A Running Doctor's Unorthodox, Dogma-Defying, Minimalist Approach To Running Fast And Injury-Free.

In this episode of the Ben Greenfield.

Fitness show, when I'm trying to get people to learn how to jog, I want them to run springy. So, you know, they're gonna have a really short stride, land soft, make little noise, you know, get their cadence up at least 170. I really don't care how fast they go. They're just learning a little different mechanic of movement. Yeah. And have fun. You know, if it's giving you a good response. You wake up every day and you feel good and you're enjoying what you're doing. It's not too technical, it doesn't cost you a lot of money, you know, and it fits into your day, you know, if you're not, fine, enjoying it, I think we all can. All the technical knowledge, but it's not going to sustain.

He's an expert in human performance and nutrition, voted America's top personal trainer and one of the globe's most influential people in health and fitness. His show provides you with everything you need to optimize physical and mental performance. He is Ben Greenfield. Power, speed, mobility, balance, whatever it is for you, that's the natural movement. Get out there. When you look at all the studies done, studies that have shown the greatest efficacy, all the information you need in one place right here, right now on the Ben Greenfield Fitness Podcast. Hey, folks, it's Ben Greenfield. And I gotta tell you, as you probably know, I'm all about unorthodox dogma defying approaches, especially when it comes to fitness. And my guest today is a running doctor who definitely fits that bill. As a matter of fact, I want to tell you his bio taken straight from his website. This guy's name is Dr. Mark Cucuzella. And I have absolutely no clue. As a matter of fact, I'm just going to have you talk right now. Mark, did I pronounce your last name right?

Right on. Yep, got it the first time. Ben.

I'm doing pretty well at these last names these days, so kukuzela. But we'll just call you Dr. Mark if you're cool with that.

I'm good with that. That's easier.

Otherwise this could turn to a very, very long podcast. So here's. Here's what Mark's website says. In the beginning, there was darkness. And runners seemed lost, confused, chronically injured, always experimenting with bigger is better footwear as a potential remedy. Then a new less is more approach emerged. A radical way of thinking. Led by a handful of scientists, athletes, coaches, and a charismatic best selling author, they looked backward to the past for inspiration. Soon a healer, an educator came forth. Collectively, they would become the shepherds to a flock of broken down, often sidelined runners accustomed to wearing conventional running shoes. This thing reads like the Bible, as it were. This health conscious individual lived in Shepherdstown, West Virginia, the oldest town in the state and just up the road from Harpers Ferry. His name is Dr. Mark Cucuzela, a family physician and an elite runner who in his early 40s can still reel off sub 2 40s at the Boston Marathon. Mark has a singular vision regarding the need to spread the gospel of natural and minimalist running to the masses. And Mark, I know you've got a little running store there called Two Rivers Treads in Shepherdstown. And, and that's a fixture in the natural running community. You get a lot of coaches, athletes, trainers, physical therapists, bloggers, runners, bunch of people come to you for advice. I've heard you on other podcasts. I've checked out your website, which is the naturalrunningcenter.com and you've got good stuff. So I figured I would get you on the show and we could talk a little bit about some of, some of what you describe as the mind draining dogma and reckless bias in the current running industry. Sound good?

Sounds good. Ben on the show.

Cool. Well, this is kind of a tough lead off question, but what exactly is your philosophy and your training when you have a runner that you can mold?

I think I'm a physician, so my first goal, Ben, is to try to make sure people are healthy. And that's really our ultimate goal, is to create health for the long term. So I put people into different groups. I mean, if I'm working with someone who, you know, high school athletes, you know, they want to win the state championship, so really performance is their primary goal. So we're going to work a little differently then, you know, we have a local couch to 5K. I mean, these folks, most of them are trying to reverse their diabetes and they're just trying to become healthy. So I want them to just have joy and fun and stay pain free. I mean, I think there's a lot of overlap because, you know, I think, you know, when we're all happy and joyful, we run well. And, you know, when we run well, we're happy and joyful. So I think there's more similarities than appear on the surface between performance and just running for health. Then there's people that are.

Well, when you have like all these. Sorry to interrupt, but like, you know, if you take, you know, meb kasalski or I probably butchered his name. Other professional runners, marathoners, etc. You know, and we even have, like, a lot of elite obstacle racers and triathletes that, listening to this show. Are they unhealthy?

I would say, you know, they'd have. Everyone's an n of 1. So I think some are, you know, I think people that are chronically overtrained, overstressed, you know, trying to achieve a performance goal with a crazy hectic lifestyle, who wake up every day and they don't really feel excited about training, maybe they aren't healthy. I've certainly seen, you know, my share of runners who have coronary disease who have diabetes. So I think running is good. You know, triathlon's good, obstacle racing is good, but it's not a guarantee for health.

What are some of the health issues like that you would see in a fast person like that?

I think the health issues that we see in runners are no different than the health issues we see in America now. Because, you know, essentially, you know, we've evolved to be insulin resistant, to be very efficient at storing calories that probably served a purpose at one time. And, you know, when you're exposed to a modern world where food is everywhere and sugar is everywhere, you could go do your two hours of cardio every day. But if you're insulin resistant, it still may be your ticket to diabetes. You know, running is running, and health is health. So I think running doesn't. It helps us become insulin sensitive. But the big problem out there is insulin resistance.

