1. Lack of motivation to change
2. Unrealistic goals 
3. Focusing on goals and not behaviors
4. Change is uncomfortable
5. Excuses, excuses, excuses 
6. Lack of accountability coach
7. Procrastination

  

My patients in my Grapevine, TX office are always asking me: “Why do some runners always seem to be hurt and others can run forever and never sidelined?” Great question!!

 

Amby Burfoot tried to answer that question in an article in Runner’s World in March 2010. He states that George Sheehan, MD, the medical editor of Runner’s World in the 1970’s, felt that one in 100 people were “motor geniuses” and never got hurt. The rest of us were destined to be injury plagued from time to time.

 

Ralph Waldo Emerson stated “that there is a crack in everything God has made,” meaning that nothing is perfect and that can be translated to runners as well!

 

An extensive review of the medical literature by Burfoot reveals a great number of papers on running injuries, but no conclusions. It turns out that running injuries can be caused by being female (funny), being male (more likely), being old, being young, pronating too much, pronating too little, training too much, training too little, having new shoes, having old shoes, and it goes on…..

 

So what can we conclude? Most of us will get hurt at some time during our running career! So what can we do to prevent major, career threatening injuries?

 

 

Best advice I can give: listen to your body, increase slowly and have a plan! If you are one of those oft injury plagued runners, take a look at these tips. Are you following the guideline? If so, take a spin in triathlon! It has saved a lot of weekend warriors…….

 

Thanks to Amby Burfoot and his crew. I have liberally borrowed from their content and just put in my two cents worth. If you want to read his article, “The 10 Laws of Injury Prevention” you can find it in the March 2010 edition of Runner’s World.

I had a great question this weekend at a running forum in Grapevine. One of the runners had lateral knee pain that came and went with no obvious cause. She thought she had ITB (iliotibial band) syndrome (sounded like symptoms her friend told her about) but she had been doing stretching and icing with no avail. What else could she do? Is it possibly from her shoes? Is rest enough?

 

Let’s talk about ITB syndrome.

 

The most common cause of lateral knee pain in runners is ITB syndrome, related to repetitive friction of the band sliding over the lateral femoral epicondyle as the knee flexes and extends.

Runners may complain of a sharp or burning pain about 2 cm superior to the lateral joint line (above the outside of your knee); exam may reveal tenderness to palpation there. Swelling and redness are usually not present unless it is severe.

 

Runners who are predisposed to this injury are typically overtraining. They often have underlying hip abductor muscle weakness; leg-length discrepancies may contribute to ITBS. They also have been found to have either a really high arched foot (cavus foot type) or an extremely flexible flat foot.

Acute phase treatment includes relative rest, ice, and anti-inflammatories. Physical therapy modalities like ultrasound and e-stim can also be helpful to break the inflammation cycle. In cases of severe pain or swelling, corticosteroid injections may be used.

 

During the subacute phase, stretching of the ITB is emphasized, along with soft-tissue therapy for any myofascial restrictions. Orthotics and shoe gear changes are also often indicated. Many patients actually are running in too heavy or too stabilizing shoes, especially if they have a cavus foot type.

The recovery phase focuses on a series of exercises to improve hip abductor strength and integrate movement patterns.

 

The final return to running phase is begun with an every-other-day program, starting with easy runs and avoidance of hill training, with a gradual increase in frequency and intensity. Remember: too much, too soon, too fast is what got you hurt in the first place!

 

Rest alone is usually not enough! This can be a painful chronic injury. Surgery can be considered in refractory cases, but this is rarely indicated.

 

 

Ryan Hall said about running a marathon, “It's a long, hard road and it's going to have its bumps; there are going to be times when you fall and times when you don't feel like going on anymore, times when you're just crazy tired but it takes focusing on that one step you're taking. That's what I'm trying to do with the marathon; I don't think about the miles that are coming down the road, I don't think about the mile I'm on right now, I don't think about the miles I've already covered. I think about what I'm doing right now, just being lost in the moment.”

 

I feel this is even truer about endurance triathlon and Ironman.  Focus on the moment and don’t think about the miles and hours to come. Most of the battle in the race is going on in your head!

 

Fight the negative self-talk. Rememeber your mantras and that it is all about the finish line! Pain is temporary and quitting is forever!

Every individual taper is unique. Your age, preparation and personal history of your previous tapers should all play into the final formulation. A balance of rest and active recovery are key, but not too much rest. I recommend that you do something every day and just maintain your schedule. I have gone into a marathon too rested and bonked. I’ve also gone in exhausted and bonked (lots of bonking history) I have learned to listen to my body. Do regular self check every morning and rest as needed. Better to be 15% under-trained than 1% over-trained. Be confident that your body will rejuvenate and respond to resting.

 

The Gods of Ironman have conflicting stories about tapering, but the truth is in your own history of recovery. If you listen to your body, and are honest about your bonk history; you will know how long of a taper you need. Keep these tips in mind and be ready to rock your next Ironman!

 

See you all in Houston Texas May 21st!

 

Next article series is on recovery!

 

Wow! What a great panel discussion put on by Saucony in Boston last Thursday night. I love going to Boston during marathon week. It's like Marathon Mecca! The whole city seems to buzz with running excitement. Boston will always be my favorite marathon. 

 

I had the privilege to be part of the discussion of the evolution of minimalist running and how to transition from stability or motion control shoes to a more minimalist shoe.

 

The panel consisted of Michael Sandler, who wrote a fabulously crazy but poignant book on Barefoot Running and how it saved him after a severe accident; myself discussing how to strengthen your feet in order to even attempt transition from minimalist shoe gear or barefoot running as well as reminding runners to proceed with caution; Spencer White, head of the Saucony human performance lab, discussing in depth the biomechanical basis for the development of minimalist shoes and how they actually strengthen your feet over time; the legendary coach Dr Jack Daniels, doing coach chalk talk on a white board in order to discuss how to integrate minimalist running as a training tool; and last but not least, Collin Dibble, the owner of Marathon Sports in Boston discussing how to fit runners into the correct minimalist shoe and how retailers have a responsibility to caution and educate consumers on how to slowly integrate these shoes. Whew! What a panel! A fabulous educational experience for all present. I could listen to Dr Jack Daniels telling stories for hours. 

 

After the panel spoke individually for 10-15 minutes each, then it was time for Q&A. Great questions from the audience showed they were actually paying attention. Even Amby Burfoot from Runners World asked a biomechanics question!

 

Then it was time to separate into small groups and talk with the runners’ one on one. I was happy to see that I drew a small crowd that wanted to discuss everything from how can I strengthen this muscle or that area to how can I transition safely or can I even think about doing this? Great discussion with a local pedorthist who will probably send me hate mail because I told him he was crazy to be running in a graphite orthotics. A few local podiatrists were also in attendance and I was surprised but delighted that they actually agreed with me that everyone does not need to be in orthotics permanently if their biomechanics can be rehabbed instead of permanently braced. We had a lively discussion about this highly controversial subject in our industry.

 

Let's briefly discuss this alternative thinking. A runners does too much, too soon, too fast and ends up with let's say plantar fasciitis. Traditional thinking is PF is most likely caused by abnormal pronation. Treatment is to put him in a more stable shoe with orthotics to brace his foot, start stretching, anti-inflammatories, rest and lots of ice. Now what? He's better in 6-8 weeks. Now he wants to start running again. Traditional thought is that his underlying biomechanics predisposed him to have the injury so we should leave him in the stiffer shoes with orthotics. What if he really doesn't have a significantly jacked up foot? Maybe just a slightly over pronating foot? Do we have an alternative to offer him? Yes! Now the hard work starts. Lots of strengthening exercises for the medial and plantar foot and lower leg musculature coupled with balance and proprioceptive training followed by lots and lots of stretching. Then slowly wean him off his orthotics and stability shoes over a period of 3-4 months and transition to a more minimalist shoe gear.

 

Easy? No! Worth it? Yes, if he wants to find his inner gazelle. No, if he really doesn't care about changing the way he runs to be lighter, faster, and in the long run, less pounding. Can everyone do this? No way! Only about 15% of runners will work that hard to change their running style after an injury, so I don't worry about the orthotics labs going out of business.

 

That's just the tip of the discussion going on in sports medicine today about the trend of minimalism that is sweeping the running world. Hmmm. Sounds like more blogs to come. 

 

Join Dr Crane at the Boston Marathon discussing minimalist shoes and training with an expert panel!

For more info, click here

Does This Describe You?

 

The genuine marathoner is a rare breed indeed: half athlete and half poet; part rock-bottom pragmatist and part sky-high idealist; completely, even defiantly individual and yet irrevocably joined to a select group almost tribal in its shared rituals and aspirations.

