British marathoner Paula Radcliffe lately has been plagued by injuries. In fact, she had to pull out from this weekend's London marathon after breaking a toe. She since has had bunion surgery and is hoping the realigned foot mechanics will end her long stream of injuries. After running the marathon for the Beijing Olympics just four months after breaking a leg, she is focused on her 2012 goal of medaling in the London Olympics, her home city.
A bunion is an enlargement of the great toe joint. It, however, is not from a growth of bone, but rather a shifting of the first metatarsal bone due to unstable mechanics. The forces causes the great toe to shift towards the second to and the metatarsal bone to shift out of alignment. Bunion surgery, when necessary, realigns the relationship of the bones, but does not alter the underlying mechanics that caused the bunion in the first place. If left uncontrolled, the bunion can return over time and can even require a second surgery.
The best way to balance the lower extremity is with the use of a custom orthotic. An orthotic redistributes the mechanical pressures, permitting the feet to function as a more stable unit. This allows for more a more efficient gait in walking and running. It also helps to moderate the deforming forces that caused the bunion in the first place.
In 2012, Paula Radcliffe will be 38 years old. It is not unheard of for a woman of 38 to win Olympic gold in the maraton. Constantina Dita of Romania won the Beijing marathon this past summer at the same age. Lets just hope that Paula is able to rehabilitate and resume her training, injury free, while taking all the necessary precautions to allow her body to function at peak performance.
Wednesday, April 29, 2009
Thursday, April 23, 2009
Don't forget your stretches before you run!!!
As podiatrists, we treat all types of foot and ankle injuries, but we also want to PREVENT foot and ankle injuries...so we encourage our patients (and friends and family) to always remember to do their stretching before running and exercising.
We practice what we preach!!! Although we all have different styles of exercising and running, we all do our stretches first. Feel free to ask us questions about your stretches and techniques. We're here to help you!
Here are some simple stretches that you can try:
HEEL CORD STRETCHES #1 (Gastrocnemius Wall Stretch)
1. Lean against a wall with one knee locked and the other bent. You will feel a pull in your calf muscles.
2. Hold the stretch for 15 seconds & alternate the locking and bent knees.
3. Relax for 15 seconds & do 10 REPS.
4. Repeat this exercise 2-3 times a day.
HEEL CORD STRETCHES #2 (Soleus Wall Stretch)
1. Position is silimar to Gastrocnemius stretch but with both legs bent and the buttocks dropped. Make sure you are facing straight and not turned out.
2. Gently lean into the wall and keep your heels on the floor while bending both knees, putting a little more weight on the back leg.
3. Continue until you feel stretching in your lower calf.
4. Hold the stretch for 30 seconds.
5. Repeat 2-3 times on each side.
HEEL CORD STRETCHES #3 (Gastrocnemius Stair Stretch)
1. Stand with the ball of the foot on the edge of a stair and heels off of the step.
2. Rise as high as possible on the toes and then lower yourself slowly as far as you can without rolling the foot inward or outward until you feel a stretch in the calf.
3. Hold this position for 1-2 seconds.
4. Repeat 10-20 times.
PLANTAR FASCIAL STRETCHES
1. Raise toes toward you while bending your ankle as high as you can.
2. Hold this position for 15 seconds.
3. Alternate doing this with the opposite foot 10 times.
4. Perform this exercise 2- 3 times a day.
HAMSTRING STRETCHES
1. Lie with your back flat to the floor with your eyes focused upward.
2. Grasp the back of the thigh with both hands and, with the leg bent, pull the thigh until it is perpendicular to the floor.
3. Slowly straighten the knee.
4. Repeat the exercise with the other leg.
We practice what we preach!!! Although we all have different styles of exercising and running, we all do our stretches first. Feel free to ask us questions about your stretches and techniques. We're here to help you!
Here are some simple stretches that you can try:
HEEL CORD STRETCHES #1 (Gastrocnemius Wall Stretch)
1. Lean against a wall with one knee locked and the other bent. You will feel a pull in your calf muscles.
2. Hold the stretch for 15 seconds & alternate the locking and bent knees.
3. Relax for 15 seconds & do 10 REPS.
4. Repeat this exercise 2-3 times a day.
HEEL CORD STRETCHES #2 (Soleus Wall Stretch)
1. Position is silimar to Gastrocnemius stretch but with both legs bent and the buttocks dropped. Make sure you are facing straight and not turned out.
2. Gently lean into the wall and keep your heels on the floor while bending both knees, putting a little more weight on the back leg.
3. Continue until you feel stretching in your lower calf.
4. Hold the stretch for 30 seconds.
5. Repeat 2-3 times on each side.
HEEL CORD STRETCHES #3 (Gastrocnemius Stair Stretch)
1. Stand with the ball of the foot on the edge of a stair and heels off of the step.
2. Rise as high as possible on the toes and then lower yourself slowly as far as you can without rolling the foot inward or outward until you feel a stretch in the calf.
