ATC 298: The Most Common Injuries To Prevent Against, The Sub-2 Shoe Debate, MAF For Health vs. Performance, And More

November 8, 2019


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Intro Banter and Announcements:

  • We have a bunch of new EP gear — including just-added men’s and women’s athletic tech T-shirts — for casual wear, kids and babies go over to our Gear page. Get your hands on some and send us a pic of you sporting the logo!
  • Wanna run Ragnar SoCal with the EP team? It’s April 3-4, 2020 and we are opening a second team. To find out more, email us at
  • Shoe debate after the sub-2 marathon: should we regulate things like midsole height and carbon plating?
  • Tawnee reviews the Apple watch vs. Garmin (Garmin wins)
  • Tawnee mentions using a stroller strap for safety; here’s the one she got.

Dr. Matthew Klitsch asks:

Most Common (and Preventable) Injuries?

I’m a huge fan of the show and have been listening to every episode for about a year now. I wanted to gather some information to better help the athletes I take care of in my office. Specifically my goal is to help keep athletes healthy and cross the finish line in the same level of health they started the race in. In doing so It’s much easier to keep athletes healthy, prevent injuries than to put out flames days or weeks before races or big training days. So to get to my question. Over the course of your and Lucho’s  coaching journey, what “injuries” have you most frequently seen (aside from traumatic incidences)?

What the Coaches say:

  • Dr. Ebonie Rio on The Fundamentals of Tendon Training and Rehabilitation: Just Fly Performance Podcast #144
  • Commonalities of injuries in adult runners (compilation of many studies):
    • Top location of injury in adult runners:
      • Knee
      • Lower leg
      • Foot
    • Top types of injuries in adult runners:
      • Tendonitis
      • Inflammation
      • Strain
    • Intrinsic risk factors for injury:
      • Previous injury
      • Age
      • Hip abductor weakness
      • Higher BMI
      • Men
      • Decrease calf strength
    • Extrinsic risk factors for injury:
      • Less experience
      • Excessive weekly training distance
      • Lower stride rate
      • Lower volume
      • Excessive training progression in novices
      • Less than 2 days off per week
      • Using orthotics or inserts
      • Minimalist shoes
  • A Review of the Current Literature on the Utility of the Functional Movement Screen as a Screening Tool to Identify Athletes’ Risk for Injury
    • Study on FMS as injury predictor – Recent studies on the FMS have demonstrated major flaws in its ability to predict overall injuries with high rate of false positives that never resulted in injury. Based on the conflicting evidence, rehabilitation and strength and conditioning specialists should use caution when attempting to use the FMS for injury prediction in athletes. The FMS is better described as an assessment of the quality of human movement as opposed to a risk-assessment tool.
    • First, although the FMS is considered a screen, studies report low to medium sensitivity and higher specificity; this is problematic as viable screens demonstrate the opposite characteristics. If anything, the FMS can rule-in factors that indicated a possible injury and thus should be considered more of an assessment than a screening tool.
    • A majority of the FMS research indicates that composite scores do not correlate with injury prediction (5,12,22). As previously mentioned, this can be due to the variability of the methodology used in FMS studies, or it may be related to components of the FMS that do not correlate with certain sports’ demands. However, when the FMS was used with a single sport or an individual component from it, a majority of the results demonstrate better correlation to a future injury (1).
  • Tendon loading types

Suzzane S. asks:

Easing Back Into Running

Hi Coaches,

I’ve been a listener of your podcast for a few years now and always learn a lot from you guys.  I’m hoping for some advice.

A brief history – 39 yr old female, Hashimoto’s and Raynauds but otherwise healthy, 5’7”, 130-135ish lbs.  I eat whole foods diet and have played around with paleo, gluten-free etc to find what works for me.  My sleep is decent.

