Fast Fact: Slow Running Is Good for You with Tamanna Singh, MD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

If you're a runner, how fast you go is a big deal. We're always racing against the clock and fixated on times, but the key to running faster and better, some say, is to focus on running slow. That's a concept that can be a tough sell to runners, myself included. It just feels wrong. But there's solid evidence to support this kind of training as we'll find out today from sports cardiologist and marathon runner, Tamanna Singh. Dr. Singh is one of the many experts at Cleveland Clinic who pop into our weekly podcast to offer tips on healthier living. So with that, let's slow things down and learn why downshifting your pace may be the secret to running healthier, longer and faster.

Welcome to the podcast, Dr. Singh. As a runner, I can't even begin to tell you how much I have been looking forward to our chat.

Dr. Tamanna Singh:

Well, I'm very excited as a runner myself to speak with you about running because I could talk about it all day, every day.

John Horton:

Well, that's awesome news. Before we start talking pace and getting into the nitty-gritty of running, can you tell us a little bit about how you got into the sport and what it has done for you?

Dr. Tamanna Singh:

Yes, so it's a very interesting story. As perhaps many college students out there, I was very active in high school and then gained, of course, the college pounds that many people do with the horrible dining halls that are at every university. But in any case, I got into running to really just lose weight and I wasn't really running much. It was probably running maybe a couple of times a week, maybe about three miles at a time. And then, during my training when I entered my sports cardiology fellowship at Massachusetts General Hospital in Boston, I remember being interviewed and them telling me, "Well, as you come here, you're going to have to bring a pair of running sneakers." And I said, "No way. I don't really run. I just do a couple miles at a time." But it was very interesting — within that year, I ran my first 10-mile race and then, I did my first half-marathon when I moved to Cleveland, and then, a year later, I did a marathon. And it's just kind of gone further than I could imagine over the last couple of years.

So my relationship with running, I think went from a very superficial one to one where running really gives me a lot of clarity. It also, I think over the years, has provided me with a means to push my own boundaries and see what I am capable of, which can be very easy to translate over to my professional work and my personal relationships. So it's also opened an incredible community to me. I've developed so many new friendships and it also helps me get to know my patients better. I see a lot of runners in my practice, in my cardiology practice, and we share a lot of different stories and a lot of tips outside of just the general relationship between a cardiologist and a patient. So it's been incredibly rewarding and I can't imagine my life really without it at this time.

John Horton:

Well, that is such a beautiful way to describe the impact running can have on your life. I mean, it truly can be transformational for a person physically and emotionally and just in all ways. But that being said, though, people who run also like to talk about their miles splits. So let's get into this notion that running slower can be better for you. Sell me on it.

Dr. Tamanna Singh:

Oh my gosh, I had to be sold on this one, too, because I think, when we start running, we get so excited about how fast can we go? How fast is my running buddy going?

John Horton:

Right. It's all about getting a little faster.

Dr. Tamanna Singh:

Exactly. I want to qualify for Boston. How do I do that? I got to run fast to run faster, and that's not necessarily true. So there's a lot of literature and evidence to show the incredible aerobic changes we can have with slow running. So that word, “slow” is an excellent word that is going to be very individual for each runner. For someone who typically runs maybe an 18- to 20-minute 5k, their slow pace is going to still be a little faster than somebody who perhaps runs the 25- to 30-minute 5k pace.

So I think the best thing to ask yourself, or the best way to, I would say, maybe identify slow running is to equate it to a subjective sensation of a jog. A jog is a perfect way to visualize a run where you're very easily carrying a conversation. There's no huffing and puffing between two or three words. If you wanted to sing to a song you're listening to while you're running, you could, and it's an effort that you could sustain essentially forever. So when you stop your run, you ask yourself, "Oh wow, I could actually keep going and going." Versus if you're running a little too fast, even if you said to me it was comfortable, at some point., you would need to stop because you would get fatigued.

So that's one way to identify slow running. And the benefit of that slower running is that in that particular pace range or subjective sensation, that is where you can start to really build up those mitochondrial energy powerhouse phenomenal cellular structure. So what do I mean by that? Your mitochondria are responsible for taking the food that you eat and generating energy, and we can increase mitochondrial density by running slowly, running aerobically. We can also develop capillary beds or beds of little blood vessels, which then help us increase the amount of oxygen delivery to that area, to those groups of muscles.

So by improving oxygen delivery, by increasing mitochondrial density — or essentially, increasing the energy that you can deliver or create in this particular muscular structure or region — you're able to increase the time between the start of your run and the time you fatigue. And so, the more you do that, the more you can also retrain your muscle fibers. Let's say you're someone who runs longer distances. It's really important to learn how to sustain effort. You can retrain your muscle fibers to be the type of fibers that can support longer distance running versus sprint types of running. So there's so many different benefits that you get by staying within that aerobic range, and essentially, that will translate to you starting to run a little faster and a little faster and a little faster.