3. Hold this position for 1-2 seconds.
4. Repeat 10-20 times.
PLANTAR FASCIAL STRETCHES
1. Raise toes toward you while bending your ankle as high as you can.
2. Hold this position for 15 seconds.
3. Alternate doing this with the opposite foot 10 times.
4. Perform this exercise 2- 3 times a day.
HAMSTRING STRETCHES
1. Lie with your back flat to the floor with your eyes focused upward.
2. Grasp the back of the thigh with both hands and, with the leg bent, pull the thigh until it is perpendicular to the floor.
3. Slowly straighten the knee.
4. Repeat the exercise with the other leg.
Wednesday, April 22, 2009
Don't Let Shin Splints Get You Down!
As the northern cities clear the last snowfall, spring is on everyone’s mind. Warm weather and outdoor activities are around the corner. Though we are all eager to play catch or hit the running trails, we need to make sure we do not get injured in the process. Outdoor sports often mean uneven terrain. This can lead to a disaster if you do not take time to warm up and train for the demands of outdoor sports.
One of the most common complaints of spring athletes is shin splints. We have all had them and they are just strait up uncomfortable! Your leg muscles are over working and you may develop small tears or inflammation in the muscles or tendons. The injury is minor and can be relieved by rest and icing but the injury can be very painful and will interrupt your training schedule. Through the pain is caused by inflammation of the muscles and tendons in your lower leg, it may actually be the result of a foot problem!
Poor shock absorption can lead to increased stress on the muscles of your lower leg. Imagine when you are jumping and running how much force is being applied to your leg. We wear shoes to help absorb this shock and decrease the stress on our feet and legs. After time, your shoes will eventually lose its shock absorption quality. So if you are planning on wearing your 2 year old sneakers to the track today, you may need to stop at the local shoe store first.
Certain foot types are also poor shock absorbers. Our feet and legs are naturally constructed to absorb the stresses of walking, running and jumping, but not everyone’s foot is created equal. A high arched foot is a poor shock absorber and shoes with additional support should be worn if you have this foot type. You can also get the needed support by wearing custom made orthotics from your local podiatric physician.
Flat feet can also lead to painful shin splints. Flat feet are often caused by excessive pronation. This means that your foot and ankle roll inward at a greater degree than normal. Since your foot and leg function as a unit, when your foot over-pronates your leg will twist. This twisting puts stress on your leg muscles that will lead to inflammation and shin splits when exercising.
Don’t let these common foot problems and painful shin splints keep you off the field or track this season. Podiatric physicians are highly trained to accommodate your footgear and to provide custom support devices or orthotics to help manage your foot type. If you commonly have shin splints, your podiatric physician may also recommend physical therapy to strengthen your leg muscles and to prevent further injury. If you are currently suffering from shin splints remember to rest and ice your leg to allow your muscles and tendons to repair and recoup from the injury.
One of the most common complaints of spring athletes is shin splints. We have all had them and they are just strait up uncomfortable! Your leg muscles are over working and you may develop small tears or inflammation in the muscles or tendons. The injury is minor and can be relieved by rest and icing but the injury can be very painful and will interrupt your training schedule. Through the pain is caused by inflammation of the muscles and tendons in your lower leg, it may actually be the result of a foot problem!
Poor shock absorption can lead to increased stress on the muscles of your lower leg. Imagine when you are jumping and running how much force is being applied to your leg. We wear shoes to help absorb this shock and decrease the stress on our feet and legs. After time, your shoes will eventually lose its shock absorption quality. So if you are planning on wearing your 2 year old sneakers to the track today, you may need to stop at the local shoe store first.
Certain foot types are also poor shock absorbers. Our feet and legs are naturally constructed to absorb the stresses of walking, running and jumping, but not everyone’s foot is created equal. A high arched foot is a poor shock absorber and shoes with additional support should be worn if you have this foot type. You can also get the needed support by wearing custom made orthotics from your local podiatric physician.
Flat feet can also lead to painful shin splints. Flat feet are often caused by excessive pronation. This means that your foot and ankle roll inward at a greater degree than normal. Since your foot and leg function as a unit, when your foot over-pronates your leg will twist. This twisting puts stress on your leg muscles that will lead to inflammation and shin splits when exercising.
Don’t let these common foot problems and painful shin splints keep you off the field or track this season. Podiatric physicians are highly trained to accommodate your footgear and to provide custom support devices or orthotics to help manage your foot type. If you commonly have shin splints, your podiatric physician may also recommend physical therapy to strengthen your leg muscles and to prevent further injury. If you are currently suffering from shin splints remember to rest and ice your leg to allow your muscles and tendons to repair and recoup from the injury.