Okay.

And that's what we're seeing in the hospital where I work every day.

Gotcha. So what you're saying then would be even when you've got, like, a lean runner, for example, you can have rapid fluctuations in blood glucose due to a combination of diet and the persistent quantities of food that are available to us. And you can have somebody that's lean, but that has things like inflammation or chronic diseases related to high blood sugar.

Exactly. And I think it's a pretty simple screen that you could do just by asking the patient a couple questions. You know, so they're a runner. So someone just sees me in my store or out at a running club event or at a race. So they're a runner and they're running, and they, you know, feel okay running, but, you know, if their body composition or, you know, and where they're carrying fat is not optimal, so they're carrying a lot of visceral fat, or if they get a test called an A1C which is an average blood sugar. So if either of those are not optimal, then they probably have some insulin resistance and their running may be just fine. But if they shifted their diet, I think they would feel better and become healthier because we know that insulin resistance and high insulin levels trigger a lot of adverse responses in the body, including what we're learning about, even with Alzheimer's and type 3 diabetes they're calling that. Now, that's a kind of a good basic screen that I do.

So I've got a question for you. If you have a runner or someone doing any type of endurance exercise or CrossFit workouts, whatever, and they are eating carbohydrates, is there some kind of a window, is there some kind of a way to know whether or not your carbohydrates or your sugar or protein is very insulinogenic as well? Is there a way to know when it's going to cause metabolic damage and when it's not, depending on how you stack it at any given point in your day?

Yeah, I think all of us are trying to figure that out based on our own metabolism, you know, so I think we want to look at a baseline first. So 20 something, you know, collegiate athlete. These folks can empty the tank and fill it every day with pizza and they're probably doing just fine. Metabolically, they're normal. Insulin's doing its job. But if someone before their workout already, you know, is showing signs of prediabetes, whether it's weight on their viscera, on their belly, or an A1C, an average sugar that's above normal, then that person should just do a two to three week trial of lowering their carbohydrates and probably reducing super high intensity workouts, let their body shift a little bit into fat metabolism and just see how they feel. Are they losing a little weight? Do they have more energy all day? Not necessarily just during their workout, but during their workday, is their brain more clear? Because I think if those things are all dialed in, then all of us can do whatever workout we want in a better state. We're just healthier and happier.

Gotcha. Now, in terms of hemoglobin A1c, this HbA1c reading, there is some talk in sports science literature about how athletes, because of how frequently they mobilize liver glycogen, which would cause a surge in blood glucose during exercise, and also how frequently red blood cells turn over because hemoglobin A1C is measuring glucose that adheres to red blood cells that hemoglobin A1C may not be a very good corollary for glucose levels in athletes compared to, say, like, you know, an athlete using blood glucose measurements or daily fasted glucose measurements. Do you have anything to weigh in on when it comes to hemoglobin A1C and its accuracy in athletes and especially people with high red blood cell turnover like endurance athletes?

It's a good question. That one would be ripe. I don't know, I'd probably have to ask like, you know, Stephen Finney or Jeff Olak, someone who's a researcher, because most of the literature is not elite athletes. You know, they're people that are average, everyday citizens. You know, from non athletes to recreational athletes, you know, running their first 5k or even running marathons. You know, half a million people ran a marathon or ran, walked marathon. But I think if someone, again, like, if someone's body composition was good and they felt really good and had energy all day and their hemoglobin A1C was a little higher than ideal, I wouldn't necessarily tell them to make any change. If it was all dialing and feeling good, if they wanted to do something different for a few weeks and see how they felt, maybe recheck their A1C, I think each person would need to look for themselves. You know, A1C measures an average over about six weeks.

Yeah, but in your experience as a physician, whether it's hemoglobin A1c or whether someone decides to just go to Walgreens and pick up a blood glucose monitor and start tracking on their phone or whatever, you would say that for an athlete, even someone who perceives themselves as healthy, that glucose readings would be way up there in terms of a way to really keep a finger on the pulse of your health.

Yeah, and again, that's a great thing. I tell my diabetic patients or pre diabetic patients to go get a blood glucose monitor at Walmart, they cost 30 bucks and there's a certain brand of strips you can get five bucks for. You know, it gives you like a month's supply. So it's pretty cheap. So that athlete who's maybe curious, maybe they did draw an A1C and it's, you know, ideal would be like four and a half and say they came up five and a half. And I would tell them, well, here, let's just do your own experiment. Why don't you go have, you know, corn flakes and check your blood glucose one and two hours after corn flakes. Now, you know, have bacon and eggs. But if they have a really high spike in glucose. So if their pre meal is 80 and they have a bowl of corn flakes and it goes up to 180, 190 and stays up there for two hours, that's telling you that that's not optimal, may not be affecting your exercise adversely. But in the long term, I think everything is about trajectory. So what is that trajectory? Are you heading for the safe harbors? That's where I want to be. Or are you sailing toward the waterfall? And that's what I see today in my hospital practice is people are heading to the waterfall and they have no clue. You know, they're told, well, maybe I have pre diabetes. My doctor doesn't seem to know. And they're carrying 50 pounds around their belly. And they really, these are smart people and it's sad. They have no idea. You know, look at their A1C. Someone even drew it and it's like 5.8. You know, it's like it's black and white and it's not even gray at that time. I mean, they have, you know, metabolic disease.

