Tips to Become a Better Runner with Dr. Morgan Busko

Faith: Welcome to Health Matters, your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Faith Salie.

Whether it’s through Central Park or along the Hudson River, there’s nothing like running in New York City. And around this time of the year, many people feel inspired to put on their running shoes after watching the New York City Marathon.

This week we talk to Dr. Morgan Busko, a sports medicine doctor with NewYork-Presbyterian and Columbia, who shares the many joys of running and why it’s a great exercise that anyone can take up. She also debunks some myths and offers tips on how to become a more efficient runner.

Faith: Dr. Morgan Busko, I’m so happy to talk to you today!

Dr. Morgan Busko: It’s so great to be here. I love all things running, so thank you for having me.

Faith: So you are, in addition to being a doctor, you are a world class triathlete, which makes you the perfect person to talk to about running.

Dr. Morgan Busko: I have had my fair share of injuries through all of this training, so I think that’s, that’s really where my interest came from, was being so injured myself and wanting to figure out why. And my goal is to try to help everyone out there keep moving and that’s where I found my greatest passion.

Faith: As a sports medicine doctor, what kind of athletes do you usually work with?

Dr. Morgan Busko: I see athletes really from all different walks of life. The far majority of probably the patients that I see are, you know, weekend warriors, parents, full time workers who are staying active, you know, in whatever way that makes them happy. But that naturally comes with having aches and pains sometimes. I do see some professional and very high level athletes at times, but the majority of my office days are filled with, you know, young and old. I see 10 year olds to 100 year olds, who have joint pain, muscle, tendon, really anything musculoskeletal.

Faith: I wanted to talk a bit about how the average person can get into running? What do you need to get started?

Dr. Morgan Busko: You don’t need much, which is one of the best things about running.

Some dedication and, and commitment knowing that the first few runs or the first few weeks or months of runs may not feel good. So even seasoned runners, professional runners who have taken some time off from running are not going to feel great those first few days. And that’s just something that you have to get over in order to get to the stage, usually, of loving the running and enjoying it. So I think acknowledging that in the beginning is helpful so you don’t just give up after day one.

I do think it’s helpful to go to a specialty running store. They have so many these days and the people who work in the stores are eager and willing to help and not just, you know, sell you a shoe. They actually want to take a look at your foot and hear about, you know, what stage of running you’re at. And so they can be very helpful and valuable in choosing the right shoe for you to start. And I generally recommend replacing them every, you know, 3 to 400 miles.

Faith: New runners are often prone to things like shin splints or knee pain when they’re just getting started. Do you have any advice for how they can avoid that?

Dr. Morgan Busko: Yeah, so one of the biggest elements of preventing injuries and particularly things like shin splints and anterior base knee pain, which is commonly known as runner’s knee or patellofemoral pain, is focusing on the gait and the biggest part of the gait for me is the cadence.

So the running cadence is the number of times that your foot strikes the ground per minute. And believe it or not, an average or really the goal running cadence that I throw out there with most patients is that we should be aiming for 180 steps per minute. So that’s 90 per leg, which sounds really high.

And if you don’t know your running cadence, a lot of times, you know, the fancy watches will tell you, you can look at the end of the run, what the average cadence was. Or the easiest way is you just, say, measure out 60 seconds on your watch when you’re running and you count your right leg, how many times you’re striking.

And if it’s 90, then you’re at 180 total. And if it’s 80, you’re at 160 total. But I find that for the far majority of beginner runners, they’re usually running with a lower cadence, you know, maybe 150, 160 steps per minute, which means that they’re naturally striking in front of their center of gravity.

And that inherently comes with a larger loading impact to the shin and the knee, especially the patellofemoral compartment of the knee. And so if we can quicken the stride, and strike under our center of gravity, we can actually reduce the loading force and it will make you a more efficient, faster runner.

So it’s not that you actually have to run faster to increase your cadence. You can keep your same pace, but ultimately in the end, if you do develop that more efficient running cadence, you’ll be a more efficient runner.

Faith: Some people believe that running is hard on the joints or bad for your knees. Is there any truth to that?

Dr. Morgan Busko: No, there have been many extensive studies, recently came out that was bigger than the rest, you know, thousands and thousands of patients. And it shows that running does not cause osteoarthritis.

Osteoarthritis being the age related wear and tear that occurs in the joints. And that’s not to say that if you have osteoarthritis that you should be able to go out and run pain free. So I treat a lot of patients with arthritis of hips and knees and they say, well, you know, I can’t run anymore because of my pain.

And that, that may be, you know, you have arthritis and now the running is causing your knee or your hip to hurt while you’re running, but it’s not that the running caused the arthritis. And it shouldn’t cause progression if you’re doing it without pain and you have the right underlying strength. It’s actually OK to proceed with running if you have arthritis and you’re not altering your gait because of pain.

