How To Run Smart...Even In the Cold

It is only October, but the snow has already fallen a couple times (luckily it hasn't stuck around) and reminds me of the special risks that come with winter running. In a state like Utah, we often need to consider running in snow or ice conditions.  I just wanted to make a quick note about the options available:

1. Treadmill Running
Although I dislike this type or running, because part of the joy of running for me includes running in nature, a very snowy or icy day is not worth the risk.  I will often run on a treadmill to limit slips or falls that may cause injury that will interfere more with my running.  This can also be an option for rainy days or days with significant wind.  I don't do this often, but it allows training to continue.

2. Indoor Tracks
A good option on a bad day may be indoor running on a track.  Many exercise facilities will include a track.  This provides an opportunity to do speed work, like sprinting fixed distances.  If I am scheduled to run a distance, not speed work, I would rather run on a treadmill than run around a track 1000 times.  (Note: Indoor tracks are typically smaller than the tracks utilized at High Schools or Colleges).

3. Specialized Equipment

By utilizing the correct equipment to stay warm to the trunk without increasing bulk and to add traction to the shoes, running can be done even outside in the winter.  Some possible traction options include:

•STABILicers SPORT

•Kahtoola MICROspikes

•Yaktrax Pro

Other important considerations include staying hydrated as the cold can be just as problematic as the warmth. 

I invite you to continue to run and enjoy the running that can come with running smart.

How Weather Conditions Affect Running Performance

If you are an outdoor runner you certainly have noticed that the weather can dictate how well you feel during your run. You may be surprised to learn that your performance during a run or race is directly related to the weather. The "perfect running temperature" has been scientifically debated to be somewhere around 50-54 degrees!! Most people begin to slow after 55 degrees and can really "hit the wall" if the temperature rises above 65 degrees while racing.

For people who live in chronically warmer states, such as we are in Houston, TX, it is essential to try and get your runs done in the early in the morning or later at night in order to avoid the heat of the day. However if you are stuck running in the hot weather, there are a couple of things to keep in mind. First, the hotter it is the more your body must work to cool you down by producing sweat. Sweating takes up energy, causing you to tire more quickly and lose fluids and electrolytes more rapidly, making it essential to replenish your fluid levels during and after runs. Increased heat also causes your feet to become moister in your shoes which can cause blisters. Make sure that on hot days you are wearing extra moisture-wicking socks to prevent your feet from blistering.

Besides the temperature, another weather factor that can impact your performance is rain. How rain impacts performance really depends on the amount of rain. If there is a light drizzle coming down on you while you run then the cooling effect of the moisture on your body can actually help enhance your performance. If the precipitation is more extreme, leading to conditions where you are getting totally drenched, then your performance is going to be hindered for a couple of reasons. First, your performance suffers during heavy rain because, whether consciously or not, you run more cautiously in order to prevent slipping on the wet surface that you are running on. Also, heavy rain can get your clothing so wet that you can develop blisters very quickly which can become painful. Some of the most common places to develop blisters from rain are on your feet, between your thighs, and around a woman's sports bra.

Although Mother Nature is not so kind as to provide 53 degrees cloudy running weather every day, there are some ways to make sure your run goes as smoothly as possible for the conditions that you face while running. The easiest way to make sure that the temperature does not negatively impact your performance is to plan ahead and anticipate any obstacles that the weather may provide.

Dancing With the Stars: Another Foot Injury?

What doe this have to do with running? A lot, if the training before a race or before a dance performance is not done properly.

Donny Osmond is the latest in a series of injuries from the reality show "Dancing with the Stars." He was dancing this week with a broken toe. A fractured toe can be quite painful, depending on the location, angle, and severity of the break in the bone(s). I speak from personal experience on this injury. I fractured one of my toes while I was a surgical resident and had no choice but to work, walk on it, wear closed toe shoes, and stand on it for prolonged periods of time. However, I did not continue to run or dance or engage in other sports for the weeks that was required for it to heal.

