Will Running Make You Slim? Advice for Overweight (AND other) Runners.

 

– The MOVEMENT Movement with Steven Sashen Episode 084 Dr. Heather Vincent

 

Dr. Heather K. Vincent is the Director of the UF Health Sports Performance Center, Human Dynamics Laboratory in the Department of Orthopedics and Rehabilitation at the University of Florida. She received her undergraduate and master’s degrees at the University of Massachusetts, Doctorate at University of Florida and Postdoctoral fellowship at University of Virginia. She is an active researcher of the health benefits of exercise and running using physical activity to prevent injury and fight diseases like obesity and osteoarthritis.

 

She is active at the national level with organizations like the American College of Sports Medicine and the American Academy of Physical Medicine and Rehabilitation. With foundation funds, NIH funding and other support, she has published over 130 papers in the area of exercise science. Since 2008, she has served the community with innovative health assessment services, running medicine, consultations and exercise prescription for people from all over the United States. She and her husband (also Dr. Vincent) and three sons are proud to be Gators and believe in all things exercise for kids to the elderly.

 

Listen to this episode of The MOVEMENT Movement with Heather Vincent who gives advice for overweight and other runners.

 

Here are some of the beneficial topics covered on this week’s show:

  • How a person’s mentality after an injury will dictate and shape their recovery.
  • Why people shouldn’t stop running because they are overweight and afraid of injury.
  • Why people shouldn’t let others tell them they are running incorrectly.
  • How it’s important for overweight people to listen to their body and run slowly to control impact.
  • Why weight and size doesn’t dictate if people can run marathons.

 

Connect with Heather:

Links Mentioned:
pmr.med.ufl.edu

Guest Contact Info:
Twitter
@ufhealth
Facebook
facebook.com/UFHealth

 

Connect with Steven:

Website

Xeroshoes.com

Jointhemovementmovement.com

Twitter
@XeroShoes

Instagram
@xeroshoes

Facebook
facebook.com/xeroshoes

Steven Sashen:

If you want to run and you’re overweight, you’re going to have to kind of drop some of that weight, otherwise running could be dangerous. And in fact, if you run, you’re definitely going to end up looking like a runner lean and slim and ready to move. Well, that’s not true. So, we’re going to be taking a look at that on today’s episode of The MOVEMENT Movement Podcast, the podcast for people who want to know the truth about what it takes to have a happy, healthy, strong body starting with feet first because those things are your foundation. We’re going to break through the mythology, the propaganda, often the lies that you’ve been told about what it takes to run, walk, hike, play, do yoga… whatever it is you like to do. And to do it enjoyably, efficiently. Did I mention enjoyably? I know I did it. That was a trick question.

But the point is, if you’re not having fun, please do something different until you are. Because by the way, if you’re not having fun, you’re not going to keep doing it anyway. So why bother? And we call this The MOVEMENT Movement, as we’re creating a movement that involves you, about natural movement, we’re helping people rediscover that letting your body do what’s natural is the obvious, better, healthy choice. Just the way we currently think of natural food. The movement part about you is simple, go to our website, www.jointhemovementmovement.com. You’ll find previous episodes, but more importantly, all the different places where we have this content where you can like and share and give us a thumbs up and subscribe, all those things you know how to do.

In short, if you want to be part of the tribe, please subscribe. So more about all that later but first, I am thrilled to introduce… I rarely use honorifics, but I’m going to call you Dr. Heather Vincent. So, it’s one of those things, I grew up in a medical family, so I never use the word doctor, but when I do, it’s just really fun. So Heather, so wonderful to see you. And why don’t you tell people who the hell you are and what the hell you’re doing here?

Dr. Heather Vincent:

Excellent. Well, first of all, I’m here to have fun. So, I’m going to go along with your first message of enjoying myself, talking about the things that we really like to do here at the University of Florida. So here I am in our Sunshine State and we are here in the Department of Orthopedics and Rehabilitation. And my role here is the director of the Sports Performance Center and a partner in the Running Medicine Clinic here. And the other half of that is the other Dr. Vincent, Dr. Kevin. And so together over the last probably 12 years or so, we’ve really tried to have a better understanding of the science behind running involving shoe wear, involving mechanics, body styles, medical histories, to really get a better handle on how we can work with runners better to optimize what they’ve got and how long they can run for. So, it’s been a joy to really discover some of those things over the last years.

Steven Sashen:

What got you guys doing this to begin with? What was the inspiration?

Dr. Heather Vincent:

When we came here to Florida in 2007 to initiate this program, at that time there wasn’t anything in the whole southeast that really drove running medicine, nor did we have a lot of information about sports performance, how to get appropriately tested, how to guide exercise prescription, and just engage in exercise safely. So, we thought that was an important hole to fill. And we spent a number of years trying to develop what services were going to be important, what the public wanted and what we were seeing from the patient perspective, what were the needs. So, it continues to evolve as we get better at what we do, and as the public and our patients shape the needs of the programs.

Steven Sashen:

The evolution part is something that’s suddenly really interesting to me. I mean, literally suddenly, because once you mentioned it, I suddenly had a flashback. I saw a guy; I’m trying to think if I should mention his name. He wrote the first book on sports medicine called Sports Medicine. I saw him as a patient when I was an All-American gymnast. And he said something that was fascinating. He said to me, well, you really shouldn’t be doing gymnastics because you have flat feet. I’m 15 years old and I was thinking, you’re a doctor and you’re a moron because I’m one of the best tumblers in the world. So, I’m just thinking about how sports medicine has evolved and sort of bifurcated in different ways and specialized in various ways. In the time that you’ve been involved in this, what have you seen as sort of the major changes and the impact of those?