Yeah. One thing that I would caution people to know about is that when you do this blood glucose testing, you will find, ironically that. And this is what I found in my case and with some of the folks I coach, blood glucose spikes during or post workout. Due to that reason I mentioned earlier about how when you do a hard and heavy workout, your liver in response to cortisol production churns out a bunch of glucose. You may find your blood glucose is elevated after a workout. That's really not the number to pay attention to as much as where the number goes after a meal, like especially staple meals in your diet. From a biomechanical standpoint, you have some interesting theories specifically regarding minimalist running. When an athlete comes to you and they're wearing this big built up overprotected footwear that you obviously eschew on your website and in your bio. What do you do?

Yes, I think again, almost back to the patient. What is their goal? Are they a performance runner? Are they an injured runner? Or are they just a new or beginner runner? So a beginner runner who's just learning the sport, I want to teach them proper movement patterns right off the bat and they're not loading up their body heavily. So I would want to get them not so much just for running, but all day. So get them in a shoe that allows their foot to behave like a foot. I mean, we've got, it's the foundation of all movement. You know, we have four layers of intrinsic muscles, you know, 26 bones, 33 joints, all moving in multiple planes. I mean, there's an infinite number of positions a foot can be in. Now, I think there's probably some smart design there. I wouldn't claim to know all the smart design of the foot, but it got there and it does what it does for a reason for us to be able to walk and run on two feet. So I want them to learn how to use their foot in relationship to their whole mechanical movement. Now if they're a performance runner and they're in mid season and they've been wearing a certain type of shoe and they're not injured, I'm not going to go tell them to go change their shoe. At least not mid season. I think off season when they're trying to reset a few things. Yeah, then maybe dabble a bit. I do screening assessments too. If a runner can't get into a deep squat or a basic squat, you know, has no hip extension, you know, they can't, you know, get into a couch stretch position, you know, they're probably, they've got some hardware issues that they're going to need to work on before just reducing the shoe. Now, if they're injured. Yeah, go ahead, Ben.

I'm sorry, a quick interruption regarding the shoe and the footwear. When you transition someone into minimalist footwear, do you have a specific series of steps that you go through as far as strengthening the foot or as far as spending a certain amount of time in the new footwear or barefoot versus the built up footwear?

Yeah. So what we encourage at our store, certainly we do an assessment. So if I have an 8 year old kid come in, he's been running around all summer barefoot, this kid doesn't need to transition. They would actually need to transition into the modern running shoe. Because if that kid put on a modern running shoe, he would be all moving different. So it depends on the person walking in the door. So if they can pass a few basic checklist assessments and there's a little bit of science to that, but it's not 100%. And then tell people to listen to their bodies essentially. So the first day you might wear the shoe for a couple minutes running. But I want people to walk around as much as they can in a level and flat shoe that is a wide toe box and is flexible. Because I don't know about you, Ben, I walk and stand more than I run. I have a day job and I'm on my feet all day is just for yucks you know, that's just to relax my mind. But so you should come to my hospital. It's kind of funny. It's not from me, but the nurses all seated around it. I mean, you go around the ICU and they're all in five fingers or lambs or ultra shoes because they're on their feet like all day and they're drinking the Kool Aid because they share this and their back doesn't hurt and their knees don't hurt, but more importantly, they feel good, you know, so when your foot's actually working, it's weird again. It's almost like going low carbohydrate. If you're insulin resistant, I just tell people, just two weeks, get rid of the big, bulky, stiff Dansko or whatever they're wearing on their shift. Just get something more minimal. Two weeks. And then try to put that other shoe on. If your body prefers the other big stiff shoe, give me the other ones back. But we've been open five years and I've never had anyone return a shoe who did the two week test.

What about people who are doing ultramarathons or spending time doing something that might be considered from an ancestral standpoint, unnatural? Would you put them in more of a built up shoe like a HOKA or something that has a lot of cushioning that you see a lot of ultra runners wearing these days? Or would you just say get your feet strong enough to be able to run 50 miles in Vibrams or some other kind of minimalist footwear?

Yeah, it's a great question. Again, everyone has their preference. So racing. I've done ultramarathons on trail. So running ultramarathons is not a training activity and it's not a normal activity. And it's kind of like you got your downhill mountain bike with the big shocks. I think you have to develop the strength and the skill of running in your training. Now, if it's race day and you're running the Leadville 100 miler, I run in a cushioned shoe. It's certainly flat and not mushy, but if I'm doing an ultra on a trail, my shoe has a lot more cushion. If I'm out in my day neighborhood here running, you know, I'm preferably, preferably barefoot, even on the pavement if it's warm and it's smooth pavement. But then I can put on any shoe as long as it's flat for whatever terrain. It's kind of like a set of work gloves, you know. So if I'm gonna go Chop wood, you know, or go pick up some thorns or, you know, yeah, I need some more protection. I think you develop the skill of running in a minimal shoe. Because what I see. And people bring in shoes to recycle and I could even send you a couple pictures. I've seen some horribly worn hokas that are tilted at 45 degrees after the person's been running in them. And I'm like, whoa, that's really. Landing on that shoe on a trail is really unstable because you will roll your ankle. So again, if you have perfect form, you know, you're gonna not create friction. You could put anything on your shoe, anything on your foot. But if you're out of alignment and you go, think the cushioned shoe is gonna fix that? You know, it's asymmetry. You know, I think runners, as soon as they start to run beyond their functional movement, run faster than their symmetries and their body can stand, you know, then they're at risk.

