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Running is a great workout, and it comes with all of the heart-strengthening benefits of aerobic exercise. But doing it for long distances�like in a marathon�may come with unintended health consequences. A small new study finds that marathon runners can experience short-term kidney injury after the race.
In the study, published in the American Journal of Kidney Diseases, researchers took blood and urine samples from 22 people who ran the 2015 Hartford Marathon, and looked for evidence of kidney injury. The researchers reported that based on the markers they observed in the samples, 82% of the runners had evidence of stage 1 acute kidney injury after the race. The problem appeared to be short-term, and most people�s kidneys returned to normal within 24 to 48 hours.
Still, the researchers say that their findings underline the fact that running a marathon is a stressful event for the body, and that some people may want to be extra vigilant. �We knew we would find something, but I was surprised by the level [of injury],� says study author Dr. Chirag Parikh, a professor of medicine at Yale University. �It�s comparable to what I see in hospitals.�
More research is needed, but Parikh says that people who have no risk factors for kidney disease probably don�t need to worry. People with diabetes or high blood pressure, or people who are older, may want to work closely with trainers and doctors to keep an eye on their kidney health if they�re running marathons.
Though the researchers did not determine how exactly running a marathon can temporarily hurt kidneys, Parikh says the damage may be due to less blood flow to the kidneys, high core body temperature and dehydration. It�s still unknown whether this short-lived kidney injury can cause cumulative damage, or if some people may not recover in the short-term.
The study is not the first to find that marathons can come with health risks. While it�s clear that getting exercise is important, research suggests that more isn�t always better. A 2015 review published in the journal Current Sports Medicine Reports found that while runners in the study lived longer than non-runners, men and women gained the lifesaving benefits of running if they ran at slow or moderate speeds for about one to two hours a week. Among the runners, the people who ran the most had worse survival rates than people who ran less.
Parikh says that his study did not identify who might be at a higher risk, but notes that people over age 40 are increasingly signing up for marathons, and may want to take more precautions. Today, people 40 and older make up nearly 50% of marathon finishers in the U.S., compared to 1980 when this age group made up just 26%.
�Is there a right amount of distance for each person?� says Parikh. �Like everything else, there might be a balance of the benefits and risks. People can find the right distance for them and train their body.�
Any marathoner will tell you that the grueling 26-mile races can do a number on the hips, knees, ankles and feet.
Now, a small study suggests that these tests of endurance are also tough on the kidneys.
“Marathon runners demonstrate transient or reverse short-term kidney injury,” said Dr. Chirag Parikh, professor of medicine at Yale University.
In his study of 22 participants in the 2015 Hartford, Conn. Marathon, Parikh found that 82 percent showed acute kidney injury after the race. In this condition, the kidneys fail to filter waste from the blood. The good news is that the kidney injury seems to clear up within two days of the race, he said.
“On day 2, they are all fine,” Parikh said.
Runners likely don’t even know they’ve had this transient injury, Parikh said. “For the short term, I don’t think they would notice anything,” he said. Parikh isn’t certain why the strenuous event is linked with kidney injury. But some potential causes include the sustained rise in core body temperature, dehydration, or the decreased blood flow to the kidneys that occurs during a marathon, he explained. When the blood is pumped to the skin and muscles while running, he said, the kidneys may not get as much blood as they normally do.
Nor can Parikh say whether the effect might be cumulative, getting worse with more marathons run. It may be that the kidney adapts over time instead, he noted.
To evaluate this type of kidney injury, his team looked at blood and urine samples collected before and after the marathon. These tests included measuring blood creatinine levels and proteins in the urine, along with looking at kidney cells on a microscope. Creatinine is a waste product excreted by the kidneys; measuring it in the blood helps assess kidney health.
In a previous study, published in 2011, Dr. Peter McCullough, vice chief of medicine at Baylor University Medical Center in Dallas, and colleagues evaluated 25 men and women marathoners. They found 40 percent of the runners met the definition of acute kidney injury based on their blood creatinine levels.
In the new study, Parikh’s team also “performed an in depth evaluation of the urine and found evidence of injury,” McCullough said.
“The larger question looming is: do these repeated bouts of injury in endurance athletes lead to chronic kidney disease years later? Can anything be done about the injury at the time including hydration strategy?” McCullough said. More study is crucial, he added.
Parikh said additional research is also needed to assess whether certain people may not recover as quickly. For now, those with a family history of kidney disease should let their physician know they run marathons, he suggested.