Dr. Heather Vincent:

With respect to the populations who are engaging in exercise, I think we have certainly improved our ability to develop the science and understand the science. What we have seen is more people wanting to empower themselves and do something to help their health. So, as healthcare costs go up or options or participation in sports go down, as people get older, they’re not as much involved with sports teams as they were maybe in high school or collegiate athletics. So, people are looking for something that gives them that feel good. They want to stay engaged with sports. And so, we’re tending to see a shift in the populations of people that come in. And what’s also really interesting is because of the spread of different kinds of information, people try to be informed. So, the challenge in the field that we’re in is to keep up with the correct information, get to the science, but then also inform this constantly changing demographic.

Steven Sashen:

First of all, I think that you’re wonderfully optimistically naive. And what I mean is that, I think most people are doing this because they don’t want to get old. They still want to be attractive or they’re on the other side of the equation where they think it’s too late for them and they can’t do it and it’ll be too much work to change. And so, I’m wondering, one of the things that I notice in this field is how certainly the consumers, and in some ways the researchers and practitioners want to look for a one size fits all solution. And that obviously seems a little silly. What are you experiencing when you’re dealing with different populations and their specific needs?

Dr. Heather Vincent:

That’s a great question. And it depends on the type of sport or activity that you’re talking about. But if we take running for example, because that’s a big staple of what we do here, one of the things that we’re seeing is that each runner is not the same. Everybody has different medical histories, they have different capabilities, body styles, different ages, different tolerance levels for what they will or will not do. Also, the psychology of running also plays a huge part in this as well. So, each person is going to have their own psychological challenges. Some people, if they’re constantly injured or dealing with nagging injuries, that takes a toll on a person’s mental outlook.

And so that’s one of the things we care about deeply here is not just the physical part, but also the emotional wellbeing of that person trying to gauge in sports. So when we develop plans and we really think about what are the needs of this person, we really do a thorough history, understand the goals of the person and really get a feel for even before starting to develop a plan, what they’re willing to do and what their long-term goals are.

Steven Sashen:

You just said something that also fascinates me, the phenomenon of how doing the activity or being injured I mean, any of these things, how it affects, one’s thinking. I don’t really want to use the word psychology, it’s too broad, but specific thinking when it’s going well, when it’s not going well. And again, you gave me a flashback. So, when I got back into sprinting, which was let’s see, 13, 14 years ago, I was getting injured all the time and just went from one to another, to another. And it was literally not only physically taxing, but it made it harder for me to do almost anything because of the sort of just literally the physical energy impacted my thinking. But my favorite phenomenon that occurred, and it was one of the strangest experiences I ever had was, I was at a track meet, my wife was with me, I’m warming up. Some kids walked across the track as I was trying to do acceleration drills. And I just decided to kind of jump out of the way and that didn’t work very well. And I pulled my hamstring really badly.

And my wife was with me not to provide any sort of emotional support but because there was a big shopping outlet mall near where the track meet was. So, she wanted to still hit the mall on the way home. So, I was doing that, now I could barely walk. And this was the interesting thing, it was a big crowd and I couldn’t walk, and I could feel and hear people right behind me. And for the first time in my life, I had this really primal urge to turn around and punch people. It’s like get out of my way, because I can’t get out of your way. It was a fascinating phenomenon. I don’t know that people are really talking about the specific effects on thinking and cognition that occur, when things are going badly when you’re injured, or even when it’s going well, and you’ve got the pressure to continue to perform. Have you looked into that or other people taking a closer look at that?

Dr. Heather Vincent:

I think there are other teams that are, and I mean, investigative teams that are focusing on that type of change in cognition. But what we’re very interested in is what happens at the point of injury when you have this person who loves this sport. And so that is their go-to, they thrive on it, it’s their identity and suddenly you take it away. So, a person with a stress fracture or a severe soft tissue injury, and suddenly they’ve had their physician visit and they say, you need to cut back on this, or you need to stop for X number of weeks as you rehabilitate.

And what we’re finding is that the level of mental stress that this person experiences compares to that you’d see in cases of orthopedic trauma; it is very severe. And the reason we’re interested in this is that for so long, I think therapy has really focused on the physical part and tracking all those metrics of when certain things get better. But I think we are missing the boat hugely when we are ignoring that mental part as a person recovers, what that challenge is because that is going to dictate and shape whether or not they’re adherent.

Steven Sashen:

And again, you keep giving me flashbacks. One is one of the first running coaches that I worked with when I got back into sprinting, whenever someone, including me, got injured, he just ignored you. You were suddenly persona non grata and just wouldn’t talk about it at all. And of course, dealing with the physical thing is, let’s call it relatively simple or somewhat straightforward, for human beings to deal with other human beings and their thoughts and feelings that’s messy and wet and challenging because there’s not a lot you can do. I mean, it’s a whole different game. I’m thinking about again, you just keep giving me flashbacks. So, I started out as a diver when I was seven. I stopped when I was 11 or something, frankly, because the pressure got to be too much for me at that time. And I took a year off when I didn’t know what I was going to do. And my mother told me that I was basically depressed.

