Got Morning After Muscle Pain??

Delayed Onset Muscle Soreness Sucks!

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

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

Let’s explore delayed onset muscle soreness.

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

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

Muscle Cramps on the Run?

Tim just completed the White Rock Marathon in Dallas this weekend. Weather was warm and extremely windy, but he was feeling good and managing to keep his pace through the half way mark. The race was going perfect and pacing was exactly as planned all the way until about mile 18. As he passed the 18 mile marker, he started feeling small cramps in his calves. He tried to slow down a bit to make them go away, but by mile 19 they hit so hard if felt like a ball bearing digging into his calf muscle and the pain literally brought him to the ground in the middle of an intersection. (Much to the traffic cop’s surprise) He had to stop, stretch and hobble along until they stopped. He had to walk for awhile, until they went away and then slowly started to run the last few miles. The cramps did not disappear and he had to stop again and stretch once or twice every mile. So much for his time goal!!

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

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

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

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

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

Run Happy! And cramp free!

Running Group "The Peeps" Survive the White Rock Marathon

The peeps at The White Rock Marathon! No one can run marathons without training with a crazy group of people. In fact, I think it's healthier and safer to run in groups. My peeps and I have been running together for years. They pick me up when I'm down, calm me down when I'm running too hard or too fast, and make me accountable to the schedule. Three cheers for Heather, Tim and Steve who have logged thousands of miles listening to me talk! (Yes, it's true - I never shut up for 26.2 miles) A successful marathon was had by all in weather that was terrible!

RunDoc Runs The Rock

RunDoc runs the Rock!

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

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

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

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

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

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

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

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

We survived to run again.....

You Know You are a Runner When...

An excerpt from my upcoming book "If Your Runner Feet Could Talk", coming to you in January 2009 from myrundoc.com

Addendum I: Every Runner Needs a Little Humor!

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

You Know You Are a Runner When…..

1. you roll your eyes when people ask, "how long was your last marathon?”
2. you think it’s totally acceptable to stop at the side of the road and accept fruit or gatorade from a perfect stranger
3. you are in a race and have to pee, bushes are now your friend
4. you come up with weird answers to questions like "why do you run so much?"
5. all your socks are either stained or torn.
6. you can spit while running.
7. you finish a race looking like you wrestled an alligator, and not only do you not care, but post the pictures on Facebook.
8. you schedule family vacations around races.
9. you spend more money on training clothes than work clothes.
10. you secretly have a stash of 20 pairs of old running shoes
11. you have running withdrawal if you don't run or at least cross-train everyday.
12. your only excuse for not running is projectile vomit and even that’s questionable
13. you wake up every morning in pain somewhere, and then rationalize it!
14. Accelerade is your drug of choice.
15. you can’t remember the last time you slept in on a Saturday
16. you count hills as your friends
17. your favorite food group is carbohydrates.
18. you are always hungry.
19. your house, car and gym bag smells like Biofreeze.
20. your toe nails are black or falling off.
21. you wear skimpier clothes than Brittney Spears running
22. you run through puddles instead of around them.
23. you can blow nose with your index finger. (Snot rockets)
24. you know exactly what a difference .10 miles can make
25. your running peeps are like family
26. you have more inside jokes than a stand up comedian.
27. your running peeps know more about you than your spouse
28. you have or almost have been hit by a car.
29. you can convert miles and kilometers in your head, but for any other math you need a calculator.
30. you buy water and/or Gatorade by the case at Costco
31. you count Power Bars as a meal
32. you've become a professional blister popper
33. you have some funky looking tan lines
34. you have a collector’s edition of “Chariots of Fire”
35. you tell how old your shoes are by how many miles are on them
36. LSD is not a narcotic
37. you can run 26 miles and never stop talking
38. you know your PR for every distance and the Boston qualifying time for your age
39. you know 20 different ways to combat plantar fasciitis and can spell and pronounce it correctly
40. when you reach your marathon goal, you think it’s perfectly normal to start planning your first Ironman…..