But...there seems to be a trend on this show with injuries and the stars continuing to dance and perform while injured. We saw this in the past few weeks with Tom DeLay who continued to dance on stress fractures in both feet until it got to the point where he had to quit the show...eventually. Other previous foot & ankle injuries included Misty-May Treanor with a ruptured Achilles tendon, Lance Bass with a toe fracture, and Kristi Yamaguchi with an ankle injury.

This is similar to what us physicians see with "weekend athletes" or runners to try to do too much, too soon. Proper sports training is just that--training. If an athlete is a beginner, such as these celebrities, with respect to a particular sport, then a gradual and incremental training process in necessary to prevent injury. If this does not occur, injury is more than likely to happen. So it is not surprising to me and many of my colleagues that these stars are getting injured at such a high rate. Perhaps the medical professionals associated with the show could point this out to the show executives and try to do something about it...or perhaps we will continue to see another series of injuries in upcoming episodes.

What do you think? Feel free to comment below on this possibly controversial subject. In my professional, medical opinion, it is quite obvious what will occur if changes are not made in the show's training schedule.

Stress Fractures in Runners

A stress fracture is a small incomplete crack in a bone that is due to repeated stress in an area in the body. 95% of stress fractures develop in the lower extremity and account for 10% of all running injuries. Stress fractures are a common injury in runners because of the repeated motion that runners go through over thousands of steps. Stress fractures commonly occur in runners when they have too many miles on their shoes, change the surface they run on, or change the intensity level of their workout.

The symptoms of a stress fracture are tenderness over a localized area, pain when you put weight on the affected limb, and slight swelling around the area. Runners who are most prone to getting stress fractures are women with amenorrhea (loss of menses) because of the role estrogen plays in strengthening bones, thinner athletes, and people who are not getting the proper nutrients to replenish their bones.

It is important as a runner to make sure that you are getting the proper nutrients to keep your bones strong in order to avoid developing stress fractures. It is recommended that you get 1000 mg of Calcium per day and 200 IU of Vitamin D per day, as well as maintaining a Body Mass Index (BMI) of at least 18.5 or higher and a body fat level of at least 14%. All of these factors will help insure that your bones have the right nutrients to sustain themselves even through daily running stresses.

If you think that you may have a stress fracture then the first thing to do is to decrease the amount of exercise you are doing. It is also important to go see your doctor or podiatrist so they can take an x-ray of the site. X-rays are not always able to detect a stress fracture and a bone scan may be required. Although stress fractures can be frustrating to an athlete who is in training, it is important to listen to your doctor’s instructions to modify your workout routine or you may create a more severe injury that may require surgery and more time away from your sport.

Are Your Legs Different Lengths?

From early in the development process, the body's two halves develop independently. As they develop, usually they will be very similar and almost identical. But since they are independent, each individual has eyes that are different sizes, nostrils that are different sizes and ears that are different sizes. This difference can also be seen in different size feet and legs. In many individuals this may be without problems, but in a runner this matters.

Which foot is larger?
- When fitting shoes, ensure that you know which foot is larger and fit that foot especially. A shoe that is too small (even for one foot) will predispose a runner to more injuries from loss of toenails, to ingrown toenails, to blisters and even stress fractures. Check your feet and fit both feet to the shoes, especially the larger foot.

Which leg is longer?
- If the leg length difference is only minor, you will often not notice any difference and can continue to run without difficulty.
- If one leg is longer, it is important to understand this and modify your training as necessary. Do you need a heel lift to even the legs and reduce the pronation force on the shorter leg? Do you need to switch sides of the road you run on so the longer leg is on the down side of the road? Is the pain you currently have when running due to the leg length difference.

Although these differences are normal, injury and pain can be the result of not recognizing even the smallest foot or leg length differences.

For additional information on leg length differences, visit Dr Gibson's blog at www.UtahRunDoc.Blogspot.com or his website at www.UtahFootDoc.com.

How do I begin to train for my first marathon?

This is a question that comes often in our office, so here are a few things to keep in mind:

Running a marathon requires both physical and mental strength, focus, commitment, and time. If you do take this step and make the commitment, you will find that completing a marathon could be one of the most satisfying experiences of your life.

