Footwear, Bike Fits, Workout Supplements, Nutrition: Mini Journal Review

Dr. Blake Middleton Article Leave a Comment


Happy New Year to everyone! Hope the motivation is high and the training is off to a great start! Congrats as well to everyone kicking butt in the IronFire Challenge! That is very encouraging and motivating to witness!

Here are the 5 articles for you all to help move your training and health forward. There is a double dose of footwear and running patterns. An article discussing beta-alanine. Also bike fitting and positioning in relationship to low back pain. Finally, a review of eating low carb, high fat for those reading more for health benefits. Please start up a conversation about these articles including questions. Or if you notice any of these studies help you. As well as any additional tips and tricks you do that relate to the studies discussed. Also, let me know if you’d like access to any of the full articles and I’ll send them your way.


Footwear and Foot Strike during Running

This is another study comparing rear foot and forefoot (mid-foot) running and load rates. However, in this study they separated the forefoot running group into two.  Evaluations of them in conventional vs minimalist running shoes. They also performed the study on participants who habitually ran with the tested shoe type and landing pattern. Prior studies only comparing rear and forefoot landing displayed the same overall loading force (rear foot with more vertical force and forefoot with more medial and posterior directed force). These studies however did not take into account shoe wear as this current study did. Many other studies required the participants to go through both landing phases creating a brief transition into forefoot running for some. This may have confounded the prior results.

To study the force and impact, each participant completed a 30 M run at an 8:24 min/mile pace while measuring ground reaction forces. The results suggest that running with a forefoot stride patter in minimalist shoes have the lowest impact on landing with similar load rates found in the other 2 groups.

APPLICATION: Injury prone runners may benefit from transitioning into a minimalist shoe.  doing so while slowly incorporating a forefoot stride. This change as there is lower load rates which likely results in lower injuries. Be careful upon transition as there is a high rate of knee and foot problems if the transition is too quick. I show bias to this study since I deal with 3 bad discs in my back. (thanks to high school sports and working for a moving company in my teens) Personally I feel like the transition to mid-foot running has taken the pressure off this area and has allowed me to continue progressing as a runner. Anyone else with similar experiences?


Bike Fit in Cyclist With and Without Back Pain

This study is a meta-analysis which is a summary of a collection of other studies. This particular study took 5 others to look at risk factors for low back pain in cyclists. If this is you, realize 58% of professionals deal with low back issues. Measuring body position showed people with low back pain have increased low back flexion and rotation while cycling. These changes were noted from the beginning of the ride and throughout compared to cyclists without pain. The study hypothesizes that this is due to poor endurance in the back and core muscles. This causes the spine to absorb more stress in this flexed position resulting in pain. So ultimately, this study reveals that spinal and core muscle activation imbalances in a prolonged flexed (cycling) position may lead to increased spinal stresses and low back pain.

APPLICATION: One of the easiest fixes  is a bike fit. Another article showed a 10-15 degree change in anterior tilt of the saddle eliminated pain in 75% of participants and reduced pain in another 20%. Another quick fix is raising your handlebar height. This is really just a Band-Aid though… the main focus needs to be on balancing your core and back muscles. That means some cross training. My go to exercises are bridges and planks that I scatter in during mental breaks throughout the day. You may also benefit in other ways with a bike fit. Professional fitters  can point out imbalances in your position and give tips on improving.


Beta-Alanine Supplementation

I’m a fan of all the creatine research and take 5 grams each day to enhance performance. Rcently I have been considering about adding B-Alanine to see if even more performance gains are seen. B-Alanine is easily absorbed inside muscles and helps create Carnosine. Carnosine is a proton buffer and calcium regulator, to help with the build-up of lactic acid (and more importantly H+).

This is the 1st study to looked at trained athletes. The participants are cyclist completing anywhere from 7 to 16 hours of biking a week. They measured results of a 4 X 1 Km bike interval session, 4 Km bike, and 10 km bike. Supplementation consisted of 6.4 g daily for 4 weeks followed by 1.2 g a day thereafter. Testing was done prior to supplementing, after the 4 week loading phase, and then after combining the maintenance dose (1.2 g a day) with interval sessions twice a week for 5 more weeks.  There was a matched group consuming a placebo (sugar pill) during this study as well.