Joel Homer, Marathons: The Ultimate Challenge

 

EPAT is the most advanced non-invasive treatment for musculoskeletal pain. Extracorporeal Pulse Activation Treatment is a new way to conquer chronic heel pain. Pressure waves stimulate the metabolism, enhance circulation and accelerate the healing process without surgery. Dmaged tissue of the plantar fascia or Achilles tendon gradually regenerates and eventually heals. Here are the top 16 frequently asked questions about EPAT.

 

The Top 16 FAQ’s About EPAT Therapy for Heel Pain

 

1. What Is EPAT?

 

EPAT is an acronym for Extracorporeal Pulse Activation Technology. It is a highly effective non-invasive office based treatment method that accelerates healing of injured tissues.

 

2. How Does EPAT Work?

 

The treatment utilizes a unique set of acoustic pressure waves that are delivered through the body and focused on the site of pain/injury with a special applicator. These pressure waves stimulate the metabolism, enhance blood circulation and accelerate the healing process.

 

3. How is the Treatment Performed?

 

Ultrasound gel is applied over the skin of the treatment area to enhance the transmission of the pressure waves. The pressure waves are applied using a special applicator tip. The tip is moved over the injured tissue using circular motions.

 

4. How Long Does the Treatment Take and How Many Treatments are Required?

 

Treatment sessions take approximately 15 minutes per site and vary slightly depending on the site to be treated. Generally 3 treatment sessions are necessary and are performed on a weekly interval. If you are improving, but not completely better; up to 5 treatments can be performed.

 

5. What Conditions Can Be Treated With EPAT?

 

EPAT can be used to treat many painful soft tissue injuries. Including: plantar fasciitis, Achilles tendonitis, tendon insertional pain, acute and chronic muscle pain, and myofascial trigger points.

 

6. Is EPAT Safe?

 

EPAT is a safe treatment with virtually no side effects. It was originally developed in Europe and is currently used around the world.

 

7. Is EPAT Safe for Pregnant Patients?

 

EPAT is a safe treatment, but has never been tested on pregnant patients. Patients are advised to wait at least 3 months post partum before treatment, as many foot pains subside after weight loss and hormonal equilibrium is reached.

 

8. Is EPAT FDA Approved?

 

Yes, the machine is FDA cleared for usage.

 

9. What are the Expected Results?

 

Most people will experience pain relief after 3 treatments. Some patients report immediate pain relief after the first treatment, but maximum relief can take up to four weeks after the last treatment to begin. Over 80% of patients treated report to be pain free or have significant pain reduction.

 

10. Are There Any Special Aftercare Instructions?

 

All patients receiving EPAT therapy should be off all anti-inflammatory medication for a minimum of 2 weeks prior to the procedure and 4 weeks after. This includes common over the counter medication such as, ibuprofen (Motrin, Advil), naproxen (Aleve) and aspirin. Your doctor will provide you with detailed after care instructions.

 

11. What are the Possible Side-Effects or Complications?

 

EPAT is a non-invasive treatment and has virtually no risks or side effects. In some cases patients may experience some minor discomfort which may continue for a few days. On rare occasion, the skin may become bruised or red after the treatment.

 

12. Who Should not Have EPAT?

 

EPAT should not be used in people who have deep venous thrombosis or malignancy. It is also best to avoid the procedure if you are taking blood thinners.

 

13. Why Consider EPAT?

 

EPAT has a proven success rate equal to or better than traditional treatment methods (including surgery) without the risks or lengthy recovery time. It is performed in your physician's office without the need for anesthesia.

 

14. Does My Insurance Pay For EPAT?

 

No, unfortunately insurance companies do not pay for EPAT, though the cost of EPAT can often be reimbursed from a qualified health savings account. Non-covered services and/or procedures without billable terminology are paid to the office by the patient at the time of service; a claim will not be submitted to the insurance, though our office can provide receipts for reimbursement accounts to consider.

 

15. How Much Does it Cost?

 

EPAT is an affordable alternative to invasive surgery, lengthy physical therapy and other costly treatments. The first 3 treatments are bundled at a cost of $500 for the procedure, but you are still responsible for any co-pays or costs associated with the initial and/or any follow up office visit. If a 4th or 5th treatments are deemed necessary, these cost $100 per treatment.

 

16. How Can I Get More Information About EPAT?

 

The physicians at FAANT all have experience in providing EPAT treatment and are the best people to speak with if you have additional questions regarding the procedure. Call or contact our office for a consultation.

 

There is also much more extensive information available at www.curamedix.com

 

The most common New Year’s resolution in the United States is to lose weight or improve your fitness. Let’s face it, even for the veteran marathoner or triathlete, the New Year gives us an excuse to refocus or give us just a little kick in the butt we need. We all need a plan to achieve our fitness goals or race success. I woke up on January first and realized it was 21 weeks until Ironman Texas. Wow! That crept up on me! Janet has been blogging for months about the road to Ironman Texas. I’ve been so busy working my butt off and being Mom, it crept up on me. Now it is time to refocus on my fitness goals, so I don’t perish on the streets of Houston on May 21st.

 

Maybe you are like me, a race is creeping up on you, or maybe you have just gained a few extra pounds from the holidays, or maybe you are like some of my friends who realized running up their stairs they get out of breath. This is a great time of year to refocus on your fitness goals. We all have obstacles; time, energy, financial, and our own self-defeating voice in our heads! Here are some tips that will help you focus and reach your fitness goals in 2011!

 

 

 

Tip #1: Do not increase your mileage by more than 10% per week. The body grows stronger if it is stressed in small increments, but starts to break down if it is stressed too much. Studies show that increasing your mileage by no more than 10% per week will help you grow stronger without breaking you down. Avoid increasing duration and pace at the same time.

 

Tip #2: Always follow a hard workout with an easy one. The body’s like a cell phone. If you continue to use it without recharging, it will eventually wear down. By incorporating easy workouts or cross training into your program, you’ll allow your body a chance to rest and repair itself.

 

Tip#3: Add strength training to your workouts. Strength training is usually absent from most training programs, but cross training with weights is the only component that has been proven to reduce running injuries. Proper strength training can help you overcome muscle imbalances that lead to injury, as well as strengthen connective tissues that help support your joints.

 

Tip#4: Do regular self-checks. Tune into what your body is telling you. How do your muscles and joints feel? How does your breathing and heart rate feel? Are you straining to keep up your pace? Anything that doesn’t feel the same may be an early sign of overuse. Keep a training log of not only your mileage, but how you feel during and after each workout. Fatigue over a period of a few days is a huge red flag that your body is trying to tell you something.

 

Tip#5: Respond to pain immediately. If you experience pain during or after a workout, follow the rule of R-I-C-E (rest-ice-compression-elevation). Use an ice massage or cold pack for 10-15 minutes every 4-6 hours to relieve inflammation and swelling. Elevation is also quite helpful in the first 48 hours. Apply a compressive wrap and hang out on the couch for a few hours and rest. After 48-72 hours, if the inflammation has subsided, apply heat to help promote healing.

 

Tip#6: Do not take pain-relief medication to finish a workout! Non-prescription anti-inflammatory medications can reduce inflammation and pain, but they do not speed healing. Taking anti-inflammatories prior to a workout may decrease your discomfort and allow you to finish a workout, but they also allow you to overstress already damaged tissue. This can prolong the healing process. Pain is a sign you should not ignore!

 

Tip#7: Choose relative rest over inactivity. Active rest, or easy exercise, is better than inactivity because it stimulates blood flow and promotes healing. If slow running is painless, but picking up the pace is painful, then stick to slow running until you feel better. Or do other activities, like swimming, cycling, or aqua running until you can run pain-free.

 

Tip#8: Don’t wait too long to seek professional help. If your pain does not respond to a week of R-I-C-E and cutting mileage by at least 50%, see a sportsmedicine specialist. Not only can a professional help you diagnose and treat the condition, but they may also help you determine and biomechanical abnormalities that can lead to recurring injuries.

 

Tip#9: Try to maintain a positive attitude.  You immune system fights injuries with a complex army of nutrients and special cells. But, you immune system doesn’t work alone. Your mind also has a voice in what goes on. Attitudes and feelings are organized in your brain to communicate with your immune system with chemical messengers. A positive attitude can go a along way to help speed healing.

 

Tip#10:  Ease back into your regular training program. Remember, too much, too soon, too fast is what hurt you in the first place. It’s tempting to jump right back in where you left off, but your injured tissue may not be fully recovered. It’s during the first few weeks back that most runners get re-injured. Use the 10% rule to ease back into mileage….