Getting Started:
*Training to run a marathon will test your physical limits and stretch the boundaries of your endurance. Before you hit the pavement and before you purchase equipment, you must first formulate a plan and educate yourself on all aspects of marathon training. It is similar to planning a trip. Once you find out where you want to go you have to figure out how to get there. Give yourself at least 6 months of training to get there.
*Set a date. Find out when the next marathon in your area will be by checking a marathon calendar or a marathon guide.
*Start running regularly. It will be extremely helpful to have your body used to running when you start a 16-week training program.
*If you haven't exercised in some time, allow yourself more time to train and try an 8-week conditioning program. Listen to your body. Your body might adjust quickly, or it might take a little longer to be ready for the marathon training program.

Invest in the proper running equipment:
*Running shoes are the most important purchase you will make on your quest to successfully train and participate in a marathon. You will be putting more miles on them per week than all of your other shoes combined. The right shoes will alleviate stress in your legs and back. Before you visit a running shoe store, check with your podiatrist to see what it is that YOU need in a running shoe. Is it stability, cushion, motion control, or would you be best off with a light weight trainer? Your podiatrist can help you with this by evaluating your foot type and your gait pattern.
*Having the right running clothes isn't as important as having the right shoes. However, you must know what type of clothes to avoid and what clothes can aid you while you train.

Preventing Injury:
*Once you begin your training program, injury prevention will be of utmost importance! Stretching, warm-ups, proper training, and nutrition will all come into play during your training in order to prevent running injuries.
*If you do experience pain in your feet or ankles while running, it is very important to visit your podiatrist right away to diagnose the problem and get proper treatment. Don't make the mistake that many people do when they think "it will go away eventually."

The Stink in Your Feet!

Are you embarrassed about the stank that comes from your feet. Do your husband’s feet stink? What about your children’s feet, especially your young athlete? Stinky feet have been plaguing man kind since the stone age! Thus, you can only imagine all of the home remedies. I once heard of one that consisted of soaking your feet in 7-up then barbecue sauce and then finishing off with a blow dryer. Sounds ridiculous to me but some people swear by it! So, what is it that instigates that odor and how do you really get rid of that smell?

The number one reason for stinky feet is perspiration. Your foot has many sweat glands on the bottom of the foot. Some people have more than others. It is just like the rest of your body. Some people just sweat more than others. It is estimated that there is over a quarter of a million sweat glands in your feet. So when your body heats up it releases heat via sweat from sweat glands.

Warm wet areas are a haven for bacteria. The bacteria live, reproduce and feed off of the foot, shoes and socks. The bacteria produce chemicals that cause an odor. Thus stinky feet are actually caused by bacteria!

To treat stinky feet we have to tackle the root of the problem: the sweat. The first line of defense is to wash your feet at least twice a day! Changing your socks to a dry pair in the middle of the day will also cut down on the bacteria because they need a warm, moist place to grow. It is also recommended to wear sandals often in the warmer months to allow your feet to breath. When choosing what shoes to wear, try to stay away from black shoes. Chose shoes that are lighter colors and that has a lot of mesh compared to all leather. It is also strongly recommended to never wear the same pair of shoes two days in a row. This allows the shoes to dry and eliminate some of the stinky bacteria. Sometimes, these precautions are not enough or are impossible because of work or lifestyle restrictions. So then what?

There are products that can help dry the foot and decrease the sweat. These products must be recommended and monitored by a podiatric physician. There are different products for adults and children and thus you should never use products you receive for your husband on your children. Other products that a doctor can provide you with is anti-fungal and/or anti-bacteria powders. It is common for people with sweaty feet to acquire athlete’s foot and toenail fungus. What starts out as stinky feet can quickly turn into ugly feet!

There is a negative stigma with stinky feet. No one wants to have them, no one wants to marry them, and no one wants to give birth to them, but sometimes stinky is just the way they come. Well, it is not as doom and gloom as it sounds. There are a number of simple treatments and other more advance treatments that decreases the stinky stigma and the chances of athlete’s foot and toenail fungus. I don’t know about you, but I think talking to your podiatrist about your or your family’s unfortunate smelling problem is worth a shot!