Optimal Training

Do you need running shoes?

You may or may not have seen this article: The painful truth about trainers: Are running shoes a waste of money?  A friend of mine posted it to Facebook with a comment that he was going to go return his shoes.  Surely he was joking, but still, it got me to read the article and it's really a fascinating read. 

This article spawned what I call a "thought thread".  It made me look at something in a different context and follow the connections to see a new picture.  I'm sure the picture I'm viewing is far from complete, but it's new for me and that made the article a success.

America has a health crisis in that more and more people are suffering from diseases such as diabetes, heart disease and obesity.  Along with a healthy diet, the best preventive measure for this is exercise.  Running is great exercise, arguably the most natural and effective exercise there is.  So people should be running more.  For most people, running shoes facilitate running.  Part of that is marketing (we think we need them), part of it is culture (everybody else wears them), and part of it is geographical (people who live in cities, etc.).  So in that respect, running shoes could logically be treated as a kind of medical device.  Even more interestingly, the article alludes to running shoes actually causing more injuries in runners.  So maybe they should be tested as a safety hazard as well...  Should the FDA be testing running shoes (or would that be another department)?  Has Consumer Reports ever tackled this?

I wonder what would happen if the running shoe companies were subjected to some rigorous scientific testing to determine just how beneficial their products are.  My hunch is that the results wouldn't be quite so dramatic, probably more in line with the last section of the article.  Running barefoot would be found superior, but the use of shoes would be found beneficial for most runners, and the overall benefits experienced by runners would outweigh the injury costs experienced by those who run.

Anyway, even more interesting would be knowing which shoes (and shoe companies) are putting out the most "dangerous" shoes for runners.  If anyone has any better articles on this, please let me know.

Doug Logan addresses the supplement industry

Doug Logan, the CEO for USA Track and Field, gave a speech at Focus on the Future, a gathering of the dietary supplement and healthy food industries on January 22.  He addressed the need for the supplement industry to clean up its act and join in the battle against performance enhancing drugs in sports.

It was a forceful speech, with a clear message that it is a cultural battle that we are waging against PED use.  After discussing they myriad reasons why athletes are afraid to take any supplements at all, even "clean" supplements, he says:

"While this battle for "clean" supplements rages on, I focus on waging the battle for the hearts and minds of our athletes, coaches, agents and support staff to win the culture war against drugs. I am a person who likes simple concepts. This is pretty simple. I have two words for any person who uses, promotes or tacitly endorses the use of drugs by any athlete. GET OUT! Get out of our sport and out of our competitions."

I am personally in favor of this approach 100%.  I am in favor of stricter penalties on users and coaches, but I am also in favor of outright bans on companies (within the extent of the law, of course).  If a company is caught lacing a supplement with illegal PEDs, we should have the courage (and legal ability) to ban any and all products made by that company for use by athletes competing in USATF sanctioned competitions.  Maybe this is already common practice, but if not, I say we take the nuclear option with them.

After further discussion of the relative success seen in the cultural war against PED use, Logan finishes with this call to action for the supplement industry:

'I am personally committed to doing our part to reverse this cultural perversion. Our partners in this war, USADA and WADA are waging the battle with ground breaking science and techniques. The supplement industry can do its part in assisting us in the fray. The next time, do not be so quick to oppose reasonable and responsible federal regulation of your industry. Those who conduct ethical and legal businesses will ultimately benefit from the tightening of laws and increased scrutiny. If you say you can self regulate, then, by gosh do it! Cast these outlaws from your midst as the money changers were biblically cast from the temple. We are cleaning our house; get your brooms out and clean yours!"

I have no faith in a billion-dollar industry that exists through the promotion of get-results-quick-and-easy making any effort to self-regulate themselves.  Sorry, but the fact that any industry with the ability to create products so drastically unhealthy should have been regulated from the beginning.  So I hope Doug Logan and the USATF will not stop at self-regulation, but will work to get all other sports federations and professional sports leagues in concert to force regulation upon the industry.  I personally believe it's the only way.

Here is the link to the complete text of the speech.  There is a lot of good information here about the state of the sport in its battle against PEDs, as well as some depressing anecdotes that make very clear just how long and protracted this battle will inevitably be.

Race Like a Spanish Footballer

I just finished watching Spain defeat Germany 1-0 in the Euro 2008 final.  They were the better team, had more attacking chances, and shut down Germany's top strikers.  Had you not known anything about their history, you'd have thought it was the German team that was the talented underachievers and the Spanish team the one that performed well under pressure.

