Summer Heat Slowing Your Run?

The heat and humidity are back! Yes, I feel like I’m running on the face of the sun! But we have goals to reach! Remember that “Run 2,015 miles in 2015?” Yes, we’ve hit 1,000 miles, but we are a little behind our goal. So how should you adjust your training program as the summer heat increases?

In Texas, the heat and humidity seem to descend upon us overnight. One day its crisp and cool, the next day we are living on the sun J Seriously, it would be much easier to get used to the heat and humidity if the temperature rose slowly and we had time for our bodies to adjust to the “new normal”, but sadly in Texas we have very little adaptation time each summer.

So what can a runner do to continue to run while the sun is beating down on us? First and foremost, slow down! You can use a heart rate monitor and adjust your pace with your zones (yes, many times that means you are walking). Many times you need to slow down at least 90 seconds per mile in hot and humid weather! This will not have a deleterious effect on your conditioning! Your body becomes conditioned to the heart rate range regardless of the actual pace. When the weather cools, you will be amazed at how fast you can run and maintain that same heart rate!

What else can you do to survive the summer heat?

1. Run early in the morning.

2. Hydrate all day long and carry a water bottle

3. Add salt tablets or electrolytes to your hydration plan

4. Wear sweat wicking clothing in light colors or run naked (just kidding)

5. Walk breaks are OK when your heart rate is all over the place

6. And last resort, run inside in the air conditioning J

Bottom line, heat stroke is not pretty and will definitely not help your fitness levels. Slow down, hydrate and use you heart rate as a guide to survive summer running in Texas!

Running During Pregnancy

So my last blog was about running after pregnancy.  The questions that followed were more about running while pregnant. It seems that there are lots of women getting mixed messages about running while pregnant. Is it safe? The answer is, it depends.

Let me start with I am not an OB/Gyn specialist. I am a podiatrist who specializes in sports medicine. That being said, I am the mother of three girls; and ran a marathon 3 months pregnant with my daughter Caitlin (who is now almost 15). I ran during my first two pregnancies; but during my pregnancy with Sasha, my youngest, I had to stop due to complications. Age definitely was a factor, since I was approaching 40 at the time. Conclusion, talk with your doctor. I can only tell you about my experience and the experiences of many of my patients with running during pregnancy.

Alysia Montano, a former University of California star, ran the 800 meters at the US Track and Field Championships last summer, at the age of 28 and 34 weeks (8 months) pregnant. Her doctor cleared her to run and she ran a slower than her normal, at a steady even pace but finished with a respectable time. Her goal was just to compete.

I ran a marathon pregnant at the age of 31, and 14 weeks pregnant (3 months), but wore a heart rate monitor, and had a Sherpa on his bike checking on me along the course. His job was to make sure I didn’t get dehydrated or have any issues along the way. I finished in a respectable time; not my best, but not my worst!

So what are the recommendations about running while pregnant?

Running is actually good for the Mom and the baby, as long as you are not high risk AND it is part of your normal routine PRIOR to your pregnancy. It is not recommended to start a vigorous exercise program while pregnant.

During your first trimester, you should continue your normal routine; but be mindful of getting over heated. Make sure you stay hydrated and cool.

During your second trimester, time to talk with your doctor. Some women have to stop running because they have weakness in their cervix. This was why in my later pregnancy I had to stop. I was slowed down to a brisk walk. Kegal exercises are also important during the second trimester.

During your second trimester, it is also important to realize that you need to shorten your stride and watch your posture. Hunch back is not a good look; and it puts too much pressure on your knees and feet. This is also the time to change your shoes to at least a half size bigger. You may need wider as well. You may also need a more supportive shoe than what you normally wear. As you start to add bulk to your frame, your feet tend to swell and get a little longer, wider and a little flatter. (This does not change after you delivery – most women stay at least a half size larger in shoe size after pregnancy)

The third trimester is usually where many women stop running just because they are uncomfortable. There are bands that can help with the bulk of your belly; but you want to avoid anything that hampers fetal blood flow. Brisk walking and slow jogging can really be helpful to keep the swelling down in your legs and help in delivery. No studies have shown running is harmful to your baby.

After delivery, it is important to get back to your routine. This helps with your recovery and also can help avoid post-partum depression. See my last blogs for tips on getting back out there.

Bottom line: Pregnancy is not the time to start a new running program, but if you are a veteran runner and just happen to be pregnant; talk to your doctor about continuing to run. Other than woman with cervical weakness, most runners can continue as long as they are mindful of increasing heart rate, over heating and dehydration.

