In this second part series on gait, I examine the importance of nutrition. Good form requires the right kind of fuel.
You’d be surprised at how rapidly one’s gait begins to fall apart when the gas tank is low. Often a runner has a fluid motion in the gait when he starts out; the form is swift and efficient, but even after 20 to 30 minutes or maybe not until mile 20 of the marathon, that person looks as if he ran through a minefield, dragging one leg, swinging one arm out to the other side, scuffing the heels, head drooping. And at the finish line, it looks even worse with the athlete leaning to one side, or hunched over holding the lower back. Was an injury involved? In a way, yes.
When the body is stressed due to dehydration and glycogen depletion, the muscles no longer have the correct nutrients to keep them functioning as well as they should be, so they fatigue. The glucose isn’t there to keep the muscle firing, or maybe electrolytes are so depleted the muscles can’t contract as well as they should.
Hydration is much more than just taking in water. The body has to absorb it to use it. The major organs of the body that deal with stress are the adrenal glands. This is where hormones such as adrenalin, (fight-or-flight hormone), cortisol (controls blood sugar and inflammation), aldosterone (regulates electrolytes), and DHEA (makes testosterone and estrogen), comes from. Fatigued adrenal glands from too much physical, nutritional, or emotional stress cause the body to lose excess sodium so it cannot hold onto the water. This makes sense to the person who drinks and drinks and drinks, but always feels thirsty or urinates often. They are dehydrated, and their gait, and running performance, is suffering.
Improper carbohydrate metabolism is another big factor that can affect gait. Carbohydrate intolerance can alter gait mechanics from a process known as insulin resistance. This occurs when either a person is consuming too many carbohydrates, often refined sugars and flours, but can also be from too many carbohydrates in general. The pancreas must manufacture more and more insulin to process the same amount of glucose that it once only used a little amount to handle. Over time, the pancreas becomes less efficient in metabolizing the carbohydrates so too much insulin is produced and the person winds up with signs and symptoms of blood-sugar handling problems. These include irritability, cravings for sweets, excessive appetite, afternoon drowsiness or headaches, getting the shakes, and trouble sleeping, just to mention a few. They also have irregular gait patterns, which explain why most, if not all of these individuals, have some chronic ache, pain, or injury. Essentially, insulin levels affect gait.
Many people who go off their high-carbohydrate diet resolve most of their aches and pains for this very reason. Adjusting your diet away from pre-race carbo meals and bagel breakfasts may make dramatic changes in your health and performance. The double-edge sword is seen when you add the fact that under high-stress situations, such as overtraining, the body makes too much cortisol as a result, which in turn raises insulin levels. So not only does the burden of high insulin levels need to be dealt with, but the chronic adrenal stress will lead to weakened ligaments, muscle breakdown, and inflammation.
Gait is affected by insulin levels so much that it is also important to not only know what to eat or drink, but when to do so. One major mistake that many endurance athletes make is that they drink a carbohydrate solution right up until the start of a race. I have seen people at the start of a half marathon or Ironman race packing in the fluid replacement drinks, or even worse, consuming a gel pack. They have quickly increased their blood sugar and insulin levels and begun the sugar burning process, when the race demands that the majority of energy come from the body’s plentiful fat stores, as in any aerobic activity. An improper gait usually follows. The proper thing to do is stop all carbohydrate consumption one hour prior to the event. Then, do not consume any carbohydrates until at least 15 to 30 minutes into the race. After 15 minutes, the body’s cells will respond to glucose without the insulin surge from the carbohydrate consumption. At the end of the event, especially those lasting well over one hour, try to consume the majority of carbohydrates within 60 minutes after, as well as some protein. A 4:1 carbohydrate to protein ratio is best. Shoot for around 80 to 100 grams of carbohydrate and 20-25 grams of protein. Great protein sources are whey protein, eggs, and meats.