Dr. Cathy Fieseler said marathoners who want to reduce their risk of kidney injury should avoid anti-inflammatory drugs before the race. Those drugs include over-the-counter ibuprofen (Advil, Motrin IB) and naproxen (Aleve), Fieseler said. Acetaminophen (Tylenol) is cleared through the liver.
Fieseler is a primary care sports medicine doctor at Christus Trinity Mother Frances Health System in Tyler, Texas. She’s also medical director of the American Running Association.
The study was published March 28 in the American Journal of Kidney Diseases.
SOURCES: Chirag Parikh, M.D., Ph.D., professor of medicine, and director of applied translational research, Yale University, New Haven, Conn.; Cathy Fieseler, M.D., primary care sports medicine physician, Christus Trinity Mother Frances Health System, Tyler, Texas; Peter McCullough, M.D., vice chief of medicine, Baylor University Medical Center, Dallas; March 28, 2017, American Journal of Kidney Diseases
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Chiropractic and Athletic Performance
Many athletes who are injured performing their specific sport or physical activity, frequently seek treatment from chiropractors. Chiropractic care focuses on the prevention, diagnosis and treatment of injuries and conditions affecting the musculoskeletal and nervous system. While chiropractic is a safe and effective form of conservative care for a variety of ailments, chiropractic can also be utilized to enhance athletic performance.
High-intensity exercise may help older adults reverse certain aspects of the “cellular” aging process, a new study suggests.
It’s no secret that regular exercise is healthy for young and old alike. But researchers said the new findings point to particular benefits from “high-intensity interval training” for older adults. That’s the type of workout that combines brief bursts of vigorous exercise with periods of moderate activity: A person might, for example, go all-out on a stationary bike for a few minutes, ease up for the next few, and then start again.
In this study, older adults who performed that type of exercise showed greater changes at the cellular level, compared to those who worked out more moderately. Specifically, interval training gave a bigger boost to mitochondrial function in the muscle. Mitochondria are the “powerhouses” within body cells that break down nutrients to be used for energy. The training also revved up activity in more genes related to mitochondrial function and muscle growth.
How Exercise Can Help the Aging Process
The study findings suggest that interval training can turn back the clock in ways that moderate aerobic exercise and strength training do not, according to lead researcher Dr. K. Sreekumaran Nair. But, he stressed, the findings do not mean older adults should jump into a vigorous exercise regimen.
“If you’re sedentary, you should talk to your doctor before you start exercising,” said Nair. He’s an endocrinologist at the Mayo Clinic in Rochester, Minn. “And then,” he said, “you can start with walking, and build yourself up to a fast pace.” For older adults who want to progress to a more-intense regimen, Nair said, it’s best to start with supervision. But he also stressed that intense exercise is not a must. “Any regular exercise will bring health benefits — absolutely,” he added.
This study demonstrated that, he pointed out. Even though interval training had the biggest effects on aspects of cellular aging, other types of exercise boosted older adults’ fitness levels and muscle strength.
Benefits of Exercise in Adults Study
The study, published recently in Cell Metabolism, involved 72 younger and older adults who were sedentary.
Nair’s team randomly assigned each of them to one of three supervised exercise groups. One group did high-intensity interval training three days a week: They pedaled on an exercise bike at their maximum speed for 4 minutes, before easing up for 3 minutes; they repeated that process four times. They also worked out more moderately — walking on a treadmill — twice a week.
A second group performed moderate aerobic exercise — using an exercise bike at a less-intense pace — five days a week, for 30 minutes. They also did some light strength-training four days a week.
The third group performed strengthening exercises only, two days a week.
After 12 weeks, all of the groups were showing positive changes — younger and older exercisers alike, the researchers found.
People who performed moderate aerobic exercise boosted their fitness levels — the body’s ability to supply blood and oxygen to working muscles. And the improvement was greater for older adults, who generally started out with lower fitness levels than younger people. Meanwhile, people who performed strength-training — alone or with aerobic exercise — increased their muscle strength.
The interval-training group showed only small gains in strength. But the training improved mitochondrial function in the muscles, especially among older adults.
Dr. Chip Lavie is medical director of cardiac rehabilitation and prevention at the John Ochsner Heart and Vascular Institute in New Orleans. He said this is a “great” study that demonstrates the benefits of different forms of exercise. According to Lavie, it adds to other evidence that high-intensity interval training is “probably the best form of exercise.”
Many studies, he said, have found that interval training beats moderate aerobic exercise when it comes to improving fitness and the heart’s structure and function.
“It would be ideal to get more people to do high-intensity interval training,” Lavie said, “and it’s possible for more-motivated individuals.” But, he added, the reality is, many people may not have the motivation or ability.
