat, lots of alcohol, soda!”

“CHOCOLATE, COFFEE, SUGARS, STARCH”

“anything with fake sugars desserts fast food of any kind”

Representative “bad foods” from surveyed marathon and ultra runners are:

“French fries, alcohol, sweets”

“Anything that takes a while to digest or impedes digestion. I tend to avoid: meat, friend foods, especially fried meat, cheese, anything ‘heavy’”

“Liquor, fast foods, red meat, salt, processed foods”

“Too much fat”

“Processed foods tell me ‘evil’. Although I used soda in ultras, just consuming them (my big vice) is not good at all. Dairy products…Eating too much puts on fat. Take out food. Coffee…”

Post-race celebrations: Reversal of food categories

Something interesting happens to the endurance athletes’ categories of “good foods” and “bad foods” after they finish an important race. At many a post-race awards dinner or party the categories of good and bad foods seem to get reversed. What is normally a  “bad food” is now a  “reward” or a “treat” and consumed with gusto. Once these athletes cross the finish line many of them seem to ignore their food prohibitions and, basically, go nuts. Post-race celebrations seem to function as a rite of reversal (a socially acceptable way to blow off steam) for triathletes and marathon runners who normally abide by their strict dietary and training regimes each day (Turner 1964). Many triathletes and runners stay up late after they finish a race (or try to anyway) and celebrate in an un-characteristicly  hedonistic fashion over-indulging in normally forbidden and unhealthy or "bad" foods, beverages and other activities... By purposely breaking their dietary rules in a post-race ritual of (food and lifestyle rules) reversal, they are reinforcing their fealty to these rules. Or, in other words, like your writing teacher taught you in high school or college, you have to know the rules, before you can break them.

Some representative "broken rule" responses of what triathletes said they ate after they raced on race day include a lot of "bad foods":

“anything/everything and beer”

“love burritos and margaritas!”

“French fries, burger, salty foods. Wine or beer. Treat foods.”

“whatever I'm craving at the time, frequently something full of fat and salt (like pizza) after a long race.”

“A big fat steak!”

 The marathon and ultra runners I surveyed had similar food category reversals. Here are some of them:

“… ice cold Sierra Nevada beer, big salad, maybe even some nachos. Mostly salty cravings and fat cravings”

“very much so, often I will eat a very large, fatty, high protein dinner, like a gigantic cheeseburger, or fried chicken.”

“1 or 2 beers, some sort of red meat. This is very different from my normal diet which is primarily vegetarian.”

“Beer and Mexican food. Spicy.”

“BEER OR MARGARITAS... BECAUSE I CAN!!!”

I like to think of these crazy post-race binges of triathletes and marathon runners as  their to equivalent of Mardi Gras in New Orleans. Competitive triathlete women, normally never seen by their training mates in anything other than lycra with their hair bound up in a pony tail, are dancing in high heals (or barefoot) in some kind of feminine dressy thing, hair flying free and beads optional...and eating anything and going for the cold beer and nachos. Post marathon race men, usually decked out in some form of sweaty running shoe, tank and shorts ensemble, are showered up and jeans clad at a hotel bar chowing down ice cream and pie, after re-hydrating with a chilled bottles of their favorite beer and, maybe, tequila shots.  Normally devout and disciplined, once a year (or on this case after a milestone race), the triathlon and marathon faithful relax and party like it's 1999.

Life is full of contradictions isn’t it?

In about a month I will publish Part II: “Food As Fuel: Eating Habits of Triathletes and Marathon Runners: How They Fit Food in Between Work and Working Out” of my research. This will include what triathletes and marathon and ultra runners to told me about their mealtimes: how many meals a day (usually more than three), when they eat (lunch is rarely at noon), how much they eat and the structure of a “perfect” endurance athlete meal.

Following that post, will be Part III: “Food As Fuel: Why Triathletes and Marathoners Eat so Weird According to Old Dead French Social Theorists”. That’s my working title for Part III for now anyway.

In the meantime, here are some healthy un-processed meal ideas from Opra Winfrey's ex-chef and marathon runner Art Smith in the October issue of Runner's World:

Comfort Fuel (Runners World, October 2011)


Happy trails and, if you just finished a race,  "Cheers!"

Note: I don't benefit from mentioning or linking to any products or brand names mentioned in this post.

Resources

Applegate, Liz

   2006  “The Best Food For Runners”, Runner’s World, retrieved on September 24, 2008, from http://www.runnersworld.com/article/0,7120,s6-242-301--10200-2-1X2X3X4X6X7-7,00.html

Applegate, Liz

   2008  “Liquid Diet,” Runner’s World, June 9, retrieved on September 24, 2008, from http://www.runnersworld.com/article/0,7120,s6-242-302--12702-0,00.html

Atkinson, M.

   2008 “Triathlon Suffering and Exciting Significance,” Leisure Studies, April, Vol. 27, No.2, pp.165-180.

