Osteoarthritis and Rheumatoid Arthritis and Running

How does osteoarthritis affect people who do endurance sports, including running? What is the difference between osteoarthritis and rheumatoid arthritis? Should you be exercising with osteoarthritis? In this article, we look at what osteoarthritis is, and how diet and supplements can play a role.

Osteoarthritis results from the breakdown of the cushioning tissue (cartilage) inside the joints. It is the most common form of arthritis and can occur in any joint and it is thought to be due to past load impact injuries or constant friction. It is therefore common in runners and people who engage in heavy-impact exercise (e.g. rugby) for long periods.

Once the cartilage wears away, the bones rub together, causing pain, inflammation and stiffness (especially in the mornings). Pain is the earliest symptom and is worsened by exercise and relieved by rest.

Arthritis (or joint inflammation) refers to a set of diseases affecting the area in or around joints such as knee, hip, and finger joints, and is quite common in middle and older aged people. Generally, arthritic diseases fall into two major categories: Osteoarthritis and rheumatoid arthritis.

Rheumatoid arthritis results from inflammation (redness, warmth, and swelling) inside of the joints – a disease in which the immune system turns on itself and attacks the joints – causing the breakdown of the cartilage instead of healing or protecting it.

It is three times more likely to affect women than men and often lasts for many years with alternate attacks and remissions (absence of symptoms). Arthritis is usually chronic but may present as acute episodes. Though the disease tends to stop by itself in periods of remission, any joint damage that occurs during the inflammatory phase will be permanent, sometimes causing much disability.

The prevalence of osteoarthritis is higher among overweight persons as compared with those of normal body weight. Obesity and injury are the two greatest risk factors for osteoarthritis. The severity of arthritic symptoms varies from person to person, and even daily.

Should you be doing Exercise?
Though excessive high-impact exercise may exacerbate arthritis, regular exercise, especially non- or light weight-bearing exercise (swimming, cycling or walking) in combination with a low-fat diet will help prevent weight gain, reduce the chance of osteoarthritis and minimise the symptoms if you already have the condition.

Non-jarring aerobic exercise has been shown to reduce symptoms, increase mobility and lessen continuous damage from the condition. The exercise must be adapted around the individual’s capability – for the most part, any exercise session should be pain-free.

Exercise can also improve sleep and can promote a greater sense of well-being. Increased muscle tone and strength as well as general conditioning can also help to protect the affected joints during exercise.

Can diet play a role?
Arthritis does not only occur in elderly people, it can afflict anyone, at any age. Scientists are still unsure what influence food has on the illness, but they are looking into the role diet may play with increased interest.

Diet may indirectly increase your chances of developing certain arthritis. For example, being overweight increases the risk of osteoarthritis as it increases weight on the joints and therefore increases wear and tear. This process can be exacerbated with long-term participation in high-impact sports.

Diet may also have an impact on the body’s immune system and may modulate the way the body’s immune system reacts to certain kinds of arthritis that involve inflammation (the inflammatory process is a part of the body’s immune system).

There is no evidence to suggest that certain diets may prevent arthritis altogether. Some very early studies in animals or in small numbers of people with certain types of arthritis suggest but do not prove, that dietary changes may help relieve some of the symptoms of arthritis. Presently, there is not enough scientific evidence to recommend that people with arthritis change their diets radically, except for losing weight if overweight.

However, the following dietary changes may provide some symptomatic relief from arthritis:
Overall, the basic guidelines are for a healthy, balanced diet:

  1. Eat a variety of foods – a good diet includes choices from each of the five different groups of foods. Eating various foods helps provide the estimated 40 nutrients (vitamins and minerals) your body needs daily. Unfortunately, arthritis can make it harder to get variety in the diet. Fatigue and pain can lower one’s appetite, and swollen joints and loss of movement may lead to avoidance of foods that need more time or effort to prepare and cook.

Certain kinds of arthritis and some medications can also affect how well your body uses what you eat; it may decrease your appetite; increase the risk of stomach upset etc. This will mean you have to be even more diligent in following a balanced intake. For most people, following a balanced diet will help keep up the levels of the nutrients that may be affected by medication.