-Former exercise addict, used to do half marathons (middle of the packer), bootcamp workouts and feel anxious if I couldn’t get in a sweaty workout most days.  Two years after having my daughter (she’s now 6), I kinda burnt out by trying to do it all, work etc and working out too hard.  Burned out.  I started to taper things down and tried the MAF approach.  Over the past few years I’ve been gradually cutting back, first with easier effort, then with less volume and so on but I don’t think I ever really slowed down enough to actually recover.  A ‘Maf-ish jog/walk’ an hour 5-6 days/week was maybe too much and even after a couple years, I was never able to actually run at MAF, it was more of a wobble, shuffle, old lady run.  A couple of months ago, with a bit of a flare in my Hashimoto’s and overall fatigue, I decided to completely CUT OUT my attempts to run and just walk (5-6 45min walks/week) and do a bit of weights at home.  It’s helping!  I’m feeling more energetic and happy.  YAY! (Also- Q from Suzzane in April 2019 she indicated she had a stress fracture on top of foot, and was wondering if her training was “too hard”? Says: my exercise routine has been to get in about 5 or 6 runs/week, 30-60 min, trying to keep my heart rate under 140 most of the time.  I would run fasted in the morning thinking that this would overtime improve my fat burning and help me to improve my pace at low heart rate.  My other reason for the way I was training was to try to keep my exercise-stress low as I’m a bit of high sympathetic-type of person.  I would also do a bit of strength work (push-ups and squats, mostly body weight).  This was convenient and worked well with my work/family life and I enjoyed getting out in the mornings.  I had no injuries for years.  However, I was not getting any faster and was not feeling very strong.  )

Here’s my question:  I really love running- fall runs through crunchy leaves, getting a bit of a sweat on (although I no longer like the feeling of pushing really hard), feeling strong and free.  I also love participating in fun runs and running with friends.  I’d really like to get back to running but want to avoid getting to the burnt out state I lived in for too long.  It would be great to go for runs with friends and do an occasional 10k again.  With about an hour/day that I can devote to exercise (ideally first thing when I wake up), what might be a way that I could integrate some running back into my life gently?  Would it make sense to replace two or three of my weekly walks with an easy run, going by feel instead of struggling to stay below MAF?  I’m just not sure that I can do enough volume to make the MAF method work.  And also, I realize that fasted workouts are a bad idea for me so I’ve been saving weights for later in the day.  I’m assuming fasted walking is fine…?

Thanks so much for your sharing your wisdom and advice!!

What the Coaches say:

  • Don’t fixate on “making MAF work” in a performance-based sense. You should be using MAF to help you get healthy.
  • It doesn’t have to be all or nothing; you can incorporate some running into your walks.
  • Volume isn’t what’s important for you right now. Your life has a lot going on, and if your MAF isn’t improving because you’re not running high volume then that’s ok!
  • Don’t stress out about when you’re eating, necessarily.
  • Racing doesn’t have to be set in stone in your life right now.
  • Don’t let your identity be wrapped up in your racing and performance. (Motherhood is way more important 🙂 )

Maury L. asks:

MAF for Triathlon on Limited Volume?

Hello, I am very interested in properly applying MAF training to all 3 sports swim, bike run, concurrently.

I find when maf is talked about it is usually done so with running being the sole sport pursued while doing maf.

I am a typical time starved person and probably can only train 7-10 hours per week. I think I understand how to do MAF training if I run exclusively. However, I do NOT understand how to apply MAF training when training all 3 sports, concurrently, with only 7-10 hours per week (with more weeks probably at 7 vs 10 hours) .

Should I just do all 3 sports at or below my MAF heart rate?

So mostly steady state, lower intensity/RPE efforts that keep my HR below my target number?

also, is there a minimal amount of training time at MAF one should do, otherwise it is not worth it?

This ties in with my above question in that if I only run twice a week for example for a max of 2 hours combined, because I am also biking and swimming, is it not worth it to do any MAF training?

Thank you for any comments, feedback or direction that can be provided.

What the Coaches say:

  • 7-10 hours of training can be sufficient if you’re fast and strong at MAF.
  • Using MAF on the bike is just like MAF on the run. You should be doing this!
  • To do MAF in the pool, figure out your pace at MAF using a HR monitor one time. Then just go by pace after that.
  • Lucho recommends undulating one week heavy running and the next week back off to 2 runs with a bike focus.
  • In the pool, the biggest bang for your buck is kicking drills.
    • A straight swim is never going to get you faster; do 10x100m drills with kicking in between.
  • Make sure you’re running off the bike, even if it’s a 10 minute T-run.
  • You could take a periodized approach by doing MAF in the off-season and base period, then doing more specialized speed workouts as your A race gets closer.