Update on the goal to run 2,015 miles in 2015: Art and I continue to churn out the miles. We are approaching 700 miles this weekend and will be in Chattanooga, Tennessee for the Ironman 70.3 Chattanooga this weekend. Full race report to follow next week.

Run Happy! Run Healthy!

Running After Pregnancy

So you are holding your new little bundle of joy, and after the first few weeks of sleepless nights and exhaustion are over, you start to think, “When can I get back to running? I feel FAT!”

You are not alone! After having my first daughter, Alex, I started a marathon training program to lose the weight and find myself again. Running makes Moms more sane (better than Prozac, ha ha). Seriously, a mother who feels better has happier children (ask mine - they send me running when I’m cranky).

So when is it OK to run again? And how should you approach it?

Most physicians will tell you that you need to wait at least 6 weeks before trying to resume exercise. Your body needs to heal. It is important to discuss this with your doctor and realize that with each subsequent pregnancy it may take longer. I couldn’t run effectively for 4 months after having my youngest daughter, Sasha, at the age of 40. Older Moms need more healing time. Talk to your doctor and listen to your body. If it hurts, wait a little longer.

It is fundamentally important to understand that new Moms experience several changes in their biomechanics due to post-partum gait changes. The greatest of these changes is a forward-tilting pelvis. This forward tilt of a typically stable area of the body can cause hip, lower back and leg pain due to compensation. Due to the strain of pregnancy and labor on the abdominal muscles, it is important to focus on strengthening them on your way to getting back to running.

Multiple exercises that strengthen your abdominals can help: Squats, bridges, and planks are great examples. Couple this with shortening your stride and increasing your cadence to decrease impact. Some new Moms need pelvic floor exercises and even physical therapy to get back to normal; don’t hesitate to ask your doctor for a referral if you feel like you may need additional help getting those abs back to the new normal!

Important safety tips prior to walking outside to run!

1. If you are breast-feeding, feed your baby or pump yourself dry.

2. Buy a slap-them-to-your-chest running bra (4+ barbell strength at Titlenine.com).

3. Buy a new pair of running shoes and realize your shoe size usually increases at least half a size with each pregnancy. You may wear a larger size or even a wider size.

4.  Go pee, even if you don’t feel like you need to (New Moms tend to be leaky while running L)

5. If you are planning to run with a baby jogger, wait a few weeks because it takes more abdominal strength to push a jogger.

You have to walk before you run. Start with walking briskly for 10 minutes. Then run slowly for 5 minutes; walk for a minute. Repeat. Then walk a ten minute warm down. You’ve been out of the house for 32 minutes. Time to go home.

The next day, walk for 10 minutes to warm up; run 5 min: walk 1 min; repeat twice, then walk 10 minutes to warm down. You should notice a pattern. As long as you are feeling fine, increase by one interval each day. Do not run more than 6 times a week and drink lots and lots of water!

Running after pregnancy can be your only ME time! It’s important to have that time for your sanity. Let’s get back at it, but slowly and listen to your body! 

What to Wear When Running

 Want to know what to wear when running?

Great question! When I get up in the morning pre-dawn, the first thing I do is reach for my phone and check the current weather. Then I go to my pile of running clothes, set out the night before, and try to pick those clothes appropriate to keep me warm, but not too warm, for my morning run. Sometimes this can be really tricky due to the bizarre and ever changing weather conditions in the Dallas-Fort Worth area.

There is an awesome helper on the Runner's World Website that can help you decide what to wear if you are questioning your choices. Click here to view.

I like this online resource because it differentiates between those runners who like to be a little chilled, and those who like to be toasty warm! It even takes into account what time of day and what kind of workout you are planning to run! 

Never again will you have to take a straw poll of your running peeps on what to wear for today's workout!

Shake Off the Winter Lazy! Here are 5 Tips to Get Motivated!

If you are like me, you hate running in the winter. It’s even worse in climates where ice and snow have been abundant this winter. I weep for my friends in Chicagoland and the Northeast!! Getting all those clothes on just for a run in the cold seems like such a chore sometimes!!

Winter Running with the Peeps!

I hate the treadmill, but it is a necessary evil when ice and snow abounds! That being said, many of us get lazy in the winter and slack off from training; only to find the early spring races on our schedule quite the challenge.

This year I really doubled down and put the Galveston 70.3 triathlon and the Boston Marathon on my April calendar, followed closely by Ironman Texas in May. Somehow I didn’t anticipate this crazy cold Texas winter! I have been diligent about trying to keep motivated but my training is definitely not stellar.