John Horton:

See, that's the part that's so hard to believe because you think, Man, if I'm running slow, I'm just going to keep running slow. But it sounds like as you do this, you build up those muscles and make them a little bit stronger. Your heart gets a little stronger, your lungs get a little better — you build up this endurance. It's really that simple?

Dr. Tamanna Singh:

It is. And like you said, building the endurance and the cardiac efficiency is what helps you then start to slowly get a little faster on your slow runs. So let's say you started running and your slow runs were around a 10-minute-mile pace, and you could sing your favorite Taylor Swift song at that pace. What you'll notice over time — and it's not over a couple days or a couple weeks, but over the course of maybe a couple of months or up to a year or whatnot — you'll notice that your slow pace, that pace where you could sing a song is going to go from 10 minutes per mile to maybe 9:50 at 9:40, 9:30. And at those faster paces, you're going to be able to maintain that easy effort. Your heart rate's not going to go as high. You're still going to be able to develop those capillary beds, increase the mitochondrial density, really ensure that you're getting excellent and more oxygen delivery to your muscles to prevent you from fatiguing early. So those benefits will be retained as you continue to practice slow running.

John Horton:

That's that whole building up your base sort of mentality, right?

Dr. Tamanna Singh:

Yeah. I mean, oftentimes, in a training cycle, the first part of it is going to be building your base miles and just building up your aerobic engine. Usually, in the de-training cycle, or after a race, we do take some time off. We want to take time off, we want to have the body physically recover, but your heart is going to get a bit detrained. And so to get back to that, we want to build our base with nice, easy, slow mileage.

John Horton:

Will these slow miles also limit the stress on our body? I mean, you said jog, which I'm pretty sure for a lot of runners is a four-letter word, but if you go out and jog, is that going to be easier on your joints, on the ligaments and tendons, everything that just takes a beating when you're outputting in miles?

Dr. Tamanna Singh:

Oh, definitely. I mean, if you even watch people spreading or doing a 200-meter, 400-meter race and you compare that to someone who's jogging along by the lake, you can visibly see the change and the difference in impact of the foot to the ground. So the amount of power you need in that leg and the amount of impact, the force of impact is going to be far greater if you're sprinting, running fast, versus if you are running slow. Plus you're requiring more power, more energy return, more muscle strength in those faster efforts than you are with slower efforts. I mean, that's why if you were asked to sprint from one end of the building to the other, you're going to be out of breath, your legs are going to hurt, they might burn because you're actually accumulating lactic acid and you're not able to clear it fast enough. Versus if someone just asked you to take a quick stroll to the other end of the building. So the demands on the body are much higher, the risk of injury is much higher the faster you go.

And so yes, jogging and doing slow running will help you stay healthy for longer. And that's also another reason why we encourage people to incorporate a lot of easy, slow mileage during a training cycle. There's a place for fast efforts and a place for learning how to run fast and how to train your muscles to run fast, but there's a huge space for keeping the rest of those miles easy to protect yourself from injury and again, to build that aerobic efficiency.

John Horton:

All right, well you've made some pretty convincing arguments. I mean, getting stronger, building endurance, not getting hurt, that all sounds really good. So if we want to try this, if you're a runner, you're putting in your miles, how can you determine what slow running is for you?

Dr. Tamanna Singh:

The first thing you need to do is throw your ego out the window because-

John Horton:

…That's the hard thing.

Dr. Tamanna Singh:

The first thing that is going to freak you out is how slow you are going. I think one way to think about it is just don't even think about it as slow running. Literally, tell yourself, "The purpose of this run is to increase my mitochondrial density. The purpose of this run is to improve my efficiency. The purpose of this run is to improve and enhance the ability for me to deliver oxygen to my legs when I'm running." And if you are able to separate the purpose from just that kind of superficial sensation of, "Oh no, I'm running much slower than I'm actually able to," I think that it's much easier to separate ego from what you're doing and commit to the slower running.

So the way to identify that pace — a lot of us are driven by watches — just remember that your body is what is giving the feedback to your watch. It's not the other way around. So if the watch is giving you anxiety, if looking down at your pace is causing you to have freak-out moments, leave your watch at.

John Horton:

We've all been there with that, too.

Dr. Tamanna Singh:

I'm guilty of course, as well. What I'll do is I'll just, oftentimes, keep my watch face on just the time of day versus on lap pace or how many miles I've run or what my true pace is. And that just helps me focus on, I'm here with the intention of keeping this easy. I am going to have a conversation with my friend who's running alongside me. If I want to belt out a song I can. I don't want to hear my breathing get more difficult. I don't want to feel fatigue in my legs. I really just want to feel like I am moving at a pace where I can look at the trees around me. I can appreciate the nature and I can have a good time. And if you set the intention to do that, you won't even care. You won't even be aware of your pace, but you'll at least have performed at the effort that's going to give you the benefit of the purpose of that run.