  1. Ensure an adequate Calcium and Vitamin D intake. Many persons with osteoarthritis do not consume sufficient calcium. One should aim to ingest at least 2 servings (cups) of dairy per day (e.g. milk, yoghurt, buttermilk, cheese, soymilk or other soy products).

Vitamin D status is generally fine in individuals who receive sufficient sunlight exposure (~10 minutes per day), but might be impaired in the elderly, who tend to confine themselves indoors, bed-ridden individuals or those who, for religious reasons, cover most body surfaces with clothes. It has been reported that the risk for progression of the disease is increased three-fold in those individuals with a poor Vitamin D status.

  1. Ensure adequate antioxidant vitamin intake – evidence shows that a diet low in antioxidants, especially the trace mineral selenium and vitamins A, C and E, may predispose some people to joint problems. Selenium is found in all fish and shellfish, meat, whole grains and cereals, and eggs. Include foods rich in beta-carotene, which the body converts to vitamin A (e.g. carrots, mangoes, apricots, sweet potato, spanspek), vitamin C (e.g. red and yellow peppers, kiwi fruit, oranges, Brussels sprouts and cabbage), vitamin E (e.g. avocado, nuts, sunflower seeds and olive oil).
  2. If you suffer from suppressed appetite or know that your diet is imbalanced (if you exclude certain food groups, skip meals, no time to prepare proper meals or snacks) then a general multi-vitamin and mineral supplement would be advisable – choose one that provides these nutrients in no more than 1.5 – 2 x RDA (or 150-200% of RDA). Avoid supplementing with large doses of single vitamins or minerals as this may cause imbalances and detrimental side effects.
  3. Maintain ideal weight – while normal joints can handle and support a vast amount of use, the mechanical abnormality of a joint makes it susceptible to degeneration. As mentioned, being overweight or obese increases your risk of developing osteoarthritis in the knees, since these joints bear the weight of your body. Even a small weight loss can make a big difference.

Avoid too much fat and cholesterol – many older adults with arthritis also have high blood pressure or heart disease.

  1. Eat foods high in fibre – it is generally more nutritious (more vitamins and minerals), more filling and low in fat; it may even help reduce high cholesterol levels. They are also helpful if you are having problems with diarrhoea or constipation, which can be precipitated by some of the arthritis drugs.
  2. Avoid too much sodium (salt), especially if you already suffer from high blood pressure as well. Some arthritis drugs, such as corticosteroids, may also cause the body to retain too much sodium. Sodium causes your body to retain water, this can affect your blood pressure.
  3. Drink alcohol in moderation – alcohol can interfere with the working of arthritis drugs. Alcohol also has a toxic effect on bones = can weaken the bones, and can contribute to unfavourable weight (fat) gain. Drinking alcohol does not mix with certain drugs for arthritis. For example, stomach problems are more likely if you drink alcohol together with nonsteroidal anti-inflammatory drugs or aspirin (consult your doctor or pharmacist).
  4. Drink lots of water – water is a key component of both cartilage and synovial fluid that lubricates the joints. Drink at least 8-10 glasses of water daily – always ensure that your urine is pale yellow (the colour of lemon juice).
  5. Avoid food that you find is aggravating your condition. Certain foods produce chemicals in the body which aggravate arthritis in some people. Some people are also allergic to certain foods. This is highly individual and varies from person to person.

Eliminating certain fruits and vegetables (tomatoes, potatoes, eggplant, green peppers, red peppers, chilli) has been reported to reduce stiffness and pain in rheumatoid arthritis. It is the solanine in these foods that causes the morning stiffness. Solanine is thought to inhibit nerve impulses. There is not yet enough research to support the connection between arthritis and eating foods high in solanine. However, if you feel better eliminating them, then continue. If you include a variety of other vegetables and grains in your diet, you should not be too concerned about losing out on any nutrients.

Several studies have found that following a vegetarian diet helps relieve some of the symptoms of rheumatoid arthritis, however, more evidence is needed before definite conclusions and recommendations can be drawn.