Blanchard, Kendall

   1995 Anthropology of Sport: An Introduction, Westport, CT: Bergin & Garvey, pp.31-224

Bourdieu, Pierre

  1984 Distinction: A Social Critique of the Judgment of Taste, Cambridge, MA: Harvard University Press, pp.200-230

Burke, Louise M., Gregoire Millet and Mark A. Tarnopolsky.

  2007  “Nutrition for distance events, “ Journal of Sports Sciences, Dec. 15, 25,  Vol. 18, no. 3, pp. 281-300.

Csikszentmihalyi, Mihaly

   1990 Flow: The Psychology of Optimal Experience, New York, NY: HarperCollins Publishers, p.77

Brownell, Susan

   2000  “Why Should an Anthropologist Study Sports in China?” Games, Sports, and Cultures, New York, NY: Berg

Douglas, Mary

   1975 “Deciphering a Meal,” Implicit Meanings: Selected Essays in Anthropology, 2^nd Ed.,, New York, NY: Rutledge Classics

Fishpool, Sean

   2002 Beginner’s Guide to Long Distance Running, Hauppauge, NY: Barron’s Educational Series, Inc., pp.30-31

Fitsgerald, Matt

   2006 Performance Nutrition for Runners, Boston, MA: Rodale Press, pp. 1-151.

Giulianotti, Richard

   2005 Sport: A Critical Sociology, Malden, MA: Polity Press, pp. 4-165

 Goody, Jack

   1982 Cooking, Cuisine and Class: A Study in Comparative Sociology, Cambridge, England: Cambridge University Press, pp. 119-190

Hab, Mark D.

   2008 “Sports Nutrition: Energy Metabolism and Exercise,” JAMA: Journal of the American Medical Association, [J. Am. Med. Assoc.]. Vol. 299, no. 19, pp. 2330-2331.

Larkin, Duncan

   2007  “Interview with Scott Jurek”, Elite Running, February 22, retrieved on October 13, 2008, from http://www.eliterunning.com/features/54/

Leslie, Charles

   2001 “Backing into the Future,” Medical Anthropology Quarterly, Vol.15,No.4,

Maughan, Ronald J., and Louise M. Burke

   2002 Sports Nutrition: Handbook of Sports Medicine and Science, Malden, MA: Blackwell Science, Inc.

Mintz, Sidney W.

   1985  Sweetness and Power: The Place of Sugar in Modern History, New York, NY: Penguin Books.

Prebish, Charles S.

   1993 Religion and Sport: The Meeting of Sacred and Profane, Westport, CT: Greenwood Press.

President’s Council on Physical Fitness and Sports

   2004, Research Digest, Series 5, No. 1, retrieved on October 12, 2008, from http://www.fitness.gov/Reading_Room/Digests/Digest-March2004.pdf

Runner’s World

   2008  “Media Kit: Demographic Profile, Runner’s World, retrieved on November 26, 2008, from http://www.runnersworld.com/mediakit/rw/audience/demos.html

Ryan, Monique

   2007 Sports Nutrition For Endurance Athletes, Boulder, CO: Velo Press.

Scott, Dave

   2008 “Nutritional Fueling for an Ironman, “ Active.com, retrieved on September 25, 2008, from http://ironman.active.com/page/Nutritional_Fueling_for_an_Ironman.htm

Triathlete Magazine

   2008 “Print Media Kit”, Triathlete Magazine, retrieved on September 25, 2008, from http://www.triathletemag.com/Assets/2008PrintMediaKit.pdf

Triandis, Harry C.

   1995 Individualism and Collectivism, Boulder, CO: Westview Press, pp. 14-80.

Turner, Victor W.

   1964 Betwixt and Between: The Liminal Period in Rites de Passage. In Magic Witchcraft and Religion: An Anthropological Study of the Supernatural, Seventh Edition, Pamela A. Moro, Arthur C. Lehmann, James E. Myers, eds. Pps: 91-100. New York, NY: McGraw Hill.

United States Department of Agriculture (USDA)

   2005 “Nutritional Goals for USDA Daily Food Intake Patterns: Goal for Macronutrients”, Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, retrieved on September 27, 2008, from http://www.health.gov/dietaryguidelines/dga2005/report/HTML/D1_Tables.htm

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USDA's MyPlate Challenge: How do we get enough time to eat healthy?

 I like to eat about as much as I like to workout so, you could say, food and foodways (the study of the norms and traditions of eating and meal taking) really interest me. This is not just because I'm a nerdy anthropology graduate student, but it's also because I'm a parent of two school-age kids and the primary "food production specialist" in our household (e.g. I do the cooking). Since I work and workout nearly everyday, I don't have a lot of "extra" time to prepare the family meals from scratch. When I worked full-time at a local company, I had even less.

In June of this year, the USDA replaced it's MyPyramid icon on healthy nutrition with a strikingly better icon based on a dinner plate called MyPlate according to an informative and well-written article on GoodGuide.com. The MyPlate icon, using the familiar symbol of a dinner plate, is a such better way to explain nutritious proportions of macronutrients to kids and adults than the previous symbol that I wonder that they didn't think of it before.