Now that the weather is improving, it is time to get motivated!! Here are 5 tips to help get you back on track this early spring!

1.     Start fresh! Time to go shopping for some new running kicks! A new pair of shoes is needed to help get you back in the groove. Most of us have been pounding the treadmill in last seasons’ shoes. Start the spring off on the right foot with a new pair of shoes!

2.     Take a long hard look at your training log! If you have been writing in a lot of zeros or minimal mileage, the first thing you need to address is your aerobic base. It’s hard to do tempo runs when you feel like your heart is going to explode! It’s also a recipe for an early season injury if you do too much, too soon, too fast! Start with an easy 3-4 miles at a pace you can talk to your peeps. Do this three times the first week and cross train the other days with swimming or biking. Add no more than 10-20% of either time or distance each day you run. Yes, I know it’s like watching paint dry, but too fast ramp up and you will be sorry! Three to four weeks of base building and you will be much more comfortable and back in the groove! When you get to the point you can run 10 miles easy, the base is built and it’s time to challenge yourself.

3.     After you have built your base, it is time for a challenge. Consider doubling up. A short easy run in the morning and a tempo run or speed session in the afternoon. Interval training is a great speed workout that will help you build more strength and endurance. Careful no tot double up more than twice a week and never the day after your longest run!

4.     Go long! Pick a weekend day and gather your friends for a long, slow run. Longs runs really make you stronger, not only physically but mentally. Increase your long run no more than 2 miles every week until you reach your training goal. The goal of the long run is to build strength and increase blood flow, so these should be slow and walk breaks are encouraged. Enjoy the run and your social time with your running peeps!

5.     The best way to get your running mojo back is to pick a race and put it on the schedule. I recommend picking a short race as well as a goal race. If a marathon is your goal, then a half marathon at least 4 weeks before and even a 10 or 15K, 6-8 weeks before are good choices. For triathletes, jump in a sprint or Olympic distance 2 months before, and a 70.3 a month before, your goal Ironman. These races help keep you tune up your training schedule and also can mentally motivate you towards your goal!

Dr. Crane and Tina B. ready to race again!

Spring is in the air! Let’s get motivated to get off the coach! Get off the treadmill and the trainer and get your running mojo back! I’m excited for the new season and ready to hear about all your experiences this year! Run Happy! Go long!

Tips for Enjoying Running in the Rain

“I’m singing in the rain, just singing in the rain, what a glorious feeling…..”  What a great old movie, but notice they didn’t say I’m running in the rain…..

Rainy weather happens everywhere, even in North Texas. We have all signed up for a race and woken up to a deluge. I actually did an Ironman in Quebec where it rained almost the entire time! Quite the challenge! (an a personal worst time to boot!) Rain happens, so here are some tips to prepare you for running in rainy weather. Personally, as long as it is not freezing cold, I enjoy the flashback to childhood romps in the puddles that can come from a rainy day run outside.

1. Dress in layers but not necessarily waterproof. I find that waterproof jackets actually trap moisture and heat, which can make you overheat in a jiffy. You can get dehydrated in the rain since you don’t notice that you are sweating that much. A water-resistant jacket breathes better. Layer this on top of a moisture wicking technical shirt and you are good to go, as long as it is over 40 degrees! Wear the least you think will keep you warm on a dry day and avoid overdressing. You are going to get wet. More is not better, just heavier!

2. Wear a hat with a brim. It helps to be able to see where you are going and avoid falling.

3. Wear reflective gear. Drivers often has poor visibility and think you are nuts for running in the rain, so they won’t be on the lookout for runners like they are on a nice day. If you don’t have reflective gear, make sure your top layer is light colored.

4. If you are running a race, wear a lawn and leaf trash bag as a fashionable jacket for the start. You can throw it off after the first few miles as you warm up. Please don’t litter! Give it to a spectator or aid station.

5. Wear older running shoes. We all have them in the closet. That pair that has a few too many miles but you haven’t parted with them yet. Pull those out as long as they are not way too worn. If you don’t have an old pair, pick your ugliest. We all have them too!

6. Chafing sucks! Wet weather can lead to chafing so use Body Glide or at least Vaseline on those parts that are prone to chafe or get blisters. This is your toes, heels, underarms, inner thighs, nipples and bra lines.

7. Leave the electronics at home. If you are a music junkie, today is the day to go au natural. Enjoy nature in its fullest and leave the IPod at home.