Supplements that may provide symptomatic relief from arthritis:

Omega 3 (fish oil) supplements:
Omega-3 fatty acids can have an anti-inflammatory effect on the joints of some arthritis sufferers. Found in oily fish such as salmon, trout, snoek, mackerel, sardines, cob and pilchards. One should try to eat oily fish two to three times a week. These fatty acids are also found in flaxseed, soya beans and tofu. Ginger and celery contain anti-inflammatory agents, which may help alleviate symptoms, while sunflower seeds are rich in vitamins D and E.

Glucosamine and Chondroitin supplements:
Glucosamine is a primary building block of cartilage. The theory (yet unproven) behind glucosamine and chondroitin supplementation is that it may stimulate cartilage synthesis, and decrease its breakdown. Though there is no direct evidence that such repair or protection occurs, supplementation has been shown to provide symptomatic relief and improve functional capacity and mobility in patients with osteoarthritis. It seems as though these favourable effects only take place after at least 3 months of supplementation.

Some studies have indicated that patients on chondroitin supplementation needed less anti-inflammatory drug treatment for pain relief, though most of these studies injected the chondroitin directly into the joint. There is debate whether glucosamine and chondroitin are absorbed from the gut in sufficient amounts after oral ingestion.

There is no evidence that these supplements will prevent the development of osteoarthritis, or that they can reduce joint pain in athletes, and it also does not seem to be effective for people who have joint (cartilage) operations and who wish to recover faster.

Despite that lack of evidence of enhanced benefit of combining glucosamine and chondroitin, many over-the-counter preparations do combine the two in dosages of 500mg glucosamine and 400 mg chondroitin to be taken 3x daily (for a total dose of 1500mg glucosamine and 1200mg chondroitin daily).

Consultation with a doctor is always recommended before using any alternative therapies.

Some unproven claims …
Some claim that special diets, foods or supplements can cause or even cure arthritis – usually publicised in magazine articles, books and TV infomercials. Most claims for such diets have not been scientifically tested to prove that they work and are safe, and are health frauds. These diets may be detrimental to health, especially if they promote the exclusion of major food groups, or stress the intake of only a limited choice of foods. Before making major changes to your diet (excluding major food groups) in the belief that it may better your condition, first discuss it with a dietician and doctor. If you are on medication, it is probably best to continue your regular medical care even if you decide to try a diet change.

Conclusion
Although researchers are looking at the role diet may play in arthritis, there is not yet enough evidence to clearly show how diet might affect certain types of arthritis. Food affects people in different ways and some people do find that the pains can be kept at bay by avoiding or including certain foods.

Good nutrition can, at the least, help alleviate symptoms.

Pop Art Graphic With Vibrant _Slow Down_ Message In Primary Colors

If you can fill the unforgiving minute
With sixty seconds’ worth of distance run,
Yours is the Earth and everything that’s in it

  • Rudyard Kipling

“Running is the greatest metaphor for life because you get out of it what you put into it.”

  • Oprah Winfrey

“You have to wonder at times what you’re doing out there. Over the years, I’ve given myself a thousand reasons to keep running, but it always comes back to where it started. It comes down to self-satisfaction and a sense of achievement.”

  • Steve Prefontaine

“I always loved running … it was something you could do by yourself, and under your own power. You could go in any direction, fast or slow as you wanted, fighting the wind if you felt like it, seeking out new sights just on the strength of your feet and the courage of your lungs.”

  • Jesse Owens

“Sometimes a slight pace change is all you need to snap out of a mental or physical funk.”

  • Mark Plaatjies

“The body does not want you to do this. As you run, it tells you to stop but the mind must be strong. You always go too far for your body. You must handle the pain with strategy … It is not age; it is not diet. It is the will to succeed.”

  • Jacqueline Gareau, 1980 Boston Marathon champ

“If you want to win something, run 100 meters. If you want to experience something, run a marathon.”