Is it really unnatural to be asymmetrical? Like is. You know, when you look at a face, for example, you very rarely see perfectly symmetrical faces. And when you do, those people are usually high paid Hollywood actors or occasionally. I actually came across this, I believe it was in ESPN magazine, that quarterbacks in the NFL have the most, some of the most symmetrical faces of the entire population. When it comes to the rest of the body, though, and you look at symmetry. When you say asymmetry, are you saying that each symmetry side of the body should move equally or are certain asymmetries okay?

Yeah, I think it's a good question. I think, again, is this a beginner or a performance runner? So we have a tool in my store called an optogate. And optogate's a, you put it on a treadmill and it measures contact time, stride length, and, you know, the folks at Nike Oregon Project use this. So Galen Rupp and Mo Farah hop on this every day. At the end of the day, it's called an optogate. Optogate, opto. And microgate.com is the website. So they'll hop on this every day after their training. And kind of like, it's kind of like, are you drunk or are you sober? Say you go do a hard workout and okay, you finish that workout, but then you're kind of drunk, you know, so you're. Peter Gorman developed this, that what that means is dramatically reduced utilization of normal kinematics. So you're jogging along and you dial it up a little bit. Now you're 3% you know, less contact time or more contact time on the right or the left. So they'll just hop on this treadmill and just kind of iron it out and get to as close to symmetric as possible and then recover, you know, so you want to recover in the right position. So those are people looking for that, you know, 0.01% performance because they're going to go load it up the next day and they just want to make sure at the end of the day they're sober, you know, okay, they're good. I would, I mean, a lot of us have structural difficulties or, you know, I've got more hip arthritis on the right or left. So that person, I wouldn't be so concerned about making them symmetric other than if I were to put them on a treadmill and if they were going at six minutes per mile, if I noticed that, okay, now they're 8% asymmetric, but at 10 minutes a mile they're like 1 or 2%, you know, are they hurt? So if they're getting hurt, you know, maybe we need to figure out how to get them a little better dialed in, tuned in symmetric to be able to go do six minutes a mile. They may be just totally good at 10 minutes a mile. But as soon as they. It's like your car out of alignment, you know, maybe going down the road at 20 miles an hour, there's no shake. But when you want to go on the interstate, I think you have to earn the right to run fast. And if you get injuries, it's telling you something's wrong, you know, and you got to go figure that out. Everyone has a different issue with why they get hurt.

Let's say you find abnormalities using these. I believe this optogate uses optical sensors to detect like mechanical abnormalities and asymmetries and stuff like that. It looks fascinating. I'll put a link to it in the show notes. For folks who want to check the technology out in the show notes, by the way, are BenGreenfieldFitness.com minimalrunning that's BenGreenfieldFitness.com MinimalRunning when you find someone who has an asymmetry, how do you fix it? Is it a chiropractic manipulation? Is it a change in the footwear? Is it like a multi week long series of strength training exercises? I mean, what can you do both acutely and chronically to fix these asymmetries?

Yeah, this is a great question because I think what you just asked there is really the key question. And I gave a talk at the American Academy of Podiatric Sports Medicine conference a month ago on this topic. So I believe, and the literature supports this, that we should be using gait as rehab. Is it software or hardware? So is it that they just can't do the movement pattern, but they have the strength and range of motion, or do they have a deficiency? So I'll take someone and just assess their movement. Do they have mobility in the hip and the ankle? Do they have. Can they balance on one leg? But quite often people can pass all these prerequisites, so to speak, but then they run and their movement pattern is off. So the magic tool that we've had in our store that I can get out of the way or any coach can get out of the way is a motorless treadmill. So we have one called a Trueform Runner. It's a motorless treadmill. You have to make it go. And you can't over stride on this thing.

Yeah, I'm standing on one right now.

Yeah. So just like if you were to go to the driving rink.

It's what I use for my standing workstation.

Yeah. You have to be symmetric to really make that thing go smooth. You know, if you're landing over stride, if you're in the back seat, meaning leaning back, if you're bent forward at the waist, if your posture is not right, you're fighting against the thing. So you start slow and easy. Get the thing running smooth, and then try to speed it up a little bit, and that'll answer for you. Okay, where's your limit? And you've got to use your glutes on that. You've got to use your posterior chain, which I think if people learn how to use, a lot of people have. And I could probably link the study. I pulled it up when I did this talk. But a lot of folks have hip extension, but they don't use it when they run. So a static assessment doesn't necessarily transfer to what happens when they're moving.

Yeah, it's really interesting because I can't make the belt on this treadmill move unless I lean forward and keep my center of gravity forward. It just won't. So it almost trains you to lean.

Forward as you run and balance. You have to be in balance, not necessarily free fall. And you've got to be in balance. Yeah, you got to use your big toe on that. You've got it. You know, most runners don't plant or flex, you know, so the way we get off the ground is plantar flexion. You know, a friend of mine coined the term tanning your soles. So when you watch any fast runner, when they're at toe off, you know their ankle is fully plantar flexed and you know, their sole is actually pointed to the sun because they're actually looking, launching their. You know, that's the Thomas Myers anatomy trains model. I mean, you're a slingshot, and you're releasing that slingshot, but the motorless treadmill will kind of get you to. Get you to feel that. So now does one session on a motorless treadmill fix you? I don't think so. I think you've got to feel it, get it, go out and run, come back, do it again, you know, until that movement pattern is hardwired. Now, till that becomes your normal movement pattern.