Results showed significant improvement in testing after loading doses and 5 weeks of interval workouts in the group taking B-Alanine in the 4 X 1 and 4 km time trial compared to placebo supplementation completing the same exercise sessions. In the supplement group there was up to 3% drop in time and 8% increase in power output. However in the 10 K there was no improvement in either group after the loading period and both groups had equal improvements after 5 weeks of intervals.

APPLICATION: Looks like supplementing may help you on efforts less than 5-6 minutes. This does not translate into improvement in longer efforts (10 K+). I think I’ll avoid adding it into my training for now. If you do take this, realize it competes with Taurine absorption and so supplementing with it at different times of day would be important. Also, ensure it is the Carnosyn version of beta-alanine as this is the best absorbed. Beta-alanine is in several pre-workout powders and so you may already be supplementing with it. I’m curious if anyone has seen benefits on this or what other pre-workout supplements you’ve seen improvements with? Please share and let us know your experience with them if so.


Insoles and Injury Prevention

Another meta-analysis looking at 18 studies to evaluate the effectiveness of foot orthosis and shock absorbing insoles on injury prevention, The studies selected are specifically looking at endurance runners and military trainees. This review establishes that foot orthosis (custom and prefabricated) prevent injuries in specific areas. These include shin pain, shin stress fractures, and toe stress fractures. However, there is no benefit in other areas. Areas such as knee, Achilles, and back issues. In regards to  use of shock absorbing insoles, in this meta-analysis, there are no benefits in preventing injuries and in 1 trial was shown to possibly increase the risk of injury.

APPLICATION: I’m not convinced everyone needs to run out and put foot orthosis in your shoes. There are quite a bit of limitations with this study. I believe for people with a history of lower leg and foot stress fracture or shin splints that this is a great option. It is known that re-occurrences are quite high with these injuries. So, any small changes to prevent them should be undertaken. The lack of benefit with shock absorbing insoles points me in the direction of gradually incorporating minimalist footwear. I’m a big proponent of working on foot strengthening and flexibility instead of again, using a Band-Aid approach. Simple interventions include placing a golf ball and a baseball under your desk to roll your feet.  Also, adding a dish towel to work on toe strength by grabbing and releasing it.


Diet: Evidence for Low Carb High Fat (LCHF)

Best for last, and I’ll just go ahead a put a link in to this article in the British Journal of Sports Medicine by one of my favorite researchers, Timothy Noaks. I know when talking about nutrition, things can get kind of messy. I do believe there is no one diet that fits ALL individual metabolic profiles. However, when people are struggling with weight loss and overall health I either direct them to LCHF or a Mediterranean Diet to try out first. These contain a high nutrition density while managing energy balances. The main goal I have for people is replacing refined, nutrient poor processed foods with nutrient dense, natural foods. This articles talks about LCHF but also goes into what types of foods are more nutrient dense and the benefits of these foods for your health. It also goes into specific diseases and common myths about the diet.

APPLICATION: I am not a fan of long term Ketosis. But, limiting carbs somewhat does look to have quite a few benefits. You must be careful of course when combining with heavy loads of exercise and other chronic daily stresses in life. I recommend incorporating times of carb re-feeding or cycling whether daily or weekly.  This ensures your metabolic systems don’t tilt too far the opposite direction. I’ve heard of people becoming too low carb for too long (usually greater than 6-8 weeks) developing thyroid, adrenal, and other metabolic disturbances.

I don’t calorie count but I ensure plenty of fats in the morning with breakfast,. I follow this by incorporating snacks that are full of healthy fats. Then with lunch and dinner incorporating more carbs. This include sweet potatoes, rice, or yummy sourdough bread. I am not a hard core follower of any specific diet. Instead I listen to what my body needs and do make small adjustments throughout the year. Most of the time it seems similar to LCHF or Mediterranean but I try to not identify my nutrition with any specific diet. I know there are lots of thoughts on the topic and I want to hear any you have.

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