  • Emil Zatopek

“It’s at the borders of pain and suffering that the men are separated from the boys.” – Emil Zatopek

“Running is a big question mark that’s there each and every day. It asks you, ‘Are you going to be a wimp or are you going to be strong today?” – Peter Maher

“Running is the classical road to self-consciousness, self-awareness and self-reliance. Independence is the outstanding characteristic of the runner. He learns the harsh reality of his physical and mental limitations when he runs. He learns that personal commitment, sacrifice and determination are his only means to betterment. Runners only get promoted through self-conquest.” – Noel Carroll

“Training is principally an act of faith.” – Franz Stampfl

“There is a time to run and there is a time to rest. It is the true test of the runner to get them both right.” – Noel Carroll

“Train little, hard and often.” – Jim Peters

“The idea that the harder you work the better you’re going to be is just garbage. The greatest improvement is made by the man who works most intelligently.” – Bill Bowerman

“The difference between my world record and many world-class runners is mental fortitude. I ran believing in mind over matter.” – Derek Clayton

“In the marathon … the contest is not so much between runner and runner, but, in the tradition of the classic drama, between man and the gods. The gods in this instance being represented by distance, heat and time.” – John Hopkins

“It is horrible, yet fascinating, this struggle between a set purpose and an utterly exhausted frame.” – Arthur Conan Doyle

“The music of the marathon is a powerful martial strain, one of those tunes of glory. It asks us to forsake pleasures, to discipline the body, to find courage, to renew faith and to become one’s own person, utterly and completely” – George Sheehan

“In every race there is a crucial moment when the body wants to quit. Then it needs imagination and mental tenacity to survive the crisis. Otherwise, the penalty is defeat.” – Derek Ibbotson

“I like the marathon because it’s one race where you can find out who’s really the toughest. On the track, sometimes a guy can just pull away, and you want to stay with him but you don’t have the leg speed. The marathon is slow enough that anyone can stay with you if he wants if he has the will. The marathon is ultimately a test of will.” – Alberto Salazar

“You don’t run 26 miles at 5 minutes a mile on good looks and a secret recipe.” – Frank Shorter

“The athlete with a sound body is at risk of finding himself considered abnormal because his body is adapted to physical activity rather than inactivity.” – Michael Sacks

“The less serious running of any description which an athlete indulges in before eighteen, the better for his future prospects.” – Alfred Shrubb

“Listen to your body. Do not be a blind and deaf tenant.” – Dr. George Sheehan

“I prefer to remain in blissful ignorance of the opposition. That way I’m not frightened by anyone’s reputation.” – Ian Thompson

“Jogging through the forest is pleasant, as is relaxing by the fire with a glass of gentle Bordeaux and discussing one’s travels. Racing is another matter. The frontrunner’s mind is filled with an anguished fearfulness, a panic, which drives into pain.” – Kenny Moore

“Fear is the strongest driving force in competition. Not fear of one’s opponent, but of the skill and high standard which he represents; fear, too, of not acquitting oneself well. In the achievement of greater performances, of beating formidable rivals, the athlete defeats fear and conquers himself.” – Frank Stampfl

“To describe the agony of a marathon to someone who’s never run it is like trying to explain colour to someone who was born blind.” – Jerome Drayton

“Learn to run when feeling the pain: then push harder.” – William Sigei

Pain is temporary, pride is forever!

“A lot of people run a race to see who is fastest. I run to see who has the most guts, who can punish himself into exhausting pace, and then at the end, punish himself even more.” – Steve Prefontaine

“Running is like mouthwash; if you can feel the burn, it’s working.” – Brian Tackett

“Good things come slow – especially in distance running.” – Bill Dellinger

“Running is a big question mark that’s there each and every day. It asks you, ‘Are you going to be a wimp or are you going to be strong today?'” – Peter Maher

“Mind is everything: muscle – pieces of rubber. All that I am, I am because of my mind.” – Paavo Nurmi

“Sport is not about being wrapped up in cotton wool. Sport is about adapting to the unexpected and being able to modify plans at the last minute. Sport, like all life, is about taking risks.” – Roger Bannister

“I am both proud of and embarrassed by that run. What kind of geek goes out and runs in a cloudburst just before midnight on his honeymoon? Me, I guess. But probably many others, too. You know who you are.” – Mark Will-Weber

“We run, not because we think it is doing us good, but because we enjoy it and cannot help ourselves … The more restricted our society and work become, the more necessary it will be to find some outlet for this craving for freedom. No one can say, ‘You must not run faster than this, or hump higher than that.’ The human spirit is indomitable.” – Roger Bannister