Gotcha. Okay, so in terms of some of the things that you want people to check off, one would be blood sugar, One would be transition to minimalist footwear. One would be identifying asymmetries and fixing asymmetries. What about actual training strategies for. For getting faster or becoming a better runner? What is your training approach when it comes to how you would. How you'd program a typical week in the life of runner?

Yeah, that's a, that's. And I think I'm a true believer that everyone adapts differently to different stimuli. So I think everyone, yourself included, Ben has probably tried a lot of trial and error like this works for me, but it doesn't work for them. And so I think all of us at some point need to make sure we develop some aerobic base. You know, just in life, not necessarily running, I mean, just be more active individuals, you know, walk more, you know, pick things up, move around your yard, play with your kids. I mean, that's all good. Now I think I truly believe that there's, as you get older, I mean, I'm 49 now, and what do you lose as you get older? You got to train for your weakness. So as you get older, we all know that we lose strength and range of motion. You know, so what am I going to focus on now as an older guy? I've run enough miles in one direction my whole life. So now I've got to work on keeping stronger and keeping my range of motion and speed. So I don't do a lot of speed work, but every day I'm doing short sprints, skips, you know, drills.

What do you mean, just like at work or when you get home or before you go?

No, during my run. So, you know, this was 20 years ago. I would just go Run for an hour, come back, you know, eat bread. No, I don't eat the bread anymore. So now if I have an hour and a good day like today, I'm off work this afternoon and it's beautiful. So I'll go, you know, I'll go run for an hour today and I'll, you know, I just came off a long weekend. It works out. I just want to have fun. So I'll go nice and mellow for by about 50 minutes. And then the last 10 minutes almost of every run I do, I have a series of skip drills, light plyometrics, short sprints called a lactic sprints. This isn't devastatingly hard speed work, but it keeps the skill and keeps the strength. And I'll do some burpees. I've got my kettlebells. Nothing that takes an excessive amount of time fits in my basement. I put them in the, the yard. And that kind of keeps, you know, my goal is just not to lose it, you know, every year, you know, you're fighting back the tide. And I think that training philosophy should translate down also, you know. So are you someone that responds well to. I think aerobic work is huge. You know, I did the maffetone method just to build my base when I was in my early 30s when I discovered that. And I found that developed a whole new layer of efficiency. And then on top of that, now I'll add the faster stuff. So I think you got to have a little of both.

What did you call those sprints that you finish up with? A lactic sprint.

Yeah, that was a corn term by Arthur Lydiard. So people thought Arthur Lydiard just told people to go run slow every day. And that's the opposite. There's so much misinformation out there. It's like people saying, well, Atkins just tells people to eat steak all day. You know, it's going to kill you from a heart attack. That means people never read the book and don't understand it. So Arthur Lydiard, through the course of the year, this is, you know, they did periodization, you know, so, okay, is it an Olympic season? World championships, you know, world cross country. So they always periodize their training based on the big meets. But even in the off season where they were just building endurance, almost every day, they did eight lactic sprints. So that would be like a 50 to 100 meter stride, you know, so you're really not building up a lot of acidity, but you're really working on neuromuscular turnover, range of motion, strength, but you don't finish that and feel like, gosh, my body's in the tank. It doesn't put a lot of stress on your body, but it puts quickness in your body.

So these are strides that are basically under two minutes. So you're not reaching up into lactic acid formation. It's all glycogen based sprints.

Yeah. 30 seconds. Recover, shake it out. And you know you're doing it right where like the first, first one always feels a little uncoordinated, especially as you're older, you're a little stiff and sticky. But after second, one third, one fourth one, then you're flying, your stride's open, your brain is working, it's activating the right muscles and then you recover. Because I think if you do that every day, you're going to recover better than if you just go out and slog your slow run every day. Shorten things up. So I think it's just a nice little tool to throw in there that's not high stress and it'll tell you. And even if you got a little tweak, so if you try to do some strides or sprints and something's tweaking you, you better go address that, you know, okay, what is it? You know, go roll it out. You don't want to just wait for the injury to happen. You want to on the front end. Okay, I got something that I need to figure out and it's worked for me, so. But that goes back to Arthur Lydiard. It worked for his, his runners never got hurt. So I figure if it worked for 12 Olympic champions, it's probably good enough for.

When you and I were emailing back and forth in planning this interview, you mentioned to me that you think that runners need to earn the right to do these kind of intervals and sprints. What do you mean by that?

Yeah, so I think if people go out and pick up a schedule and it says go do half mile repeats on the track, but they, you know, they're hip, I mean, they're weak, you know, they have a horrible movement pattern. You know, their knee goes into valgus and then they go try to do these workouts and maybe metabolically they can do it, but it's a ticket to disaster of injuries, you know, so if at six minutes a mile, you know, their stride length is 10% asymmetric versus slower, you know, if you load up dysfunction, you know, you'll create more dysfunction. So the body will tell you. So if people get hurt, it's telling you something ain't right with that plan. So I think, you know, you build it like anything. You build a foundation, you know your movement patterns and I know you're a big proponent of this. So if you can't move well and then you go try to do high intensity stuff, whether it's in a CrossFit gym, you see people trained to failure. I think training to failure is teaching failure. It's going to bite you in the end. You should feel at the end of the day, if you feel like you couldn't do that workout again, you probably trained too hard.