Feel free to add to the list and pass it on :)
Run Happy!!!
http://www.myrundoc.com/

How to Survive the Thanksgiving Holiday Without Gaining Weight!

Thanksgiving is just a few days away and most Americans plan to spend it stuffing our faces with turkey and watching football. We then follow that with eating desert and late night leftovers into the next day. Overeating is almost felt to be our patriotic duty on Thanksgiving! Most will wake up on Friday morning with indigestion and a few extra pounds. Sadly, we will continue this pattern throughout the holidays and wake up in January, ten to twenty pounds heavier! How do we break this holiday tradition? How can we survive the holiday without gaining that requisite 5 pounds or so? Here are a few tips from your favorite doctor:

1. Run your local Turkey Trot road race. This is a great annual tradition in many families. Think about it, no matter how fast or slow you run, after completing a 5K or 10K Thanksgiving morning, you can basically eat almost anything you want! If you can’t run, then at least take a brisk walk that morning. This will start the holiday off on the right foot and get you in a good mood to survive your friends and family!

2. Drink lots of water instead of wine or beer. Water helps fill you up so you won’t feel so hungry when that late dinner finally is ready. Have only one or two glasses of wine spaced throughout the day. This will keep the calorie count down and keep you out of trouble.
Be light on the gravy. Have you ever looked at how many calories are in that turkey gravy? A little gravy goes a long way!

3. Eat the white meat turkey and forgo the heavy dark meat. Even though it’s my favorite part, it is packed with calories.

4. Chew slowly and talk constantly! (I never have any problem with this!) Have fun with your family and keep up a brisk conversation. Chew slowly and keep talking, you will eat less and get to know them better!

5. Just say no to the multitude of desserts! It’s OK to have just a bite of this or a bite of that. It will not offend anyone if you don’t eat an entire piece of each of five kinds of pie!

6. Cheer for the Cowboys! This may not help you keep the calorie count down, but I’m from the Dallas area, so it’s a necessary part of the holiday! If you actually watch the game, you will spend so much energy cheering “the ‘Boys” that you won’t eat as much!

7. Spend your holiday giving back. Volunteer at a homeless shelter or soup kitchen. Deliver meals to the elderly. You will be blessed ten-fold and definitely will not over eat when you realize how many people go without every day!

These are just a few tips on how to survive the Thanksgiving holiday without packing on the pounds. Happy Thanksgiving!

I Love Runners! Running Out of Town in Ft Lauderdale

I Love Runners....

What other sport can you email a random person from a running club website and end up with twenty more running peeps virtually overnight.

I have to thank the Ft Lauderdale Florida Running Club for opening their training run to all-comers and then actually being extremely nice and hospitable. They gave me detailed directions on where to find them as well as parking, hooked me up with a veteran from the club that ran about my pace and then actually listened to me talk for 16 miles straight :) (and my usual running peeps will tell you I actually do talk non stop while I run) I had a wonderful run on historic A1A from Deerfield Beach through Boca Raton to almost Palm Beach then back. They had Gatorade out at the 2 and 5 mile markers and the whole course was marked every half mile so you knew where you were. I ran with Tom who graciously listened to me babble and actually got a few words in edgewise. Andy, the local crazy man, jumped in at about 10 miles and then dusted us at the end. I call Andy the local crazy guy because he described a racing schedule that included at least 3 marathons, an Ironman and a few halfs all in the last 2 months! We all have one like Andy in every club....he makes the rest of us look like a moderate! All in all it was fun. They were very friendly and I got a good run in! Thanks guys!! I'll see you at the Tamarac Turkey Trot on Thursday!!

Run Happy...and never be afraid to call up the local club when you'll be out of town....you never know who you will meet!!

What's In Your Training Bag?

Many people have been asking for exerpts from the upcoming book so here is a chapter that reminds our friends and families what we need for Christmas...make your shopping lists.

What’s in Your Training Bag?