“The long run is what puts the tiger in the cat.” – Bill Squires

“A race is a work of art that people can look at and be affected in as many ways as they’re capable of understanding.” – Steve Prefontaine
“The marathon is like a bullfight. There are two ways to kill a bull, for instance. There is the easy way, for one. But all the great matadors end up either dead or mauled because for them killing the bull is not nearly as important as how they kill the bull. They always approach the bull at the greatest risk to themselves, and I admire that. In the marathon, likewise, there are two ways to win. There’s the easy way if all you care about is winning. You hang back and risk nothing. Then kick and try to nip the leaders at the end. Or you can push, challenge the others, make it an exciting race, risking everything. Maybe you lose, but as for me, I’d rather run a gutsy race, pushing all the way and lose, then run a conservative, easy race only for a win.” – Alberto Salazar

“The will to win means nothing without the will to prepare.”- Juma Ikangaa

“In running, it doesn’t matter whether you come in first, in the middle of the pack, or last. You can say, ‘I have finished.’ There is a lot of satisfaction in that.” – Fred Lebow
“I had as many doubts as anyone else. Standing on the starting line, we’re all cowards.” – Alberto Salazar

“Running is real and relatively simple … but it ain’t easy.” – Mark Will-Weber

“The will to win is worthless, without the will to prepare.” – Pat Civitano

“We all have dreams. But in order to make dreams come into reality, it takes an awful lot of determination, dedication, self-discipline, and effort.” – Jesse Owens

“Gold medals aren’t really made of gold. They’re made of sweat, determination, and a hard-to-find alloy called guts.” – Dan Gable

“It’s rude to count people as you pass them. Out loud.” – Adidas ad

“Cross Country – A practical use for golf courses.” – Anonymous

“Some people don’t have the guts for distance racing. The polite term for them is sprinters.”- Anonymous

“I run because it’s so symbolic of life. You have to drive yourself to overcome the obstacles. You might feel that you can’t. But then you find your inner strength, and realize you’re capable of so much more than you thought.” – Arthur Blank

“If you run, you are a runner. It doesn’t matter how fast or how far. It doesn’t matter if today is your first day or if you’ve been running for twenty years. There is no test to pass, no license to earn, no membership card to get. You just run.” – John Bingham

“Methinks that the moment my legs began to move, my thoughts began to flow.” – Henry David Thoreau

(list compiled by Quintus van Rensburg)

Pop Art Graphic With Vibrant _Slow Down_ Message In Primary Colors
Slow Down, You’re Doing Fine
running table mountain

The following minimum age restrictions apply to road races in South Africa – as determined by Athletics South Africa (ASA) for Road Running:

5 km: 9 years and older

10 km: 14 years and older

15 km: 15 years and older

Half Marathon: 16 years and older

32 km: 19 years and older

Marathon: 20 years and older

Ultramarathon: 20 years and older

Organisers should not accept entries from under-age athletes. If they do manage to enter and run then prize money will not be awarded to under-age athletes.

In Road Running the OPEN category is open to all athletes of the same gender irrespective of age. The prize money for the race winner is usually an OPEN category so anyone can win it. Please note that this may be subject to event restrictions.

In Track and Field (T&F), the SENIOR age group is open to all athletes 16 years and older on 31st December in the year of competition. In Road Races the Senior category is IN PRACTICE a closed category for athletes aged 20 to 39. However, please note that the official rule for Road Running reads: “20 years and older on 31st December in the year of competition, up to 34 years on the day of competition. If Master athletes 35-39 are not catered for in the prize lists then Senior shall be deemed to also include those athletes aged 35 to 39”.

In T&F Youth athletes are 16 or 17 years on 31st December in the year of competition. JUNIOR athletes in T&F and Cross Country are defined as 18 or 19 years old on 31st December in the year of competition. As Road Races do not have a Youth category, in Road Races Juniors are defined as 19 years and younger on 31st December in the year of competition.

The “Year of Competition” is worth explaining further. For instance, to be a JUNIOR you have to be 19 for the WHOLE YEAR. If you turn 20 on say 28th December, you are a SENIOR for the whole year from 01 January.