Tuesday, April 21, 2009
Are Your Feet Overstressed?
A stress fracture is a tiny crack in the bone caused by overuse. Most stress fractures occur on your metatarsal bones in your foot but they can occur in any part of the body. Stress fractures develop over a long period of time and are often initially unnoticed. Your bones naturally break down bone and rebuild bone on a continual basis. If too much force in repeatedly applied to the bone, then the breaking down of bone will exceeds the rebuilding of bone. The bone is insufficiently repairing itself. This is called bone fatigue. Over time the bone becomes weaker and eventually cracks. The fracture is very small and is often unapparent on x-rays.
Physical activity is always encouraged, but working out too hard too fast puts your body at risk for injury. When starting to work out or changing your workout routine, make sure you give your body time to adjust to the new stresses. It takes time for your muscles and bones gain the strength necessary to absorb the impact of running, jumping, and jarring. When your muscles fatigue, they no longer distribute the forces along the entire bone and the bone has to carry an increase of load. This will lead to fractures. Sometimes even changing the surface you run on can lead to injuries. If you are used to running on the grass or a softer surface, changing to cement or concrete surfaces will force your body to absorb more of the impact. You may not notice the bone fatigue initially but over time, you may develop a small crack in the bone or stress fracture.
Stress fracture pain is usually experienced with increased activity. Therefore, one may notice the pain to get worse the more they work out. The pain also occurs earlier in the workout as the fracture progresses. Initially the pain will subside with rest, but as the fracture increases in size the pain will become more constant. The pain may also be elicited by palpating the area over the fracture. Sometime a doctor may use a tuning fork to elicit the pain. The fork causes vibrations in your bone, and if a fracture is present it will cause pain. If no fracture is present, the tuning fork will not cause pain. Your podiatric physician will also take x-rays to rule out any other complications. The stress fracture will often be unapparent on a x-ray because the crack is so small. Therefore, the physician may need to order an MRI or bone scan to further assess the injury.
The best treatment for a stress fracture is rest. Chen Lu, a professional figure skater, missed the Olympics due to a stress fracture, Scott Neidemayer missed his Hockey All Star Game, and Yao Ming had to sit out a large portion of the season to nurse his stress fracture. Whether you are a professional athlete or have sport hobbies, you need to rest if you have a stress fracture. The only way to fully recover and prevent the injury is to slow down and allow your body to heal. Changing your workout to less impact sports and slowly increasing your body’s demands is highly recommended. Athletic shoes lose their shock absorptive properties and should be replaced at least every 6 months. NSAIDS can be taken to reduce the pain but should not be taken for long periods of time. If you are experience any foot pain that is continually getting worse, you should see a podiatric physician to assess the injury.
Physical activity is always encouraged, but working out too hard too fast puts your body at risk for injury. When starting to work out or changing your workout routine, make sure you give your body time to adjust to the new stresses. It takes time for your muscles and bones gain the strength necessary to absorb the impact of running, jumping, and jarring. When your muscles fatigue, they no longer distribute the forces along the entire bone and the bone has to carry an increase of load. This will lead to fractures. Sometimes even changing the surface you run on can lead to injuries. If you are used to running on the grass or a softer surface, changing to cement or concrete surfaces will force your body to absorb more of the impact. You may not notice the bone fatigue initially but over time, you may develop a small crack in the bone or stress fracture.
Stress fracture pain is usually experienced with increased activity. Therefore, one may notice the pain to get worse the more they work out. The pain also occurs earlier in the workout as the fracture progresses. Initially the pain will subside with rest, but as the fracture increases in size the pain will become more constant. The pain may also be elicited by palpating the area over the fracture. Sometime a doctor may use a tuning fork to elicit the pain. The fork causes vibrations in your bone, and if a fracture is present it will cause pain. If no fracture is present, the tuning fork will not cause pain. Your podiatric physician will also take x-rays to rule out any other complications. The stress fracture will often be unapparent on a x-ray because the crack is so small. Therefore, the physician may need to order an MRI or bone scan to further assess the injury.
The best treatment for a stress fracture is rest. Chen Lu, a professional figure skater, missed the Olympics due to a stress fracture, Scott Neidemayer missed his Hockey All Star Game, and Yao Ming had to sit out a large portion of the season to nurse his stress fracture. Whether you are a professional athlete or have sport hobbies, you need to rest if you have a stress fracture. The only way to fully recover and prevent the injury is to slow down and allow your body to heal. Changing your workout to less impact sports and slowly increasing your body’s demands is highly recommended. Athletic shoes lose their shock absorptive properties and should be replaced at least every 6 months. NSAIDS can be taken to reduce the pain but should not be taken for long periods of time. If you are experience any foot pain that is continually getting worse, you should see a podiatric physician to assess the injury.