In that case, Lavie advised finding a moderate regimen you can live with — such as 30 to 40 minutes of walking or using an exercise bike or elliptical machine most days of the week.
SOURCES: K. Sreekumaran Nair, M.D., Ph.D., professor, medicine, Mayo Clinic, Rochester, Minn.; Chip Lavie, M.D., medical director, cardiac rehabilitation and prevention, and director, exercise laboratories, John Ochsner Heart and Vascular Institute, New Orleans; March 7, 2017, Cell Metabolism
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Chiropractic Care for Older Adults
With the progression of age, it’s common for the human body to naturally begin to degenerate. Although degenerative changes in the body are normal, it’s also common for complications associated with aging to develop. Chiropractic care is a safe and effective, alternative treatment option utilized by many individuals to prevent, diagnose and treat injuries and conditions associated with the structures of the spine. Research studies have demonstrated that chiropractic treatment can help older adults find relief from their neck pain and back pain.
Any marathoner will tell you that the grueling 26-mile races can do a number on the hips, knees, ankles and feet.
Now, a small study suggests that these tests of endurance are also tough on the kidneys.
“Marathon runners demonstrate transient or reverse short-term kidney injury,” said Dr. Chirag Parikh, professor of medicine at Yale University.
In his study of 22 participants in the 2015 Hartford, Conn. Marathon, Parikh found that 82 percent showed acute kidney injury after the race. In this condition, the kidneys fail to filter waste from the blood.
The good news is that the kidney injury seems to clear up within two days of the race, he said.
“On day 2, they are all fine,” Parikh said.
Runners likely don’t even know they’ve had this transient injury, Parikh said. “For the short term, I don’t think they would notice anything,” he said.
Parikh isn’t certain why the strenuous event is linked with kidney injury. But some potential causes include the sustained rise in core body temperature, dehydration, or the decreased blood flow to the kidneys that occurs during a marathon, he explained.
When the blood is pumped to the skin and muscles while running, he said, the kidneys may not get as much blood as they normally do.
Nor can Parikh say whether the effect might be cumulative, getting worse with more marathons run. It may be that the kidney adapts over time instead, he noted.
To evaluate this type of kidney injury, his team looked at blood and urine samples collected before and after the marathon. These tests included measuring blood creatinine levels and proteins in the urine, along with looking at kidney cells on a microscope. Creatinine is a waste product excreted by the kidneys; measuring it in the blood helps assess kidney health.
In a previous study, published in 2011, Dr. Peter McCullough, vice chief of medicine at Baylor University Medical Center in Dallas, and colleagues evaluated 25 men and women marathoners. They found 40 percent of the runners met the definition of acute kidney injury based on their blood creatinine levels.
In the new study, Parikh’s team also “performed an in depth evaluation of the urine and found evidence of injury,” McCullough said.
“The larger question looming is: do these repeated bouts of injury in endurance athletes lead to chronic kidney disease years later? Can anything be done about the injury at the time including hydration strategy?” McCullough said. More study is crucial, he added.
Parikh said additional research is also needed to assess whether certain people may not recover as quickly. For now, those with a family history of kidney disease should let their physician know they run marathons, he suggested.
Dr. Cathy Fieseler said marathoners who want to reduce their risk of kidney injury should avoid anti-inflammatory drugs before the race. Those drugs include over-the-counter ibuprofen (Advil, Motrin IB) and naproxen (Aleve), Fieseler said. Acetaminophen (Tylenol) is cleared through the liver.
Fieseler is a primary care sports medicine doctor at Christus Trinity Mother Frances Health System in Tyler, Texas. She’s also medical director of the American Running Association.
The study was published March 28 in the American Journal of Kidney Diseases.
The woman I want to be looks something like the woman I saw in a recent Athleta catalog. She�s effortlessly jumping across a babbling brook in a verdant forest�while wearing sleek slate-gray workout tights and a quilted jewel-toned hoodie. Or wait: Maybe I�m the lady doing yoga on the beach in a slouchy pale-pink tank top, who I saw pictured in the window at Lululemon. While I definitely admire both of their strong bodies and what looks like adventurous spirits (as well as their choice of vacation spots)�I also really, really want those clothes.
Confession: I�ve never met a pair of leggings I didn�t love. As far as I�m concerned, if I could spend 90 percent of my life in slimming, strategically seamed workout wear that makes me feel ready to leap and bound, I would.