With MyPlate (see graphic on the left) it's easy to visualize that 50% of a meal should be veggies and fruits, 25% protein and so on. The icon of the glass of milk I don't agree with as there are better sources of calcium than dairy, but I figure the folks at the USDA  had to give in on something to appease dairy industry lobby. What is noteworthy is that "Grains" are no longer the staple macronutrient. They are no longer the base of the traditional food pyramid, so to speak. For most Americans, this nutritious diet plan will be easy to understand but difficult to employ.

The hard part of the MyPlate nutrition plan will be getting the time to cook healthier meals in our industrialized, dual-earner-families-are-the-norm culture where more often than not, families are eating out.  In the United States “restaurant bills account for 48 percent of spending on food” in 2008 according to National Restaurant Association (Bunker 2009).

How will we translate the healthy precepts of MyPlate's nutrition recommendations into a practical plan for the typical busy professional who doesn't have the time to cook every meal from scratch and relies on prepared or fast-foods?

“Today the average American spends a mere 27 minutes a day on food preparation (and another four minutes cleaning up),” according to nutritious food advocate and professor of journalism Michael Pollen (Pollan 2009). That is less than half the time spent cooking and cleaning up forty years ago (Pollan 2009).

Obesity rates are inversely correlated with the amount of time spent on food preparation according to a cross-cultural study led by Harvard economist David Cutler in 2003 (Pollan 2009). Some people guess this has to do with women entering the work force in the United States. However, food preparation time has also declined in households with stay at-home wives due to the increased availability of convenience foods (Pollan 2009). In the industrial economy, affordable fast food outlets provide calories for busy working people who don’t have enough time to prepare meals at home from scratch. Processed convenience foods are marketed to women, the traditional home meal specialists, as emancipatory.

What we will need is a huge cultural and economic shift towards restaurants and markets selling healthier prepared meals with a higher proportion of fruits and vegetables. We can market the dietary shift to Americans as emancipatory and healthy.

All civilizations have been based on surpluses of grains or starches. Even the ancient civilizations such as the Mesopotamia, Maya, Chinese, Yoruba, and Inca relied on either a surplus of wheat, cassava, rice or corn to feed the masses as well as to provide wealth to finance for their civilization's growth (Trigger 2003). The United States, socially and economically, is no exception. “Grain is the closest thing in nature to an industrial commodity: storable, portable, fungible, ever the same today as it was yesterday and will be tomorrow,” says journalist and food activist Michael Pollen. He adds that, “Since it can be accumulated and traded, grain is a form of wealth…throughout history governments have encouraged their farmers to grow more than enough grain… (Pollen 2006:201).” It's no accident that most fast food and packaged snack foods are based on corn, wheat,  and rice. These grains are the foundation of many an American's diet and are also government subsidized, inexpensive (e.g. highly profitable for food manufacturers). They are also the pillars of our economy as well as our diet.

But it is these pillars that are also making us sick. The cheap processed grain-based foods are contributing to the epidemic of chronic diseases (diabetes, heart disease, some say cancer from processed grain-based foods) and the epidemic of obesity in this country.

“Chronic diseases—such as heart disease, cancer, and diabetes—are the leading causes of death and disability in the United States. Chronic diseases account for 7 out of 10 deaths among Americans each year,” according to the U.S. Centers for Disease Control (Centers for Disease Control 2009). Today, heart disease is leading killer worldwide but was rare in ancient societies other than in the very elite upper classes who had access to high sodium preserved foods, more sweets and more calories in general (Winslow 2009:A5). As the most lethal chronic disease, some believe it is an unavoidable consequence of the modern diet.

Happy Meal Makeover: First Lady Michelle Obama praised McDonald's reduction of fries (from 2.2 oz to 1.1 oz) and the addition of a side of fruit in their iconic Happy Meals as "first steps."on the Obama Foodorama blog.  The First Lady has been advocating for more healthful foods served to children in restaurants in her Let's Move! campaign to end childhood obesity. The USDA tries to tackle the junk food preference of many children with their "Ten Tips Nutrition Education Series.

I hope these initiatives work but it will take time for both kids and their parents, raised on french fries and junk food, to develop a taste for more veggies, fruit and other healthier choices. Food gurus such as English chef Jamie Oliver realize how difficult it is to change culturally bound eating habits on both sides of the Atlantic. He is trying to get American kids to eat a healthier diet that will make them smarter and more slender by taking on the food lobby controlled lunches in the American school system in his television show Jamie Oliver's Food Revolution (Gordinier 2011).

Our biggest hurdle to clear towards healthier eating in this country will be more than just educating people on nutrition and getting nutrition information posted in fast food restaurants. It will making nutritious foods available to Americans more cheaply, already prepared and available virtually everywhere. Especially since so many meals are eaten in the front seat of a car these days.

We may need another icon for that campaign. MyBag anyone?

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Cited Non-Linked Resources:

Bunker, Katie (2009) “ On the Menu: Nutrition Facts May Be coming Soon to A Restaurant Near You,” Diabetes Forecast, Pp. 72-75.