If you're not a soccer fan, here's the history.  Spain is a consistently talented team.  They have one of the top leagues in Europe with some of the best teams (Real Madrid and FC Barcelona being the most famous).  They play creative, exciting soccer and consistently enter tournaments as a team with the potential to win.  Then they play like crud and get eliminated way too early.  The victory today was the first major championship for Spain in 44 years!  Throughout that time, the expectation on the part of the entire country was for the team to let everyone down.

Germany, on the other hand, has won four European Championships and a couple World Cups in that time.  They have a history of finding a way to win, even when they are not playing their best, and of imposing their will on the teams they play against.  They are big, physical, and play skillfully efficient soccer.  In short, the expectation is that they will come out on top, because they have a history of doing so.

The commentators covering the game said something interesting in the first few minutes.  I will paraphrase here: "We have to see if the Spanish are going to play the jerseys, or the men wearing them.  If they play against the 11 men on the field, they're the better side.  If they play against the "Legend of Germany" then we don't know."

It became pretty apparent early on that Spain was playing the men on the field, and not the German "legend".  Having already dispatched Italy earlier in the tournament--a perennial champion they'd not beaten in 86 years--I think the Spanish side came into the Final with the self-efficacy of a champion, having taught themselves that history only determines the present when you let it.  From there, Spain's skill and strategy won them the game.

While soccer and track and field don't have that much in common, I think the notion of "racing the man, and not the legend" is an important idea to remember.  Especially in a meet like the Olympic Trials.  When you toe the line against a Bernard Lagat, or a Jeremy Wariner, or a Tyson Gay, you can't get caught up in the "legend" of that person.  You have to go out and race the man wearing the jersey that day.  Sometimes he's even better than his legend (as Gay appears to be after winning the 100 meters so convincingly), but that's something that has to be re-proven every race.

Past victories and personal records do mean something.  They are indications of an individual's ability at some point in time.  And as we all know, if you've done it once, it's easier to do it a second time.  But for great runners, they can do more; they can establish a "legend" that creates a mental barrier in the minds of their competition.  When you start running against a competitor's past and present, you've given your competitor an advantage.

Next time you step on the line, don't get psyched out by the mystique your competition has created.  They still have to do it on that day.  So race like the Spanish played football this past month.  With pride and confidence in your abilities, and with no fear of what your competition has done before.

Gina Kolata: Mythbuster

The NY Times columnist Gina Kolata writes for the Fitness & Nutrition section of the paper, but her calling is probably to join the popular Discovery show Mythbusters.  I've discussed her articles about muscle cramps and muscle fatigue, and now she's written about "recovery foods".

I've written about the importance of how much you eat here, and about how "well" you eat here.  I still stand by everything I wrote in those posts, but there is one area where it might be good for me to "Think a Second Time."  What area is that?  It's where I rattle off optimal percentages of carbohydrates vs proteins vs fats.  In my previous post, I recommended following a 60-20-20 balance, but Ms. Kolata's new article has me questioning whether I should really be so bold as to put specific numbers to the amounts.

As Gina continues to show in her articles, it can be dangerous to assume any of the "common knowledge" associated with what we know about training.  Much of it isn't based on rigorous science.  At best, it's based on hunches that are "right enough" to withstand most armchair attacks on them.  That and as soon as something becomes marketable, there are any number of companies willing to throw some bogus statistics out and sell you a product.  (That's not just a "recovery foods" issue, though.  That's a "capitalism" issue.)

It turns out that there aren't much in the way of scientific studies to show that regular athletes need to eat so many carbos so long after exercising.  And that's not surprising, really.  There's no magic number of glasses of water we need to drink, either.   And if you're only doing one workout a day, the article argues that just eating your regular meals will be enough to get you fully recovered.  The only people who need to worry about eating optimally right after a workout are elite athletes...

...but wait, isn't that who we're talking about here?  Isn't this blog about becoming an elite athlete? Yes, it is, so this is my advice to you.  Even if you're not an elite athlete yet in terms of performance, start training like one today.  Prepare food to eat after a workout, when your body is ready to absorb the amino acids and glycogen it's recently lost.  But keep two things in mind when you do this.