 

Above all, have fun! Marathon running is a challenge that is mental as well as physical. The miles between 20 and 26.2 take determination, stubborness and probably a tiny bit of inner insanity! Whether you finish in 2 hours or 6+, you are still a marathoner forever after you cross the finish line!

 

Run Happy! And Injury Free!

How long does it take to recover from a marathon? How long does it take to recover from an Ironman triathlon? How much racing is bad for my body? These are all good questions posed in my office on a regular basis. The problem is that the answer is always, "It depends". Everyone recovers at a different rate. Age, experience and current fitness level are large variables in the equation. I know a marathon runner in town who ran 100 marathons in a less than 10 years; and of course, we have all heard of Dane Rauschenberg who ran 52 marathons in one year for charity and then wrote a book about it! The flip side is that I know runners who can only do one marathon a year without getting hurt and most triathletes only train for one Ironman a year.

 

So what is the magic formula? How much is too much? I think the first thing to think about is what is your goal? If you are just talking about finishing the marathons and not really having a time crunch, then feel free to do up to six a year but realize that having more than two quality runs in a year is very difficult. The Ironman distance should not be attempted more than 2 or 3 times a year regardless of time goals! Now, for those of us who are addicted to the watch, "racing" a marathon is something that should not be done more than twice a year. "Racing" an Ironman triathlon should only be attempted one a year.

 

Why is this true? Well, simple math. It takes a minimum of 4 months to train effectively for a marathon and 6 months for an Ironman. Then you need at least one day for every mile you ran and three to five days for every hour your triathlon took. That means a month of recovery before you start to train again after a marathon and at least 6 weeks after a 12 hour Ironman. Last time I checked, there were only 12 months in a year; hence, the common recommendation of racing no more than 2 quality marathons or one quality Ironman triathlon a year.

 

Why do some people recover faster? Age. My feeling is that youth is wasted on the young. I remember being able to run a marathon and get up and go to work the next day. Now I have to take at least one day off and often take two! Experience does help. Your body has been there before, so it knows it will live. Veterans often have a post-race routine down that helps them recover. (Often this includes the anesthesia known as beer!) If your fitness level is high and your nutritional status is good, you will recover faster.

 

What can you do to hasten recovery? Walk a cool down after the race. Do not sit down immediately even though your legs are begging you to! Take a 15 to 20 minute walk and stretch gently. An ice bath is best, but very few people I know are that tough. A cool bath followed by stretching before you go to bed is helpful. A large amount of carbohydrates and water also helps. Hence the beer phenomenon! A massage a few days after the race will help you recover. More than anything, do not start training again until you are fully recovered. Many injuries occur due to too much, too soon, too fast and too fatigued syndrome!

 

So how much is too much? Again, the answer is always, "It depends." Listen to your body. Really listen and stop being stubborn or stupid! If you start training and you are exhausted, you are doing too much. If you are spending too much time in my office and less on your bike, you are doing too much. The answer is really simple stupid. Listen to your body and it will tell you how much is too much.

 

Bottom line: Let your body fully recover from your races and quality times will be recorded. Race only one to two marathons or one Ironman triathlon a year. As for other distances, keep in mind that you need one day for every mile of a running race and at least 3 days for every hour you raced in triathlon. Anything shorter, you better take off your watch and go for the finish instead of the time and prepare yourself to spend some quality time with your local sports medicine physician!

 

Run Happy! And Recover Well!

 

2. It is a great pain reliever.

3. It makes the end of a race much more enjoyable.

4. It can precipitate post-race amnesia making you want to do another one.

5. It tastes much better than Gatorade.

6. I think I even read a study that showed beer helps flush out all that lactic acid!

7. It promotes social activity after a race when you feel like you just got run over by a truck

8. It’s a great carbohydrate replacement recovery drink.

9. It makes the ride home so much more comfortable……….and the next morning if you don’t have to go to work 

 

All right, all funny aside, how about the ice versus heat question?

 

Ice versus heat? This is a common question a lot of athletes, coming into my Grapevine, Texas office, ask. Most understand that ice immediately after injury is very important. The questions usually revolve around when to use heat.  There are some basic guidelines that every athlete can use to reduce confusion.

 

Immediately ice the “fall down, go boom injuries.” Ice works well for reducing redness, swelling and internal bleeding in acute injuries.  It also is a great pain reliever. Acute injuries and post surgical pain and swelling usually respond well to 10 to 15 minutes of ice every few hours. This should be done for up to several weeks after an injury or surgery. Ice can be in the form of an ice pack (ice wrapped in a protective towel) or ice massage (massaging with a frozen water bottle or block of ice). 

 

Ice can also be helpful in reducing swelling in a chronic injury like runner’s knee or plantar fasciitis. Icing immediately after activity can prevent further inflammation of an already annoyed area and help in recovery.

 

So where does heat come in? Heat can be used in several different ways. Contrast baths with ice/heat/ice can be helpful in chronic injuries. Especially those joints or tendons that still have just a little inflammation or edema. Heat should never be used alone in these cases. Moist heat is best for chronic stiffness and old injuries with scar tissue. It can also help in the rehabilitation process. For example, when plantar fasciitis becomes plantar fasciosis after four to six months (which is a chronic degeneration of the plantar fascia), deep heat therapy with ultrasound or moist heat packs can help increase range of motion of the area and increase the effectiveness of physical therapy. Heat actually temporarily increases inflammation in an area, but this is often helpful in kick starting the healing process.  Heat can also be used to calm muscle spasms and relax a tight muscle. 

 

Heat causes an increase in circulation to an area, so it should never be used in acute injuries or chronic injuries with a lot of swelling. It can actually make an injury worse if there is still a little internal bleeding going on. A great way to heat a joint or tendon is to use a reusable heating pack or an electric heating pad for about 20 minutes before stretching, massage or other therapy. Heating an old injury before exercise can also be helpful in warming up the area to ready it for increased activity.

 

The simple rule of thumb is that ice is used for acute, swollen injuries and heat is used for stiff, chronic injuries. This subject is debated continuously, but I hope this discussion clears up the mystery of ice versus heat!

 

Run Happy!

I declared myself heat tolerant this weekend in my recent Twitter. I did a 3 hour bike ride in 99 plus heat at 5pm in the Texas heat and could still spit when I was done! That’s a success in my book! It definitely took 2 full weeks of suffering in the heat and a good hydration plan to finally feel like my body had made the transition to feeling relatively comfortable in the soaring Texas summer heat. 

 

Dehydration, heat stroke and hyponatremia are your biggest worries while training in the summertime. Whether you are in Texas or Rhode Island, when the temperature soars over 90 degrees, heat illness can seriously hamper your endurance training. Most of us have an “A” race on the calendar in the fall and require a lot of base training in the summer. No way around those long runs and even longer bike rides in the heat. The average triathlete can sweat up to one liter of fluid an hour while training and sweat contains about 3 grams of salt per liter. How can we conquer the heat? Preparation and constant hydration! Diligence is the key! Always stay one step ahead of the hydration curve. Remember that heat illness really can kill you and hyponatremia has taken out more than one healthy marathon runner and triathlete!

 

Here are some simple tips that will help you train safely in the heat:

 

“I have been running since I was 13yrs old and I am 42 now. Friday I was diagnosed with osteoarthritis after 6 weeks of no running but cross training on the elliptical. The doctor thought it was tendonitis but after not getting better he decided a MRI would be appropriate. The MRI confirmed it was osteoarthritis. I am starting physical therapy on Monday 3x a week.

 

My question: Is it possible for a runner who has osteoarthritis to be able to run again. I feel like my world has been rocked and shaken. Running is HEAVEN for me and nothing compares. It is my total stress reliever and if I do nothing else in a day if I've run my day is totally complete. I am the mother of 3 great kids and I guess I should be thankful I can do the cross training now because I get cranky when I don't get to do something. I just feel like this means my running career is over. My mileage before getting injured was about 25 a week.

 

Please let me know your thoughts. I have searched the internet for help on other runners who are going through what I am and have osteoarthritis of the foot with no luck so far. Thank you so much for taking my comment. I'm praying for a miracle. I know it's not life threatening but it's my mental state I'm concerned about.”

 

Answer:

 

Let me start my answer with a story. I have a runner in his late 30’s as a patient who had the unfortunate luck to be blown up in the Desert Storm conflict while he was serving in the Marines. He has severe arthritis in both feet from his injuries. He has had at least 5 foot surgeries including a fusion of his subtalar joint in one foot. He ran the 2008 Marine Corps Marathon in less than 41/2 hours. If he can run a marathon on feet that are that bad, I am confident that you can get back to some kind of running.