Centers for Disease Control and Prevention (2009)  “Chronic Disease Prevention and Promotion,” U.S. Centers for Disease Control and Prevention web site,retrieved on November 24, 2009, from: http://www.cdc.gov/nccdphp/

Gordinier, Jeff (2011) "Will Work 4 Food," Outside Magazine, September, pp.66-68.

Pollan, Michael (2006) The Omnivore’s Dilemma: A Natural History of Four Meals, New York, NY: Penguin Group, Inc., Pp. 450.

Pollan, Michael (2009)  “Out of the Kitchen, onto the Couch,” New York Times Magazine, August 2, 2009, Pp. 26-47.

Trigger, Bruce (2003) Understanding Early Civilizations, Cambridge University Press, MA, pp.757.

Winslow, Ron (2009) “Curse of Heart Disease Is Found in Mummies,” The Wall Street Journal, November 18, 2009, P. A5.

(Almost) Happy Feet: Steps for plantar fasciitis recovery & good shoes

I still have plantar fasciitis (PF) in my left foot but I'm finally seeing progress again. This is since the disasters earlier this year that have pushed back the healing process.  In January I tried running a few miles (2 to 4) per my doctor's okay after having my PF foot immobilized in a cast for a month (in October'09) followed by three months of physical therapy and a cortisone shot (November thru December'09). I ended up with a calcaneal contusion (bone bruise in my heel) and plantar fasciitis all over again. While riding my road bike in May, I got hit by a van and between the road rash, an infected abrasion on my ankle, bashed up hand, and whip lash from hitting the pavement that day, I wasn't able to train or do the PT exercises for about 8 weeks. Argh! So, 2010 will not be my fondest year.  After doing core and strength workouts in the gym with an athletic trainer beginning in July and getting the foot treated by running injury specialist chiropractor once a week in mid-October this year, the PF is finally getting better. And, I'm finally starting to much feel better physically and mentally.

If you are suffering from plantar fasciitis, I have a lot of empathy for you. Don't ignore that heel pain! I did two years ago and that is how I got into this situation. I've had to deal with this running injury off and on since December 2008. Finally, it's starting to go away. Here is what is working for me...

Plantar Fasciitis Recovery Steps That Seem to Be Working –Finally:

1. Sleeping with a Strassburg Sock night splint on my PF foot; By keeping the foot stretched in a dorsaflexed position, it allows the damaged fascia tendons to heal in a stretched position that prevents re-tearing every time my arch flexes down when I walk or run (Earlier this year I wore the Swede-O Thermoskin night splint with good results but had to stop after a bike accident since its thick ankle strap irritated the road rash on my left ankle) - every night
2. Stretching the Achille's tendon every day (and calves and hamstrings) for 30 seconds each day- 1x/day
3. Core and strength training (upper and lower body) in the gym to develop better running posture and prevent re-injury - 2x/week
4. Foot strength training with toe-towel pull and other exercises from recommended by my physical therapists, chiropractor and the book Injury Afoot by Patrick Hafner* - 2x/week
5. Increasing circulation to damaged fasia tendons to expedite healing and optimal tissue alignment (while breaking up the twisted scar tissue) with deep tissue massage, ultrasound or rolling my foot on tennis ball (followed by 10min ice treatment) - 3-4x/week
6. Cardio workouts in the pool, on an elliptical machine or on my road bike - 2x/week
7. Good chiropractic therapy by a sports injury specialist at Wilson Chiropractic Clinic in Ventura. This place was recommended to me by someone who had plantar fasciitis and recovered from it (I don't receive a benefit by mentioning this place and haven't told my chiropractor about this post) - 1x/week
8. Think positive thoughts (thinking positively lowers one's stress hormone levels which enables healing)
9. Eat highly nutritious foods: A fresh organic fruit smoothie on most mornings followed by a low-processed carbohydrate diet mostly nutrition-rich whole foods (fruits, vegetables, dairy and nuts)  in meals I prepare for my family at home from our local grocery store and CSA farm basket from Ojai 
10. Wear good shoes: I wear my regular shoes with custom orthotics or the anatomically designed comfortable Kuru shoes** or stylish FitFlops (Both of these footwear companies make shoes that come with anatomically supportive arch supports and heel pads, and they are, honestly, the most comfortable shoes I have ever worn.* ) I had to get rid of all my sandals and flip flops that didn't have arch supports.:(
    
    

Weekly Workout Time: Those ten steps translate into a half hour to one hour workout per day– about 5 hours a week. That should be do-able for most people. As a busy parent, who is in a graduate program and who works part-time, this is all I have time for now. This is about half to a third of the time I normally would like to workout each week (10 - 15 hours). Wouldn't that be nice.

Motivation: I try to workout first thing in the morning before I take the kids to school. Also, I register each workout on my free  DailyMile.com account. Stressing about staying on track with my workouts on dailymile.com is self-motivating and allows me to see progress and trends with workouts the past year.