First, understand where this ranks on your list of priorities.  There are a number of things that should be more important than this post-workout snack, especially if you're only training once a day.  If you're training twice, it should go up in importance.  Second, you don't need to go out and buy any special concoction to get the benefits of this snack.  Particularly not at $4/energy bar.  A half a PB & J sandwich will do the trick just as well!

Oscar Pistorius and the real issue

The news of the day has spread far and wide, so I'm about 23 hours too late in writing this post.  (Alas, my employer considers his work to be important, too.)  Yes, Oscar Pistorius has been ruled eligible to compete in able-bodied competitions by the Court of Arbitration for Sport today.  My own views on this matter have changed dramatically since I first heard of Oscar, and can be tracked in my coverage of him (here, here, here and finally here).

This has generated varied responses from within the distance running blogosphere.  At The Final Sprint, "Justice Prevails!" whereas at the Science of Sport, "Pandora's Box has been opened".  Heck, this news even has the guys at Less Than Our Best looking into picking up some used moon shoes.

This is certainly a topic I'd like to comment on, as I most certainly have an opinion on the matter.  I do not believe, given what I've read about this issue, that Oscar should be eligible to compete.  But first, I want to clarify what the real issue is here, because I feel it gets missed by most writers on both sides of this issue.  First, what it's not:

• The issue is not Oscar's lack of legs or his being disabled.  Similarly, it is not my ability to relate to Oscar's situation.  That is the biggest point made in the majority of arguments in favor of Oscar's eligibility.  But empathy or pity for Oscar is not the issue.
• The issue is not Oscar's talent or work ethic.  I have no idea how talented Oscar is or would be with legs.  Quite frankly, no one does.  And as for his work ethic, I have no doubt it's on a par with the greatest sprinters in the world.  I treat that as a given.  But then again, that's not the issue either.
• The issue is not "disabled" people's rights.  I've seen this argued and quite frankly, I don't buy it.  The integrity of the competition supersedes this issue, in my opinion.  Not the issue.
• The issue is not how Oscar feels or believes.  So what if he doesn't believe that his blades give him an advantage.  Maybe he's right.  Maybe he's wrong.  When was the last time he ran with real legs to compare?  Exactly.  That's not the issue.
• The issue is not money or fame.  Though Oscar stands to make a lot of it, for sure.  This may be one of the driving forces behind Oscar's relentless pursuit of the Olympics.  It's certainly a driving force behind Ossur (the maker of Oscar's "blades") attempting to prove they provide no advantage over human legs.  It's probably a good thing for the IAAF, too, when all's said and done.  Actually, this is an issue that hasn't been brought up enough.  But it's not the biggest issue in my mind, either.
• The issue is not "spectator-friendliness" aka "giving the people what they want".  Even if every person in the world wants to see Oscar compete in the Olympics, it doesn't matter one bit.  Again, the integrity of the competition supersedes this.  If enough people want to see Oscar run against the best in the world, there are plenty of meet directors itching to set it up.  So yeah, this isn't the issue either.
• The issue is not the "slippery slope".  Is it possible that by making Oscar eligible to run, we've "opened Pandora's box" as The Science of Sport put it?  Sure.  But some degree of technological encroachment has been happening for decades and will continue to occur.  Maybe I'm just not a pessimist about these things, but I don't see this as the most important issue either.
• The issue is not what the Court of Arbitration for Sport ruled.  Yes, it matters.  But that is a judicial ruling made by non-scientists.  We shouldn't be concerned with whether three judges made a good or bad decision.  That was an after-effect of our lack of dealing with the one crucial issue in this whole affair.

So what is the most important issue?  The "Cheetah" blades themselves.  This is really the only topic anyone should be talking about.  We shouldn't be talking about making any runner eligible or ineligible.  We shouldn't be talking about whether anybody "deserves" to compete or not.  And we shouldn't be talking about what this means for the future of the sport.  We should be talking about one thing: the blades.

Relative to the human leg, do the blades provide an advantage to the runner?  If so, how much and in what ways?  After reading the IAAF's original conclusions, my opinion was that Oscar should not be eligible to compete.  Oscar says he has more evidence (and he must have something to have won the ruling), but he hasn't made it public.  Personally, I have my doubts. 

I have nothing against Oscar as an athlete.  Nothing whatsoever.  He's incredibly inspirational.  I actually want to see him compete in the Olympics, at least on a personal level.  But not given what I've read about his "blades". 

