#291 How oxidative stress slows running injury recovery - DOC

#291 How oxidative stress slows running injury recovery

Today on the Doc On The Run podcast, we’re talking about how oxidative stress slows running injury recovery.

Stress makes you stronger and when you apply stress, you get adaptation. We know that’s true for workouts. You go out, you specifically do a hard workout, the muscles grow, you become more fit, you get aerobic fitness, you get all these benefits from deliberately applied stress. That’s true in all areas. It’s true for emotional stress, physical stress, mental stress. All of these kinds of stress can force us to change and although sometimes that’s good, sometimes it’s bad.

Runners always think of stress from workouts and when we think about that, that’s only one type of stress and I was recently on stage at the International Foot and Ankle Foundation meeting in Lake Tahoe this past weekend and I was given a presentation designed to help doctors understand why running isn’t the problem with running injuries. What I was trying to explain to them is basically why they shouldn’t always tell runners like us to stop running just when we get an over-training injury. Running is only one form of stress.

And in that talk, I had one slide in my talk where I was talking about all the different stressors afflicting runners and there are a dozen of them and biomechanical stress is the first on that list, but that’s only one of 12 different ones that I specifically talked about in that lecture to physicians to help them understand this. 

Now the second one on that list was oxidative stress. And I think that it can be a very helpful thing when physicians understand how we runners, recovering runners, injured runners, even runners who are training hard and need to recover after hard workouts, what we do to manage oxidative stress and what can be done differently.

So I basically gave a brief biochemistry 101 explanation of what oxidative stress really means and why it’s so important and why recovering runners really need to think about it. So what is oxidative stress?

It is kind of a buzz word now, antioxidants, oxidative stress. It’s sort of like how a lot of runners think that inflammation is bad, but we know that inflammation is the first phase of any kind of tissue healing. And if you have tissue damage from training or an over-training injury, you have to have inflammation to get that process started.

 We also have oxidative stress in your body as a component of tissue, communication, healing processes, all that. So it’s not entirely bad, but oxidative stress in itself in excess can certainly be damaging. So if oxidative stress must be bad, then antioxidants must be good. And generally speaking, I think most athletes, most runners would think that having antioxidants included in their diet is helpful to heal faster, recover after hard workouts, and so on.

And certainly if that’s true, then it would be true that that would be helpful to you when you’re recovering from an over-training injury. So what exactly is oxidative stress? What does that really mean? Well, basically in its simplest explanation, oxidative stress is a disturbance in the balance between the production of reactive oxygen species, meaning free radicals and oxidative defenses.

So if you think about basic chemistry and you think about a water molecule, it’s H2O. What that means is there’s one hydrogen atom and two oxygen atoms. And when you split that apart, it becomes two hydrogens paired together in the form of hydrogen and a molecules of oxygen get paired up to become the O2 oxygen molecule that we normally think about. Well, when you get a free oxygen molecule where you have unpaired electrons, that oxygen molecule wants to pair up with another oxygen molecule to get stable. Free radicals are just unstable molecules in search of an electron. And so if you don’t have another oxygen molecule available where it can immediately pair with some other molecule which can donate that electron, in order to lock up and basically become stable again and be paired, then it will find that additional electron somewhere.

So when you have these free radicals that are searching for that additional electron and they steal it from another cell, another molecule in the tissue, it does damage to the tissue basically. And so that is really the simplest explanation of what an unpaired oxygen atom scavenging for electrons is. And that, in a sense, is really what’s going on when you have oxidative stress happening in your body. Now this happens in the mitochondria. It happens in all tissues. It happens in your brain to a huge extent because your brain uses more oxygen than any other organ in your body.

I mean it really is just your brain is just a tremendous source of potential reactive oxygen species and free radicals and oxidative stress. And the reason I bring this up and the reason this is important for you to understand this basic principle and the reason I really wanted to sort of have this Biochemistry 101 lesson with doctors when I was giving my lecture at the International Foot and Ankle Foundation meeting is that if you look at those 12 different forms of stress I listed in my talk, the 12 different forms that only number one is biomechanical stress, but that’s running and the stuff you do when you’re running.

That’s only 1 of 12.  I was explaining to the doctors, “Look, the reason this is so important, and the reason we’re talking about this today is that you have to understand that if you can basically address all of these other forms of stress, like emotional stressors, all these other ones that are in that other list of six of them, have half of these forms of stress. Those alone, if you address those, will also further reduce the oxidative stress in the runner’s body.” 

That gives you 6 different ways to reduce the stress in a recovering runner without even beginning to look at biomechanical stress. 

The key to healing quickly is to do more stuff that you know is helping and less stuff that is not helping. So anything that you can do to address these things where you have free radicals that are causing oxidative stress, causing tissue damage, delaying healing, preventing recovery, you will heal faster and you will get back to running sooner. That’s just the bottom line. It’s just a way to look at it differently, so you can really try to identify some simple strategies that can add to the things you’re already doing that your doctor has already told you to do to try to maximize your body’s capacity for healing as quickly as possible and getting back to running faster.

All overtraining running injuries are stress induced injuries. If you want to recover as fast as possible, the single most important goal is stress reduction.

Biomechanical stress is the only form of stress many runners (and truthfully many doctors) try to address. Running form, decreased activity, fracture boots, different shoes…all ONLY modify biomechanical stress.

I created a free worksheet to help you assess the 12 Forms of Stress that can slow a runner’s recovery. Download it and go through a series of questions to ask yourself if you want to recover and get back to runnig faster!