Performance a matter of taste?

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Adam’s Training Journal

I went for a jog the other day with my friend David. As so often happens, we began chatting about running-geek things.

You see, David is about the best-informed runner I know. In addition to his full-time job, he has taken on the considerable task of knowing absolutely everything there is to know about long-distance running.

For David, no part of the running experience goes unexamined. Is it more efficient to initiate your foot strike with the heel or toe? How many minutes before a race is it optimal to begin a warm-up? To minimize your chances of injury, is it better to run in the morning or evening?

As you’d imagine, in searching out the answers to such questions, David acquires a lot of interesting information. As we clipped along in north Norman on a recent morning, he shared a tidbit that left me scratching my head.

According to David, a recent study found that sports drinks infused with carbohydrates enhanced the performance of endurance athletes. And that they did so even when the athletes did not swallow the drinks. Could this possibly be true?

Dr. Prescott Prescribes

Yes, David is spot-on.

In a study that appeared this spring in the Journal of Physiology, researchers gave one set of endurance athletes a sports drink containing glucose (a sugar) while giving another set of athletes a drink that tasted identical but was flavored with artificial sweeteners. They then asked the athletes to complete a challenging time trial during which they swished with — but didn’t swallow — the two drinks.

The researchers found that the study subjects who rinsed with the sugary drinks outperformed their counterparts who received the artificially sweetened drinks by 2 percent to 3 percent. They also sustained a higher average power output and pulse rate, even though they didn’t perceive that they were working any harder.

Even more confounding, the researchers also tested a third group of athletes by having them swish with a drink laced with a tasteless carbohydrate. This group performed just as well as their counterparts who rinsed with the sugary drinks.

What does it all mean?

When you consume a sports drink during a workout, you’re receiving the obvious benefit of hydration. Your muscles are getting a boost from the easy-to-burn carbohydrates the drinks provide, and you’re restoring electrolytes you lose in perspiration. Still, this study shows there’s even more at work.

It appears that your mouth harbors receptors that respond to carbohydrates (rather than to sweetness). These receptors seem to send signals to areas of the brain associated with reward or pleasure, reducing athletes’ perception of their exertion and, thus, increasing output.

The findings suggest that if you’re looking to optimize performance, traditional sports drinks — as opposed to the newer low- or no-calorie options — are superior. They also suggest that when it comes to the skinny on exercise physiology, you’d do well to listen to your friend David.

The rub on sports creams

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Adam’s Training Journal

The other day, after a long run, I felt some tightness and pain in the back of my right knee. After a bit of internet sleuthing, I determined that the culprit was the iliotibial band (ITB), a common injury site for pavement pounders like me.

Dr. Wikipedia prescribed RICE—rest, ice, compression and elevation. I chose my own variation, which involved ice, stretching, running on soft surfaces and otherwise keeping time on my feet to a minimum. Fortunately for me, the treatment regimen seems to have worked, as I’m once again running pain-free.

But in the good, old days, when I was younger and faster, my treatment regimen undoubtedly would have consisted of another element: Bengay.

Like many young athletes, I imagined the surest way to loosen up was a healthy dose of this cream (or its cousin Icy Hot). So before every track meet, you could find me—and dozens of my teammates—anointing our legs with the stuff. Even today I cannot set foot in a locker room without it immediately conjuring the medicinal smell of days gone by.

I’ve long since left this pre-run ritual behind. I mean, who wants to smell like a medicine cabinet? But as my muscles have grown older and tighter, I’ve begun to wonder whether this aromatic practice might be worth reviving.

Dr. Prescott Prescribes

Last year, Americans spent more than $200 million on topical analgesics, or pain creams. Indeed, it’s a market that has existed in the U.S. since before the 20^th century. So you’d think that there might be some good evidence that they work.

You, however, would be wrong.

From a physiological standpoint, there’s little benefit that occurs in the tissue when you apply a topical cream. And research on the subject has been minimal and inconclusive.

Although many swear by these creams, they are most likely benefiting from the placebo effect, which can cause people to feel therapeutic effects from an inert medication simply because they have been told it works.

Also, these products contain chemicals that cause a warming or cooling effect on the skin, a sensation that can temporarily “crowd out” pain signals sent by injured or sore muscles. Yet this does nothing to alleviate the underlying cause of the pain.

Even doctors have Achilles heels

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Dr. Prescott’s Journal

I have a friend—let’s call him Steve—who’s suffered a running injury. Only problem is, Steve isn’t a runner.

In fact, he’s assiduously avoided running since those wind sprints he detested during his Vietnam-era high school football practices. But now it seems even the relatively minor bouncing of Pilates and some overly ambitious stretching has proven too much for my—I mean his—Achilles tendon.

Okay, you found me out. Apparently, two-plus years of dispensing medical wisdom in this column hasn’t rendered me immune to training injuries.

My Achilles, the tendon that connects my calf to my heel, is killing me. In fact, not long ago, the pain was so great that I had to resort to using a cane.

Unlike some people, I don’t have any aspirations to run a marathon. Or, frankly, ever to run again. But I would like to be able to walk and do Pilates again without pain.

What do you recommend?

Adam Prescribes

I may not be a doctor, but I am a runner. And like so many other runners, I’ve had to battle an Achilles injury.

The Achilles (named for the sole point of vulnerability on the otherwise immortal Greek hero) is the largest and strongest tendon in the body. But because activities like running—and Pilates—involve repeatedly applying large amounts of force to the tendon, members of the sweat set commonly suffer Achilles injuries.

So, dear patient, for openers, I prescribe rest. That means as little weight-bearing activity as possible. No Pilates. Keep walking to a minimum. And while that cane may not make you look young and spry, it will help your heal your Achilles heel (sorry).

You’ll also want to ice the tendon as often as possible to reduce swelling. If non-steroid anti-inflammatories like ibuprofen agree with you, those are also a great way to reduce tendon pain and inflammation.

If this course of treatment doesn’t prove effective, see a physician. (Not yourself, of course.) In particularly severe cases, the injury might require a steroid injection.

You know, I’ve enjoyed this rare opportunity to play doctor to your patient. But with the Oklahoma City Marathon coming up Sunday, I suspect I’ll be back on the examining table in no time.