Monday, April 20, 2009
My 4 Keys To Marathon Recovery
After my recent marathon, I had near complete resolution of my muscle pain and weakness after just 48 hours. Since many runners are seaking keys to quicker recovery, I felt it was benefitial to list my current recovery regimen.
1. Cool Down
As recommended in research, I walk for at least 10-15 minutes without sitting or stretching to ensure the muscles have time to cool down with a light stretch from regular motion. If the cool down is done effectively, it will alleviate some of the after marathon recovery.
2. Refuel
Since exercise related pain is due to lactic acid or protein (muscle) breakdown, refueling is a key.
In a study by the University of Illinois on rats in 1999, quicker recovery was found from refuelling quickly after exercise with Leucine (an amino acid) containing products. Leucine is found in protein products such as meats and dairy products, as well as in protein bars and some sports drinks. So how do I refuel after a race? After any run, and especially after this marathon, I drank a large glass of milk withing 30 minutes of completing the exercise. Fluids are also imperative as are some other carbohydrates to help further maintain blood glucose and reduce lightheadedness from low blood glucose. When I don't want to eat within 30 minutes after an exercise, I eat anyway, especially the large cup of milk and/or a yogurt to get the Leucine benefits. (For addition information on this research, visit my original post.)
3. Fluids, Fluids, Fluids...
Part of refueling is getting the necessary fluids to replenish the body. I have a tendancy to start sweating when I think about exercise. I therefore must replace a large amount of fluid after any form of exercise. This replacement is both for refueling and for providing the reservoir for flushing out waste products from the body and especially the muscles. It requires more fluid to carry all these waste products out of the muscles into the kidneys for excretion. Try to drink 6-8 ounces of water every 2-3 hours during the initial recovery period.
4. Hot or Cold?
Although everything I have read recommends ice baths or ice massage after a strenuous exercise, and often they recommend avoiding the heat after exercise. I will say now that I aggressively treat my muscle soreness after an exercise (even after the marathon) with soaking in a warm bath or hot tub. Let me explain the science behind my actions. (Note that for me this works really well and decreases my muscle soreness significantly within the first 24 hours and reduces it nearly completely by 48 hours.)
The body reacts to hot and cold by dilation or contracture of blood vessels. Cold (ice) will reduce(vessel contracture) the blood flow into the area or cause the body to pull the blood from the area. Heat will increase (vessel dilation) the blood flow to the area and allow increased blood flow through the area. Since muscle pain is often due to lactic acid in the muscles or other waste products of "anaerobic" muscle metabolism (contracture), heat will allow blood flow through the muscles that can remove these waste products. Heat is only recommended by me during the first 12-24 hours. Ice can be utilized at anytime, but is rarely necessary if I undergo my usual exercise recovery regimen.
These four steps or keys find me nearly painfree 48 hours following a strenuous 26.2 miles. I plan to continue to train and run marathons and will evaluate the benefits of this regimen after any strenuous exercise. The proof will be in my recovery.
For additional information on my running: http://www.utahrundoc.blogspot.com/
1. Cool Down
As recommended in research, I walk for at least 10-15 minutes without sitting or stretching to ensure the muscles have time to cool down with a light stretch from regular motion. If the cool down is done effectively, it will alleviate some of the after marathon recovery.
2. Refuel
Since exercise related pain is due to lactic acid or protein (muscle) breakdown, refueling is a key.
In a study by the University of Illinois on rats in 1999, quicker recovery was found from refuelling quickly after exercise with Leucine (an amino acid) containing products. Leucine is found in protein products such as meats and dairy products, as well as in protein bars and some sports drinks. So how do I refuel after a race? After any run, and especially after this marathon, I drank a large glass of milk withing 30 minutes of completing the exercise. Fluids are also imperative as are some other carbohydrates to help further maintain blood glucose and reduce lightheadedness from low blood glucose. When I don't want to eat within 30 minutes after an exercise, I eat anyway, especially the large cup of milk and/or a yogurt to get the Leucine benefits. (For addition information on this research, visit my original post.)
3. Fluids, Fluids, Fluids...
Part of refueling is getting the necessary fluids to replenish the body. I have a tendancy to start sweating when I think about exercise. I therefore must replace a large amount of fluid after any form of exercise. This replacement is both for refueling and for providing the reservoir for flushing out waste products from the body and especially the muscles. It requires more fluid to carry all these waste products out of the muscles into the kidneys for excretion. Try to drink 6-8 ounces of water every 2-3 hours during the initial recovery period.
4. Hot or Cold?
Although everything I have read recommends ice baths or ice massage after a strenuous exercise, and often they recommend avoiding the heat after exercise. I will say now that I aggressively treat my muscle soreness after an exercise (even after the marathon) with soaking in a warm bath or hot tub. Let me explain the science behind my actions. (Note that for me this works really well and decreases my muscle soreness significantly within the first 24 hours and reduces it nearly completely by 48 hours.)