 

The name of the game is accommodation. You will need a great pair of orthotics made by a podiatrist that knows what they are doing and specializes in biomechanics. They can fabricate a device that will transfer the stress from the arthritic area to a strong, healthier part of your foot. That coupled with physical therapy, core strengthening exercises and a good pair of running shoes will get you back on the road! For more information on living with arthritis click here!

 

Run Happy! And pain free!

 

 

 

It’s just a few days from a big race and I’m already anxious. What am I afraid of? Running a bad time? Totally bonking? Looking stupid in front of my friends and patients? Drowning in the open water swim? Getting a flat tire? Perishing on the street? Where does all this performance anxiety come from? After 30 years of competitive running you would think I would have conquered race day jitters, but they are always there…kinds like an old friend…or a fungus….

 

So, how do I cope with race day jitters? Positive self-talk, preparation, visualization and organization!

 

A race is just another long training day in the company of a few hundred, or sometimes a few thousand, of your closest friends. Most anxiety comes from fear of the unknown and lots of negative self-talk. Reality – your friends and family really don’t care what your time is, whether you place or not, and the world will not end if you run a bad time! My patients are just amazed this old lady is still racing! Times are irrelevant! Setting high goals will just stress you out! Focus on running your best race that day! Relax! Have fun! Go into the race realizing you have nothing to lose and everything to gain. I treat every race as a learning experience. Even if you get kicked in the face in the swim and lose your goggles, get a flat tire or totally bonk on the run; you learn something you can use another day!

 

There are many things you can do to stay relaxed. Here are just a few I have learned along the way:

 

 

Race day jitters can completely derail your race before it has even started. Don’t let the negativity ruin all your hard work and preparation! Relax! Follow these tips and remember to banish the negative, and stay positive throughout the race! Try to have fun! Whether this is your first marathon or your 100^th triathlon, remember to celebrate your training and have a great race!

 

Run Happy! And anxiety free!

Let’s look at the research. A recent survey of 30 different studies of runners and decreased immune function that may lead to increased upper respiratory infections revealed little agreement from the experts. Yes, they all agree that moderate activity may enhance immune function, but they describe this as brisk walking for 30 to 45 minutes a day. What runner does that little activity? Most studies also agreed that high-intensity exercise temporarily impairs the immune competence. Hence the increased incidence of upper respiratory infections in marathon runner and especially ultra-marathon runners.  

 

Athletes, when compared with their couch potato colleagues, experience higher rate of upper respiratory infections especially in the few weeks after intense training and races. In non-athletes, increasing physical activity is associated with a decreased risk of upper respiratory infections. 

 

This so-called open window of altered immunity is temporary, lasting from three to 72 hours after an intense, prolonged event. Nevertheless, it presents an ideal opportunity to viruses and other invading pathogens, especially those that enter the body through the respiratory system.  

 

Sounds bad, so what can we do to increase our immunity and avoid the runny-nose syndromes?

 

Several vitamins and minerals, including vitamins A, E, and C, and the minerals zinc and iron, are essential for normal immune function. Vitamins C and E, in particular, are also powerful antioxidants. It has long been known that long-distance running and other endurance events can increase the levels of free radicals—molecules that oxidize and cause damage to cells, including immune cells. The body produces its own antioxidants to counter free radicals and oxidative stress.

 

Many runners, operating under the theory that more of a good thing is better, take vitamin and mineral supplements. And while moderate amounts may very well be beneficial for the active individual, there is little evidence to support taking megadoses, with the possible exception of vitamin C. Some studies found that taking vitamin C (about 600 milligrams/day) for three weeks before an ultramarathon reduced postrace cold symptoms. Other researchers have found that vitamin C supplementation made no difference. Sounds like a multivitamin with extra vitamin C can’t hurt, but may not be our savior! 

 

Should you run when you’re sick? 

 

If you have a cold, most doctors recommend waiting a day or so after your cold symptoms disappear to resume intensive exercise. Mild to moderate exercise (such as walking) when you have a cold is fine. If your illness is more serious—fever, fatigue, muscle aches—you should wait two to four weeks before resuming your training regimen. Like any of us do that! 

Just as intense, extended physical stress can depress certain immune responses, so too can chronic psychological stress and inadequate sleep. So during periods of intense training and before long races, the take-home message is this: keep other life stresses to a minimum if possible. Get enough sleep, avoid rapid weight loss, and eat a healthy diet. Sounds like a no-brainer! 

 

Bottom line: marathon runners are more susceptible to upper respiratory infections. Getting more sleep, decreasing your overall stress and taking a multivitamin with extra vitamin C may help. 

 

 

Is carbo loading all about eating more pasta?

 

Is there a magic formula?

 

If you are an endurance athlete who is fearful of hitting the wall,listen up: proper fueling before a marathon, triathlon, century bike ride, or other competitive endurance events can make the difference between agony and ecstasy!

 

 

If you plan to compete for longer than 90 minutes, you want to maximize the amount of glycogen stored in your muscles, because poorly fueled muscles are associated with needless fatigue. The more glycogen, the more endurance (potentially).

 

Read the entire article by Nancy Clark, a leader in sports nutrition.

http://www.goldsnutrition.com/0209carbo.html

In Texas, the saying goes that if you don’t like the weather; wait 5 minutes, it will change. This week alone it’s been 70 degrees and 24 degrees. No wonder the whole world is sniffling. Personally, I hate the cold. I’m a tiny person so I’m very cold intolerant. My bike goes inside on the trainer when the weather hits 40 degrees and I look like an Eskimo running. How do we keep motivated during the winter? Things seem to change for me when it’s cold outside. It seems much harder to get out of bed, much harder to run out the front door and a whole lot harder to finish a long run.

 

In spite of my obvious aversion to cold temperatures, I have trained for years all winter long. In Texas, this means crazy temperature swings. As a teen, in Rhode Island, it meant bitter cold and snow.  In fact, I can remember as a high school cross country runner racing in snow and ice and wearing shorts (like an idiot). Training in the cold can make you tougher, but take some advice and dress for the elements. Thank God they finally invented cold weather gear that does not weigh a ton and make you look like you are ready for skiing, not running!

 

The real goal of cold weather running is to maintain motivation, not get too cold and not get too hot. Easier said then done! One solution to this is to just head indoors and stick to the treadmill. I absolutely despise running on treadmills much more than running in the cold, so unless it’s raining; I’m outside. In addition to the boredom, the repetitive motion of the treadmill can put you at risk for other injuries such as stress fractures. It’s best to have some variety.

 

The key to staying comfortable and cold weather condition is to be prepared for changing temperatures. Dress in layers and don’t be afraid to overdress. Wear a hat and gloves. I even pull out chemical finger warmers if it’s really cold. If it all possible try to run small loops somewhere near your car or a place where you can discard layers if you start to get hot. You don’t want to be nine miles from home and running with hat in hand, sweating with two jackets tied around your waist.

 

If you are overloaded with too many layers, you can just as easily overheat when it’s 30° outside. This will make you nuts because you will lose the energy needed to finish your run, just like a hot day, and you may become soaked with sweat be more prone to thermal injury such as frostbite. As soon as your run is over, do not stand around outside. Immediately change into dry clothing. Your core body temperature will drop precipitously immediately after a run. This is why they always shroud you in a blanket at the finish of a marathon, even when it’s hot outside.

 

Aside for making sure that your temperature is regulated, there are special environmental considerations when running outside in winter. If it happens to snow where you run, you obviously have to watch your step. Be very careful running on ice. Running on snow is easy, but ice will put you on your back before you know it. If you’re lucky it’ll just be an embarrassing fall, but you can get seriously injured this way.

 

Always wear a hat to keep your head warm. This can be a baseball-style cap, but once it gets colder than about 40° however, you will likely have to switch to a knitted cap that will do a better job of keeping your head warm. It likely goes without saying that you should avoid natural materials such as cotton, that retain moisture and can put your risk of getting too cold. Always use synthetic materials.

 

As a general rule, you can get away with shorts or tights and a long sleeve T-shirt when it’s in the 50s. If it drops down into the 40s, you need to add a hat, gloves and an additional layer on top. A vest is a nice addition. Once it gets down into the 30s, it’s better to stick with tights or pants and wear three layers on top, as well as hat and gloves. If you’re brave enough to run when it’s in the 20s, you might also want to wear a jacket on top of your many layers. Unless you really like to torture yourself, or live in Alaska, it’s probably better to just stay inside when the temperature drops into the teens. 

