The 21 day rule for medical treatments

Not really relevant to the article;
but I do like it!

The 21 day rule

I often come across people including athletes who have been undergoing a form of medical treatment for months; sometimes longer.

It raises the question:

"How long should one undergo a course of medical treatment before calling it quits?" 

As a general rule of thumb, I recommend applying the

"21 day rule"

If you are undergoing any form of treatment or therapy, be it physical therapy or medicine, apply the 21 day rule.

If, after 21 days of consistent application of the therapy, there has not been a significant improvement in your condition and at a rate or level above what would normally be expected if things were left up to Mother Nature herself, then you need to review what is being done. 

Far too often, ineffective therapies are continued with long after when their use should have been critically reviewed, modified or ceased altogether. In addition, progress is often erroneously attributed to the treatment or medicine when it is really just the natural healing processes that should be getting the credit.

Many medications (unlike herbs, vitamins and minerals) cease to be effective after a month of regular use.  In many cases, the body "habituates" (another term for "addiction") to medicines such as steroids, anti-depressants and pain medications).

Simple methods of monitoring progress, such as using a personal heart rate monitor, are often overlooked, therefore causing a loss of objectivity when assessing progress.  Always ask:

"How is my progress being measured?"

Nutritional and lifestyle strategies, including exercise and deep tissue massage, can be extremely effective. These enhance and support, rather than replace or inhibit normal body physiology. Sometimes no obvious benefit is ever demonstrated by exercise, eating well and supplementing where the need exists, other than looking good and feeling great over the long term. Give these strategies at least 3 months to take effect.

How do I determine how much and what to drink while training for a marathon?

Hi Gary, i"m a first timer doing the marathon (Rotorua) having trouble with the fluids, how much is too much, how much is too little? On my longer training days would a camel back be the answer as I run in the country, nowhere to get water on the way, my last long run [2hrs] came back feeling sick, light headed , not great, obviously not enough fluid, water or sports drink? your advice would be grateful.
Cheers Anon.
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Gary Moller comments:
The first thing to do is to have a method of feedback to determine if, in fact you are getting dehydrated and to determine your needs.

Weigh yourself immediately before you run and immediately after. What you have lost in weight is water. So, if you lost a Kg then that equates to 1 liter of water. Drink 1 1/2 liters over the next hour or so to make it up. Weighing regularly before and after runs gives you an idea of how much you are losing on a typical run (depending on factors like, temperature, humidity and pace, of course!) and therefore how much to drink during a run.

Learn to listen to your body signals. The weighing will help you to become sensitive to your body. Thirst is very useful - as long as you know how to listen carefully and respond early. Most people have no idea how to listen and therefore must resort to rote formulas for fluid consumption which I detest.

If you are suffering nausea and light-headedness after a long run, it could be worthwhile to purchase a blood pressure and heart rate monitor and take regular readings to determine what is happening to heart rate and blood pressure before and after a run. If you do so, then write to me with the reults to assist interpretation. Read these giudelines here for a good explanation about blood pressure.

When we lived in Putaruru all of our long Sunday runs with our Dad were in the forests of Tokoroa and the Mamaku. It was 2-3 hours before breakfast with no fluids. While this was tough I can assure you that I am still alive and in excellent health! My kidneys are fine. It seems the body does adapt if given the right nudging and time. In my sister Lorraine's case, being able to run very fast for 2.5 hours in heat and humidity with little more than a cup of water along the way was essential for winning an Olympic marathon medal in stinking hot Barcelona.

However, getting deathly dehydrated is probably not necessary in training for most and drinking a liter or so of water along the way is a good idea especially if the runner is a heavy sweater and the conditions warm.

I am not keen on carrying water when running. The risk of leg injury is high enough as it is and adding a Kg or two more onto the legs is adding to that risk. It is better to plan the course so that there is a drink station, like a tap or bottle along the way. This could be done by doing a couple of laps of a course from where the car is parked, or planting a bottle of water at the 1/2 way mark before you commence the run.

I do not recommend using a sports drink or similar when training. Water is best. You are using your long runs to stress your body's energy reserves and swigging sweet liquid is not going to allow this to happen. The sports drinks should be reserved for the actual race - not in training. However; if you are going to be running at pace, then you must ensure that you can tolerate sweet electrolyte drinks. Practice drinking your sports drink during some of your short, fast runs and see if it stays down. I have found that water is best when running; whereas sports drinks are fine for sports like cycling where there is less problems with jiggling and jostling of the gut. I prefer to make my own using Balance Elite but any of the commercial powders are fine. I have even taken to adding a teaspoon of Balance Glutamine to the mix to assist stamina and recovery and it seems to work. Read my e-book about training for a marathon which has plenty of training information.