The body reacts to hot and cold by dilation or contracture of blood vessels. Cold (ice) will reduce(vessel contracture) the blood flow into the area or cause the body to pull the blood from the area. Heat will increase (vessel dilation) the blood flow to the area and allow increased blood flow through the area. Since muscle pain is often due to lactic acid in the muscles or other waste products of "anaerobic" muscle metabolism (contracture), heat will allow blood flow through the muscles that can remove these waste products. Heat is only recommended by me during the first 12-24 hours. Ice can be utilized at anytime, but is rarely necessary if I undergo my usual exercise recovery regimen.
These four steps or keys find me nearly painfree 48 hours following a strenuous 26.2 miles. I plan to continue to train and run marathons and will evaluate the benefits of this regimen after any strenuous exercise. The proof will be in my recovery.
For additional information on my running: http://www.utahrundoc.blogspot.com/
Tuesday, April 14, 2009
Are Runners More Susceptible to Upper Respiratory Infections?
I’m just getting over a spring sinus infection. Again! I’ve always considered myself a middle-of-the road, moderate intensity runner. I run two marathons a year and dabble in triathlon in the spring and summer. Nothing crazy. Yet, every spring I seem to be susceptible to the dreaded runny nose syndromes. I’ve always chalked the whole thing up to Texas allergens, but is that it? Or does my running make me more susceptible to the common cold? Interesting question posed to me by an ENT colleague. She pointed out that many marathoners experience significant increase in upper respiratory infections in the post-race months.
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.
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.
Saturday, April 11, 2009
Treadmill Running...Just Slow Down!!
I was reviewing the post about Madonna falling off of her treadmill and started thinking of the multitude of injuries I see due to the perceived safety of a treadmill. True, the surface of a treadmill does absorb shock, but there is a major natural pitfall with using a treadmill.
When you run - for real, with real forward progression - you are in control. As you tire, what happens? You slow down, of course! Not so on a treadmill. We typically set a speed and stick with it the whole way, for better or for worse. Some can maintain that steady pace, but most can not. As we tire, we'll naturally shift the upper body forward and the running gait will be more unnatural. What will happen? The anterior muscle group of the lower extremity (the front of the leg) will be overworked, as will the Achilles tendon. Then comes the pain...shin splints most commonly along with Achilles pain.
So what do you do to stop it? Well, just slow down! Not by a lot...every so often, maybe after the first third of the run or walk, lower the speed by 0.2 mph. This will allow for the natural fatigue of your baby.
If you wait too long and start to feel some discomfort, drop the speed even more, by as much as 0.5 mph to even a full mph. Then, depending how you feel, slowly increase your speed. If the pain persists, be sure to visit your podiatrist sooner than later.
A treadmill is not meant to be a passive experience. Be sure to listen to your body and make appropriate adjustments along the way.
When you run - for real, with real forward progression - you are in control. As you tire, what happens? You slow down, of course! Not so on a treadmill. We typically set a speed and stick with it the whole way, for better or for worse. Some can maintain that steady pace, but most can not. As we tire, we'll naturally shift the upper body forward and the running gait will be more unnatural. What will happen? The anterior muscle group of the lower extremity (the front of the leg) will be overworked, as will the Achilles tendon. Then comes the pain...shin splints most commonly along with Achilles pain.
So what do you do to stop it? Well, just slow down! Not by a lot...every so often, maybe after the first third of the run or walk, lower the speed by 0.2 mph. This will allow for the natural fatigue of your baby.
If you wait too long and start to feel some discomfort, drop the speed even more, by as much as 0.5 mph to even a full mph. Then, depending how you feel, slowly increase your speed. If the pain persists, be sure to visit your podiatrist sooner than later.
A treadmill is not meant to be a passive experience. Be sure to listen to your body and make appropriate adjustments along the way.
Friday, April 10, 2009
Newton Running Shoes
I just got a pair of Newton running shoes....yes, I did. I'm very curious if they will help me in the transition from bike to run in triathlon. The more biomechanics research I read, the more I believe that for some runners they may be helpful. I'm not saying I completely support their use just yet, but I'll keep you posted! The research is quite good and anecdotal evidence from all my triathlon peeps is good!
Here is a video that outlines the basis of Newton shoes.
I'll update periodically so you know how the trial is going!
Run Happy! And don't be afraid to try new things!
Here is a video that outlines the basis of Newton shoes.
I'll update periodically so you know how the trial is going!
Run Happy! And don't be afraid to try new things!
Friday, April 3, 2009
Top 3 Preparations For A Run
As you prepare to run any distance, how you prepare is important. Of all the preparations you make, there are 3 top preparations that should be undergone.