 

Keep in mind, your body can become acclimatized to colder temperatures if exposed to them often. However, for people like most of us who are only rarely exposed to cold temperatures, they’re more likely to be a poor judge of when frostbite or other cold injuries are starting to set in. Use common sense. Texas weather is nutty, so the layered look is a must this time of year!

 

Run Happy! And Bold in the Cold!

 

 

It’s the day after the marathon. You get out of bed feeling like you should have gotten the license pate of the truck that just ran over you. You find you can walk small steps but notice you can go upstairs but downstairs is nearly impossible. You take a shower, stretch, eat at least your weight in breakfast and then realize you need to call in sick to work. There is no way you can work today. It just hurts too badly. Your bed is calling but you know if you crawl back under the covers, tomorrow will be worse.

 

Does this sound familiar? I think every runner who races has felt this pain I’m describing at one time or another. It could be after a marathon, a PR in the 5K or just an extra hard track workout. Why is this? What did you do wrong? How could you have done differently so this post-race soreness wasn’t so acute? Or is this the price you pay for a fast time?

 

Let’s explore delayed onset muscle soreness.

 

Delayed onset muscle soreness (DOMS) was always thought to be caused by the build up of lactic acid in the muscles. This theory has been debunked for years after multiple muscle biopsy studies. The most popular theory is that DOMS is the result of muscle tissue breakdown caused by microscopic tearing precipitated by activity that is either more intense or more prolonged than normal. The pain associated with this injury is most likely due to inflammation which is why the pain usually is delayed at least several hours after the acute damage and can last for 2 to 3 days.

 

So, what can we do about this pain? Can we prevent it? Can we make it go away faster? Or do we just have to suck it up and endure it as a side-effect of our never ending pursuit of faster and longer training and racing intensity.

 

Bottom line: No method has been shown to significantly speed the recovery from DOMS BUT there is some empirical data that a few things do help us endure it.

 

Let’s look at some common treatments:

 

Reality: no good data shows that any treatments help with DOMS, but some can decrease you suffering. Best treatment is prevention.

 

How can you prevent DOMS?

 

There is always one in every crowd that answers, “Run slower.” Ha Ha!!

 

But seriously, while DOMS is common and annoying, it is not a necessary part of racing. There are many things you can do to try to prevent, avoid and shorten the duration of DOMS:

 

DOMS is a regular visitor in most distance runners’ lives. This does not have to be debilitating, but prevention is your best defense against this nagging pain. We have discussed some of the treatment options and suggested methods for prevention.

 

Above all, remember that certain muscle pain or soreness can be a sign of injury. If your muscle soreness does not get better within a week consult your doctor.

 

Run Happy! And try to avoid muscle soreness!!

 

Question is, why do cramps happen and how can you prevent them? They have never occurred during his extensive training, so why in the middle of a race? 

 

Muscle cramping usually occurs due to a depletion of "The Big 4": sodium, potassium, magnesium, and calcium. Also, if an athlete is dehydrated, even slightly, going into a race, muscle cramps can be common (no matter how spot-on race day hydration is). Cramping can occur due to the depletion of one or a combination of these four minerals. One area that I would first examine is your everyday fueling. I realize that conventional thinking says that if an athlete cramps up during a race, then it must have been something nutritionally that went awry during the race. This may be the case, but actually the answer usually lies in one’s everyday nutrition and hydration. 

 

The first thing I would suggest is to monitor your hydration levels before and after training (especially long training days). This can easily be done with a body fat scale that also measures body water percentage. Take this reading each night before bed for 7 days straight so you can determine an average body water percentage; then, after training sessions, re-measure your water percentage. You will probably notice a reduction in your water percentage, as this is normal. Your goal now is to refuel and rehydrate in order to get this water percentage back to its ‘normal’ level. Another easy way to monitor your hydration level is to pay close attention to your urine color. The goal is to keep your urine color in a range from clear to a very light yellow. If one’s urine color is a darker yellow, this can be a sign of dehydration (be aware, that if you take a multiple vitamin, the B-vitamins will turn your urine color yellow, and this is normal; not a sign of dehydration). Following a long training run or race…get your urine clear and keep it clear throughout the day, as this will ensure proper hydration. 

 

In regards to the Big 4, try to consume a fluid replacement drink that contains all four of these minerals, and be sure to consume this fluid replacement drink during training and racing. Also, be sure to use your “sodium capsule” of choice during training, and not just on race day (you may already be doing this). If you find yourself avoiding sodium in your daily nutrition, try to lightly salt your foods with sea salt. Also, drinking vegetable juice is a great source of sodium and potassium (be sure to check with your physician that there are no blood pressure issues that would contraindicate the use of additional sodium). 

 

So, in summary, my advice to Tim would make everyday hydration and fueling your focus as this will get you to the start line in a state of optimal hydration. This should help avert any nasty cramps in your next race! 

 

Run Happy! And cramp free! 

 

Today was the White Rock Marathon in Dallas. This is an annual event that I usually participate in with many of my patients and peeps. Wonderful event with a full marathon, a half-marathon, and a 5-person-relay. This year had record participation of 17,000 people with almost 7,000 runners in the full marathon. Unfortunately, today it was 68 at the start and warmed up to about 75. Did I happen to mention the 30 mile an hour head wind that was in our face for at least 14 miles of the marathon.

 

This should be the tale of two half-marathons. Most of us were doing great at the half. I personally hit the 13.1 mile marker exactly as predicted in my pre-race planning at 1:52 which would have brought me in at 3:45 with the negative split I was planning. I've always said that a marathon is a fast 10K with a 20 mile warm-up, so I always try to bust it in with a negative split. Unfortunately, the weather was not cooperating! I turned the corner at 14 miles to go on the lake access road and was hit by gale force winds. Being small of stature, I was blown all over the place! I felt like a small kite for at least 10 miles.

 

At 16 miles, my day was done! I was putting forth the effort for an 8 minute mile and crawling at somewhere between 10 and 11 minute miles. My goal was shot, but my wonderful brother (who on the spur of the moment last night thought he would pace me in the marathon - crazy!) would not let me quit (I really wanted to because the wind was positively evil!)so we persevered on against the wind.

 

My friend Mike Horton was a sight from God that jumped in at 19 miles and ran us through the worst of the hills (Thanks Mike!) We did some walking, then decided it would be faster to finish if we were running.

 

My awesome BFF office administrator Lori Cerami jumped in at 23 (at this point my brother jumped out since this was the most he had run in 2 years) and yelled at me to get my butt moving....she stayed with me giving me gummy bears and Accelerade until the 25 miles marker. At that point I figured I was almost done so I ran a quality 1.2 miles to the finish.

 

My assistant Penny, associate Dr Mollye Karp and pedorthist Janet were at the finish, but had already drank all the beer :) So salty pretzels and some Starbucks were my reward, but I loved seeing them with signs cheering me on.

 

Only one of my peeps was even close to her goal today, so it was basically a PW (personal worst) for almost all of us, but I think my finishing time of 4:13:45 deserves an astericks next to it for the weather.

 

To put it in perspective, only 3,878 people finished out of almost 7,000 and I was 1,339 overall, the 329th woman, and 58th master woman (yes, I am that old). Not what I had hoped for, but the course humbled all today due to the crazy conditions. The winner finished in 2:22 in comparison to the 2006 winner who ran 2:12; so I think we can all comfortably subtract 20 minutes from our time for conditions. :)

 

We survived to run again.....and should rejoice that we can....

 An excerpt from the upcoming "If Your Running Feet Could Talk" coming in January 2009! From myrundoc.com

 

Appendix I: Every runner needs a little humor!

 

I hope after reading this book you feel like part of our running communities. It never ceases to amaze me how I can travel to another part of the country or the world and instantly make new friends with other runners. We share the same experiences, goals and crazy traits across age, sex, and abilities. Runners are a world community. So I have included this list that has traveled the internet and has been edited many times by many groups. Here is our version:

 

You Know You Are a Runner When…..

 

 

Feel free to add to the list and pass it on

Run Happy!!!

 

 

What’s in Your Training Bag?

 

The greatest thing about running is the low “getting started” cost, but here are a few things that are essential if you want to progress to distance running and competing or just want to avoid injuries.