8. Let loose and enjoy your inner child! Make it fun and even jump in puddles! Life is too short not to enjoy a rainy day like a 6-year-old!

9. Take care of your shoes when you finish. There is nothing worse than a pair of running shoes that shrink. Stuff your shoes with old newspaper and this will draw the moisture away and helps keep their shape. You can put them in the dryer on no heat and that helps too! Spray them with Lysol after they dry to ward off any fungus or mold that may accumulate!

Rainy days can be fun and a time to enjoy a long run! Keep safe and enjoy running in the rain!

Video: Help With Motivation to Get Running in the New Year!

Listen to the tips the doctor gives to get you going in the New Year! Let's get going and make running a daily habit again! The holidays are over and we need to get rid of those extra cookies!!

Step into Minimalism Slowly at the Boston Marathon

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

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

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

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

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

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

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

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

Running Too Much, Too Soon = Shin Splints

The last few weeks, lots of patients have been coming into my office in Grapevine, TX saying, “My shins are killing me after running". This is a common complaint of new runners or runners increasing their mileage or intensity. It has been estimated that "shin splints" account for approximately 15% of all running injuries and may account for up to 60% of leg pain in runners. Many terms have been used to describe exercise-induced leg pain, including shin splints, medial stress syndrome, tibial stress syndrome, recurrent exercise-induced ischemia, and chronic exertional compartment syndrome. "Shin splints" has been commonly used as an all-encompassing term for many disorders causing lower-leg pain so that’s how I’ll refer to it during this discussion.

So what is a “shin splint”? Shin splints are pain in the lower leg usually caused by a variety of overuse or chronic stress related fatigue syndromes. The root cause of most shin splints is chronic biomechanical imbalances of the lower leg and feet. What does that mean? Bad feet, muscle imbalance, bad shoes, or improper training. In Caitlin’s case, she was running too much, too soon, too fast like many new runners and needed better stretching and arch supports.

What can a “shin splint” represent? The underlying pathology of a shin splint can be a fatigue injury of almost ever tissue seen in the lower leg. This can include:
1.stress fractures
2.periostitis (irritation of the covering of the bone also known as medial stress syndrome)
3.Muscle fatigue or fascial herniation (compartment syndrome)
4.Tendonitis
5.Peroneal nerve entrapment
6.popliteal artery entrapment or intermittent claudication (decrease blood flow)
7.spinal radiculopathy (spinal nerve compression causing referred pain).
Wow! That’s a lot of things that can cause shin splints!

While every shin splint injury has its own specific biomechanical causes, most are rooted in tight calf muscles and relative weakness in the front leg muscles. What's going on is that your tight calves are pulling up on your heel, which in turn pulls the front of your foot down. This puts strain on the muscles in the front of your leg, which unfortunately are not strong enough to resist the pulling. This causes a big pain in the leg! This is very, very common in runners, since running tends to exercise the calf muscles more than those in the front. But fear not, a little rest and a lot of stretching and strengthening will fix you up and possibly make you a better runner, too.

How do we treat them? Early on in the syndrome, shin splints are treated with ice, relative rest (slow down and get off the hills and uneven surfaces), anti-inflammatory like ibuprofen, stretching, and arch supports. Take a good look at your shoes. These often need to be replaced or upgraded to a better pair for your foot type. (More discussion on that topic in a future article). Yo may even need a custom foot orhtotic.

After we address your shoes and overpronation or underpronation (your foot rolling in or out excessively when you run), then we move on to the muscle imbalances in your lower leg. Your calf muscles are too strong and tight, while your front leg muscles (anterior compartment) are too weak. This is easy to remedy but won’t happen overnight. Stretching your calf muscles with a simple wall stretch for your Achilles tendon many times a day( how many?) will help. Strengthening the front of your leg can be done by actually putting a small weight (or an athletic sock full of sand) on your foot and lifting it towards your shin. Hold that for a count of ten then relax. Repeat twenty five times. You will be amazed how tired those muscles are!

If your pain persists after two weeks of these simple solutions or is at any time pinpoint or severe in nature, call you podiatrist or sports medicine physician. Stress fractures can creep up on the overzealous new runner and can take 8 to 10 weeks of no running to heal!

Shin splints are common in today's active population. It is important to keep in mind that shin splints, like most running injuries, are basically an overuse injury. Listen to your body and back off when you begin to feel pain.

These are just a few tips to get you on the road to recovery! Run Happy!