1. Physical Preparation --> In preparing physically, this should include getting adequate sleep at night (6-8 hours recommended), eating regular, quality, well balanced meals, and working up to the distance you plan to run. If you have never run, part of physical preparation is starting to run with enough time to train for your first 5K (3.1 miles), 10K (6.2 miles) or marathon or half-marathon. Physical preparation is a constant process and not a destination.
2. Mental Preparation --> I talk to people on a regular basis that say they could never run 2 miles. They are correct. Not because their body can't be trained to do it, but because they have already given up. One of the keys to running (again any distance) is self belief. In your physical preparation, have you done adequate running to believe you can complete the distance? Belief is what helps you push a tired leg forward, continue through an aching muscle, climb a hill that doesn't seem to end and finish even when you body says it is tired.
3. Correct Equipment --> With all the physical and mental preparation, injury can occur in a run if poor equipment (or even worn out equipment)is used. Things to consider are the shoe, and what clothes will be worn for the run.
With shoes, mileage over 300 - 400 miles will wearout a shoe. A new shoe, however, should also not be worn in a race without a breakin period. A quality running store with staff that understands running can be utilized to get a good shoe.
Clothing choice is more variable. What will the weather be like? How will you limit rubbing that can cause soreness throughout a run? What will you do to limit sunburn or other discomfort during the run? Will you wear a hat? Whatever the clothing choices may be, it is important to train with these clothes, even utilizing them on longer runs to ensure that you are able to enjoy the race without interruptions from the clothing you wore (or didn't wear).
It is important to prepare correctly to avoid even minor injuries during a run. You deserve to continue running without interruptions and preparation is the key.
1. Physical Preparation --> In preparing physically, this should include getting adequate sleep at night (6-8 hours recommended), eating regular, quality, well balanced meals, and working up to the distance you plan to run. If you have never run, part of physical preparation is starting to run with enough time to train for your first 5K (3.1 miles), 10K (6.2 miles) or marathon or half-marathon. Physical preparation is a constant process and not a destination.
2. Mental Preparation --> I talk to people on a regular basis that say they could never run 2 miles. They are correct. Not because their body can't be trained to do it, but because they have already given up. One of the keys to running (again any distance) is self belief. In your physical preparation, have you done adequate running to believe you can complete the distance? Belief is what helps you push a tired leg forward, continue through an aching muscle, climb a hill that doesn't seem to end and finish even when you body says it is tired.
3. Correct Equipment --> With all the physical and mental preparation, injury can occur in a run if poor equipment (or even worn out equipment)is used. Things to consider are the shoe, and what clothes will be worn for the run.
With shoes, mileage over 300 - 400 miles will wearout a shoe. A new shoe, however, should also not be worn in a race without a breakin period. A quality running store with staff that understands running can be utilized to get a good shoe.
Clothing choice is more variable. What will the weather be like? How will you limit rubbing that can cause soreness throughout a run? What will you do to limit sunburn or other discomfort during the run? Will you wear a hat? Whatever the clothing choices may be, it is important to train with these clothes, even utilizing them on longer runs to ensure that you are able to enjoy the race without interruptions from the clothing you wore (or didn't wear).
It is important to prepare correctly to avoid even minor injuries during a run. You deserve to continue running without interruptions and preparation is the key.
Thursday, April 2, 2009
Toenail Troubles Slowing Your Runs?
Toes can be a runner's weakest link. For some, it's the knees, for others, the back. And for many, the toes, or at least one of them, can be the problem that tortures an otherwise trouble-free runner. Any runner can get into toe trouble with the right (or wrong) conditions. From blisters, corns, and calluses to stress fractures and ingrowns, those cute little toes can become a big headache.
Toenails alone can be the source of a long list of troubles. Chief among the potential problems is the ingrown toenail--with or without infection. Other, not too pretty problems, are nail thickening due to fungal infections, black toenails due to repeated trauma, and of course other irritations, inflammations and infections. Here are just a few common causes of troubled toenails.
Ingrown Nails
You may be familiar with the warning, "Don't cut the nails too short." Trimming too short can cause the leading edge of the nail to grow forward and cause pressure on the soft tissue at the toe tip. Although this can happen, by far the more common cause of ingrown toenail, and the pain that goes with it, is the curvature of the nail into the tissue on both the medial (inner) and the lateral (next to the other toes) sides of the nail. You can get the picture by looking head-on at your thumbnail. From this vantage point, it looks as if the nail were clipped onto the top of the thumb. Toenails follow a similar curve.
If there is excessive pressure on the nail against the soft tissue from the forefoot of the shoe, problems can develop. Pressure on the side of the nail, where the toe touches the shoe, can push the soft tissue against the incurved edge of the nail. Then the toe gets inflamed, enlarges, and more pressure is felt on the toe. With enough pressure, the nail edge will break the skin surface allowing bacterial or fungal contamination into the toe, causing infection and even more swelling and pain. The warm sweaty environment of a running shoe makes an ideal site for proliferation of infection. Infection can spread around the rest of the nail, further increasing pressure and pain.