 

Goal Setting

 

A very smart person once said that a goal not written down is just a mere wish.  I passionately believe this is true and have proven the power behind written goals in many aspects of my personal and professional life. In fact, this year I was planning on running the Sacramento Marathon, but fell in a pothole and broke my foot just a few months before the race! The fact that my foot was broken did not deter me from trying to reach my goal (Yes, I am that stubborn). I cross-trained; swimming and biking for hours, trying to keep my cardio fitness intact, just so I could indeed run this planned marathon. It was the week before the race when my husband interjected just a little common sense (please don’t tell him I said he was right) and he asked me why I was so hell bent on running Sacramento? There were so many other races on the schedule and I had only recovered from my stress fracture 3 weeks prior and done a long run of only 16 miles. I really did not have any good reasons to tell him except for the fact that I had written it down as a goal almost 6 months prior and I was determined to reach that goal. Common sense intervened (maybe I’m not that stubborn after all) and instead I did my first triathlon, all that biking and swimming was good tri training, then I picked a marathon 2 months later that I could run after adequate training. Goals are a powerful thing. Running goals can take on a life of their own and guide our training.

 

I challenge all of you to do a goal writing exercise to determine where running fits in your life. Think about lifetime goals; perhaps qualifying for Boston or just to finish an entire marathon; then break down your goals into smaller segments. Try to ascertain how you will reach that lifetime goal by achieving smaller goals; write down your 5 year goals, your 3 year goals, your 1 year goals, and finally your immediate  goals. It is hard to run a marathon without starting a running program, perhaps training for your first 5K can be your quarterly goal, then a 10 or 15K for 1 year goal, then build up to the marathon or a faster marathon from their. Again, looking at lifetime goals by themselves is often overwhelming; but broken down into smaller increments  become very doable!

 

1. Lifetime Goal:

2. 5 Year Goal:

3. 3 Year Goal:

4. 1 Year Goal:

5. Next Quarter’s Goal:

6. This Week’s Goal:

 

Look at your goals then start a reasonable plan to meet them! Not only are you more likely to meet your goals if you write them down, but you are also less likely to get injured if you follow a plan.

 

Run Happy! And reach For Your Goals!

What is patellofemoral pain?

 

Patellofemoral pain a.k.a. chondramalacia patella is the most common running-related knee problem. If you have this condition, you feel pain under and around your kneecap and often swelling of the area under the knee cap may occur. The pain can get worse when you are running or when you sit for a long time. Pain can also be associated with a “crunching” sensation when the knee is put through range of motion. You can have pain in only one knee, or you can have pain in both knees. It usually starts as a minor knee pain after running that progresses to pain when you get up in the morning, pain during or after exercise then pain all the time. Prompt intervention can decrease the period of disability form this injury.

 

The exact cause of patellofemoral pain is hard to define. It has been described as having something to do with the way your kneecap (called the "patella") moves on the groove of your thigh bone (called the "femur"). Contributing factors include overuse and overload of the knee joint (too much, too soon, too fast syndrome), biomechanical problems and muscular imbalance or weakness. Often it is associated with an extremely flexible foot type and over-pronation (rolling in of your foot). It is more common in women than men and this is due to the “Q angle” of woman’s hips putting more stress on the knee. Weakness of the vastus medialis or the inner thigh muscle has also been implicated as a cause.

 

What can I do to help my knee mend and relieve the pain ?

 

Take a break from running and any other activities that can cause a lot of pounding on your legs. Practice relative rest activities like swimming, biking, or the elliptical trainer which supports your body weight and puts less stress on your knees. As your knees feel better, you can slowly go back to running. It is important to do this slowly, and increase the amount of time you run by only about 10-20% a week. 

 

Physical therapy is the mainstay of treatment. It is imperative to work on the muscle imbalances that led to injury as well as stretching your hamstrings and strengthening your quadriceps. Strengthening is very important because your quad muscles control the movement of your kneecap and this is the most recognized cause of this syndrome.

 

Talk to your podiatrist about your running shoes and orthotics; it would help to bring your shoes in for the doctor to see, proper running shoes can really help knee pain. Orthotics are often needed to decrease excessive foot motion that causes stress on the knee. Even just a simple arch support insert can be helpful. Although custom orthotics are considerably more expensive than off-the-shelf devices, they last much longer and provide more support or correction. For hard core runners, the durability is important. Many people wear out a store purchased device in just a few months when a custom device can last for 2 to 3 years. In some cases, however, an over-the-counter device can be just as effective, particularly when combined with a stretching and exercise program.

 

Ice your knees for 10 to 20 minutes after activities, this can ease the pain and speed up healing. To keep your hands free, use an elastic wrap to hold the ice pack in place. An anti-inflammatory medicine like ibuprofen may also help, however this should not be used to “get through” your workouts.

 

Will I ever be able to run again?

 

Be patient! Keep exercising to get better. Patellofemoral pain can be hard to treat, and your knees won't get better overnight, some people are lucky and get better quickly but it might take six weeks or even longer for your knee to get better. Very few people need surgery to relieve their knee caps instability. Remember, you'll be less likely to get this pain again if you continue to strengthen and avoid “too much, too soon, too fast syndrome!”.

 

Even though the cause of patellofemoral pain syndrome remain uncertain, the good news is that most patients do well with conservative treatment, particularly if they maintain a disciplined approach.

 

Run Happy! And free of knee pain!

 

      

There are general rules for injury prevention that must be followed to avoid loss of training due to injury. Consistency and gradual incremental increases in overall athletic stressors are the key to any successful training program.

 

Causes of injury 

 

Probably the main cause in distance running is the volume of training, especially if there is insufficient rest between sessions. This is the classic “too much, too soon, too fast” syndrome. Research has indicated that there is no link between speed and injury in distance runners, unless of course an appropriate warm-up routine has not been followed. Don't overdo it! The amount of training you actually carry out plays a key role in determining your real injury risk. Studies have shown, for example, that your best direct injury predictor may be the amount of training you completed last month. For example  if May is a heavy training period, watch out in June! This relationship may seem strange at first, but it simply reflects the fact that vigorous training produces tired muscles which may not be able to stand up to further training stresses. Fatigued muscles also do a poor job of protecting their associated connective tissues, increasing the risk of damage to bones, cartilage, tendons, and ligaments.

 

Many injuries occur due to weak muscles or muscle imbalance. Assessment of muscle strength and balance and regular sports massage can be an integral part of a sports injury preventative strategy.

 

Resistance strength training can make muscles less susceptible to damage. This can be achieved in the gym or at home in your living room with a few dumbbells and a core ball.

 

It is important that any exercises are specific to your sport. In distance runners, adding hill training to your strength program can be a valuable tool for injury avoidance if carried out properly. Core stability exercises are an extremely useful tool in preventing muscle imbalance, especially in woman.

 

Top Tips For Injury Prevention

Remember that to achieve your running goals, you need months and years of successful running free of injury and illness. Pay attention to your body and all of these tips to ensure that you’ll continue to pound the pavement injury free for years to come!

 

Run Happy!

 

At Mile 24 Vinnie asked what my goal was for this race. I already knew that his goal was just to casually finish. After all, this was just a long training run for him. I told him that 4:32 was my PR, but I wanted to come in under 4:30. He looked at his watch and commented that I was going beat that goal by quite a bit. I said it was looking that way, but until I crossed the finish line I wouldn’t say that. Noting he was a 3:20 marathoner I told him that I didn’t want to slow him down and he was more than welcome to move on without me. He immediately said no. He wanted to watch me get a PR and encourage me along the way if I started to falter. I realize that running is often considered a solo sport, but sometimes you’ll find success with a team. Vinnie was my team. He was the reason I didn’t need my iPod to motivate me. As we continued along mile 24 I told him that I would like to reach mile 25 under four hours, another one of my smaller goals. He looked at his watch and then me. "That won’t be a problem." We reached mile 25 a few minutes under four hours, a bridge greeting us just on the horizon that made me inwardly groan because of its incline, but Vinnie and I again took it without slowing down.

 

Now we were less than a mile from crossing the finish line and my stomach was starting to feel funny. Maybe it is nerves or too much adrenaline or just my psyche, but whenever I get near the finish line of a marathon my stomach always begins to feel a little queasy, making my legs not feel as strong. This time, though, I had Vinnie pacing me. We ran by two ladies within .2 mile of each other telling us that the finish line was just around the corner. After the second one Vinnie joked, "That’s what the last lady said."

 

We crossed mile 26 and there was the finish line just ahead. Vinnie looked at me and said congratulations and offered his hand. I shook it hardily, a handshake that said "Thank you" better than I could then verbalize. In a moment that is etched in my mind we came upon a runner at mile 26.1, without a word we both pivoted, Vinnie to the right and me to the left, passed him and crossed the finish line. The time was 4:07:18. Later I would discover that my chip time was 4:06:12. I had beaten my PR by over 25 minutes.

