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The Road to Ironman Mont-Tremblant Goes Through New Orleans

Posted by: Dr. Marybeth Crane Posted Date: 04/24/2012

The road to Ironman Mont-Tremblant went through New Orleans this weekend. As many of you know, that follow this blog, Janet decided to go to Galveston and I chose New Orleans for our early season half Ironman. I chose New Orleans because last year in Galveston, I had a really hard time staying upright while biking into a 30 mph head wind. I thought New Orleans would have better weather! God has a sense of humor!

 

New Orleans Ironman 70.3 was in a word - windy! Crazy, insane windy!! It was also only 67.1! The wind caused the race director, Bill Burke, to have to cancel the swim for the second year in a row. I actually felt bad for the guy since so many people were so upset, but when we got down to the water on Sunday morning, it was obvious that drowning was a risk given the 5 foot and higher waves!

 

We actually did a run-bike-run triathlon, which was much better than what they did at the Poconos 70.3 last year. At that race, after cancelling the swim, they attempted a time trial start of the bikes starting participants 3 seconds apart. This sounds good in theory, but the roads were very wet and there were crashes all over the place! In New Orleans, they were creative and wanted to keep the relay teams intact, so they made us run 2 miles to start then ride 52 miles (shortened due to road closures) and then run 13.1 miles to finish.

 

I met my friend Linda, from Arizona, in New Orleans and she was pretty anxious to do her first 70.3. She is attempting Ironman Arizona in November, so she needed a warm up race as well. I made a pact that I would never race without Janet again! Every time I go to a race without Janet, the weather sucks!

 

The best part of my race was the beginning of the 2 mile run. They started us in pair about 2 seconds apart and I was in the 5th wave (40 and older women). This wave included all the “old” ladies. I started near the back of the wave and was just completing the first mile when I came upon a woman with an “81” on her calf.  I glanced at her and then realized it was the “Iron Nun”! Sister Madonna Buder is a Catholic nun who has completed over 400 triathlons and is an inspiration to all at The Ironman World Championships every year! (If you haven't read her book, it will inspire you!) I said, “Good Morning Sister!”, just to make sure it was her and then had a short conversation running along with her.  Such a positive person and it was a thrill to meet her. She is still running strong and should be an inspiration to all of us to keep moving! I told her I only hope I am still competing in 40 years!

 

After the short run to warm up, we jumped on our bikes to brave the wind. Crazy, insane and, at times, dangerous wind! I was trying to maintain 19-20 mph but no such luck. I worked very hard to keep 17.8 mph average into a 25mph+ head wind! It seemed like the wind was in your face no matter what direction you were going in! There were only 4 hills on the entire course, (Louisiana hills also known as overpasses ha ha) and at the top of one of them, a gust practically threw me off my bike. The bike actually felt like it went airborne for a second! I finished the bike in one piece and was happy to start running.

 

Then someone turned up the heat! The run was a double loop with awesome crowd support and plenty of aid stations! Thankfully lots of water and wet sponges since it was so hot! Very flat with a few small hills but overall a nice rolling course.  The casts of characters were out, just like most races. We had 3 Spidermans, guys in jester suits, and my favorite….guys running in their wetsuits with goggles and all, probably protesting the no swim!

 

I was happy to wave to Sister Madonna on the run and shamefully happy she was on the other side of the road about 5 miles behind me (who wants to get beaten by an 81 year old!!). I finished strong and with a smile. Legs of jelly from pushing hard on the bike made for a slow run, but overall a good day! No pesky plantar fasciitis showed up, so I think I have cured myself with EPAT finally! I have some work to do before I am ready to tackle the mountains in Quebec, but I earned my post-race beer today! Linda finished not so far behind me with a big smile!

 

Next up….Buffalo Springs 70.3….

11 Tips For Preventing Running Injuries

Posted by: Dr. Marybeth Crane Posted Date: 01/31/2012
  
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?
 