Using local antibiotics like bacitracin and antifungal creams may help, but it's hard to reverse an ingrown, infected nail without an office surgical procedure using local anesthesia. See your podiatrist! Never try to cut the nail "to relieve pressure" yourself. This is a recipe for disaster. It will heal faster and better with a smaller chance of recurrence if you see a podiatrist for treatment. Ingrown toenails do not lend themselves well to bathroom surgery.
Runner's Nail
Long distance runners and ballerinas both may be known for their athletic prowess and war-worn, beat up feet. Thickened toenails are so common among long distance runners, the condition has been dubbed, "Runner's Nail." The thickening and changes in color are caused by repetitive pressure of the shoe on the nail. The resulting thickening makes the nail even more vulnerable to additional problems since it is raised closer to the top of the shoe. These can be treated with a urea compound to soften the nail.
Fungal Toenails
A fungus (like the one that causes athlete's foot) can infect the nail and also cause thickening and discoloration of the toenail. This problem is distinguished from the Runner's Nail by infection. The fungus invades the nail when there is an injury or trauma, which may be so subtle you don't even know it is there. Once infected, a fungal nail is very difficult to treat. New laser therapy works, but prevention is a much better bet. If you notice changes in your toenails, see a podiatrist for diagnosis and treatment.
Black Toenails
Although you can get a black toenail from a sudden, painful trauma that causes bleeding under the nail, for runners it is more likely a chronic, repetitive trauma to the nail caused by short shoes, running downhill, or wearing loose shoes. This repeated micro-trauma causes only a light amount of bleeding and minimal pressure buildup, so little or no pain is felt. In many cases, you only realize this is happening when you notice your toe is discolored. But don't ignore it. The nail can gradually become thicker, and more problems develop.
Eliminate the cause of the irritation, and a new nail will gradually form. It takes six to nine months for a new nail to form, so be patient. If the nail thickens, you can file it down. If there is pressure and pain under the toenail, see a doctor. Drainage from a blackened nail can be a sign of melanoma and should not be ignored.
Why did that toe decide to torture you?
Trauma, either acute or chronic can contribute to all of these toenail troubles. Trauma--like stubbing a toe--can cause changes in the growth pattern of the nail and eventually it can cause thickening, discoloration, or infection. More often, excess pressure and repetitive trauma is caused by the mechanics of the foot inside the shoe.
Trauma can come from shoes that are too small or shoes that don't grab the midfoot firmly. If the shoe is too small, every step causes the toes to press against the front of the shoe. Tight shoes restrict blood supply to the toes, increasing the risk of infection. If the shoe doesn't grip the midfoot adequately, each time the shoe hits the ground and stops abruptly due to friction, the foot will slide forward unless it is firmly held in place inside the shoe. Momentum forces the foot forward inside the shoe until the toes collide with the front portion of the shoe.
It is important to prevent this sliding or pistoning of the foot inside the shoe. If the shoe comes up high enough on the front of the foot, it can help prevent the foot from sliding forward by holding it at the ankle. Most running shoes, however, don't come up high enough to be effective. In most cases, the lacing across the midfoot has to do the job. You can also glue extra tongue padding in the shoe for a tighter grip on the foot. The extra padding allows the laces to be tighter without pain. Both the padding and tight lacing stop the foot from sliding forward in the shoe.
The best way to prevent most of these problems is to get the right fit. Find a running shoe store where the employees are professionals who understand runners' needs and the differences in the shoes the sophisticated industry is producing. Shop late in the day or after a good run to allow for the natural swelling of the foot. Don't rely on street shoe size or assume that the size is the same from one shoe to the next. Try on both shoes, lace them firmly, and run. A good running shoe store will let you run up and down the block. Get a promise that you can return the shoes after several days of wear inside at home. Don't ever expect running shoes to "break in." They need to fit well from day one.
As you can see, toenail troubles are often from self inflicted trauma or trauma from shoes. If your toenail are looking funny or painful, see your podiatrist for answers to your toenail troubles.
Toenails alone can be the source of a long list of troubles. Chief among the potential problems is the ingrown toenail--with or without infection. Other, not too pretty problems, are nail thickening due to fungal infections, black toenails due to repeated trauma, and of course other irritations, inflammations and infections. Here are just a few common causes of troubled toenails.
Ingrown Nails
You may be familiar with the warning, "Don't cut the nails too short." Trimming too short can cause the leading edge of the nail to grow forward and cause pressure on the soft tissue at the toe tip. Although this can happen, by far the more common cause of ingrown toenail, and the pain that goes with it, is the curvature of the nail into the tissue on both the medial (inner) and the lateral (next to the other toes) sides of the nail. You can get the picture by looking head-on at your thumbnail. From this vantage point, it looks as if the nail were clipped onto the top of the thumb. Toenails follow a similar curve.