Full Disclosure:

I promoted several products in this post. For full disclosure, below are the details about my experiences with the two products that I have received free for this review and my relationship each.

*You can find plantar fasciitis recovery and strengthening exercises in the book Injury Afoot: 30 things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Fasciitis by Patrick Hafner. The book is clearly written and features photos of every stretch and strength training exercise recommended by podatrists to recover from plantar fasciits. The author has a degree in kinesiology and has recovered from PF himself. I bought my first copy on Amazon.com and reviewed it earlier this year on a post about minimal shoe and barefoot running. The author Mr. Hafner contacted me after reading my post and offered to send me a free copy. The exercises in the Injury Afoot book worked for me except that I put off wearing good shoes and a custom orthotic the first year. Now, I know better.

**Kuru Shoes sent me a pair of their Halcyon model in October to review on this blog. I wore them at our kids cross-country meets for a few weekends and they are the most comfortable shoes that I have ever worn. They were even more comfortable on my feet than my running shoes with my custom orthotics. I asked a few parent friends what they thought about my free comfy Kurus and here is what they said:

"They look funky...With shoes I don't care what they look like. It's all about comfort for me." ~ Physician and mother of two very speedy little girls on the cross-country team.

"Well, they're earthy looking. I'm not a real earthy person." ~ Local race director and multisport retail store owner

"They're, uh, kind of funny looking. But I like 'em!" ~ Local catering business owner

"You didn't buy those, did you?" ~ Hubby

Oh well, so the particular model they sent me won't be found in a fashion magazine but at least they allow me to walk pain free and are good for my PF recovery.

When recovering from chronic plantar fasciitis (or "plantar fasciosis" as one of the several foot specialists I've seen has called my particular chronic case), the key is doing something every day to help the healing and prevent re-injury. After spending hundreds of dollars on medical care for this running injury, what seems to be finally working is doing basic stuff consistently: Deep tissue work followed by ice treatment, daily stretching, wearing a night splint each night, cross-training and wearing good shoes.

Sadly, I can't walk around barefoot anymore. And running in minimal shoes--at least in the near future-- is out of the question. But I really don't care. I would wear clown shoes if I thought it would help me run again...Really!

Social reproduction of two ex-Ironman triathletes: Why our kids like sports

Our family has fun working out together.

This morning, after the kids and hubby left for school and office, I was thinking what a wonderfully wacky and athletic family we have.  Our kids, a 14-year old son and 11-year old daughter, actually wanted to get up at dark-thirty (in multisport terms that means "pre-dawn" which was 5:15 this morning) and hit the gym with their parents.  This isn't every morning and usually my son sleeps in until the last possible moment before school or friends or sports drags him away from dreamland. I asked him why he wanted to get up so early. It was still dark! "It would be a fun way to start the day," he said. "The jacuzzi and a swim just sounds so good right now." Similar response from our daughter: she likes to get her workouts "done in the morning." She's been running regularly since last Thanksgiving and she joined the local club cross-country team this Fall.

Our kids think that running and working out every day is normal.

I think that is so cool.

But why do they like sports so much when some of their friends seem to be allergic to sea water, "hate running," and couldn't stay on a skateboard un-assisted for longer a second?

Pierre Bourdieu, a French anthropologist,  said the goal of a family, culturally speaking, is "social reproduction". Whether it is our conscious intention or not, our kids repeat our lives in one way or another.

Social reproduction: Praxa and doxa

In An Outline of a Theory of Practice, Bourdieu’s ethnography of the indigenous Kabyle tribesmen of Algeria, Bourdieu explains his materialist (socioeconomic) and post-modern social theories within the context of interpreting Kabyle cultural practices (Bourdieu 1977:vii).  In particular, Bourdieu makes a decisive break from his French structuralist predecessors by analyzing the human agency and strategy behind the practices of his Kabyle informants, or, what Bourdieu calls their culture’s assembled practices or praxis. Bourdieu believed that “society is constructed by purposeful, creative agents” who create their culture “through talk and action” (Erickson 2008:187). He believed that a cultural group or a society is united in “systems of relationships" and praxis and that have a natural order or "orthodoxy" that is promoted by the dominant group or authority. He calls this cultural authority, it's doxa (Bourdieu 1977:169).

Our family is a prime example of what happens when two athletic ex-Ironman triathletes have kids.

Our family praxis is based on working out together. There are usually workout clothes and sports equipment somewhere on the floor of our house, water bottles on the kitchen counters, HEED and Cytomax tubs in the cupboards and wet suits and beach towels drying in the tree by the backdoor. We "play" every day. Nearly, every day since they were born our kids have seen Mom and Dad leave the house for a run, swim, bike, surf or do some other physical activity, alone or with friends. By watching us, they've learned that working out is fun and makes them feel good afterwords. With friends, it's like a playdate. Soccer, rugby, swimming, taekwando, running, and junior lifeguards, our kids have been on a competitive team of some kind since kindergarten. When not competing, they are usually doing some sport just for fun like surfing, playing around on their skateboards or riding their bikes around town with their friends. Working out is just part of our family's daily praxis. It is a part of our daily routine like brushing our teeth is in the morning.