John Horton:

So just kind of chill out a little bit more when you're out there. Make sure you're not just constantly out of breath. Just get yourself in that nice little pace where everything's good. And like you said, you can talk, you're enjoying what's around you and you're just, I guess, eating up those miles.

Dr. Tamanna Singh:

Yeah. And if you're someone who loves heart rate zones, I think the easiest way to think about this is really going to be nice, easy zone two, maybe a little bit of zone one, but more zone two running, which is basically usually around 55 to 65% of your max predicted heart rate — which, itself, I would say, please don't calculate your max predicted heart rate from the Fox formula — just 220 minus age. That's a moot formula that really has no evidence behind it in terms of the way that it was developed. But there is no other more validated calculators out there that can help you calculate your max point to heart rate, or you can raise a 5k or run a 5k time trial and get your max heart rate that way. So there's different ways to get that data, but again, if data is going to make you be too aware of pace and effort and that's going to psych you out from the purpose of the run, then don't even think about it.

John Horton:

Well, as you mentioned, we are addicted to these little watches and all the information they give.

Dr. Tamanna Singh:

I know. We do.

John Horton:

If you are somebody like that, and so you want to try slow running and just this whole letting it just go with how you're feeling and whether you can talk using that method … if you want a firm number, is there a rule of thumb, like take your 5k pace and add X amount of time to it or your 10k pace or half-marathon pace or whatever?

Dr. Tamanna Singh:

Yeah, so usually, it's going to be if you took your marathon pace or slower pace — your slow pace is going to be probably about a minute slower — usually, around 5k or 10k pace — your slow pace could be two to three minutes slower. Oftentimes, I'll bring up one of the fastest runners in the world, Eliud Kipchoge. People often say that his marathon pace is probably shy of five-minute miles somewhere in the 4:50-minute per mile range, but he runs his slow easy jogs at maybe seven minutes, eight minutes per mile.

I mean, there's a lot of people out there who run marathons under two hours and 30 minutes and they're running their easy miles at nine-minute per mile pace. So I say that just to remind you that again, usually ego is really the enemy of the runner and it just gets in the way of us really maximizing the potential of our body. And I know we all want to be faster, but one of the ways to become faster is to improve the ability for us to utilize energy, improve the ability to get the energy, and improve the ability to get the oxygen. And then, overall improve the ability for our heart to function. So again, think more about purpose and attention that's going to translate over to you being successful in your journey of discovering slow running.

John Horton:

And that's just so hard because, I got to be honest, I've heard this whole slow running concept and pride is the muscle that hurts the most, I think as we both know sometimes. And just feeling like you're getting faster is such an addiction and when you slow down intentionally, it's just hard not to feel like you're going backward. But it sounds like the key is to think of it as a process like what you do in any sort of training cycle or if you're looking to get into a half or a full marathon.

Dr. Tamanna Singh:

Yeah, it is a huge piece of the puzzle. Like I said, a training cycle, depending upon what you're training for, is going to encompass certain puzzle pieces. Yes, if you're practicing marathon pace, you should do one to two workouts a week where you're practicing marathon pace or something faster than that pace to get your body accustomed to running faster to recruit those fast twitch fibers. But honestly, 80% of your running really should be easy mileage to generate that aerobic efficiency and aerobic capacity because when you're running the marathon, no one's going to care-

John Horton:

…80%? Wow.

Dr. Tamanna Singh:

Yeah. When you're running the marathon, no one's going to care that you ran faster than your training buddies during your training cycle. All they're going to care about or all you're going to care about is how fast you get to the finish line. And honestly, I think it's incredibly more rewarding when I'm passing people because I ran slow during my training cycle when I'm passing people during a race than when I'm getting passed during a training run. There is some satisfaction there when you're reeling people in it and you're getting faster in those later miles and you're feeling strong. To feel strong in those later miles, you really had to have developed that aerobic base to start. And so slow running is really essential to doing that.

John Horton:

So it sounds like as you do this, you should make, like you said, 80% of your training runs kind of this slow running sort of method. The other 20% I take it then you do need to ... it is best to kick it up a notch for a day or so.

Dr. Tamanna Singh:

Yeah, I mean, this will also depend upon what you're training for, what your running experience is, what your injury experience is. I also personally work with a coach, but I'll, oftentimes, tell my patients or advise them or my colleagues or friends who are looking into running to work with the coach because they're going to be able to see certain patterns in your running and they're going to be able to objectively identify if you're running too fast or too slow, and also develop a plan that prevents you from being on the injury struggle bus and supports your running and supports your goals.