If there is excessive pressure on the nail against the soft tissue from the forefoot of the shoe, problems can develop. Pressure on the side of the nail, where the toe touches the shoe, can push the soft tissue against the incurved edge of the nail. Then the toe gets inflamed, enlarges, and more pressure is felt on the toe. With enough pressure, the nail edge will break the skin surface allowing bacterial or fungal contamination into the toe, causing infection and even more swelling and pain. The warm sweaty environment of a running shoe makes an ideal site for proliferation of infection. Infection can spread around the rest of the nail, further increasing pressure and pain.
Using local antibiotics like bacitracin and antifungal creams may help, but it's hard to reverse an ingrown, infected nail without an office surgical procedure using local anesthesia. See your podiatrist! Never try to cut the nail "to relieve pressure" yourself. This is a recipe for disaster. It will heal faster and better with a smaller chance of recurrence if you see a podiatrist for treatment. Ingrown toenails do not lend themselves well to bathroom surgery.
Runner's Nail
Long distance runners and ballerinas both may be known for their athletic prowess and war-worn, beat up feet. Thickened toenails are so common among long distance runners, the condition has been dubbed, "Runner's Nail." The thickening and changes in color are caused by repetitive pressure of the shoe on the nail. The resulting thickening makes the nail even more vulnerable to additional problems since it is raised closer to the top of the shoe. These can be treated with a urea compound to soften the nail.
Fungal Toenails
A fungus (like the one that causes athlete's foot) can infect the nail and also cause thickening and discoloration of the toenail. This problem is distinguished from the Runner's Nail by infection. The fungus invades the nail when there is an injury or trauma, which may be so subtle you don't even know it is there. Once infected, a fungal nail is very difficult to treat. New laser therapy works, but prevention is a much better bet. If you notice changes in your toenails, see a podiatrist for diagnosis and treatment.
Black Toenails
Although you can get a black toenail from a sudden, painful trauma that causes bleeding under the nail, for runners it is more likely a chronic, repetitive trauma to the nail caused by short shoes, running downhill, or wearing loose shoes. This repeated micro-trauma causes only a light amount of bleeding and minimal pressure buildup, so little or no pain is felt. In many cases, you only realize this is happening when you notice your toe is discolored. But don't ignore it. The nail can gradually become thicker, and more problems develop.
Eliminate the cause of the irritation, and a new nail will gradually form. It takes six to nine months for a new nail to form, so be patient. If the nail thickens, you can file it down. If there is pressure and pain under the toenail, see a doctor. Drainage from a blackened nail can be a sign of melanoma and should not be ignored.
Why did that toe decide to torture you?
Trauma, either acute or chronic can contribute to all of these toenail troubles. Trauma--like stubbing a toe--can cause changes in the growth pattern of the nail and eventually it can cause thickening, discoloration, or infection. More often, excess pressure and repetitive trauma is caused by the mechanics of the foot inside the shoe.
Trauma can come from shoes that are too small or shoes that don't grab the midfoot firmly. If the shoe is too small, every step causes the toes to press against the front of the shoe. Tight shoes restrict blood supply to the toes, increasing the risk of infection. If the shoe doesn't grip the midfoot adequately, each time the shoe hits the ground and stops abruptly due to friction, the foot will slide forward unless it is firmly held in place inside the shoe. Momentum forces the foot forward inside the shoe until the toes collide with the front portion of the shoe.
It is important to prevent this sliding or pistoning of the foot inside the shoe. If the shoe comes up high enough on the front of the foot, it can help prevent the foot from sliding forward by holding it at the ankle. Most running shoes, however, don't come up high enough to be effective. In most cases, the lacing across the midfoot has to do the job. You can also glue extra tongue padding in the shoe for a tighter grip on the foot. The extra padding allows the laces to be tighter without pain. Both the padding and tight lacing stop the foot from sliding forward in the shoe.
The best way to prevent most of these problems is to get the right fit. Find a running shoe store where the employees are professionals who understand runners' needs and the differences in the shoes the sophisticated industry is producing. Shop late in the day or after a good run to allow for the natural swelling of the foot. Don't rely on street shoe size or assume that the size is the same from one shoe to the next. Try on both shoes, lace them firmly, and run. A good running shoe store will let you run up and down the block. Get a promise that you can return the shoes after several days of wear inside at home. Don't ever expect running shoes to "break in." They need to fit well from day one.
As you can see, toenail troubles are often from self inflicted trauma or trauma from shoes. If your toenail are looking funny or painful, see your podiatrist for answers to your toenail troubles.
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