  1. Know Your Limits. This is a hard one. Some people cannot tolerate long distance running year after year. I’ve seen this in my office all too often. Some people try again and again to get to the marathon distance, but just keep getting hurt. Everyone has a threshold. Learn yours. Follow the rules and avoid too much, too soon, too fast syndrome! If you get to 15 miles and get hurt every time, maybe your body is trying to tell you something. Work on your 5K time instead of trying to attempt a marathon yet again.
  2. Listen to Your Body. I give this advice every time I talk to a group of runners. Many do not listen. If you get out of bed feeling like you got run over by a train, perhaps a little rest in is order; not a long run! Most injuries do not spontaneously occur; they start with little aches and pains. Ironman triathletes are the worse! Do not “train through the pain”. That’s just plain stupid (and yes, I’ve tried to do it too!)
  3. Consider Shortening Your Stride. I have to admit, I hadn’t really thought of this advice until I read Amby Burfoot’s article. It makes sense. Overstriding increases stress, so shortening your stride will soften the landing when you run. I think this is also why the recent “barefoot” or “minimalist” craze has taken a string hold. It’s hard to overstride in minimalist shoes!
  4. Strength Training Can Help. One thing that has been shown to decrease running injuries is strength training. This is especially true in women. Core strength training twice a week can really help you avoid the doctors office and prolonged time on the couch.
  5. Ice is your Friend! See my video on first aid for tendonitis, rest and repeat every time you have an ache or pain. A little rest, ice, compression and elevation goes a long way!
  6. The Surface Makes a Difference. Here’s great tip: Don’t always run on the right side of the road facing traffic! It allows you to see the cars coming at you, but here in Texas, it means you always run on a slight slant that causes a functional leg length discrepancy. (And don’t try to make up for it by putting a lift in your left shoe- that’s stupid too!) Also try to vary your surfaces, one day on the road, one day on the track, perhaps a treadmill day or a day on the golf course. Trails are also a good thing to put in the mix. The same thing, at the same speed, on the same surface all the time can quickly add up to an injury.
  7. Too Hard, Too Much is a Recipe for Disaster! When I was younger (about a thousand years ago) I used to “race into shape”. Not a great plan unless you are a gifted teenager! Too much speed work or too much racing beats the heck out of your body. Always follow a hard day with an easy one, or two if you are over 35!
  8. Stretch. I’m not going to debate the value of stretching. I’ve done that in other articles. I know there are some people who think stretching is bad. I’m not one of them! All I know is that runners that are tight get hurt a heck of a lot more than those that are flexible.
  9. Cross training is not a Bad Word! When I turned 40 (yes, about 5 seconds ago), I took up triathlon. Why? Because I knew as a thin female runner, getting older, I needed to cross train to keep up my aerobic fitness and decrease the stress on my body. This lead to a love of swimming and eventually an Ironman. Who says you can’t evolve as an endurance junkie? Seriously though, swimming, biking, the elliptical, circuit weight training….These all help to maintain your fitness and change up the stressors n your body.
  10. Shoes Make a Difference! Find the shoe that works for you. Your podiatrist or a good experienced shoe sales person can help you, but bottom line….get a shoe that fits and is the correct type for your foot type. The reason there are a million shoes are on the market, and growing, is that there is not one perfect running shoe (although this doesn’t stop people from asking for it!)
  11. Orthotics Can Help! I realize that many people are shying away from corrective orthotic and trying to embrace the minimalist wave. Not everyone can run barefoot and not everyone needs orthotics. If you continue to have similar injuries over and over, what’s the definition of insanity? Doing the same thing over and over, yet expecting a different outcome! If you are one of those biomechanically perfect gazelles, more power to you! But most of us could use a little help in that department. In many cases, you can correct some biomechanical problems with strengthening and stretching, but let’s face it….most of us are too lazy to do the work to correct our biomechanical imbalances. Orthotics can help. Thin of the as eye glasses for your feet. The majority of us could benefit from a tire realignment!
 
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.

What Should I Eat and Drink After Exercise?