So my ideal solution: make him change his "blades".  Identify what it is about his "Cheetahs" that gives him the advantages identified by the IAAF, and modify the "blades" to eliminate some of those advantages.  (Yes, I'm assuming these advantages exist and Oscar's "evidence" does not outweigh them--until he publishes his evidence, I think that's a reasonable stance to take.)  Identify what criteria the blades would have to meet in order to be acceptable and then, if Oscar qualifies using those, let him run.

Not an ideal solution, perhaps.  But I haven't heard many others that are.

Science of Sport takes on fatigue

The Science of Sport blog has taken on the topic of "fatigue".  And not just taken it on, but challenged it to a month-long grudge-match whereby only the last man will be standing.  They've already written three great posts setting up the debate, which will center around a biochemical explanation for fatigue (i.e. muscles get tired/leaky/lactic/etc, causing people to slow down) versus what they call "anticipatory regulation" (i.e. the brain forces the individual to pace themselves to handle the task at hand -- also known as the Central Governor model of exercise, though the authors choose not to use that terminology due to its implication of a "black box" part of the brain that does all of the governing).

They've gone through a couple examples of pacing and why it should be strange that an individual is able to run faster at the end of a race.  They've also discussed leaky calcium channels, performing in the heat and a few other scenarios.  Now's a great time to get yourself caught up on the series because they're about to get into the nitty-gritty.

And in case you haven't read their blog, Ross and Jonathan are recent PhD grads who studied exercise physiology and this is basically their dissertation.  So the content promises to be thorough and the views passionate.  I'll be sure to direct you to anything particularly interesting from an Optimal Training standpoint, but by all means you should check it out as there is quite a lot being covered.

(Graphs from part 1A)

Learning, memory, and optimal training

I just read an interesting article in Wired magazine about memory, learning, and a product called SuperMemo.  SuperMemo is a product that uses an algorithm to ensure that you review things you want to remember at the optimal time.  This is based on well-documented research around what's called the spacing effect, which says that humans learn something best if they are reminded of it just before they are about to forget it.  Therefore, optimal studying follows a chart like this:

The part of the article that really caught my interest was this, however:

"We are used to the idea that normal humans can perform challenging feats of athleticism. We all know someone who has run a marathon or ridden a bike cross-country. But getting significantly smarter — that seems to be different. We associate intelligence with pure talent, and academic learning with educational experiences dating far back in life. To master a difficult language, to become expert in a technical field, to make a scientific contribution in a new area — these seem like rare things. And so they are, but perhaps not for the reason we assume.

The failure of SuperMemo to transform learning uncannily repeats the earlier failures of cognitive psychology to influence teachers and students. Our capacity to learn is amazingly large. But optimal learning demands a kind of rational control over ourselves that does not come easily. Even the basic demand for regularity can be daunting. If you skip a few days, the spacing effect, with its steady march of sealing knowledge in memory, begins to lose its force. Progress limps. When it comes to increasing intelligence, our brain is up to the task and our technology is up to the task. The problem lies in our temperament." (emphasis mine)

You know, if we swapped the words "ability" for "intelligence" and "training" for "learning" we could use this paragraph to explain why more people aren't better runners!  I am a firm believer that "the problem lies in our temperament."  But I'm also a firm believer that you can change your temperament.  The Optimal Training Principles provide just such an avenue, by shifting how you think about such things as ability, talent and training.

This article also brings up an interesting topic for discussion that I don't read much about (and I'm pretty sure that's because there isn't the same kind of research on it).  That is whether our current training methods are even close to what would be "optimal". 

Extensive research into cognitive psychology hasn't been able to change the way educators and teachers (and to a lesser extent, parents and other authority figures) approach learning.  Even after 100 years, educators still don't appropriately take into account the spacing effect in their curricula.  Which begs the question about training:
Do we train this way because it's the time-tested proven method for generating peak performance, or just because we've been unwilling to adopt the methods that would lead to those breakthroughs?  Have we been ignoring running's equivalent to the "spacing effect"?  Or has enough research even been done to determine whether there is an equivalent to "the spacing effect" in training?

And for you runners reading this blog, there's good news.  You're probably already smarter!  Now here are a couple more interesting "hacks" (here and here) that can not only make you smarter, they can make you faster, too!