Vinnie came over and again congratulated me. I then let him in on another reason I had trained so hard for this run, a reason I hadn’t told anyone directly. It was written on the back of my pacer tag. "I RUN IN MEMORY OF SUE KATE WEBB." She was my grandmother, one of the greatest women I have ever known and will ever know. She had passed away in March of Breast Cancer. When I crossed the finish line I had pointed Heaven-ward and thanked God and then thanked my grandmother. I began to choke up when I told Vinnie, but held it together. He wished me well and we shook hands one more time.

 

Suddenly I heard my name being called and there was George, waiting outside the finisher’s coral. He "high-fived" me and said, "I was expecting you around 4:30! What is this all about?" He made me feel like a "Rock Star", telling me how awesome my time was. I was humbled by this considering he had just run the marathon in a time of 2:52:33 (a 6:35/Mile pace). I thanked him for waiting around to see me finish and he smiled and said it was worth it.

Shortly thereafter Tom crossed at a mark of 4:11:03, a Boston Qualifier (again) at 66 years of age. I congratulated him. I waited around a few more minutes for Gordy to lead the rest of 4:15 crew across the finish line which he readily did at 4:13:59. I walked over and thanked him for helping me to achieve my goal. He is a great guy and the best pacer I’ve ever had the privilege to meet.

 

I spent a while longer meandering around the finish line, wanting to verify that my time was legit and not my imagination. I took the shuttle back to my hotel where my brother, Owen Kelly, and Trisha had already texted me to ask how I had done. I made calls to my wife and kids, mom, dad, friends, coaches, and runners to tell them how I did. I was ecstatic. Carolyn Bolsinger called me and simply asked, "How did you do?" She had jokingly (or maybe not) told me that if I didn’t break the 4:30 barrier she wouldn’t talk to me until next year. I told her that I didn’t break the 4:30 barrier; I broke the 4:15 barrier. She was very happy for me. I guess we’ll still be talking for the remainder of the year.

 

That night I had a pizza at a local establishment known as "Cranky Pat’s", but I was anything but "cranky". I was so happy, so thrilled. I still feel that way. At times like this I feel sad for those who have never experienced the thrill of finishing a marathon, that feeling of accomplishment. This is also when I remember why I run, why I enjoy it after all these years. Yes, there are times when I’d rather not train, when I’d rather not wake up so early to get in my run. But marathoning is not meant to be easy, and that is what makes it fun.

 

I think that's a great story! Run Happy!

I fully believe that the week prior to a marathon, those seven days while you wait and pray that you don’t fall victim to some ridiculous injury or random virus, can be more taxing and trying than training for a marathon (or even the marathon itself). It is pretty well known amongst the friends and families of marathoners that this is the week when we become rather "edgy". Moody might be a better term. Aloof, still another. As I left Luke’s Locker the previous Saturday to begin my "taper week" for the Community First Fox Cities Marathon, Suzanne St.Clair, after wishing me "Good Luck", said, "You’ll be fun to live with this week". I just smiled. Truth be told I’d become edgy around a week prior.

I had trained harder for this marathon than I had for any other. Taking a page from the book of Julie Brauer I had followed the Luke’s Locker schedule almost verbatim. I promised myself that I was going to break the 4:30 marathon barrier, but I was also running for a much more personal reason. One that I had kept to myself. One that I would write on the back of my pacer tag.

 

Saturday morning rolled around and I boarded a plane to Chicago O’Hare. From there I flew to Green Bay, Wisconsin. The drive from Green Bay to the Fox Cities area was around 30-minutes, enough time for me to get acquainted with Wisconsin and get nervous thinking about the race. The packet pick-up was very efficient and the people running the Expo were very nice. That is one of the reasons I so enjoy "smaller" marathons: the people are so sincere and personable. That afternoon I met with the leader of the Pace Group with which I would be running. His name was Gordy McDaniel. He’d paced every Green Bay Marathon, lived in the Fox Cities area and had paced the Fox Cities Marathon several times, and was an Ironman Triathelete. I felt I was in really good company.

 

After picking up some "Olive Garden" pasta (and some chocolate chip cookies from a local grocery store called "Woodman’s") I proceeded back to my hotel, the Holiday Inn in downtown Neenah, just a half-mile from the finish line. All week I had been receiving calls and emails from my Luke’s Team and Luke’s coaches wishing me well. Now I was receiving the same from family and co-workers. My wife had hidden a card in my duffel bag that I didn’t find until late afternoon so I set it on my desk, encouragement from her and my kids to further inspire me. Then the phone rang and it was no other than Julie Brauer, the woman whose training regiment I had followed for the duration of the season. She was calling to make sure I was "ready" and that all the "last minute" questions that sometimes plague us runners had been chased away. We talked around twenty minutes and I felt better. Then the phone rang again and it was Trisha Cavender (with Stacy Geigenmiller in the background) calling to wish me well. We had a very short, but funny, conversation and I hung up feeling that I had all the support in the world behind me. The last call of the night was to my wife. She wished me luck and then I put the phone away for the evening.

 

I think that is loneliest part of being a runner, the time between when you go to bed and when you start the race. That is when you try to sleep and wrestle with any and all insecurities that still might be plaguing you. You feel cut off from everyone because, after all, only you can run that race. As I lay in bed I recounted, out-loud, as I had done for several nights now, my race strategy. Start out with the 4:15 Pace Group. First Gel between miles 7 and 8. At Mile 14 pick up the pace if you feel okay. Second Gel between miles 14 and 15. Put your iPod on at mile 18 and pick up the pace. Third and final Gel between miles 20 and 21. If you start to feel sick, ignore it. You can be sick after you cross the finish line. Don’t leave anything on "the table". Somewhere around 10:30 I fell asleep.

 

However, nervousness does not lend itself to a good night’s sleep so I proceeded to wake up almost every hour, making sure I hadn’t overslept (despite the fact that I had set the alarm for 5:15 AM and had arranged for a wake-up call at 5:30 AM). Around 3:30 AM I woke up to find that the alarm clock had come unplugged. I plugged it back in, reset the time, reset the alarm, and then arranged for a second wake-up call (that is one alarm and two wake up calls). I woke up on my own at 5:00 AM and turned the alarm off and cancelled the wake-up calls. I prayed, showered, dressed, reviewed my plan and left for the shuttle. Leaving the hotel I was greeted by a crisp 54-degree Wisconsin morning.

 

The shuttle ride to the starting point was around 15-minutes long. Upon arrival I proceeded to the "Bag and Tag" where I had arranged to meet with George Bene, our very own Bobbie Mulholland’s brother. He is an elite runner who happened to be up in Green Bay on business and decided he’d go ahead and run the Fox Cities Marathon. I had a vague idea of what he looked like as I’d seen him in a picture with Bobbie from the Disney Half-Marathon (one of the best marathon pictures I’d ever seen by the way). Aside from that all I knew is that he was full of energy. He arrived on the scene as advertised, very outgoing and friendly. It was almost as if we’d known each other our whole lives. He asked me what my goal was today and I told him that I’d told everyone at Luke’s it was sub-4:30, but my primary goal was 4:15 or better. George’s goal? He said he’d just see how he felt. He wished me the best of luck and then I proceeded off to the restroom before finding the 4:15 pacing group. I remember how three days before I had been talking with Brent Wolfe and telling him how I wished I was at the starting line. He had said I would be there before I knew it. Well, I was there. Brent had been right.

 

The race began with The Call’s "Let the Day Begin" ringing through the Appleton, Wisconsin area. The sky was mostly overcast and the temperatures had not seemingly changed, a slight breeze lending a chill to the air on occasion. Everyone seemed to being doing well at the start with jokes of "the first .2 miles are always the toughest" and similar comments being heard. From the onset I was impressed with the crowd support. The Fox Cities area is made up of several small cities such as Appleton, Menasha, Neenah (which is pronounced Nee-nuh, but being a Texan I kept pronouncing it Nee-Nah like Hee-Haw) and Kimberly. Everywhere you went people were out there to greet you, sometimes in droves sometimes just a family or two, but they were there. Most runners had their names imprinted on their bibs so if the crowds could see the name they would call it out as you ran by them. Cheerleaders from the area schools were out in force, doing cheers for you as you went by, creating "tunnels" to run through, or doing the wave for individual runners. It was so encouraging that you couldn’t help but unconsciously speed up as you ran past. It was an exhilarating atmosphere from beginning to end. However, I think the first point where I felt that the race would be different was around mile 3 when another runner named Chris and I stopped for a restroom break. There was a line so after (patiently) navigating that, we had to speed up for almost a mile to catch our crew, averaging a sub-eight minute mile for the duration and I didn’t feel tired. I felt ecstatic.