Posted by: Dr. Marybeth Crane Posted Date: 07/17/2011

Drinking and Eating After a Race

 

Ok, I have been joking all week with my triathlon peeps that beer is the best recovery drink! But seriously, I think there are two questions that need to be answered:

  1. How much do I really need to drink after exercise, especially in this ridiculous heat?
  2. What is the best thing to drink and/or eat?

So, here are some simple answers to what is actually two very complex questions! Remember that individuals all differ and our sweat ratios also differ. A great way to determine how much fluid you need after a race or long run or ride is to weigh yourself before and after exercise and replace fluid losses by drinking 20-24 fl oz water for every 1 lb lost.

 

What should you drink and/or eat? Yes, I like beer after a race but science shows that you should consume a 4:1 car/protein ratio. (I hear all those fans of chocolate milk cheering).

 

Research has shown that eating 0.3-0.6 grams of carbohydrate for each pound of body weight within two hours of endurance exercise is essential to building adequate glycogen stores for continued training. Waiting longer than two hours to eat results in 50 percent less glycogen stored in the muscle. The reason for this is that carbohydrate consumption stimulates insulin production, which aids the production of muscle glycogen. However, the effect of carbohydrate on glycogen storage reaches a plateau.

 

Research also shows that combining protein with carbohydrate within thirty minutes of exercise nearly doubles the insulin response, which results in more stored glycogen. The optimal carbohydrate to protein ratio for this effect is 4:1 (four grams of carbohydrate for every one gram of protein). Eating more protein than that, however, has a negative impact because it slows rehydration and glycogen replenishment.

 

One study found that athletes who refueled with carbohydrate and protein had 100 percent greater muscle glycogen stores than those who only ate carbohydrate. Insulin was also highest in those who consumed a carbohydrate and protein drink.

 

Consuming protein has other important uses after exercise. Protein provides the amino acids necessary to rebuild muscle tissue that is damaged during intense, prolonged exercise. It can also increase the absorption of water from the intestines and improve muscle hydration. The amino acids in protein can also stimulate the immune system, making you more resistant to colds and other infections.

 

Good replenishment food?

  • 1 medium banana and glass of low-fat milk.
  • A bowl of granola with 1 C low-fat milk.
  • Low-fat yogurt with 1/2 C of fresh berries.
  • Almond butter on whole wheat toast.
  • A bowl of whole grain cereal with low-fat milk.  

Bottom Line

 

If you are looking for the best way to refuel your body after long, strenuous endurance exercise, a 4:1 combo of carbohydrate and protein seems to be your best choice. While solid foods can work just as well as a sports drink, a drink may be easier to digest make it easier to get the right ratio and meet the 30 minute window. Personally, I’m sticking to beer and will add a peanut butter and jelly sandwich!

How Do You Know When You Need Rest?

Posted by: Dr. Marybeth Crane Posted Date: 06/29/2011
How Do You Know When You Need Rest?
 
Good question. Personally, I err on the side of caution. If I’m tired when I wake up in the morning or I feel like I was run over by a truck…..well, that’s a good indication to take a day off. Many runners and triathletes burn the candle from both ends.  The old saying is that it is better to be 15% undertrained than 1% over trained. This is my motto that allows me to take a day off here and there when the fatigue of the mega miles is kicking in. I find that I race way faster when not fatigued! Really!! (Sarcasm)
 
So, do you get adequate rest? How can you gauge your fatigue if you are a sadomasochist training for an Ironman or marathon? The June issue of Runner’s World has a great article on gauging rest. I had to laugh, because you can actually pay someone to tell you to take a day off! Simple solution: Pay me!! Just kidding, let’s look a little closer at guidelines for rest days.
 
On a serious note, there is a service called Restwise, which looks at simple biological markers input by the athlete first thing each morning, calculates a daily recovery score from 1 to 100, then trends it over time. (Rest-wise subscriptions start at $119 for six months; go to restwise.com.) You certainly can pay them, or you can look at 10 biological markers and rate yourself.