I was 11 years old and I was just lying around depressed. And I hadn’t thought about that in a while. But I’m curious about this. For me, what’s happened is over time when I get injured, and it happens very, very rarely in the last 11 years. But even if I have a little thing that puts me out for about a week, mostly the response now is like, Oh, well, I mean, I’m 58 years old and it’s going to get better or it’ll do something, but it just doesn’t have the same impact. It’s kind of like back in the days when I was performing for a living, if a gig got canceled, at first it was really annoying. And after a while, when I realized that’s just part of the game, then I used it as an excuse to take a vacation.

Dr. Heather Vincent:

It’s changing, it’s reframing what’s going on. And it’s changing your thought process based on context, because you have stepped back a little bit and seeing the bigger picture. And I think when you’re either a runner that’s starting out and you fall in love with it and you just gravitate to it and then it’s pulled away from you, that’s a shocking situation. Another type is a competitive runner who, whether it’s the high school all the way up through postgraduate again, you take that away, it can also be very shocking. We’re also seeing the cases where, for example, we have folks who are the nontraditional types of runners, whether they’re masters and have different body styles, or if we have had the heavier runner contingent who comes in and they love it and they want to participate, but they’ve been discouraged by their physicians or their providers not to run because of injury risk.

And that also is a real downer and changes the mental outlook of the person and then self-doubt sets in and so on. So, we get a lot of people that come to us and say, this is what I’ve been told, is this accurate? And should I stop? And our answer always is no, we modify, and you listen to your body. And so, we talk about things being sensible. It’s never a yes or no. It’s a, let’s look at the information, let’s see what your pattern is. Let’s work through why you’re experiencing what you’re experiencing. So, I try not to look at a person and a label and say, you shouldn’t be doing that. You shouldn’t be doing that because again, that interferes with the mental health and wellbeing of the person.

Steven Sashen:

Well, I want you to dive into more about the whole thing of people, especially people who are overweight are told they can’t, or shouldn’t run. I mean, we hear it all the time. I get at least, Oh my gosh, two or three emails a week from someone saying, I weigh 300 pounds, can I do this? Can I wear your shoes? Can I go running? And luckily we’ve been doing this long enough that I can point them to other people who weigh 300 pounds or 400 pounds and who have been able to run enjoyably or hike or whatever it is they want to do, enjoyably and successfully, and do it in footwear that allows them to move naturally. And of course, our contention is by having the right footwear, that’s going to help with this process because if you’re wearing ironically highly cushioned footwear it’s going to be more difficult on your joints and all the rest, which is the whole counter-intuitive thing. But yeah, if you could dive into the, let’s call it, alternative body types.

Dr. Heather Vincent:

Yes. Yeah and actually, this is a niche for me, which I personally really enjoy because these are people who are taking a big risk. They’re going out there against all stigma. They are out there against medical advice that may or may not be fully founded. And I want to share some of the evidence that we have collected here in our laboratory at UF, very interested in looking at the mechanics of successful heavier runners compared to age and sex matched people who were not overweight or have obesity. And so, when you look at their mechanics, they’re doing something actually quite clever, and it’s just a natural way of moving with comfort. So, when you talk about get moving, you pick a movement strategy that feels comfortable on your body and who’s to tell you that that’s a wrong way to run. And so, what they’ve done, and they’ve figured out is, compared to runners that are not heavy, they actually run a little lower to the ground. So, there’s not as much bounce when they run, their steps are ever so slightly shorter. Their stance is a little bit wider, but they’re very, very soft.

And so, when they hit the ground, they can damp and forces a whole lot better than people who are not overweight because they have to. They listen to their body and they go a little bit more slowly. So, the speed is not as high, but what it allows them to do is land all comfortably and control that impact. So that way if you put a heavier person running at the same speed as a lighter person, we might get into a little bit of trouble there. But if they pull back on the speed and just focus on form and being gentle and soft, they can run without injury. Assuming that the volume is controlled, and they don’t push past their endurance, just like any other sensible advice you would give any runner, when you feel like you’re going past your endurance, is you stop running.

Steven Sashen:

What’s fascinating about that is, we like to say that, my wife in particular, Lena loves to say that our shoes are not doing anything, they’re getting out of the way, but at the same time they’re becoming your coach. Or what I say is you’re becoming your own coach by listening to the feedback you’re getting from your body. And it sounds like what you’re saying is the heavier runners are doing that naturally, frankly, because they have to, if they want to engage in this activity, it’s the only way to do it is by paying more exquisite attention to what works and what doesn’t which is very interesting.

Dr. Heather Vincent:

Exactly. Yes. So, they’re not forcing themselves into a situation where they’re running for speed or they’re running for time. They’re doing it because they enjoy it and it feels good. And that’s another message that I really wanted to leave that over time as maybe some weight is lost or not, but if some weight is lost, it’s going to feel easier. It’s going to feel better. Then maybe they can think about speed at that time because they can, but right now, if they just work on the form and the motion, they can do it. And so, it’s that form of grounded running, if you may have heard that term. So grounded running appears to be quite successful for people that might be carrying some extra weight so you can engage in it, just do it softly.

Steven Sashen:

Sorry, for people who aren’t familiar with that phrase, if you would.

Dr. Heather Vincent:

Sure. So, it’s that concept of when you move your feet, you don’t need a big kick up in the back. You don’t need to lift your knees high in front. It’s just, you keep your feet almost trotting. So, it’s a nice, gentle, low bounce type of strategy that is actually quite comfortable. And you can go for miles and miles and miles and feel really good. The body can handle that.