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

1. Road ID. I made this first because it is so important and often forgotten. You need some type of ID on your body for the one time you pass out, get hit by a bus, or just fall off the curb and hit your head. If you think it doesn’t happen, read the papers. One year at the half-marathon in Dallas, several runners got hit by a car on their way back to their cars. Some kind of ID will help the EMTs find your family. I recommend the kind that is attached to your running shoes so you never forget it. Make sure the phone number is current! I’ve never needed mine in 30 years of running, but it only takes once.
2. Two pairs of running shoes. I always recommend you have two pairs of shoes that you rotate unless you are running less than 15 miles per week. The midsole material often takes almost 24 hours to rebound and frankly the shoes take time to dry out. Wet shoes equal fungus infections. Buy two pairs of either the same and mark A and B or buy a stiffer shoe for your longer runs and a lighter shoe for your short stuff and speed workouts.
3. Shorts
4. Shirt or Tank. Preferably a moisture wicking technical shirt.
5. Socks. There is a whole chapter on socks, but remember cotton is not your friend! Buy several pairs of synthetic moisture wicking socks so when you lose them in the dryer or your kid steal them because they are comfortable (yes. My daughter loves my running socks) you still have some to run in.
6. Sports Bra (woman only)
7. Hat. Mesh or visor, whatever your preference. Hats keep your head warm in the winter and cool in the summer.
8. Water bottle and carrier. Get the kind with a pocket to carry your cell phone and a little money as well as your gels.
9. Nutrition. This can be Power Bars, gels, new jelly bites, electrolyte replacement, or really whatever your heart desires. There will be a day when you skipped breakfast or lunch and need some fuel before you run. You should also carry some type of nutrition when running over an hour.
10. Body Glide. Everyone chafes sometime no matter how thin you are!
11. Sun screen. Melanoma kills 35 year old runners…enough said.
12. Sunglasses.
13. I pod or MP3 player. This is for the days your peeps blow you off or leaves you in the dust. It happens.
14. Towel. To dry off or to protect your car seat from your sweaty body. Your family will thank you.
15. Tights or sweats and gloves for those unexpected cold days
16. Extra set of clothing (for the days you forgot to clean out your bag and the clothes are dirty, it happens – our lives are full)
17. Plastic Bag for the stinky stuff
18. Toilet Paper or tissues for the sniffles and the port-a-john that’s out of tissue
19. Money. Have about $20 or so in your water bottle carrier just in case you’re having a rough run and need to take a cab home or just want an ice cream cone J
20. Put all this in a nice bag in the trunk of your car. Carry it every day. That way you are always ready to go and have eliminated one excuse entirely.

Run Happy...and don't forget the essentials!

Barefoot Passengers in Disgusting Airports

I was returning this morning from Ft. Lauderdale and going through security with a few hundred other sun-kissed travelers when it hit me that most people were actually BAREFOOT going through the security line. I had my trusty socks on, but the majority of people were barefoot on carpeting that probably saw at least several thousand stinky sweaty feet a day. Disgusting! Don’t people realize that walking barefoot in an airport even for a short period of time puts their health at risk? I guess not.

Let’s talk about this. You would never walk barefoot in an airport bathroom, right? No. That would be completely gross to most Americans. Yet, the bathroom floor probably is cleaner than the carpeting in the security line. The bathroom floor gets cleaned several times a day with disinfectant. The carpeting in security might get vacuumed once or twice a day, but most likely gets actually cleaned very sporadically and only when something gets spilled. I can’t confirm this because the TSA agent working the security line had no idea when or even if the carpeting was ever cleaned!

What’s at risk? Let’s make the assumption that you are a very healthy person with no chronic diseases that would hamper your immune system. What could you possibly pick up from a dirty carpet? Let’s just talk about the really common things because the list could actually be quite lengthy!