 

Gordy was an excellent pacer. He’d run the Fox Cities area for several years and knew every curve, divot and pot hole and directed us accordingly. Another gentleman in our crew was Tom Jensen, a 66-year old runner who was a veteran of 50 or so marathons. I also met Vincent Uzzardo, or "Vinnie" as he introduced himself, a runner from Chicago who was running his first of three marathons in nine weeks. He had run a PR of 3:20, but was using this race as his final long distance run for Chicago. His reasoning? "What’s 6.2 more miles?" You have to love the attitude of marathoners!

We soon came across a girl limping along the course and my "Luke’s Coach" instinct took over. She had a 4:30 pace sign on her back, but it was obvious she had taken off on her own and (maybe) gone slightly faster than she should have. I asked her if she was okay and it turned out her knees were really bothering her. I had some ibuprofen so I offered it to her which she gratefully accepted. Again, I sprinted back to catch up with the group and still felt great. Chris joking said that I should now be referred to as the "Road Doc".

 

As we moved along Gordy, Tom, Vinnie and I were heading the 4:15 crew with the others behind us. At mile 9 we reached Riverside Park and it was Gordy’s turn for a quick restroom break and I was (somehow) "elected" to be the pacer until Gordy’s return. For a minute I was back at Luke’s and it was Saturday morning. Margaret McKinnon and I were leading the Yellow Crew out on a long run. Gordy quickly caught back up and I was released from "point". The weather was still cooperating and the miles felt great.

 

We reached our first hill at Mile 11 and Vinnie and I trudged up it. Gordy caught up with us and told us that we were going too fast and needed to slow down just a little. I’d never been told I was too fast with any pace group; that was another sign that maybe this race would be different from the others. But we still had 15 more miles to traverse and things could change quickly.

 

We crossed the halfway point and I told Gordy I was thinking, per my plan, about pulling away at Mile 14. He said it was my call, but he suggested that I wait until mile 20 and then take off. I decided that it might be wise to listen to a course veteran so I held off and continued with the group. Besides, I really enjoyed the company. The clouds were starting to clear away so I donned my University of Texas bandana (i.e. "do-rag") and a cheerleader encouraging the runners yelled out, "Go, bandana guy!". My second nickname of the day.

 

We reached Mile 18 at just under 3-hours, a small goal that I had established for this race. Gordy said that Vinnie, Tom and I should plan on speeding up at mile 20. We said okay, but didn’t want to just leave Gordy behind, especially since he had so expertly navigated the course for us. It seems though he had a subtle way to make sure we complied. As we approached Mile 20 he told us he was dropping back to check on the rest of our crew that was starting to dwindle. Telling us to "maintain our pace" and that he’d "be back later", he dropped back and we proceeded onward. It wasn’t until mile 22 that Vinnie noted Gordy hadn’t returned. "I think that was his way of getting us to speed up", Vinnie offered. From miles 20-23 we did sub nine minute paces and sometimes, sub-eight. Around mile 23 Tom said he was going to slow it down a little. He was trying to qualify for Boston, 4:15 at his age, and he didn’t want to do anything that might cause him to falter. So now it was Vinnie and I.

 

To be continued......

The motion of running, repeated over many years, strengthens and shortens several posterior muscles. The most affected are the calves, the hamstrings and the lower back muscles. These muscles play a primary role in lifting the feet and moving the runner forward. Exercise physiologists blame shortened muscles for a reduced range of motion, decreased athletic performance and increased risk of injury. To add insult to injury, the aging process contributes to further loss of joint and muscle flexibility.

 

The majority of runners and coaches believe stretching improves performance and reduces the risk of injury. In the meantime, experts disagree on the benefits and dangers of stretching. While many experts credit stretching with numerous benefits, improper stretching remains the second leading cause of running injuries! So, if we believe in stretching; what is the most effective method?

 

First and Foremost; the warm up and cool down should never be optional in your running routine. Cold muscles are at the highest risk for injury; by warming up and increasing the temperature of your muscles they will be more flexible and have an increased speed of motion. Warming up can loosen your muscles and soft tissue as much as 20 percent. The cool down allows blood to continue flowing through your muscles, working its way more slowly from a high level of exertion to its normal resting condition. Build stretching into your regular schedule, both before and after your daily run; after warm up and as part of your cool down. Take the time, it’s worth it!

 

The Do’s and Don’ts of stretching:

 

Do

 

 

Don’t

 

Any kind of sports participation can increase the incidence of osteoarthritis due to increased twisting forces, high impact, muscle weakness or over-development and joint instability which causes abnormal peak pressures and greater stress in certain areas of cartilage which can lead to osteoarthritis. Nevertheless, for normal joints , there is no scientific evidence that simply the action of running, even over a long period of time, causes permanent joint damage or even a predisposition for osteoarthritis.

 

What is the risk of osteoarthritis in runners? Many studies of long-term runners show no increased incidence of osteoarthritis in these competitive runners. Some studies did show more evidence of osteophytes, but no correlation with joint pain or instability. Confusing the issue for many runners are the numerous incidents of misdiagnosis of repetitive stress injuries like patella-femoral syndrome as arthritis. This is reversible and caused by abnormal tracking of the kneecap, which is treated with physical therapy and orthotics.

 

Joints are in fact strengthened by activity and damaged by inactivity. Studies have shown that the articular cartilage actually thins and becomes more fragile with inactivity, therefore increasing the risk of arthritis. Joints adapt to the stress of exercise and become stronger and more able to endure the long term stress of running. Remember the doctor saying to increase slowly? This is why. Ligaments and muscles, which support the joints, are strengthened and reinforced by the stresses of the running activity, improving joint mechanics, if the joints are properly aligned.

 

Here is the truth about foot biomechanics. Proper biomechanics during the strengthening process is essential for joint health. Improper biomechanics can increase the stress on the joints in an abnormal fashion and actually increase the incidence of osteoarthritis and hasten joint damage.

 

Bottom line? Running does not increase the incidence of osteoarthritis unless the lower extremity biomechanics are faulty. In fact, almost 75% of Americans over the age of 65 experience some symptoms of osteoarthritis. This is not increased in runners. In fact, running may actually help with the symptoms of osteoarthritis.

 

The benefits associated with long distance running profoundly overshadow the risk of osteoarthritis. In runners, orthotic devices to correct their biomechanics early in their training may actually decrease the stress associated with increased osteoarthritis. If you have joint symptoms, see a sports medicine podiatrist today and have your gait realigned. Your joints will thank you. Remember, your feet are meant to carry you for a lifetime. Don’t let the fear of osteoarthritis rob you of the joy of a lifetime of distance running!

Race Website: http://www.texasmarathon.com for results

 

 

You have got to check out this story! A 101 year old man decides he wants to run a marathon. He decides to start with a half-marathon which takes him 5 hours because he stops for a beer.

 

What an inspiration (just kidding), but hey...the guy is still running at 101 years old! Maybe he knows something we don't. PS. He smokes too....check it out...It's at least good for a chuckle!

 
http://abcnews.go.com/International/story?id=4385601&page=1

 

 

What a terrific Saturday morning!

 

I met with the Team in Training group in Grapevine at 7 am and had a great discussion about shoes, socks, and sun screen! They are on their fourth week, so many are still running in tennis shoes with cotton socks! I reminded the group that running shoes only last 400-500 miles (or six months, whichever comes first!) and that if they are training for anything longer than a 10K, they should have two pairs that they alternate. We also discussed the need for moisture wicking socks and sunscreen even in the morning in Texas….don’t want to be the health nut that dies from a melanoma at age 35! I directed all of them to the “Top 10 Stupid List” on the website and wished them all well in their running plans as well as their fundraising. It’s great to spend time with new marathoners and I only hope a few listened so they won’t repeat the mistakes of the past. Some things are only learned in the school of blood, sweat and tears!

 

I then ran 6 miles with my peeps (who decided to run way to fast this morning) around Grapevine Lake. It was inspiring to see all the Lake Grapevine Runners and Walkers out cleaning up the trails. If I didn’t have such a busy day planned, I would have been right there with them. It’s amazing how much trash accumulates on the trails!

 

At 9am, it was off to Luke’s Locker in Colleyville to meet with their newby runner’s group. They had lots of questions about biomechanics and how your feet can cause your hips and knees to hurt. We discussed OTC inserts versus custom orthotics and had a lot of great questions. The morning concluded with a three hour foot screening and shoe clinic inside Luke’s. I think I saw about 30 people and definitely helped quite a few with their shoe choices.

 

It always amazes me when young girls and boys just want to try on Nike shoes…what an advertising machine! I personally wear Brooks and think that there are so many shoe choices that you shouldn’t limit yourself to one brand….see the Shoe List for details on shoe choices and foot types….that’s a discussion for another day.

 

Run Happy!