Steven Sashen:

This is actually a variation of… So, one of the most successful running coaches in history, Arthur Lydiard from New Zealand, this was part of his training is, just do that. Especially as you’re building an aerobic base, just doing that, it’s not about speed, it’s not about distance, just putting in the time.

Dr. Heather Vincent:

That’s right. Right. And it also allows tissues of the body. So, for example, the lower extremities that bear the brunt of the learning time to adapt. And so, you’re not overwhelming it with these really high impact forces. You’re keeping it nice and gentle. You’re allowing the muscles of the feet and the lower extremity to really engage a little bit better too.

Steven Sashen:

It makes me wonder if there would be any application that would be beneficial for any runner to add weight in some way, for both of those reasons. I know I have a friend who’s a big deal strength and conditioning coach. And one of the things he trains people to do is do very heavy, either caries or partial reps, you’re going to do a squat and you’re only going to bend your knees. You’re really going to go down a few inches and come back. Now there’s a lot of videos on YouTube of gym fails, showing people doing this, if you know very small partial reps and they think idiot, but it’s like, what that does is it builds up the connective tissue and it’s something I’ve never heard anyone doing with, let’s say lighter athletes of having them do that kind of work to improve their connective tissue, which sounds like it could be interesting. It also sounds like it would be hard to apply correctly in a way that would work or fit in with someone’s training cycle or not cause weird changes to your gait.

Dr. Heather Vincent:

And again, sort of thinking about what’s the long-term goal. So, if there would be an advantage in some way where you would be in a situation where you would have to do heavier carries. So, when you think about firefighters or the military, that might be a perfect way prior to either starting bootcamp or as part of your training to really work on.

Steven Sashen:

That’s part of their testing. So, a couple of times a year at the track, we’ll see the firefighters come by and they’re carrying 40-pound packs to whatever they’re carrying. And I tease them mercilessly which is fun. I go, it’s good to know that if I’m in a very slow growing fire, you’re going to be able to come get me. If it’s really not moving or expanding very quickly, you’re my guy. If I need you in 20 minutes, you’re definitely the guy. And they take it very well. They have a great sense of humor as they’re doing exactly what you’re describing. The way they get around the track is exactly what you’re describing for us in saying obese athlete. And I think it’s interesting that phrase, obese athlete is not an oxymoron. I mean, I have some friends who are dedicated triathletes, who are “100 pounds overweight”. I mean, I have one friend who’s 5’2″, 300 pounds and does triathletes or triathlons and has been doing it for 20 years. Doesn’t get any thinner, doesn’t change anything, just loves doing them. And that’s the shape they’re in.

Dr. Heather Vincent:

That’s right. That’s right and so I think if we don’t give the seriousness to this, that it deserves because to me, they’re a person who’s exercising and deserve the same level of study and careful thought process when you’re building programs with them. It’d be a shame not to engage them because they’re doing healthy habits that are going to keep them around for a lot longer and engaged in life a lot better, keep cognitive health, physical health, and so on.

Steven Sashen:

I mean, this is a message that really has not gotten out. And of course, there’s the other normative pressure to look a particular way if you’re going to show up at a gym or go out running. And I’m just thinking, what would it take to start spreading this word, to give this kind of advice to the people who frankly is the majority of Americans, and in a way that would make them, make it feel like the idea of doing any activity just weren’t so onerous or dangerous, or would subject them to unnecessary criticism or even whether they’re just imagining. I mean, a lot of times you’re just thinking people are having that thought when you’re going out, doing what you’re doing, and no one’s paying attention to you. Any ideas on how to get the word out?

Dr. Heather Vincent:

I think public messaging right now through social media is going to be extremely important. So, we get a lot of messaging through magazines, through websites, but using it as an opportunity to promote safe engagement, irrespective of body size. But it’s a good thing. It’s good to go ahead and get started but doing it safely and with slow progression is going to be key. I would hate to try and get a message out there and then people jump in and then suddenly now we have metatarsal stress fractures, which also happens. So just understanding that being able to provide even general plans of just showing how slowly people need to progress, be aware of body symptoms, what it should feel like, what it shouldn’t feel like. So, people understand is this reaction to what I’m doing normal. So, I think good public messaging, having some safe, progressive plans out there for people to kind of get a sense of how quickly I should be moving and then understanding the physiological symptoms, I think would go a long way and just encouragement.

Steven Sashen:

This just strikes me as the perfect Parade Magazine article. And to that point, this is really interesting. I’m going to say something obnoxious, but I’m doing it just for fun. So, you’ve been a failure according to my way of looking at things and what I mean by that is what you’re talking about now, when I say it’s a perfect Parade Magazine article, it is. And so, you have this research that hasn’t made it into the zeitgeists, that hasn’t made it into public awareness, but this is not the first time you’ve had this problem according to me. And so, a previous time, I don’t know if you’ve seen it. You and Kevin wrote a white paper about selecting proper footwear. And what you say in there, I mean, not surprising to me, it may as well say, go buy a pair Xero shoes, but more importantly, I mean, there’s a lot of information in there that’s contrary to what you will hear if you walk into a running shoe store.

And this paper, wonderful as it is, certainly did not get the attention that it deserves. So hence the failure joke. This is something that I think about a lot, obviously for both my personal/professional reasons, but also because I have a fondness for the truth. And I don’t like it when people lie to other people in order to make money, I’m not mentioning big shoe companies by name. I’m not going to talk about Adidas or [Flick 00:24:16], any of those companies, but again, I’m just curious if you have any idea of what the gap is between this meaningful, valuable, accurate, truthful information and what people think and what they’re being told and what they’re doing.