From age 40 upwards, athletes are known as MASTER athletes. Road races usually give prizes in 10-year age groups. The old terminology of Veterans (40-49), Masters (50-59), Grandmasters (60-69), and Great Grandmasters (70+) is still commonly used but has officially been dropped because World Athletics has a different definition for Veterans. (World Athletics classifies Women 35-49 as Veterans). Master age categories are based on your age AT the DATE of the RACE. Any athlete who has reached his/her 35th birthday. For multi-day events age is taken on the first day of competition.

In addition to the above, please note the following rules that apply:

  1. Any age groups and age categories, as determined by the technical regulations for that specific
    competition/championship may be allowed on approval by the Provincial/ASA Board.
  2. Athletes may not compete in more than one age category during the same competition unless there is no corresponding event within the age group they initially selected to compete in.
  3. In events where the competition takes place according to age categories, in addition to the OPEN category, if offered, the athlete will participate and only be eligible for the prizes in the category they
    entered for, provided they display the relevant official numerical age category tags front and back on their vest. Any athlete may thus qualify for a maximum of two individual prizes (one in the Open category and a second in the age category entered for.
  4. Age-category athletes in the Master categories may enter either their chronological age category or any age category younger than their chronological age down to the Senior level.
  5. Age-category athletes may not compete simultaneously in more than one individual or team category in the same competition and must declare at the time of entry which category they are competing in.

(source Baleka Baleka, Edited by Chris Goldschmidt) (updated 25 March 2015 and 27 August 2024 by Quintus van Rensburg)

running table mountain
Table Mountaim, photo: Tembela Bohle
The Impact of AI on Endurance Running Coaching

The latest technological advancement, the Generative Pre-trained Transformer 3 (GPT-3) autoregressive language model, is making waves across the internet. ChatGPT, an AI language model, has learned 300 years’ worth of information in just 6 months, allowing it to engage in conversation with users. This new technology is being hailed as a potential game-changer in many fields, with Microsoft CEO, Satya Nadella, predicting that AI will significantly impact software categories and, I suggest, will extend to diverse areas of study, including endurance running.

Coaches who have tested ChatGPT for creating training plans have reported a range of reactions. While some were thrilled with the results, others were disappointed, particularly when asking for basic training plans for events like the Marathon. The AI-generated responses were basic and lacked the expertise expected from experienced coaches. However, coaches who approached the conversation with ChatGPT in a more personalized way, providing additional context about the goal race and the athlete’s running history, were more satisfied with the results. ChatGPT was able to create a tailored and detailed training plan, taking into account factors such as the specifics of the goal race and the athlete’s available training time. The plan even included suggestions for strength training and cross-training activities.

This technology has raised questions about the role of coaches in the future. However, as renowned coach, Renato Canova, highlights, the training plan should be tailored to the athlete and not the other way around. A coach’s expertise lies in adapting the training plan to the individual athlete and making changes based on the effects of each session. Coaching remains a dynamic process, and the coach’s role cannot be fully replicated by technology.

rear view of silhouette man against sky during sunset

Experienced ultra-distance runners know that performance is improved by a reduction in body temperature. Or, cooling your body with water in the heat will make you run better. This practice has become a priority for long-distance runners.

Science has proved: that heat hurts endurance performance, even when it’s not very hot.

There are many studies on major marathons*. The findings agree that rising temperatures hurt performance – much earlier in a run than we realise. Reducing body temperature improves speed and is likely to reduce the effects on your health from ultra running.

How do we cool our bodies? Some of the following will give you an immediate advantage in your next race.

Keep your body wet, ideally with cold water. Don’t just drink at water stations. Spray yourself with the water. Focus on your head, neck, core and hamstrings. Male runners should tape their nipples securely. It may be loosened by water and become a bloody mess. When you wear compression socks, keep water away from them as they may pool water at your feet.

Light, reflective clothing keeps your skin surface temperature cool in extreme heat. Running vests are generally much better than shirts under extreme conditions.