Our kids have seen their mother push herself to try qualify for Boston and have their seen their father race the Big Sur Trail Marathon with the flue. (He survived fine thank goodness. We figured he scared the flu right out of him with that run--the old "in-hospitable host" theory of flu recovery).  They have also seen their parents go back to school and take entrepreneurial risks so they can be more competitive professionally and happier personally. We have had set-backs, been injured, and have bad days like everyone else, but pushing ourselves physically and mentally is a positive value in our family's doxa.

If all of that sounds too good to be true, I don't blame you for thinking that.  But how did we get our kids to join us working out? How did we get them to not rebel against a parental and cultural hegemony that extols a healthy and athletic lifestyle?

They gotta wanna

I think it is, in part, just as Bourdieu said: social reproduction. Our kids are only mirroring what we are doing every day. If they saw us read, compose songs, drink a lot of beer with our friends, or work longer hours instead of working out in the outdoors--they would probably seek and mirror those behaviors instead.

But I also think their choices are due to our high expectations and use of constant positive re-enforcement.  We don't make them go running with us because it's healthy, we encourage them because it's fun. We ask them to just give a sport a try for one season, and if they don't like it, they don't have to do it again.

The key is for us to encourage our kids to try new things, to  do their best, and to have fun.

Our daughter just started running regularly last year. Before that she really wasn't in to sports. It was our idea when she was younger that she try soccer, Junior Lifeguards, and taekwando. Now, it's her idea to go running and workout at the gym.

Our son got into soccer,  taekwando, and running, initially, because it was our idea. Now he runs and plays rugby because it is his idea. We tell our kids, "Just try it for one season. Do your best. If you don't like it, you don't have to do it next year." If they don't like a sport, that's fine. It is important that they know that we are on their side.

It is also about those old fashioned words of parenting that I remember hearing when I grew up: "Just try it," "Don't quit," and "Do your best."  With the grueling cross-country races our kids have been enduring lately, our advice has been even more empathetic, "I know it's hotter than hell out here and it sucks. Just do your best." and "Don't listen to that guy.  Just do your best."  And, most importantly, and simply, "I'm so proud of you."

The key for me is to make sure our kids' main motivation is internal. They have to want to do well to really excel and be true competitors. They have really believe in themselves. As my old Masters swim coach in San Diego used to say, "You gotta wanna."  Empathy coupled with high expectations are important values in our family doxa.

Old School

My childhood experience was not particularly athletic. As an admittedly non-athletic artist and family iconoclast who preferred books and horses to bicycles and health clubs, my single-parent mother  couldn't relate to my desire to run the trails after school when I was a teenager. Or, to learn surfing, on my own, when I was 19. My mom didn't even know how to swim. But to her credit, she always encouraged me and cheered me on  at dozens of cross-country races in high school and drove me to many a 5K and 10K race on the weekends. She allowed me to hang out at the beach, it seemed, nearly every single weekday, during the summer. She even bought me my first triathlon racing bike, a Specialized Allez, when I was in college. I rode that bike all over San Diego country in my twenties and decorated it with my product sponsor's stickers. I heard "I'm so proud of you" a lot from her when it came to racing.

I'm an old school runner and triathlete. When I started racing, it wasn't cool for girls to be a competitive runner. It was unusual. I was the only girl I knew to enter the first Los Angeles Marathon in 1986. My college training buddies were a Phi Delt and a Sigma Chi who were in my advanced running class. I think I was the only girl in that class, too. That first marathon was only two years after the first Olympic woman's marathon ever at the 1984 Los Angeles Olympics. I did my first triathlon in 1987 as one of the few women in my age group and one of the few people who even knew what a triathlon was it seemed. I taught myself how to swim freestyle in Mission Bay in San Diego – trying to keep up with my roommate who grew up with a pool. Eventually, I found my way to the slow lane and some coaching at a local Swim Masters club in La Jolla. On the bike, I would train Dave Scott-style, usually alone, with a ziplock bag of Fig Newtons, a baked potato or a PB&J, stuffed into a fanny pack for long road rides and a bottle of water.  My training pals were usually athletic college students or young people trying to make money in the outdoor sports industry.

It's an endurance sport culture

Nowadays, there are packs of brightly colored and jerseyed road cyclists all over our local highways each weekend morning. Nearly every town has their own running club, triathlon team and local Masters swim program.  Most of the multisport athletes, it seems are middle aged professionals. The doxa of American sport culture has changed since the days when I was a kid. Marathons, triathlons, and lately long-distance trail running ("racing ultras") have gone mainstream (Helliker 2010).  Today there are about 1.2 million triathletes in the United States, up 51% from 2007, and according to last Sunday's New York Times article, a third of them are men in their 40s (Gardner 2010). A few weeks ago, the Boston marathon sold out in less than eight hours. The proportion of women racing marathons have grown from 10% of the field in 1980 to 41% in 2009 (Running USA 2010). "Marathoning has soared in popularity in the United States. In 1976, 25,000 Americans finished marathons, according to Running USA. Last year, there were a record 467,000 American marathon finishers," according to The Boston Globe on October 18th (Pepin 2010).