Isn't that part of how you get more fit though, by. By throwing curve balls at your metabolism or at your muscle fibers that cause them to bounce back stronger or harder or faster the next time after you, after you recover and super compensate? I mean, wouldn't you risk being at a plateau if you kind of like maintained the same intensity all the time?

Yeah, no, I'm not saying maintain the same intensity. I think this one sentence probably defines it all. The body will adapt as long as the load applied is not greater than the capacity to adapt. So yeah, so improvement is adding some EU stress, adding some stress to the body recovering and then it's super compensation. But if you go beyond the body's capacity to adapt, that's when, whether it's metabolically, structurally, whether it's load or repetition, you look at quantifying mechanical stress. So you could go and do 10 box jumps from 4ft, that takes you a couple minutes and you could destroy yourself doing that because that's a lot of mechanical stress. Or you could go out and run a 20 mile run when you're not ready for that. It's not a lot of mechanical stress, but it's a lot of physiologic stress and mechanical stress with just the time on the feet. So you have to like everything, you've got to adapt progressively.

Yeah. It's interesting though. I've had some races that have completely chewed me up and spit me out in terms of me looking like freaking Raggedy Andy by the time I get to the end of that course. As far as my biomechanics are concerned. Right. Like completely beat up because the race, you know, pushed me pretty hard. If I recover well and I, I super compensate from a race like that, I wind up getting huge breakthroughs in my fitness, in the ease of my workouts down the road, etc, but it seems to me that I kind of break, break that rule in a situation like that, pushing my body beyond what would be like biomechanically appropriate or pushing my body beyond what it's biochemically been exposed to before. How do you kind of align that with your thoughts about not going to failure?

Yeah, so what you just said there is the key. You said you recover. I think you even said it, quote, you said I recover well or something. But yes, recovery is the training because that's when we improve. So you've developed your strategy of thousands of experimental methods of recovery. Whether it's a cold shower, whether it's eating eggs or a hot tub, or putting your legs up or putting compression boots on. I mean, you probably have a whole list of recovery hacks that you've done that either give you a good response, no response, or a negative response. So you know that, okay, you took yourself to a little bit of failure, but you're going to recover before you go try to do it again. So if you didn't allow yourself and you're aware that that recovery is the training. So if you don't recover from that, train to close to failure effort, whether it was a spartan race or what have you those next few days. And I think Joe Dye shared the heart rate variability app and I use that now too, and I'm just figuring that out. I don't know yet exactly what that's doing, but it's actually been correlating pretty well with me too.

Yeah, I use it every day.

Like this morning I put it on and I just came off a 24 hour call shift, you know, when I was up most of the night and it was way worse than it was a couple days ago. And I didn't run anymore. It's just my recovery and how I slept and ate like crap and all that for a day. All right, that didn't treat my body well. So I'm running a marathon this weekend. So I'm going to to try to make sure my heart rate variability in the morning is back to kind of an optimal before and then I'll know, okay, I'm ready to roll on Sunday.

You're running a marathon this weekend?

Yes.

What's your week look like leading up to the marathon? I'm curious what you're doing from a taper standpoint. And then also if your diet or your supplementation protocol changes at all going into a race.

Yeah, it really doesn't change much for me, Ben, because I'm not training so hard that I need to taper. I mean, I think if you're training or over training, you know, trying to overreach a little bit to try to get a super compensation. Yeah, you better taper. But my life's so busy is the beauty of having a busy life is you can't over train. So I kind of run right into it. I'll probably take because it's just I'm busy a couple days before I'm teaching a sports med conference. So that's like a 12 hour day. So I won't have time to run that day. That's the Friday before. This is the Marine Corps Marathon in D.C. i'm on the Air Force team and Saturday we get together, we have some team functions. What's really cool too all the services. I'm in the Air Force, the Marines, Navy, Army, Coast Guard sometimes will have a team. We'll go out for a nice easy run on the mall just as camaraderie. Just in honor of other fallen airmen and soldiers in our services. That's our easy shakeout on Saturday. I don't carbo load. I'll have whatever my usual dinner is the night before. I prefer to have some steak and a salad the morning of the race. Certainly I won't sabotage my race by having a lot of carbohydrates early morning because that'll just make my insulin go up which will block fat burning. So you know, I'll maybe have a, you know, half a bagel at the most with a lot of peanut butter or almond butter. I'm in a hotel so I don't have a kitchen, something like that. So get a little carbohydrate in probably about three hours before the race. But more fat and protein I think just to keep me from feeling hungry. If I put that in my belly, I'm good. I may take a gel or two along the way. Just a little carbohydrate along the way. And I think just the way I respond that just helps. Fat burning, you don't bonk. I'm not worried that I'm going to bonk from sugar depletion during the race. We certainly, we can all go out too fast and get a little muscle damage and all. But I'm not too worried that there's not enough fuel in the engine to go right now.