1. BODY MASS: You lost weight from yesterday
A two percent drop in weight from one day to the next indicates a body-fluid fluctuation. Most likely, you didn't hydrate enough during or after your last workout. Dehydration negatively impacts both physical and mental performance, and could compromise the quality of your next workout.

2. RESTING HEART RATE: Your resting heart rate is elevated
Take your pulse each morning before you get out of bed to find what's normal for you. An elevated resting heart rate is one sign of stress. It means your nervous system prepared for fight or flight by releasing hormones that sped up your heart to move more oxygen to the muscles and brain. Your body won't know the difference between physical and psychological stress. A hard run and a hard day at work both require extra recovery.

3. SLEEP: You didn't sleep well or enough
A pattern of consistently good sleep will give you a boost of growth hormones, which are great for rebuilding muscle fibers. Several nights in a row of bad sleep will decrease reaction time along with immune, motor, and cognitive functions—not a good combination for a workout.

4. HYDRATION: Your pee is dark yellow
This can be an indicator of dehydration, barring the consumption of vitamins, supplements, or certain foods the evening before. The darker the color, the more you're struggling to retain fluids, because there's not enough to go around. You need H2O to operate (and recover).
 
5. ENERGY LEVEL: You're run down
If your energy level is low, there's something amiss. The key is honesty. Athletes can block out signs of fatigue to push through it, thinking it will make them stronger. It won't always work that way.

6. MOOD STATE: You're cranky
When your body is overwhelmed by training (or other stressors), it produces hormones like cortisol that can cause irritability or anxiety. Stress also halts chemicals like dopamine, a neurotransmitter in the brain that has a big bummer effect on mood when depleted. Crankiness probably means not enough recovery.

7. WELLNESS: You're sick
Any illness, or even a woman's menstrual cycle, will increase your need for energy to refuel your immune system, which is having to work overtime. This means fewer resources available for recovering from training.

8. PAIN: You're sore or nursing an injury
Whether you're sore from overworked muscles or an injury, your body needs more energy to put toward repair, lengthening total recovery time.

9. PERFORMANCE: Your workout went poorly
This is a subjective measure of workout quality, not quantity nor intensity. If you felt great on yesterday's run, you'd evaluate that as good. If you felt sluggish on that same run, you'd count it as poor. Trending workout quality—multiple poors in a row—is one of the easiest ways to identify the need for more recovery.

10. OXYGEN SATURATION: Your oxygen level has dipped
The amount of oxygen in the hemoglobin of the red blood cells can be measured by placing your fingertip in a portable pulse oximeter, a gadget available online for about $40. The higher the percentage, the better: Above 95 percent is the norm at sea level or for an athlete who is fully acclimated to a given altitude. This is a new area in recovery science, requiring more research, but there may be a link between low oxygen saturation and the need for more recovery.

Count Your Red Flags

The restwise algorithm assigns more weight to some markers (e.g., performance) than others (e.g., mood), along with other factors to generate a precise recovery score. But you can get a sense for your ballpark recovery quality by tallying the red flags (left) you average per day in a week.

0-1 GREEN LIGHT
You are clear to train hard.

2-4 CAUTION
You can go ahead with a hard workout if your training plan calls for it, but cut it short if it feels too hard. Better yet, take an easy day, or a day off.

5-6 WARNING
You're entering the danger zone, which could be intentional according to your periodization or peaking protocol. If not, back off.

7-10 DANGER
You require mandatory time off, ranging from a day to a week, depending on the severity of your fatigue and what you've seen over the previous few days and weeks. You may need to visit your doctor.

FEEL Better: Too much rest has its own problems: Your performance stalls. On your recovery days, do something active; go for a leisurely  bike ride or swim (I take my 11 year old out on her bike), walk, or do yoga.
Keep in mind that muscles need 48 hours to recover from a hard workout. Always follow a hard day with an easy one. Watch your red flags and rest accordingly. Your times will show improvement!
 

Race Recovery Secrets Revealed!

Posted by: Dr. Marybeth Crane Posted Date: 05/25/2010

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!

 

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