Dr. Heather Vincent:

Well, what I try to think about are where are the potential obstacles or blocks or places where information stops, and it comes down to the interfaces where there’s sports science and then there’s the end user. And then all the people in between who have their other reasons for saying what they’re doing, or maybe just have not kept up with the literature or have seen the literature so they just don’t know. And so, we have to spend a lot of time here in our clinics on sport performance, undoing the knowledge or what people have been told by salespeople or by other companies to say, no, no, no. We’re going to steer you to these products or to the… and they might not even need the products at all. Or they might push them in a direction, whether it’s a running coach or otherwise funnels everybody to do the same thing, and they shouldn’t be doing that.

So, we have to spend a lot of time undoing a lot of the thought process and or damage that’s been done. And that’s sometimes heartbreaking, but when you get people on the right track, they know what it should feel like, they know what they should be doing. So, I truly think that it’s the interface where the communication is not getting through that I’ve got to figure out how to get through them.

Steven Sashen:

Yeah. So, this is a really interesting thing. So, a, the problem that you’re running into, that we’re all running into, and I think you’re right. I think it really is that intermediary between the information and the end user of said information. And we have a couple of problems in dealing with those people who are all well-intentioned, fine, upstanding human beings, granted in any given profession, 80% of the people are pretty much unqualified to be doing what they’re doing, but that’s a whole other story, But the two problems and they’re interrelated, one is you give people data that conflicts with their belief and they don’t change their mind. This is the old cognitive psychology news. It makes them more ingrained and more attached to what they already believe. And similarly, for anyone who’s made a career out of disseminating this information, if you’re telling them to start changing, then it’s even because they think or they may think that it’s making them look like they don’t know what they’re doing if they suddenly come in and say, here’s a new thing, or I learned something new or whatever.

So, both the affront to their professional appearance, if you will, and just the cognitive problem, those are two big issues. There’s a book, by the way, you might find this useful called The Catalyst, or maybe it’s just Catalyst by Jonah Berger. The subtitle is how to change anyone’s mind. And what’s interesting about the book, there are a lot of things, but fundamentally what he does is he breaks down the different ways we come to believe different things. And based on those different ways, we believe these things are the kinds of beliefs, here’s a way to address them.

Now it’s not perfect of course, but fundamentally, almost every one of the techniques that he presents is about getting people into a state of cognitive dissonance where what they believe and what they’ve now just experienced is so different that they can’t reconcile them. And they’ll either hold on to what they’re doing, or they’ll make a change. But because the new experience that you’ve introduced them seem so much more valid that it often does inspire change, how to do this in a massive way and affect all physical therapists and all sports medicine doctors, and all, fill in the blank, that’s a whole other, I think that’s a multi-generational issue. But nonetheless, you pointed it out there.

Dr. Heather Vincent:

And there’s a comment I want to make about that too, that it is. It’s going to take a culture change, but if any listeners are out there that are medical providers or interface with patients, what patients really appreciate is when the provider or the expert says, this field is constantly changing, we’re doing our best to keep up with the science. What that does is it gives you that out to say, things might change again in another couple of years, this is what we know now. And patients really appreciate that. So, they know that you’re trying to stay on top of it. So yes, you may have had a different opinion two years ago based on what you knew, but it’s perfectly okay to look at new evidence. And we should be because as we continue to evolve, we’re going to continue to serve our patients better.

Steven Sashen:

I think the sun has gotten to your head because if we’ve learned nothing over the last number of months during the pandemic is telling people that things are evolving and changing and you’re learning new things, doesn’t play very well.

Dr. Heather Vincent:

Right. But the people that we see are looking for answers and when they come looking…

Steven Sashen:

That’s a good point. It’s a different population.

Dr. Heather Vincent:

And when they do, they’re willing to see what’s new there, they’re searching for ways that they can help themselves. And it’s also a level of trust. So, if you’re working with some patients, and they’re not getting better, it’s not working. Whatever it is, is not working. The treatment plan is not doing what it should be doing, or they’re not. So, we need to think about things differently.

Steven Sashen:

Yeah. And again, that’s a very difficult position for someone to be in, to say, look, I tried these things and it didn’t work. In fact, I’m really lucky what got me from being a perpetually injured athlete to not was a physical therapist who after three sessions said, if what I just did, didn’t help you need to go see an orthopedic surgeon, get a bunch of x-rays find out what’s going on, which changed my life. But I also have to back up for a, if there are any medical people who are listening to this and I know there are. When I said, people tend to get stuck in their ways, conflicting information must hold on to existing beliefs even more. And we don’t want to change because it’ll affect how we look to patients. I’m sure there are medical professionals who heard that thought, well, I don’t do that. We all do that, and we don’t recognize it, that’s the problem.

Dr. Heather Vincent:

Yeah. And even sometimes I still feel like I have ideas that I cling on to that I was convinced certain things would turn out certain ways and they just don’t, but that’s what makes it exciting. And I think as I get older, at least I do, stop being so ingrained in the old thought process because as new information comes forward, it is more exciting. It’s discovery. And that’s what patients are looking for. What’s the newest thing? What do we know?