Why are Kenyan gardeners so fast? (and other semi-answerable questions)

I recommend reading this very well-written blog post on Kenyan distance running success by Peter Vigneron of the KIMbia Foundation. This is an issue that's come up on this blog before (here and here)

I particularly like the fact that Peter doesn't jump to conclusions about why there are so many individuals with such high levels of ability in Kenya.  Throughout my running career when the topic of Kenyan runners comes up, people trip over themselves to attribute more and more of their success to their genetics.  Peter doesn't do this.  He discusses a number of potential causes, and concludes with his own opinions, but he does so in a very measured way.

The possible reasons for Kenyan success that he's identified include:

"I’ve read that the Kenyan diet is they key to their success. I’ve read that it’s the altitude, and I’ve read that it’s because they lie down and sleep in the grass everyday between runs. I’ve read that it’s because they do so much mileage, that it’s because they run twice a day every day, or even that it’s because they run thrice a day everyday. A rowing coach I met in Colorado told me it was because they sprinted all their runs. He was certain that they didn’t do high volume. I’ve read that it’s because they are poor and desperate and view running as a way out of poverty. I’ve read that it’s drugs. I’ve read that it’s genetics, and that the rest of us should just forget about beating them.

"I don’t know if any of this is true. Distance running is a greatly understudied activity."

First of all, Peter reads a lot.  Second, I think there are two things that need to be remembered when discussing the relative success of one country over another in a sport like distance running.  First, the factors that make one individual great and the factors that cause a country to have numerous great runners are related but different.  Second, neither will ever be captured in one "smoking gun" reason.  Translation: it's not just genetics.

The fact that there are so many strong runners in Kenya means that the conditions for generating great runners are present.  But separating the causes is an incredibly difficult task.  A whole field of statistics, econometrics, has been created to attempt to answer these semi-answerable questions, and it only succeeds as much as it fails.

Genetics must play a role.  If it's part of a person's experience--and I think we can agree that genetics most certainly is--then it will play some role.  As the Science of Sport guys write:

"There is a growing body of evidence that a good deal of the East African advantage comes from this neuromuscular advantage, their ability to maximize the energy returns of what is called the stretch-shortening cycle. For example, it's been shown that African runners have a higher level of what is called preactivation than Caucasian runners. What this means is that their muscle is active BEFORE the foot hits the ground, and that this stores energy that can be used on push off. I am sure that this advantage is one of the key reasons they are dominant."

They may be right.  They don't link to any source, so I can't say I've read the research.  (A Google search on preactivation led me to words like Ooplasts and Blastomere!)  But even this can't account for much more than a small fraction of the reason why Kenyans are so much better en masse than athletes from other countries (save maybe Ethiopia).  I prefer Peter's conclusion:

"I’m a betting man, and I bet altitude has a lot to do with Kenyan success. I bet poverty is a powerful motivator, I think their diet helps, and the type of training they do should be studied and replicated further. But I also think that being the best in the world at something means that everybody else is not as good, and I’m not certain that the Kenyan dominance can be easily distilled and copied."

This is where the distinction between success on a group level and success on an individual level is important.  Can America replicate Kenya's success in distance running?  Probably not, because America is so different culturally, socially, environmentally, demographically, spiritually, educationally, etc.  But can any one American replicate the success of any particular Kenyan?  Absolutely!

The factors that make up success for an individual are different from those that are necessary to create group success.  Talent will play its role, but so will passion, work ethic, discipline, focus, opportunity, etc.  That is why Peter's line that "the rest of us should just forget about beating them" is so disappointing to read.  Many people think this way, yet at the individual level, their best runners are no different from our best.  It's only at the 100th or 1,000th place that the gap is really visible.

So if you are a young runner aspiring to beat the Kenyans someday, don't get sucked into the notion that "Kenyans are genetically superior and out of your league".  They aren't.  The average Kenyan may be a better runner than the average American.  But you're not trying to be average!

Give in to give more?

How many times have you set out to do something and after you get partway into it, you just can't sustain the energy needed to do it?

The mind is a weird thing.  For example, you wouldn't think that eating a radish would make you more likely to give up during an activity than eating freshly baked chocolate chip cookies does.  Or that circling every "e" on a page would make you more likely to give up watching a boring video.  But that's what happens according to this article by Sandra Aamodt and Sam Wang at the NY Times.  They go on to say:

"Other activities that deplete willpower include resisting food or drink, suppressing emotional responses, restraining aggressive or sexual impulses, taking exams and trying to impress someone. Task persistence is also reduced when people are stressed or tired from exertion or lack of sleep."

How you go about your day will affect how you perform in practice or during the race.  Not just physically, but mentally.  In other words, your willpower is affected by...everything.

