Wednesday, August 26, 2015

Addicted to Ironman?

"Former drug addict and alcoholic Todd Crandell has swapped an unhealthy addiction for a healthy one," writes Daniel Hoy in his article Addicted to Ironman. He goes on to chronicle Crandell's transition from a ten-year addiction to drugs and alcohol to completion of 27 Ironman triathlons. But are triathletes, marathoners or other dedicated athletes truly addicted to their sports? And are their behaviors healthy?

The American Society of Addiction Medicine defines addiction as a "chronic disease of brain reward, motivation, memory and related circuitry" and says "without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death." By these standards, there is no such thing as a healthy addiction.

Anyone who trains for and completes even one Ironman undertakes a program of chronic exercise. She must be intrinsically motivated and thrive on the psychological reward of completing a workout or race or achieving a personal record. Furthermore, at least 65% of runners are injured each year. Men in their fifties who have run a marathon each year for 25 years have increased risks of heart attack or stroke compared to their sedentary counterparts. So continued participation in these types of endurance races will very likely result in injury (if not disability) and premature death.

Image by Michael Foley
One might argue that exercise is a more beneficial behavior than consuming alcohol. All other things being equal, a person who never consumes alcohol will be better off than a person who never exercises. But the problem is one of degrees. Restricting calorie intake is also a beneficial behavior; anorexia is not. Neither is running yourself into the ground day after day.

So when does beneficial behavior become deleterious and possibly addictive? Two distinctions come to mind:
1. At some point, the accumulated intensity, frequency and/or volume of a particular activity will become harmful, no matter how beneficial single or limited instances of that activity may be. An alcoholic will likely discover that a having a few drinks no longer takes the edge off at the end of a hard day's work, and will notice a decline in his physical health and the well-being of his relationships. An overtrained triathlete will cease to progress and may become injured.
2. A second possibility is that the individual can no longer control the behavior in question. An alcoholic will ignore or forget previous voluntary allegiances to family, friends and career in order to satisfy the single-minded obsession of his addiction. Athletes may exhibit the same behavior, becoming consumed by the nagging thought that they need to complete the day's workout(s). When such a loss of control occurs, it will almost certainly require an outside observer to point out the obsession.

Returning to our original questions, are regular Ironmen and Ironwomen engaging in healthy behavior? If healthy means living longer, pain-free lives, probably not. If healthy means finding happiness and achievement while openly acknowledging the risks involved, then yes. Are they addicts? If we accept that--by any definition of healthy--there are no healthy addicts, then Ironmen who compulsively pursue their sport but take no enjoyment from that pursuit appear to exhibit addictive behavior. In contrast, Todd Crandell seems to enjoy his new life. It seems likely he will live longer as an Ironman than as an alcoholic, though neither pursuit is conducive to the greatest possible lifespan. But if he is truly happy, and therefore healthy, he is no addict.

Tuesday, August 4, 2015

Study links highly cushioned running shoes to higher impact load

In June I wrote about the fallacy of heel striking while running, and the mistaken belief that running shoes with thick, cushioned heels are a safe alternative to learning to run properly. A new study published by the Spaulding National Running Center at Harvard Medical School offers further evidence that cushioned running shoes actually put runners at a greater risk of injury. 14 healthy heel-striking runners ran on a treadmill in both highly cushioned and lightly cushioned shoes. Contrary to claims by manufacturers of cushioned running shoes, "the investigators found highly cushioned (HC) shoes result in a significantly higher vertical average load rate (VALR) and vertical instantaneous loading rate (VILR), both of which have been associated with overuse injuries such as tibial stress fractures and plantar fasciitis."