Steven Sashen:

Well, it’s so funny you say that I got some information from strength and fitness guy the other day with an idea that I had never heard before and is so perfect. I mean, one of the things that I “love” and I’m putting air quotes around love, because I find it incredibly frustrating, but it’s also something I zone in on and like to discover, and then rip apart and debunk is when people are just passing on information because they heard it from somebody else and it just get passed on until it becomes common knowledge. And that’s just the way you do it. And so, there are a lot of people in the strength and conditioning community. And the whole idea is you just need to do a little more, every time you go in and do what you’re doing, lift a little more, do an extra rep, do an extra set, whatever it is.

And this kind of made the point that if you… let’s say you’re bench pressing 200 pounds, and you’re doing it eight times, you can do some math and determine what your maximum, one rep max would be if you can bench press 200 pounds, eight times. And if all you did the next time is add 10 pounds or add one rep the difference in your one rep max is so vast and so large, that there’s no way that’s the right progression. And so, he did the math on how to do tiny, tiny, tiny progressions, where you’re not going to just hit a plateau because you just can’t get that much stronger proportionally. And I’m fascinated by just the idea and what that means for the things that we’re talking about of how to give people these tiny, incremental things, where the increment is so small, they feel like they’re doing nothing, but over the course of a very small amount of time, a few weeks, a couple of months tops, they see a massive progression.

Dr. Heather Vincent:

Yes, that’s exactly right. And so, when we think about our nontraditional athletes, for example, I’ll show them the progression and they’ll look at it and kind of look at me funny and kind of shake their head and say, that’s not, I mean, I walk more than that. Like, no, no, trust me. Trust me on this because you could do it, but your bones and muscles can’t. So, the mind wants to, but you have to let the tissues adapt. And I think you’re spot on with that, that it’s the small progressions where you allow in the growth, the re-healing and the adaptation, that takes a little bit of time, but it can happen quickly.

Steven Sashen:

Well, and some of that is just this phenomenon where, however old we get, we always think we’re some large number younger in our brain. I mean, it took me years to realize that the thought, let me just do one more set, one more rep, one more run, was the signal that I needed to go home immediately and not do the next one. Because in my brain, my body is still 22, 23, and it’s actually 58.

Dr. Heather Vincent:

Impossible. I don’t believe it, it’s impossible.

Steven Sashen:

Well, that’s true. So the slow, incremental change is challenging because it just doesn’t feel like something’s happening and you really do need to be able to step back and look at the information objectively, somehow you got to make sure you’re tracking it and doing whatever, because otherwise it just doesn’t seem like anything’s happening, muscle growth. I say, this is a joke that I have with my wife after I finish lifting weights, I go, I’m just shocked that I’m not infinitely bigger than I actually am after that workout. It doesn’t make any sense to me. And it looks the same as yesterday or half an hour earlier. It just doesn’t seem fair.

Dr. Heather Vincent:

Not it doesn’t, does it?

Steven Sashen:

No, it’s like, I’m all pumped up, let me go measure. And then I see the exact same measurement. How? How’s that possible? That’s really annoying. And to your point though, I mean, to something we’ve talked about before, people who are wanting to get into running for example or any activity, really. I don’t know that anyone presents a really good model for how to make that appropriate progression into it. And sometimes it’s only because there isn’t, some people will talk about let’s use barefoot running as an example. They say, well, I got to spend a lot of time walking fast. And it’s like, well, walking’s all fine and dandy, but it’s not the same as running. The gap is so large that you can’t extrapolate from one to the other.

Dr. Heather Vincent:

That’s right. And the same holds true whether you’re transitioning shoes from one type to another, we always just want to do things safely.

Steven Sashen:

That one’s a weird one though, because a lot of people… because again, and this is because of lying big shoe companies who when the whole minimalist footwear and barefoot running thing kicked in, in 2009, 2010, when they knew they weren’t going to make a truly minimalist shoe, came up with the idea of transition shoes. So, if you’re wearing something that’s super thick, go slightly lower, slightly lower, slightly lower until you’re ready for something like what we do, but that doesn’t help at all. The reality is the transition is to go straight to what we’re doing just not be, if you’re running 10 miles run for 20 seconds on your first run instead of going up a mile.

Dr. Heather Vincent:

Yep. There are two different approaches and you’re absolutely right. So, you have to be willing to cut the volume and really bring it down and you can start right away. But we often don’t get a lot of takers with that. If you’re used to running 30 miles a week and you say, okay, well, if you’re going to do this, you’ve got to drop down to five, you see the faces just fall. Well, I don’t know if I can do that. So, I think the transition is kind of a backup, but at least it will minimize the risk of some serious injury, if you can give them a second option. But I completely agree with you. You can do two different things and achieve the same end.

Steven Sashen:

Yeah. I mean the thing that’s so interesting, I like to give an analogy to people, I go, imagine that you broke your arm and you’re in a cast for eight weeks. You’re not going to get out of the cast and go do bicep curls for 10 hours a day, you’re going to slowly build up strength again. And then in a few weeks to a few months, depending on who you are, you’ll be back to normal or better for the rest of your life until you break your arm again. This is what we’re talking about. It’s like we’re making a what could be slower than you like transition, but once you make that transition, you’re set.

And again, human beings where we just are not wired for that long-term play, we’re not wired for it, it’s going to take you a year to lose that weight. People want to lose it next month or next week or overnight, or why am I not bigger after I did that workout this morning? I mean, this is a fascinating thing that we’re really struggling with our evolutionary psychology and biology in ways that, back to the beginning of our conversation, I don’t think people really address this nearly well enough and I’ve never thought about it as much until this conversation.