Following these guidelines will help ward off erratic blood sugar spikes while keeping the nervous system functioning better as it is under a high deal of stress already from training and racing. In addition, your gait will benefit, delaying muscle fatigue, increasing power output, and improving performance.
The point of all of this is simple: Gait is important, yet the only thing runners often hear about gait is how to practice it. “Work on your form,” is what we are told. Gait typically cannot be fixed with a coach. Common advice to runners such as relax the hands and focus on relaxed, controlled breathing are all beneficial. Video analysis may help to some degree, but often it just identifies the problem but not the reason. In other words, a video might show the athlete the imbalance in foot strike from right to left, but it won’t show why it is there and how to address it. You can’t force yourself into a normal gait.
Now, one might develop better technique via a coach, and that can influence their gait. For example, consider the runner who is leaning too far forward when he runs. This could be because of improper footwear, muscle imbalances, or perhaps due to the way he was taught or learned to run. If it’s the footwear, then proper shoes are the answer – often the runner is having a problem from overly supportive shoes that is not letting his foot function normally. If it’s muscle imbalances, then those need to be identified and corrected accordingly by a qualified physician or therapist. If the bad form is a result of old habits, then the coach may be able to adjust the athlete to get him out of that faulty position and therefore lessen the chance of injury. A combination of all three is very common. If a runner may have worn the typical thick-heeled running shoes for so long, he created a gait problem and subsequently muscles in the pelvis, calves, and feet have developed some muscle and tendon trauma. So he needs to be fitted for proper shoes, and have those muscles and tendons treated accordingly, and he may also need to learn how to run properly and break the old habit of how his body was used to running for so long in the improper footwear.
The truth is that an athlete’s form is sub par because there is something throwing it off. Trying to push through and alter the gait to make it look better is like painting over rust. The rust (the problem) always wins. This is not at all to say that you shouldn’t work on form; it is necessary to some degree. It is to say that your gait is a significant reflection of your overall health and fitness more than anything else except for perhaps improper equipment, such as poor running shoes. The wonderful thing about gait is that when it’s all working correctly, performance really takes off.
For Part One, click here.
This article was originally written for Zero-Drop.
Brian Lavender says
I note in many of your articles that stress affecting the levels of cortisol produced by the adrenal glands has a marked detrimental effect on performance. In my case I have Addison’s Disease (auto-immune, as best as they can tell) and take hydrocortisone and fludrocortisone replacement medication daily. Do you have any additional advice for my particular circumstance?
Sock Doc says
Hi Brian, typically auto-immune issues require very individualized treatment. When I see someone with any auto-immune disease I look to see what may help support as well as calm down the hyper-vigilant immune response. This could be from a food allergy, environmental toxin, heavy metal, or maybe from a past infection. Of course supporting the adrenal glands and the entire hormonal system is necessary – which means proper training, diet, etc.
Ivan Bruno Hostil says
Wow!!! It’s pretty hard to educate at least 75% percent or professional runners who keep having carbo gel sacks or meals before running whatever distance running races. Sometimes I starve in the last minutes of a race or trainning session just because I don’t have such a meal right before or in the previous two hours of one of those events. Tell me that it’s normal and that I shouldn’t get desperate when I feel so and I’ll keep this habit. I used to have very low carb intake before exercising when I was overweight. The results were fantastic. However the “starvation” at the end and on my way home was almost unbearable. Are low glycemic impact meals the solution for this feeling?
Very good article. Pretty much fits what I wanna learn about now.
Sock Doc says
I think the whole low glycemic/high glycemic idea is old news and really irrelevant for most. I used to discuss the glycemic index, as did others in the field who I respect, but most of us don’t mention it anymore. It’s too easy to misinterpret. Fructose is low, some fruits are higher than processed foods, and you can just add some fat to a food anyway to lower the GI.
So the way you burn fat and hold off glycogen is by training aerobically and eating to get your body in fat-burning mode. That means more fat/veges/protein and less carbs especially simple sugars. But eventually depending on the duration and intensity of your race, you’ll need some carbs.