The authors continue:

"In the short term, you should spend your limited willpower budget wisely. For example, if you do not want to drink too much at a party, then on the way to the festivities, you should not deplete your willpower by window shopping for items you cannot afford.

"If you need to study for a big exam, it might be smart to let the housecleaning slide to conserve your willpower for the more important job. Similarly, it can be counter-productive to work toward multiple goals at the same time if your willpower cannot cover all the efforts that are required. Concentrating your effort on one or at most a few goals at a time increases the odds of success."

Basically, not forcing yourself to exert willpower on some things will help you retain your willpower for when you really need it.  But what does this mean for us distance runners?  Should we be eating and drinking whatever we crave, wearing our emotions on our sleeves, satisfying our every sexual impulse, blowing off our exams, sleeping in late, and belching and farting in front of everyone we meet?

Does it mean we should just give in on some things in order to give more during our race?

Well, yes and no.  It may benefit you in the short-term, but in the long-term, the correct approach is to build your willpower.  You do that by literally exercising it.  And that requires that you build more discipline and self-control into your life.  You don't have to start big, either.  (In fact, trying to do too much will likely just result in failure.  In this regard, it's no different than training.) 

You can build willpower incrementally.  And in surprisingly easy ways.  Like brushing your teeth with your non-dominant hand.   Or by managing your finances (Need a good starting point?  Try iwillteachyoutoberich.com).  In terms of your daily training activities, however, this is boosted by keeping a training log, by maintaining stretching routines, and by simply regimenting your lifestyle.

Just as with physical talents, some people have natural mental talents.  These include passion, motivation, focus, and of course, willpower.  But great champions don't get all their willpower naturally.  They build it, reinforce it, nurture it.  They do this by demanding an inordinate amount of discipline from themselves.  Over time, this discipline becomes routine, but the process of building that discipline into their lives makes their willpower that much stronger when they really need it.

Like, say, in the last lap of a mile, or the last mile of a 10k. 

I posted a quote earlier this week by Meb Keflezighi: "The workout's not over until you do all the little things."  Yes, doing all the little things is essential to Meb's being physically ready to perform on the big day.  But imagine what years of doing all the little things has done for Meb's willpower.

What's more mysterious than muscle fatigue? Muscle cramps.

This post makes this week a sort of de facto science week here at Optimal Training.  Well, so be it.  This stuff is really interesting.

The last couple posts here and here have been about the apparent discovery of why muscles fatigue.  I'm glad to see the guys over at The Science of Sport took up this topic, and as usual, they provided some depth and insight into the topic.

Now, we have another article at the NY Times on a topic near and dear to every runner's heart: muscle cramps.  I have to say, I never suffered from these the way I've seen others suffer.  Probably because I'm genetically superior and inherently more tough.  Be that as it may, I have suffered calf cramps.  The most memorable were in high school.  I ran a high school cross country race in the morning, and then played in a club soccer tournament in the afternoon.   Later in the evening, I stretched my legs and both calves locked up something fierce.  Then, in the middle of the night, they locked up again.  Talk about a wake up call!

Personally, I find the muscle-shaking nerves-freaking-out feeling of a good calf cramp to actually be pretty cool.  I've always tried to stop screaming in pain and look at what was happening as objectively as possible.  It's amazing to watch your muscle look like it's literally sucking itself in and blowing itself out.

And like most people, I've heard different things about why we get cramps and how we can prevent them.  Drink more water, eat a banana, drink Gatorade (I think Gatorade told me that one), stretch well, etc.  And since I never knew what was supposed to work, I just kind of did it all.  I imagine you are much the same.

Now I find out from Dr. Andrew Marks of Columbia University that "there is no really convincing biological explanation for muscle cramps".  What?  Is anyone else here appalled that we spend so much money on things like HIV, cancer, and heart disease when we don't even know what causes muscle cramps or muscle fatigue?

Seriously, just look at this logical argument for why we should be focusing first on muscle performance related issues.

1. People aren't naturally strong enough to fight off HIV, cancer, heart disease
2. Strength resides in muscles.
3. Eliminating fatigue in muscles makes them stronger.
4. Therefore, eliminating muscle fatigue would make people strong enough to fight off HIV, cancer, and heart disease.

I mean, duh. 

Anyway, we don't know what causes muscle cramps.   But we do know that we don't know what causes them.  And knowing is half the battle.

(photo from TheFinalSprint.com)