Dr. Heather Vincent:

Right. And so, one of the topics that’s really coming out now is kind of a hot area, is getting people to understand the importance of the present. So that whole mindfulness concept where, years ago, I really wasn’t as interested in this, but when you see a pattern over and over and over again, there’s something going on. And so, when you think about getting people engaged at that moment, what does it feel like? On this day, look at what you’ve accomplished, celebrate what we’re doing today, and then tomorrow let’s see what we can do, but it’s very, very difficult to put the tunnel vision on and not look behind and then not look forward. But just right now, what does it feel like and how are you doing?

Steven Sashen:

Well, and again, back to the evolutionary psychology, we’re wired to try to look at the past, to figure out patterns that will get us to the imagined future that we think will give us what we want. I mean, we are built for that and to overcome that or to understand that in a way that it doesn’t impact us in some, I was going to say deleterious, but that would just show off a study for the SATs 40 years ago, in some hard way, it’s tricky but it’s also interesting to me because when we do understand that these thoughts we’re having, these tendency we have are just a function of being human and not a problem that we have with our whatever, then it’s easier to just hear it rattling around in our brain and not be impacted as much.

I think it’s funny, I think the whole idea of being in the present, which is not really possible because of how neurology works, but nonetheless, this whole idea of paying attention to now, there’s an easier way, which is to understand how we don’t do that, how we are trying to pay attention to the past and the imagined future in a way that those don’t have the impact. And then you’re sort of left in this more open space where you don’t have to call it a thing of living in the present or whatever, which makes you sound hoity-toity, and better than your friends. So, I’m just living in the present and really bam, it’s just, I spent 21 years living in Boulder and it was all I could do not to smack people when they would say things like that.

Dr. Heather Vincent:

I get it, I get it.

Steven Sashen:

I just accept things as they are, smack.

Dr. Heather Vincent:

Yeah, and the only reason I brought that up is that there is more science coming out to show that there is some value about helping people kind of deal with the anxiety related to injury, some of the frustrations avoiding depression. So, for some people, I think it can work really quite well if they get the skillset. So, having more people out there to help athletes or active people or movers, whatever term you would like to use when you hit a roadblock, how do you overcome it? And that I think would smooth out a lot of the yo-yos on the ups and downs as people recover from injury or changes in life and so on too.

Steven Sashen:

I think you’re right. I think there’s also another thing where people have ideas about what it’s supposed to be like or where they’re supposed to go. I was having dinner with a dear friend who’s Olympic marathon and multiple World Champion and a bunch of other people. And somebody asked her about getting in the zone and she spent 20 minutes just going on about getting in the zone and being in the zone and everyone was transfixed. And when she stopped, I said, did you ever have a race where you were totally in the zone and it just didn’t go well? And she goes, yeah. I said, do you ever have any races where you were sick and just felt like crap and you won? And she goes, yeah. Well, there goes that zone crap.

We just debunked sports psychology in 20 seconds. It’s like, that’s all fine when you get that feeling, but it’s not required. It doesn’t translate to performance. It’s definitely not, it’s not the Holy grail it’s so irreproducible that to think that you need it is going to just cause you more suffering and you just watched everyone just kind of… half got deflated and half felt relieved.

Dr. Heather Vincent:

It’s like, Oh, do I have to do it? Or do I need that to get there? That’s exactly right. That’s exactly right.

Steven Sashen:

It’s, I’ve never felt that before. Oh, you just told me I don’t need to. Oh, that was helpful.

Dr. Heather Vincent:

Exactly. So, everybody’s different. And again, that circles back to what we were talking about at the beginning is that everybody can’t be coached the same way. They can’t be given the same advice on how to start your running program. Everybody must be looked at as an individual with their variations and their goals, their concerns, and really their mental outlook.

Steven Sashen:

Well, considering that most people are not going to have access to someone who has the skill and eyes to see, to give them individual instruction. What would you recommend for someone who’s going to start approaching either…? Again, whatever activity is for the first time or whatever the next level is, or trying to improve what they’re doing without that kind of third party skill because look, you know it as well as I do, the number of people who have eyes to see and the flexibility to come up with something new for each situation they’re in is very tiny.

Dr. Heather Vincent:

Right. So, do you mean with respect to…

Steven Sashen:

Let’s just say I’m an overweight athlete or I’m an overweight person who likes the idea of starting to run but has been told that it’s not a good idea. And we just said that everyone needed something a little different and all those things that you just said. What would you recommend if they’re not going to be able to find someone who has the ability to coach them per their individual needs and situation?

Dr. Heather Vincent:

Oh, that is a fantastic question. So now I have to pull myself out of my own body for a minute. What I would probably recommend is just start first with, what do you want out of this? What is your goal? Where do you want to be in six months, a year and then a few years? Is it for health? Is it for actual competition? So, once you start separating those pathways, now you can start thinking about, okay, if I’m starting fresh and I want to begin a running program for health, let’s say what I would recommend is just keep it simple. When you think about even the recommendations for physical activity, few times a week at a specific dose, I would start at the lowest dose.

So those are generally available pieces of information that you can get on CDC, those types of websites, but really few times a week start the volume really, really, really low, do a little walking, do a little bit of running and make the transition slower than you think that you should. So, everybody throws around the number of increasing the volume of running by 10%, but there’s some science to show that and others that may not be as strong. So, I’d even be more conservative and go with a 5%. And then over time, are you looking to be an interval runner? Are you looking to just take some daily runs a few times a week just for health? So, it really comes down to sort of identifying what your goals are. Start slow, few times a week progress very slowly, much more slowly than you would think.