Our kids are turning out athletic like us. And, it appears to be national trend. Those wacky multisport events called "triathlons" and long-distance races we did in our younger years are conventional now. "Training for Ironman is the new golf!" an old Ironman training pal and multisport retail shop owner told me the other day, rolling his eyes.

I'm so grateful that both of our kids like doing endurance sports.  It has been so fun to workout together--as a family. I'm going to enjoy it as long as it lasts.

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Resources

Bourdieu, Pierre, 1977 An Outline of a Theory of Practice, New York, NY: Cambridge University Press, Pp.248.


Gardner, Ann Marie 2010 "Triathletes, Swim, Bike and Run for Youth," New York Times, October 24, 2010, R12.

Helliker, Kevin 2010, "Making marathons even tougher," Wall Street Journal, August 17, 2010; Retrieved on October 26, 2010, from: http://online.wsj.com/article/SB10001424052748703960004575427561884547420.html

Pepin, Matt 2010 "Boston Marathon sells out in a day," The Boston Globe, October 18, 2010; Retrieved on October 26, 2010, from: http://www.boston.com/sports/marathon/blog/2010/10/boston_marathon_sells_out_in_a.html

Running USA 2010 "Running USA's Annual Marathon Report," Running USA; Retrieved on October 26, 2010, from: http://www.runningusa.org/node/57770

5 Steps to heal plantar fasciitis (after getting hit by a car)

It's been exactly two and a half months since my last blog post about treating plantar fasciitis and it is with great disapointment that I must report that MY HEEL STILL HURTS. And, you know that really sucks and I'm tired of blogging about it and it's not entirely my fault (or my heel's fault) and I wish to God that I could blog about being CURED of plantar fasciitis, instead.

(Sorry about the all-caps words. I just wanted to get my point across that if you are tired about this topic of mine, I am very, very tired of it.

If you are new to plantar fasciitis and are looking for treatments that work, please see my earlier post: "5 Steps to Heal Plantar Fasciitis: Cloud Care from Running Twitter Friends" or go see a physical therapist or athletic trainer who specializes in healing running injuries – or a podiatrist– with good references from runners. If I learned anything from this year of chronic plantar fasciitis pain is that getting a good reference from a runner is key. I didn't a year ago. And, I still have plantar fasciitis.

The reason why I haven't written earlier is two-fold and related:

1. I got hit by a car while riding my road bike on May 15, 2010
2. I had to stop doing my "5 Steps to Heal Plantar Fasciitis" after the accident

Because of the accident I have not been able to follow the "5 Steps..." for the past eight months. Before the accident, according to my orthopedic surgeon foot specialist on my last visit in mid-February, I had a calcaneal contusion and still had plantar fasciitis – but it was going away. I was getting better and was advised to keep doing what I was doing and to gradually build up my running mileage from jogging a block, to a mile, to two miles, etc. Two months of doing this, on my first road ride since December,  I got hit by a car. :(

However, I believe my "cloud care" steps to get rid of plantar fascitis came from real people who really recovered from plantar fasciitis.  I found them at my Twitter account @MultisportMama by posting a tweet: "How did you recover from plantar fasciitis?"

So, that being said, here are the 5 Steps to Heal Plantar Fasciitis that worked for other people*:

1. Stretch (gastrosoleus/calves/hamstrings): Increase flexibility by daily stretches and by wearing night splint when sleeping
   
   (From the accident I had road rash on my legs and elbow from hitting the pavement and a puncture wound that got infected on my left ankle. That means I could not wear a night splint. Consequently, my arch stiffened up while sleeping and I experienced heel and arch pain with the first foot step out of bed each morning. Sound familiar? The night splint was really helping me keep the fascia loose before the accident.)
   
   
2. Strength train: Heal raises, towel pulling with toes, core workouts, etc
   
   (After the accident I had to stop weight training for about 6 weeks because of my right strained wrist and hand, a wicked cervical (neck) strain from my helmet hitting the pavement, and a strained left shoulder. I couldn't carry anything in my right hand for weeks and, doing push-ups, pull-ups and using free weights were just not possible.)
   
   
3. Increase circulation: Get deep tissue massage, Rolfing, ultrasound in the affected area or by rolling your foot on tennis or golf ball each day
   
   (With a banged up body trying to heal itself, the idea of causing more muscular and tendon pain with deep tissue work seemed like a bad idea the first few weeks after the accident.)
   
   
4. Wear custom orthotics
   
   (Yay! The one thing I could do consistently-- except that week when my foot swelled up with an infection from the heel wound--was wear my new custom othotics. They relieved some of the pressure on my arch but I can honestly, say that used alone without the other four healing methods, didn't work.)
   
   
5. Cross-train: Swim or bike
   
   (My bike was trashed and I'm still waiting for the insurance settlement to get it fixed. With the road rash and a seeping icky infected punture wound on my left heel at that, swimming was out of the question for a while.)