When you finish the marathon or when you finish a hard workout, do you have any go to recovery methods that kind of fly under the radar that you don't think a lot of athletes know about or are currently using, you know, that go beyond just like, you know, massage and foam rolling and stuff like that?

It depends on the time of day. Usually I'm a Morning runner before work. So I, you know, gosh, I have a friend who's a farmer, so eating. My kids call it the stinky omelette. You know, So I take everything out of the fridge and I started dreaming about this omelette, you know, maybe about a mile from the house. I'm thinking about what's in my fridge that I'm going to put in the omelette, you know, what did I have for dinner last night? You know, because, yeah, it makes you happy. You know, I'm going to make this big guacamole. I got pork in there, you know, vegetables. And you throw that in this big omelet. And then I don't sit. You know, I think if you sit right after you run, you know, everything shortens up. So I have a beautiful quick commute to work. It's like 10 miles. And I'm a hospital doc, so I'm on my feet all day. So I don't sit. You know, I have a little mobilization. I have a stand up workstation. You know, I'll put one foot up on a stool, you know, just change the position a lot through the day. Now at night, you know, I'm an older guy, 49, and I think that water's magic. So just sitting. I have a small hot tub in the backyard. And heck, that just feels good. I mean, it just feels really, just like.

Like hot water.

Yeah, hot water. And I, you know, I sit in there, you know, I just hang out. I may answer a couple emails. You know, you can get into the couch stretch position for a few minutes and you can get into a squat position for a few minutes, you know, read something. But yeah, just, I think there's something about that that just relaxes the body.

Now a lot of people will use cold water. Why do you use hot water?

Because I like it more. Maybe I'm soft. But I lived. Oh yeah.

Gosh.

I lived on an island in Portugal for the Air Force for a year and a half and we didn't have hot water. And I think it actually helped me recover. But no kidding, if I had to do it voluntarily, I wouldn't do it. So I'd run at lunch and we had, it was called the Azores. So it's up at about the same latitude as, I think it's about England, so it's not tropical. And the water was kind of groundwater, so the water temp was like 50ish degrees. So you'd come back from your run and you didn't have hot water. We had one shower so we did have hot water for patients, but not for us as staff, because no one really showered other than me, who ran and I'd get back from my run and I, you know, you get to get up the guts. 1, 2, 3. You jump in there and threw some shock in your body. And then you did the navy shower really quick, and it really felt really good. But if I had the choice, if I had my hot tub there or jump in the cold shower, you know, maybe. Maybe the cold water would be more beneficial, but I like the hot water better, so that's my answer. Take.

When it comes to health and stuff like that, are you. Do you get concerned about chlorine or do you geek out on the kind of water that you drink or soak and bathe in?

Yeah, so it is a hot tub. I have it very, very low because my wife and I are the only ones using it. I put just a tad of chlorine in it. I change it frequently. So it's just got a very small amount, not even close to what a pool would have. If I had a lot of money, I would figure out how to get one of these. Salt water. But then I'll make them for the small spas. They have these salt water type of pools now.

I think they can be kind of tough on the pumps, but yeah, they have like, mineral based systems. I use one called. It's like an enzyme based system called Natural Clarity. And it's just. My hot tub has no chlorine at all. And then you use a little bit of what's called potassium. I believe it's a potassium chloride after you finish swimming or after you finish soaking, just like every few bathing sessions. And it works pretty well for a hot tub.

So I'll send it. I'll just. I'll empty my tub and try.

Yeah, I'll show you this stuff. Basically, you. You empty the hot tub. You. You fill it, and then you do a shock to kill anything in it. So chlorine, once the chlorine all subsides and it's gone. And you test and it's below about 2 parts per million. Then you add these enzymes, and it's just one bottle of the enzymes that lasts for like eight months.

Wow.

Yeah.

And, yeah, it works really well. No one told me that.

So I'm curious, too, to turn around and talk about something completely different, about all these different running gate systems out there, like pose chi running. There's a lot of different forms out there. Do you have a specific running form system that you stick to. Or that you use?

No, I think we're designed to move in a way, and we're all moved differently. So there's not one stamp that says we're all supposed to move this way. So I have a video now, and I think it's got 700,000 views or something. So. Talks about the basic biomechanics of running. You know, what muscles, what fascia, where you need mobility, where you need strength. So you can watch that. It's called Principles of Natural Running. So that's my overriding philosophy. So running is just running. You know, there's no brand of it. It's not proprietary. All of us are going to look a little bit different. And that's my. That's my philosophy, is get people to learn. I think the main deficit in running now, maybe it's because of the shoes, is people don't know how to use their glutes. They're kind of glute amnestic, and they don't have mobility in their ankles, you know, so they. They can't get into a, you know, lower drop shoe easily because they're so tight. And most of that's from wearing healed footwear through the course of the day. So it's a gradual progression into more springy, you know, so our body, when we run, actually our muscles are more isometric, meaning the lengthening is coming from the fascia, meaning the connective tissue, the tendons, the ligaments, and the muscles kind of stabilize. So getting people to wake up their fascia, jump rope, you know, do jumping jacks, do, you know, light box jumps, you know, anything that involves skipping helps wake up the fascia. And then learn to use your glutes. So do some drills. Every sport except running really has a focus on drills. Look at swimming, look at anything. So do some simple drills to help you activate muscles that you're going to use when you're running, and then get on the motorless treadmill. So I think it's no more complicated. If people hop on that motorless treadmill we have and they can make it run like butter. They don't need my help. They don't need anyone's help. They're good if they can't make that thing move. Let's figure out what their problem is.