When mixing your drinks, err on the dilute side. If the weather is hot and humid, then you need more liquid and less of the sugary stuff. If it is cold and wet, then you need less water and more of the sugars. If you are running very fast, then you may only tolerate a little fluid in your gut which is why having a good tolerance of dehydration is important for elite runners; whereas when running very slow, or walking, you should have no trouble drinking and your main risk might be death from drinking too much.

During the marathon, there are more than enough drink stations by the organisers so there is no need to carry your own. Run light. Drink early and listen to your body signals and respond accordingly.

The ten most important rules for training for running or walking a marathon

Give yourself time and be consistent. You need at least three months of training to have the stamina to complete a marathon. So, whether you have three months or six months to go before the big day, get your shoes on and start your training now! Be consistent. Have a training plan that progressively increases the mileage covered and stick to it week after week, month after month.

Get time on your feet. It’s not so much the mileage or speed; but time spent running and walking that prepares you for completing the marathon. Very gradually build up to doing one weekly run that is up to three hours duration; or, if you are walking, your goal is four hours on your feet. This is your goal about 4-6 weeks out from the marathon, after which you ever so gradually reduce so that you are fresh and raring to go on race day!

Make your journey to the marathon interesting and fun. Try making every training session different from the last one. Explore new places. Organise mystery runs with your mates. Get lost and get very fit. Play “chase” now and then. Do the occasional day-long or multi-day hike (Even if you are a runner, a long hike in the bush is wonderful physical conditioning).

Do not over-train and ensure you recover. You only need to do three long runs or walks per week (Plus one short, faster one, if you are really serious). While you should be active on the day in-between, you must ensure that you are as close to fully recovered before the next long training session. Make every fourth week a relatively easy “recovery” week. Have your regular training partners; but do the majority of your training on your own so that you go at your pace and distance and do not risk being constantly dragged along too far and hard too often by others. The risk of injury and illness is too high.

Run or walk mostly on trails. Training on roads and pavements is especially hard on the legs; especially if there is an unrelenting off-camber. Train on trails that vastly reduce the impact shock and which vary the stresses on the legs with every stride. You will find you can go longer and faster and still recover in time for the next session.

Eat a nutrient rich diet. Your body cannot recover properly or build strong, healthy tissue if your diet is lacking in essential nutrients. Have a home made Super Smoothie that contains proteins, carbohydrates, vitamins, minerals, essential oils and antioxidants within an hour of finishing each training session.

Keep hydrated. Weigh yourself before and after a training session: If you lose 1kg then you must replace this by drinking 1kg of fresh water (1 liter), plus an extra ½ liter for good measure over the hour of finishing. You will later be able to dispense with the weighing because you will have learned to listen to your body signals. Got the idea?

Get plenty of rest and quality sleep. Ideally, you want to have a sit-down job, rather than one that has you on your feet all day. It is during deep sleep that your body produces its daily peak of growth hormone that stimulates repair and growth. Be in bed and asleep by 11pm every night and get 7-8 hours of sleep.

Treat injuries before they incapacitate. Unless you fall over, or are run over by a bus, running and walking injuries happen slowly. Cut your training short and take a compulsory four day rest the moment there is a hint of an injury and then gradually work your way back into training. The same rule applies to illnesses like colds. Follow this rule, and others, and you will never have to visit a health professional about a training related ailment.

Listen to your Inner Voice. The most important rule has been saved for last. You are a living being – not a mindless automaton. Learn to listen to your Inner Voice. If it is telling you to stop, then stop; if it is telling you that you can go further or faster, then do it; if it is telling you that you need more water or food, then give yourself some; if it is telling you that you need a few days break, then do it. Ignore your Inner Voice at your peril – illness, injury and mental staleness are the inevitable consequences. Listen carefully to your Inner Voice and you will thoroughly enjoy your training and you will complete the marathon with a personal best.

The zen of running

GRASSHOPPER, BE YOUR SELF. AND NEVER FEAR THUS TO BE NAKED TO THE EYES OF OTHERS. YET, KNOW THAT MAN SO OFTEN MASKS HIMSELF. THAT WHAT IS SIMPLE IS RARELY UNDERSTOOD. THE DUST OF TRUTH SWIRLS, AND SEEKS ITS OWN CRACKS OF ENTRY. AND A TREE FALLING IN THE FOREST, WITHOUT EARS TO HEAR, MAKES NO SOUND. YET IT FALLS - Master Po from the original Kung Fu TV series.
I get a nasty headache whenever I hear some expert advising athletes that they must eat so many grams of this and that per hour and drink xyz Mls of water with various ingredients added to make it completely indigestible.