Now, it's eight weeks since the bike accident.  I've made an appointment with a podiatrist recommended by a running friend. In the meantime, I will be back at the "5 Steps to Heal Plantar Fasciitis" again (with the exception #1's "wear a night splint" since the abrasion on my heel is still sore and number 5's "bike"). Barring any other ridiculous miss-fortune (with my luck lately, who knows?), I will post a status report on the results of the 5 Steps to Recover from Plantar Fasciitis. Believe me, I'm motivated get running again. :)

QUESTION: How did you recover from plantar fasciitis? Please let me know by posting a comment. I may try it. If it works for me I will happily sing your (or the product or services you used) praises right here. Please, only first person experiences.

Best wishes and health and have a great injury-free summer!

:) A

*The 5 Steps To Heal Plantar Fasciitis methods have been validated by peer-reviewed medical research that I have access to as a graduate student. The latest research suggests increasing flexibility, circulation and using orthotics and anti-inflammatories to help that crummy little fascia tendon heal itself. The medical research and Runner's World running experts also suggest supporting the arch during the healing process. They also recommend  s-l-o-w-l-y working up to barefoot or minimalist running if you are injury free. However, with plantar fasciitis, barefoot and minimalist running like a Tarahumara (as mentioned in the book Born to Run by Chris McDougall), running in minimalist shoes like Vibrams and running on the beach are definite no-nos. It puts additional strain on an already strained arch.

Eccentric Exercises for plantar fasciitis & patellar tendonitis (runners knee)

After six months and hundreds of dollars spent treating my running injury under a conventional doctor's care who proscribed solely the treatments paid for by my insurance company has failed, I'm trying unconventional methods. By "unconventional" I mean therapies that are not paid for by my insurance company.

To find these therapies I crowd sourced therapy advice from runners, cyclists and multisport athletes on Twitter. I coined the term "cloud care" to describe my new medical care system that involves free outcome-oriented advice from injury-recovered athletes. Basically, it's asking people what worked for them. The old "conventional" care system, based in large part on what my doctor figured that my insurance company would pay for,  I now like to call "crappy care." I posted the results of my survey on a previous post titled "5 Steps To Heal Plantar Fasciitis".

Since my last post, I've discovered three basic tendon/fascia healing principles:

• Increase circulation: Rolfing, deep tissue massage, PRP,  and "tennis ball therapy"
• Increase flexibility: Stretches specific for the injured tendon/fascia
• Increase stress gradually: Stress the injured area to facilitate tissue repair and regrowth

Notice how these principals do not include many of the ones proscribed by crappy care: Cortisone, immobilizing the injured area with a cast, daily intake of ibuprofen and icing. What I'm not saying is that these treatments don't work. They just didn't work for me and they cost me and my insurance company a lot of money. In defense of crappy care: the physical therapy and proscribed flexibility, stability and strength exercises did help my injury recover. However, due to poor management of my case, a stress fracture went undiagnosed and the foot pain became worse at month five of crappy care.  Also, I just could not afford more PT after over 20 visits at $40 co-pay each. Below are some links to online sources about some "unconventional" (e.g. not paid for by insurance) therapies that have really worked according to athletes. They are treatments you can do at home for free (with the exception of the deep tissue massage/Rolf Therapy and the PRP therapy).

Cloud Care Healing Therapies for tendon/fascia injuries:

1. Rolfing–Rolf Integrative Therapy
   http://www.rolf.org/about/index.htm
2. Eccentric exercises and tendonopathy treatment research:
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/
   
3. Eccentric exercises and stretches that worked for by Sigfús Víkþörðson a cyclist who suffered from patellar tendinitis (runners knee):
   http://eccentric-exercises.blogspot.com/2007/12/video-deomonstration-of-eccentric.html
   http://eccentric-exercises.blogspot.com/2007/12/importance-of-daily-stretching.html
   
4. PRP (Platelet Rich Plasma) blood therapy to oxygenate fibers with little blood circulation such as tendons, fascia, ligaments to induce faster tissue repair and recovery:
   http://www.nytimes.com/2009/02/17/sports/17blood.html
5. http://www.google.com/hostednews/ap/article/ALeqM5jDu_yK6FpCreFsGIVMeNVgYcxEmQD9ESBQI00  (concerns about PRP)
   
6. Eccentric exercises (strength training by lengthening muscles/tendons) for plantar fasciitis:
   http://www.sportsinjurybulletin.com/archive/rehabilitation-exercises.html  (scroll down half the page to "Problem: Plantar Fasciitis...")
   
7. Stretches and more strength training with eccentric exercises for plantar fasciitis:
   http://www.plantar-fasciitis-treatments.com/exercises.php

Please let me know what works for your tendon injury by making a comment or sending me a tweet @multisportmama. I think more people should know what really works–even if it's not blessed by the insurance companies.

Here's to hitting the trails, roads or courts again soon!

Cheers,
:) A