So my personal relationship with running and coaching — my coach really abides by that 80-20 "rule", where 80% of our running is quite easy and quite slow, and the other 20% are my workouts — those are my faster efforts. My Thursdays are my speedy days. And I usually will have some sort of pace work or a higher effort on my long runs depending upon what I'm training for. And that allows for me to get accustomed to how my body feels at certain efforts, but also prevents me from getting injuries.

So working with someone who has more skill in developing that type of cycle for you is probably going to be the best bet, especially if you are unsure of how to get into slow running or you're worried that you're always going to run too fast because you fear that if you don't run fast, you're going to lose it all, but you won't. And I will say that, personally, I have become much faster after incorporating slow running to the point where even one of my buddies that I run with who perhaps doesn't really subscribe to slow running has said, "I can't believe you run 10:30, 10:40 minute miles and then you're able to clock like a 6:30 something mile. How do you do that?" And I said, "Slow running."

John Horton:

You got to trust the process.

Dr. Tamanna Singh:

Yeah, it's playing a long game. That's what it is.

John Horton:

So give us a few tips on how you can slow run successfully. Just a few things that you can do if you are running, putting in your miles every week.

Dr. Tamanna Singh:

One way to think about it is we've already talked about throwing away the ego, getting rid of the watch or getting rid of the technology, if that's getting in the way of your running. Focus on the intention.

Sometimes, what I do is I'll focus on running a specific amount of time versus a specific number of miles and that takes the stress out of getting a certain number of miles within the confines of my morning. It'll take that stress away, which means, I won't try to run faster to get the mileage done. So if you say, "You know what, today I'm going to run for 45 minutes and however much I run is however much I run," that's one way to start to incorporate slow running. But I think, just learning how to do it, how you feel, being able to absorb that subjectivity behind the slow running will help you emulate how to do that with each day and with each month as you run.

John Horton:

How important can buddying up with somebody be in this process, too? You had mentioned using your ability to chat as one of the measurements for this. I mean, I think people already think a lot of runners are a little nutty anyway. If you're either running and talking to yourself, they're going to think that even more. So is having a friend with you a good way to kind of maybe bring it down a bit?

Dr. Tamanna Singh:

Yeah, it can be incredibly helpful. I think especially if you and your buddy run at similar paces, it's probably much easier because everybody's easy pace could be a little different, but setting the intention of, You know what, we're going to do a run today and we're going to catch up on what's been going on this week, or I want to talk to you about X, Y, and Z, I think that's a phenomenal way to start to incorporate and learn and understand what slow running is. And time flies when you're having a good conversation. So before you know it, you'll get your miles under your belt and then you'll say, "Wow, that felt pretty easy. That felt pretty great. I could run like that forever." And if you can say that to yourself, then you're doing it right.

John Horton:

And it sounds like to start doing it, just start doing it and just kind of like you said, tamp down that pride, that ego and just make this part of your routine.

Dr. Tamanna Singh:

Oh, exactly. And like I said, just remember, this is a huge piece of the puzzle if you want to become a faster runner, and Rome wasn't built in a day and your gold marathon pace isn't going to be built in a day. But the time you spend and just optimizing your body, optimizing the biological mechanics within your body are really going to help you in the long run, in the long game when you're thinking about how you want your running to improve over the course of several years.

John Horton:

All right, well, after all this talk, I feel like I need to go out and run and not have my pace in the orange and red zone where it lives way too much. I think I would get a big lecture from you if you actually saw some of those.

Dr. Tamanna Singh:

That would be another podcast episode. Oh, my gosh.

John Horton:

Before we part ways so I can go and slow things down a little bit, do you have anything else to add on slow running and why it just can be so beneficial?

Dr. Tamanna Singh:

I think, like I said, there's so many gains you can get from a cardiovascular perspective. I mean, these are also the same gains that are going to help improve your cardiovascular health, help keep your blood pressure well controlled, help keep your cholesterol nice and low, prevent you from getting diabetes, helping to keep your body composition in favor of lean muscle mass versus body fat. So there's a lot of benefits to that and you can easily translate the slow running experience to riding aerobically or rowing aerobically. So your heart really doesn't care what activity you do. You'll get those aerobic gains with those easy, conversational, sustainable efforts.

John Horton:

All right, well, I'm going to give it a try and I will let you know how it goes.

Dr. Tamanna Singh:

Keep me posted.

John Horton:

Well, thank you so much for coming in and like I said, I hope we can get you back on and break down some more running fitness stuff at some other point.

Dr. Tamanna Singh:

Sounds great. Thanks so much for having me.

John Horton:

Bye-bye.

Slow it down. If you're a runner, consider those three words the secret to better performance and staying injury-free while training. It's a concept that works for some of the world's fastest runners. Odds are it'll work for you, too.

If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.