Faith: If you’re just a regular runner and not training for a marathon, it’s important to think about what we should put in our bodies. Is there something specific that runners should keep in mind when they’re planning their weekly grocery trip?

Dr. Morgan Busko: Yeah, so immediately after or within 30 minutes of each run or workout of any sort, it’s important to try to get, you know, roughly 150, 200 calories of some mix of carbs and protein, because that’s really what’s going to be the best fuel for the muscle cells to immediately restock their glycogen stores, and that’s the element that prevents injury and prevents our muscles from becoming, you know, kind of chronically worn down with these little micro tears from the efforts

Faith: How would you describe a recovery food? What should people eat after a big run?

Dr. Morgan Busko: So that’s that window where we’re trying to get rapidly-absorbed nutrition. And the easiest thing to absorb for the muscles is glucose, or glycogen or carbohydrates. So thinking about something like a smoothie which has a bunch of fruits in it or often power bars are a mix of just protein and carbohydrates.

And then, you know, smoothies also add the element of Greek yogurt or something which includes the protein element. So, avoiding the fattier foods during that period is probably better because things like peanut butter, avocados are harder to absorb right away. They’re more of a slowly processed food and we want to prioritize carbohydrates and protein right after.

Faith: When do you recommend stretching? Is stretching necessary and does it need to happen both before and after a run?

Dr. Morgan Busko: Stretching has a role, but I don’t think that it needs to be done before and after because in general, just a static stretch where you’re holding one position to a muscle for, you know, longer than 20, 30 seconds is actually, kind of, quieting that muscle and trying to turn that muscle off and promote a real relaxation that allows it to elongate.

And when we’re about to run or exercise, we don’t really want the muscle to relax. We actually want it to engage and activate. And so I’d actually prefer more of the static stretching be done after the run when it is appropriate to really let that muscle relax, and fall asleep a little bit. But I think that static stretching should be combined with more dynamic soft tissue muscle release such as foam rolling or dynamic movements that help to mobilize the joints and tissues, and that we shouldn’t focus solely on stretching afterward.

Faith: I feel like runners are kind of in two camps. They either think about mileage or they think about time. What kind of guidance do you have for someone who might be starting out? Should they be thinking about either? Both?

Dr. Morgan Busko: I love this question, because I think that for the beginner runner, we should not be staring at our watch. So, I ran very competitively for a long time now, whether it’s through running races or triathlons. And it wasn’t until recently that I even got a GPS watch. And I honestly just want to throw it out some days because it makes you way too focused on the numbers.

And it really should be about, How are you feeling in the moment? You know, the joy of running, if you’re not looking at your watch or, you know, worried that you’re going too slow or that your heart rate’s higher than you thought it would be for this pace or you haven’t hit this mile you don’t get as absorbed and lost in the moment. And I find that my best runs are just when you’re out there, you have no idea how far you’ve gone, how fast you’re going, and you’re just out there listening to your body. That’s the most important, I think, thing for a beginner runner is to focus on the joy of it because you are going to progress and enjoy it and probably be in the game of running a lot longer.

Faith: Let’s talk about runner’s high.  Is this a real thing? Have you experienced it?

Dr. Morgan Busko: Oh, absolutely. I mean, even, sometimes on a casual weekday morning, I can go out extremely exhausted and not motivated for a run. And then, you know, even the first two miles feels awful. And then by mile five or six, I’m like, these are the endorphins because I feel awesome and I’m ready to tackle this day. And the endorphins are really what, what takes over. So your body truly does release chemicals, you know, the longer and longer that you’re running, and it’s not an exact set amount of time, so it’s not like, oh, at three miles the chemicals are released.

They stimulate a happy, serotonin response in the body, which is, you know, something that we get from eating good food and, you know, seeing friends and socializing and having, you know, positive outcomes in life. Those are all things that release these happy chemicals.

Faith: As a runner yourself, what is your very favorite thing about running?

Dr. Morgan Busko: I love being on a quiet trail, where you can really get lost in your thoughts, and kind of get lost in the act of even running, and just really kind of find peace with the world. Because I think that there’s so much going on just as a working mom and you know, the chaos of the beautiful young children phase. It’s really easy to not really have that moment to find quiet and think through life. And so it really brings me peace and calmness and that also just invigorates me and energizes me for the day.

Faith: Dr. Busko, thank you so much for this conversation.

Dr. Morgan Busko: Thank you, Faith, but it’s wonderful to chat with you and we’ll definitely have to run soon.

Faith: Our many thanks to Dr. Morgan Busko. I’m Faith Salie.

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