Tia M. asks:

Postpartum mama wondering how to structure offseason?

Hi guys, a huge thank you for this amazing podcast.  The impact of your work has been huge in my life.  I’ve been listening since 2015, a very dark time as I was recovering from a slew of female athlete issues and 2 years of infertility.  After not having a period for nearly 8 years, thanks to your podcast and Tawnee, your blog, it led me down a rabbit hole of knowledge that totally shifted my mindset about training and wellness.  Fast forward to today, I’m a mommy of 2 beautiful little humans.  I feel like you guys had some doing in that, as crazy as it sounds. Thank you!

I have a background in competitive kickboxing for 12 years, Crossfit and running.

-Running for me was mostly long and slow; several 50Ks which I completed in roughly 7 hours.

-I spent 2015 exclusively focused on MAF getting my pace from 10:30 mile/min to 8:50 mile/min with 35 to 45 miles/week just before getting pregnant.

-I was able to work out 4 to 5 days a week throughout my entire pregnancy.  This included light jogging 4-6 miles, scaled/modified Crossfit and the bike trainer.

-I took postpartum really slow as I had a pretty big mindset shift with the second baby.  Instead of rushing back to the gym, I didn’t do more than a short walk here and there for the first 6 weeks.

-I also worked with a Pelvic Floor PT (highly recommended) to ensure my insides and lady parts were healing and recovering well.  I’ve also been able to return to my pre-pregnancy weight without dieting or restrictive eating.  I’ve just been focused on intuitive eating and quality foods as much as possible, carbs and all.

I’m now 1 year postpartum after having back to back kids and am starting to get excited about more structured training. I just finished breastfeeding too so the timing feels right.

I’m 36 but I still run MAF slightly higher, 147-154.  It still feels easy.  Recent MAF Pace is 9:09 min/mile.

I ran a half marathon last month with a 1:51 finish and felt great. I felt like I could’ve easily gone sub 1:50.  It’s no where near my PR 1:43 many years ago but it was the best I’ve felt in 6 years since my healing journey.  I also have a full marathon in October. My goal is to simply enjoy it and see where I’m at to prepare for next season.

My question is about my upcoming off season after the marathon.  I have my eyes set on a 1:45 Half marathon next year and possibly another Full marathon.  I’ve never worked on speed but would like to next season!

My parameters for training these days are:

– 5 to 7 hours a week dedicated to training.  I work full time and not willing to sacrifice any more family time for training.

– I live in upstate NY so running in the winter can be spotty. I don’t have a treadmill (should I get one?) I have a Peloton/Indoor spin bike that I love.

-I really enjoy Crossfit 2 days a week just to get out the house, be social and break up the week.   I have no issues scaling these workouts if I need to…I just really don’t want to give this up completely.

My question is, how should I structure my off season?  More leg extensions? Should I dedicate this time to building/improving MAF? Is 5 hours a week enough time to do so? Would the bike be effective for MAF in the off season? Or do I really need to consider dishing the money for a treadmill and keep MAF specific to running?

What the Coaches say:

  • A treadmill would be really useful, but it’s not worth going into debt for.
  • Cycling doesn’t benefit running as much as running benefits cycling.
  • Incorporate CrossFit workouts that are run bias, such as:
    • Lucho’s Bert Ladder
      • Weight optional and/or modify as needed
      • R- 400 MAF
      • 100 squats (50#)
      • R- 800
      • 100 core
      • R- 1200
      • 100 Lunge or Bulgarian split squats (50#)
      • R- 1 mile
      • 30 KB swings (55#)
      • 30 V-Push ups
      • 30 Pull ups
      • 10 Push ups
      • R- 1200
      • 100 squats (50#)
      • R- 800
      • 100 Lunge or Bulgarian split squats (50#)
      • R- 400
      • 30 KB swings
      • 30 V-Push ups
      • 30 Pull ups
      • 10 Push ups
      • (4 miles total)
  • Tawnee recommends polarized training if you’re not seeing gains running 4-5 hours a week at MAF.
  • Lucho recommends fartleks: 10x 2 min at tempo effort (half marathon pace) for 45 minutes straight.

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