But it comes with a catch. If I want a piece of new gear, I�ve got to earn it. I have to be out there logging miles, slogging through spin class, grimacing through the ridiculously hard thigh portion of barre workouts. I need to be using the stuff so much that occasionally the items actually wear out and have to be replaced! It�s simple: The more consistent I am with my exercise regimen, the more justified I feel bringing home a new goodie.
Judging from what I wear the majority of the time�note that I work from home�you�d think I was pretty much always coming from or going to the gym. But that�s the point. The last person I want to be is the lady who looks like she is suited up for the gym but whose main cardio is gabbing at school drop-off. Oh, and my little sweat-for-spandex bargain also works once the gear has come home with me. On a day when I�m short on motivation, a cute new top is often what gets me out the door.
Look, I�m not aiming to be the best in the class, the fastest in the park, or even a seven-days-a-week exerciser. I�m only trying to keep myself on track when it comes to my spending, my sweating, and my style. Some people need a prize at the finish line. Me? I need something dangling at the starting gate�something just within reach and preferably ankle-length.
To get better balance, power and agility, kickboxing is king among workouts. Experts who have studied the sport say nearly everyone—even older people who might shy away from such things—can benefit from throwing a punch.
Unlike most other types of exercise, kickboxing emphasizes powerful movements. Power is different from strength, and for older adults, it’s an even better predictor of mobility and their risk for falls, says Kurt Jackson, an associate professor of neurology and rehab science at the University of Dayton in Ohio. “Pure strength is what a weightlifter uses, but producing power is about both force and speed,” he says.
Kickboxing training tends to involve shorts bouts, two to three minutes long, of intense, repetitive movement—like hitting a punching bag over and over again and kicking and kneeing a pad someone else is holding. “If you look at the research on high-intensity interval training [HIIT], you see these short, intense periods of activity can have big benefits,” he says. Some research shows that even very brief stretches—just 60 seconds—of HIIT can offer the same gains in heart and lung health as 45 minutes of less-intense exercise.
Kickboxing has been shown to improve fitness, power, flexibility and agility, according to a study of healthy men in their twenties who trained three days a week for five weeks. The men in the study improved their upper and lower body power by about 7%, while shaving off more than a second from their time in a 50-meter dash.
It also torches a lot of calories. One study from the American Council on Exercise (ACE) found that the kind of punching-and-kicking combinations used in Tae Bo or “cardio kickboxing” classes burn more than eight calories per minute—about the same amount you’d burn while swimming.
The sport can also improve coordination, even in the most extreme cases. Jackson studies the neuromuscular benefits of kickboxing training for people with multiple sclerosis (MS), a condition in which poor communication between the brain and muscles can lead to falls or problems with activities that rely on multitasking, like walking and talking. Kickboxing helps strengthen neuromuscular control in people with the disease in ways that improve balance, mobility and dual-tasking activities, he found.
The benefits likely apply to older adults as well. Kickboxing improves both types of balance that the body requires—anticipatory and reactive—and better balance reduces risk of falls or muscle weakness. “Anticipatory balance is something you use when you can see a need coming, like when you’re stabilizing yourself to reach up into a cupboard,” Jackson says. Reactive balance is the type of mind-muscle coordination you need to catch your balance when you trip, or when life throws some unexpected object your way.
Those skills are useful before you hit old age. If your workout routine relies on lifting weights, running or yoga, your neuromuscular system may not be tuned to handle the kind of dynamic motion required for sports—even the ones you do just a few times a year, like skiing or pickup basketball. “You see these people step or twist wrong and suffer major tears,” Jackson says. “Kickboxing training is a great way to avoid those types of injuries.”
However, the swift whole-body movements required in kickboxing could also cause injuries. Back, knee, hip and shoulder strains are all common among kickboxers, found a study in the Journal of Strength and Conditioning Research.
As with most other forms of vigorous exercise, if you’re a newbie, it’s important to ease into kickboxing gradually. “If you have a bad knee or some other limitation, it’s important to have a coach or physical therapist who knows how to adapt a kickboxing program to your needs, and who will introduce it in a controlled, systematic manner,” Jackson says. Start slow, and you’ll get the most benefits in the end.
A variation of the traditional push-up, the pike push-up zeroes in on your arms and shoulders. You won’t have to worry about what’s your best angle in your wedding photos—your arms will look sexy from every angle.
How to do it: Begin in push-up position with hands in a wide diamond (fingers pointing toward each other).
Bend at waist, lifting hips up and coming onto toes (walk them in a bit if needed) so body forms upside-down “V”. Bend elbows to lower head toward hands.
Press back up; do 10 reps. For even more of a challenge, do 10 reps with right leg raised, then repeat with left leg raised.
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