Sure there are some basic rules of thumb for how much to eat and drink on a run or ride and in certain conditions; but this this is almost as bad as trying to paint a masterpiece by numbers. Training and competing are as much an art as it is a science. Gosh! Why don't we just turn off our senses and hook oursleves up to intravenous drips, open the tap, turn up the iPod and run mindloessly until we drop!

Even though I have worked my way through the academics of sports nutrition (An excruciating experience) I have never gotten off on measuring how many grams of this and so many mls of that - I have always gone by the philosophy of learning to listen to my body and this is what I teach athletes to do. This is something I learned early on from my sister, Lorraine, who applied the concept with artful precision to have lasting success when running marathons very fast in extremes of weather.

Would you know it! - Humans have two little known sensory feedback systems that outperform the best of modern rechnology hands down - one is called thirst and the other is called hunger. "Now, little Grasshopper, listen to your body". This is something the modern urbanised human has long forgotten and since replaced with fancy machines, mathematical formula and white-coated experts. Thirst and hunger are extremely sensitive mechanisms that tell us what to do well before there is a decline in performance - if only we would sensitise our minds and listen and respond early enough to the subtle signals.

Listening to our very own in-built feedback systems has served us well since time began, enabling man to survive and even fluorish on next to nothing in the harshest environments. Our problem today is that we are forgetting how to use them.

Training for a marathon has been updated!

This free e-book is now up to 88 pages with more to come shortly. The latest version has a new-look table of contents that is easier on the eye. There is more information about designing training schedules and we have added a whole lot of content about the "walk-run" option for completing a marathon or 1/2 marathon. There is more advice about injury and health issues and a few more pictures and illustrations.

Would you like to advertise your products and services in this publication which gets distributed world-wide? If so, please contact me.

These updates are guided in part by reader feedback, including inquiries about training and injury issues, so keep it coming!

Was it the barley sugar?

"How much sugar wud switch your body from running on body fat to runnning on sugar. for example would a single barley suger during a marathon switch ones body to suger as fuel???? the reason that I asked is because I was given a barley sugar just before the 20km hill I was going fine until then just over that hill I crashed and burned, the barley sugar was great to suck going up the hill but was it my undoing??"
- Anon
_______________________________

World class runners go at a pace so fast that it is
next toimpossible to take in carbohydrates and
only a few cups of water, so they train for this.

Dear Anon,
Sorry, Mate; but you can't blame the barley sugar for the crash and burn act. It was probably the 8 week build-up to the marathon that was your undoing.

Your inquiry raises a few interesting points that I will try to cover:

1. Do at least 12 weeks training before a marathon, preferably the best part of a year. Each week, at least one run should be long and slow and completed without sustenance other than water. Follow the guidelines in the "Training for a Marathon" e-pub. Have a diet that is low in refined carbohydrates (whole grains and unprocessed carbos are essential). It will take at least 12 weeks of this kind of training to adapt; and you will notice with delight that you can go longer and faster during these long runs without getting irresistible carbo-cravings.
2. Doing what is recommended in (1) will help your body conserve its internal carbohydrate stores during a race like a marathon, enabling you to run longer and faster before hitting the wall. While there is no "switch" between fat and carbohydrate metabolism (Useage is in terms of ratio, rather than just one or the other), there does come a critical point in body carbohydrate store depletion where the body and brain appear to do a sudden drop in performance - the wall. this can feel a bit like throwing a switch.
3. When you are running really hard, it is almost impossible to take in anything other than the smallest quanity carbohydrate without suffering disabling stomach upsets. This is why the training as outlined above (1) is so important. The only other way to avoid hitting the wall is to run much slower and to eat and drink as you go. But, the more you take in, the slower you must go and that means a long time out on the road, which can be just as hard as trying to go fast.
4. Trying to eat and drink, including sucking a barley sugar, when going at anything other than a slow pace also causes interference with breathing and running rhythm. This can force the runner ever so slightly into oxygen debt. This hastens the hitting the wall.

So Anon, when you felt yourself seizing up, the best thing you could have done was to slow right down and take on a dozen or so barley sugars, wait for the sugar to infuse the body and hope. However; with the lack of training, other metabolic problems compound the seizing up, such as the nervous system itself running out of gas (the muscles go into a kind of rigor mortis).

With regards to the barley sugars, there is an additional issue:
If you are breathing heavily, jostling and being distracted there is a serious risk of inhaling the barley sugar and chocking to death. This is why responsible coaches ban chewing gum and sweets during training and competition. Barley sugars are fine if only walking slowly; but not if the pace is brisk and definitely not if running. The better choice is a sugary drink and soft caramel bars.

However, Anon, if you start training now (you are allowed 10 days rest) you will find that everything is so much less complicated when you run your next marathon.