Now, what about the issue that some people maybe can't run? Well, maybe they ran perfectly when they were a kid, right? And you say that you shouldn't. You know, everybody can run according to the way their body is built, but what if they've just had Years of sitting, poor movement patterns, injuries, etc. If you just tell them to go and run and just, just do what they do naturally, won't it be kind of messed up running?

Yeah, I want to give them some instruction first and I think getting them to slow down and run slow, give them permission to run really slow with an optimum cadence. So when you teach people who haven't, like we do a lot of couch to 5k stuff and the walk is actually a little quicker than the jog, you know, because you can walk, you know, 12, 14 minutes a mile. But when I'm trying to get people to learn how to jog, I want them to run slow, springy, so you know, they're going to have a really short stride, land soft, make little noise, you know, get their cadence up at least 170. I really don't care how fast they go, they're just learning a little different mechanic of movement, you know. So running is, I mean, we're a mass spring. When we run, our center of gravity, center of mass drops in mid stance. We're walking as an inverse pendular gate where our center of mass rises. So there are two different movement patterns. And if you want to run, you've got to practice running. So getting them to walk a couple minutes, run a minute, but run easy. And ultimately they're going to feel that and they're going to feel that springiness and they're going to be able to do more of the jog than the walk. And pretty soon they're jogging the whole time. So they mix it up. When people start out on a running program, if they just go and try to run 10 minutes, they get anaerobic going around the first turn because they're so unfit. So we want to give them permission to just go really slow, get springy. And it's a progression, it could take months. But slow jogging is powerful for a new runner.

So the number one key is to work on cadence and work on cadence without necessarily feeling forced to get fast while you're doing it.

Exactly. Because it'll come, the speed will come.

Okay, gotcha. Alright. Is there anything else that you use that you think is kind of unique or non run of the mill when it comes to the way that you coach or program for runners?

No, I think what I really get people to try to do are things that have been used for 50, 100 years. So foundationally what Lydiard did with his runners, meaning building endurance. Because it's not about, I'm working with the Air Force now I'm a reservist, but I'm highly involved with their fitness programs and trying to get people to pass their fitness tests, you know, which is a mile and a half test, which is six laps of the track. And almost never are they limited by their speed. So say for your age and sex, it's a 14 minute, or let's pick 12 minutes, which is two minutes per lap and you'll get a good score. But you can't do two minutes a lap for six laps because you fall off the cliff. But if you tell them to go out there and do one lap, most of them would, would beat me in one lap. You know, they can do 65 seconds, 70 seconds. So speed is not their limiter for the majority of, you know, your average recreational, non endurance athlete population. So they, they have the speed, they just need to build the endurance.

Gotcha.

So I think foundationally starting there with most people is going to be their ticket to safe success. And then work on the skill, you know, do some strides, do some drills, do some plyometrics. So this is nothing different than what Lydiar did with 12 Olympic champions in the early 1960s.

So it sounds to me like if we were going to wrap all this up, you'd want to monitor your blood sugar, you'd want to effectively transition from built up footwear to some kind of a minimalist running shoe approach. You would want to work on your symmetries using something like a gait analysis, maybe seeing if this optigate exists somewhere in your hometown where you could get analyzed that way. And even consider using something like a true form or a manual treadmill. You'd want to finish up even slow workouts with some kind of a little bit of this alactic speed work and look into the programming protocols of a guy like Dr. Arthur Lydiard. And then as far as recovery and things along those lines go, you're a big fan of water. And a lot of these other recovery methods that we've talked about before, like foam rolling and massage and things of that nature. And then finally, one of the most important things that you can do, even if it means starting off slow, is to focus on a cadence of 90 plus RPM. That about wrap up a big part of your running approach.

Yeah, and have fun. You know, if it's, you know, it's giving you a good response, you wake up every day and you feel good and you're enjoying what you're doing, it's not too technical, it doesn't cost you a lot of money. You know, it fits into your day. You know, if you're, if you're not fine, enjoying it, I think we all can have all the technical knowledge, but it's not going to sustain. You know, try things and you see what kind of, if it gives you a good response, you'll keep doing it and you'll, these light bulbs will go on and you're like, oh, my gosh, that is so simple. And it feels good.

Yeah. Cool. Well, Your website is naturalrunningcenter.com for those of you listening in. You can visit naturalrunningcenter.com I've also been taking notes on a lot of the things from the treadmill to the optigate to everything else that Mark discussed in this episode. And you can check those out over in the show notes@bengreenfieldfitness.com minimalrunning. You can also leave comments over there and either Dr. Mark or I will reply and we'll be happy to help you out and point you in the right direction. So, Mark, thanks for coming on the show today.

No, thanks, Ben. Been a pleasure.

All right, folks. Well, this is Ben Greenfield and Dr. Mark Cucuzzella from the Natural Running center signing out from BenGreenfieldFitness.com have a healthy week. You've been listening to the Ben Greenfield Fitness podcast. Go to BenGreenfieldFitness.com for even more cutting edge fitness and performance advice. Sa.