Apply ice or water to your body using your clothing. Grab some ice at a water station and use your cap, buff, sleeves or pants to keep it near your skin. Stuff it wherever possible. You may have pockets you don’t use at some point. I use my buff to hold a broken water sachet on my head.

Apply cold water to your skin and head before the race on hot days. If core temperature increases in hot conditions, it is difficult to lower.

Remember to test the above in training to see what works for you.

* Studies were sourced from PLoS One, the International Journal of Environmental Research and Public Health, Sports Medicine and the British Journal of Sports Medicine – from 2010 to 2019

Scientists from the Department of Physiology of the University of Granada (UGR) have shown that caffeine (about 3 mg/kg, the equivalent of a strong coffee) ingested half an hour before aerobic exercise significantly increases the rate of fat-burning. They also found that if the exercise is performed in the afternoon, the effects of the caffeine are more marked than in the morning.

In their study, published in the Journal of the International Society of Sports Nutrition, the researchers aimed to determine whether caffeine–one of the most commonly-consumed ergogenic substances in the world to improve sports performance–actually does increase oxidation or “burning” of fat during exercise.

Maximum fat oxidation

The results of our study showed that acute caffeine ingestion 30 minutes before performing an aerobic exercise test increased maximum fat oxidation during exercise regardless of the time of day. The fat oxidation was higher in the afternoon than in the morning.

These results also show that caffeine increases fat oxidation during morning exercise in a similar way to that observed without caffeine intake in the afternoon.

In summary, the findings of this study suggest that the combination of acute caffeine intake and aerobic exercise performed at moderate intensity in the afternoon provides the optimal scenario for people seeking to increase fat-burning during physical exercise.

Reports have indicated that COVID-19 may cause heart damage in hospitalized patients with severe cases of the disease, but it’s unclear whether cardiac injury also occurs in infected patients who are asymptomatic or experience only mild symptoms. This question is of particular concern for athletes because myocarditis–inflammation in the heart usually caused by viral infection–can cause sudden cardiac death during exercise. In a special report published in JAMA Cardiology, a group led by sports cardiologists at Massachusetts General Hospital (MGH) and Emory University School of Medicine offers guidance for athletes’ return to play after they have recovered from COVID-19.

The researchers observed that athletes infected with COVID-19 who experienced no or mild symptoms did not exhibit signs of heart injury. For such athletes, they do not recommend detailed cardiac screening. The prevalence of cardiac injury in athletes who were infected with COVID-19 is still unknown, however, and the team believes it’s prudent to screen for heart damage in athletes with moderate to severe symptoms. The experts also note that despite recent small studies showing that cardiac magnetic resonance imaging has detected potential cardiac abnormalities in individuals who have recovered from COVID-19, they feel that current evidence doesn’t justify its use as a universal screening tool for athletes’ return to play.

Myocarditis
mobility exercises

Mobility training helps develop a full range of motion in your legs. It also plays a crucial role in injury prevention and generally improves joint and muscle health.

Starting with Mobility Exercises

When starting, I suggest a Build from the Base approach. The exercises below are in that order.  Start with Foot Doming and progress up the body to the hips. Start with 10 minutes a day, every day, until you have done all the exercises a few days later.

When you have mastered all the exercises, you may start increasing your sets and load.

Cultivating a daily mobility practice will enable you to resolve recurring issues before an injury occurs.

When building up to long-distance, we need to avoid layering strength on top of movement dysfunction.

Start with this basic approach if you have no existing problem areas.

Focus on Problem Areas

If you suffer from recurring running injuries, start by focusing on the problem area. Not only there, but also the parts above and below the problem. When you have sufficiently recovered, you can start with the basic approach.

ExerciseProblem Area/s
Foot DomingFoot, Ankle
Toe ResistanceBunion, Foot, Ankle
Heel DropFoot, Heel, Achilles
Ankle TurnAnkle, Calf, Shin
Hip HikeKnee, ITB, Hip, Glutes, Core
Step DownAnkle, Knee, Quads, Hip
Step UpQuads, Glutes
Hip RotationHip, Core
Hip ExtensionGlutes
Back ExtensionHip, Glutes, Core, Back, Spine, Shoulders
Mobility Exercises (Click on the exercise for the detail.)