Steven Sashen:

I’m going to add a tweak to that. I think that the try something a few times a week is not a good idea. And the reason that I say that this is totally from my personal experience. It’s not because I have anecdotal information from working with clients and patients, et cetera. But my thing is, if I’m doing something three times a week and one day I wake up and I don’t feel good or something happens or whatever, it’s easy to go, whatever. But if instead I do even, so let’s say I’m taking that volume of three times a week and I reduce that. And so that I’m doing something every day or at least five days a week, but preferably every day, that little bit, every day is easier for me than doing slightly more three times a week. Doing a 15-minute workout every day is easier for me than doing four or doing three 45-minute workouts because it’s just simpler.

Dr. Heather Vincent:

Yep. And so, for you, that strategy might work. For some people…

Steven Sashen:

Yes. I’m not saying that it will for everyone else, but I want to throw that out as a possibility.

Dr. Heather Vincent:

Yeah, absolutely. And you’re absolutely right, because some people might have different pockets of time where they’ve got it during the lunch hour, other people don’t, and they work 14-hour days. And so, they may only have a couple of days a week or three times a week. So, part of that, pre-planning and your goal setting and where you want to be and what you want to do. We think about time slots that are available that you’ve got, what you’re most comfortable with, locations of where you want to do it and what’s going to make you feel good.

Steven Sashen:

Location’s a good one. Again, using my personal thing, I can’t join a gym because just going somewhere else, I’m an efficiency geek. If I have to go somewhere else to do it, I’m not going to get there. So, I have a nice home gym because if I didn’t have it right underneath my feet, it just wouldn’t happen.

Dr. Heather Vincent:

Absolutely.

Steven Sashen:

Another thing about your own personal thing.

Dr. Heather Vincent:

Yeah. So, when you’re starting out, I kind of think of this as you’re getting an appraisal of what it is that you’re trying to put together. What do you have for resources, the time, the location and your goals? And if you don’t start with that, it’s going to be kind of a mishmash and it’s going to be randomly thrown together. But if you put a little fun into it and find those chunks of time to be able to slowly increment up either your volume or intensity or whatever format you want to do, that’s fine. But I also really appreciate the point that you made that if you have to break up that time throughout the week in smaller chunks, you get just as much health benefit from that. So, any of the listeners who have questions about that, you can accomplish it, you can slice and dice it a couple of different ways.

Steven Sashen:

And I also want to add the whenever possible, find a partner, find someone else to do it with, make a social component to it. One of the things that’s the most satisfying thing for me, I have a sprinting training partner. I’m 58, she just turned 70. She’s a world champion and we’ve been training together for, my God, 12 years. So, we see each other a couple times a week depending on the season for the last 12 years. And the number of times one of us says to the other, thank you so much for coming out today because I just didn’t have it in me is really high. And so, the social component can make it or break it for some people as well.

Dr. Heather Vincent:

Yes. Especially at the beginning, if you’re a novice at the beginning and there’s a little self-doubt, or you’re not feeling that great today, it’s easy to just kind of fall off the wagon there as well and say, well, you know what? This didn’t work. I tried it; it didn’t work. So yeah, I appreciate that quite a bit.

Steven Sashen:

Well, Heather, this has been a total, total pleasure, I’m so glad we got to connect. It’s been too long since we saw each other, thanks to the magic of COVID and all the rest. I can’t wait till we’re at yet another event where we can try and get thousands of people to understand the newest and latest and most up-to-date and accurate information for helping other human beings. And by the way, I’m referring to the American College of Sports Medicine event where we met. And in fact, I’m going to put a link to the presentation or the panel discussion that I was on there all about footwear, that was super fun. And by fun, I mean I pissed off a bunch of people by saying things that made them upset because it was contrary to what they’ve been telling.

Dr. Heather Vincent:

Challenging dogma, yes.

Steven Sashen:

That is, it. Their karma ran over their dogma. So, if anybody wants to find out more about what you guys are up to or anything else, if they just want to get in touch, how would you recommend they do that?

Dr. Heather Vincent:

Sure. So, the exciting part is that our group in physical medicine and rehabilitation is breaking off and we’re becoming our own department on July 1st.

Steven Sashen:

Congratulations.

Dr. Heather Vincent:

So, we have a whole new website come and check us out. It’s pmnr.ufl.edu.

Steven Sashen:

Wait, do that again in slow motion.

Dr. Heather Vincent:

It’s just P-M-R@ufl.edu. So, we’re here at University of Florida and the EDU is the little last part of that address but come check us out. You can see what type of science we’re doing, the way that we think with respect to treating patients, the type of people that we see. And the bottom line is that we are trying to serve the patient population to improve function and keep people active through physical activity and mobility. So, there’s a lot that we have in common. And that’s our big, common goal.

Steven Sashen:

Splendid. Well, thank you so much. And everybody else, thank you for joining us for another episode of The MOVEMENT Movement Podcast. If you want to find out more, again, go to www.jointhemovementmovement.com. You’ll find all the previous episodes, all the different ways to interact with us, all the ways you can like and share and spread the word. And as I said again, if you want to be part of the tribe, please do subscribe. And if you have any questions or recommendations, people that you think should be on the show, et cetera, show them an email, move@jointhemovementmovement.com and most importantly, go out, have fun and live life feet first.

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