1. Warts. Plantar warts (verruca vulgaris) are a caused by a virus that infect the skin. This virus is very hardy and if you have children (or ever were one) you probably have seen or had a wart somewhere. They are annoying, but probably won’t kill you.
Herpes. Yes, the herpes virus is also quite hardy and cutaneous herpes can be passed from individual to individual but certainly not as quickly or easily as the wart virus. Again, annoying but not deadly.

2. Fungus. You know well the athlete’s foot fungus from your childhood. Hasn’t everyone’s mother warned them not to take a shower in the locker room barefoot so they won’t catch foot fungus? Same idea…..but again, annoying but easily remedied. PS. Fungus in your toenails can take up to A YEAR to eradicate! (Yes, it’s the same fungus)

3. Staph. Our friend the staph bacteria is growing stronger and infecting more people every day. If you have any doubt on how nasty this bacteria can be you should read my article on “Deadly Pedicures”. Staph can kill you and only needs a small opening in the skin to give you a major infection. MRSA (the really nasty staph) is more common than every before.

But you say you don’t have any cuts or holes in your feet so it’s probably OK for you to boldly walk through security at the airport barefoot. Think again! Let’s take a look at your feet. Any dry skin? Tiny little blisters? Maybe a rub mark from a sandal or a tight shoe? A minor ingrown toenail? These can provide openings for all our little microscopic friends that want to join us on our airplane journey. And let’s not forget. You are BAREFOOT! You could easily step on something, drop a piece of luggage on your foot or stub your toe on a bag and provide an easy opening…hello puncture wound!

So the next time you are traveling by air, either wear or bring a pair of socks. If you forget them, many airports will provide you with little booties to place on your feet to go through security. Your mother always told you not to go barefoot in a locker room. Common sense keeps you from going barefoot in a public bathroom. So why go barefoot through security? You may actually be saving your life with a pair of socks! Bring an extra pair and save a friend!

Run Happy through security with socks on!!!

DRC Half Marathon Results

Congrats to all the runners...over 5000! Wow! What a huge race for Dallas and a beautiful morning. It was 55 or so at the start and warmed up to 76 at the finish. Lots of great times were run (I unfortunately was not one of them) and the post-race parties in the tents were fun! Nice showing from the Lake Grapevine Runners and Walkers as well as the Dallas Athletes (most of which did a tri last weekend). My peeps all ran well with Tim Jacobs leading the way with a 1:35, Heather Wallace blasted by me at 8 miles and finished in 1:45, I personally bonked at 8 miles, but held on to a 1:48 (but at least it was a minute faster than last year and 19th out of 329 in my age group...not a terrible showing) and Steve Buksh rounded out the crew with a 1:50. Special guest appearance by an old friend, Dan Banse at 1:51. Dan and I suffered from the same disease....going out too fast and having unrealistic expectations! This was a good building block for the marathon next month...watch out White Rock here we all come! And hopefully will be smarter from our bonk today!

Goal Setting Motivates Your Training Runs!

Goal Setting

A very smart person once said that a goal not written down is just a mere wish. I passionately believe this is true and have proven the power behind written goals in many aspects of my personal and professional life.

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

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

1. Lifetime Goal:
2. 5 Year Goal:
3. 3 Year Goal:
4. 1 Year Goal:
5. Next Quarter’s Goal:
6. This Week’s Goal:

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

Run Happy! And reach For Your Goals!

I Survived Injury and You Can Too!

Surviving Injury With a Twist!

Let’s face it….there will be a day when all of us get injured. Just like the fact that there are two kinds of cyclists: those who have fallen and those that will fall!

In a recent survey 90% of runners revealed some kind of injury in the last 12 months that resulted in the loss of more than one day of training. Some of us are just more hardy than others. I have several ultra-marathon running patients (yes, they embrace the fact that most of us think they are crazy) who train like maniacs and think that running a 50K on Saturday and then a marathon on Sunday is just a fun weekend in Texas! These people and their considerably more sane counterparts, a group of which I have been fortunate enough to consider myself a member, almost never get injured unless we fall off a curb, get hit by a car, or fall in a pothole. I define those as the “shit happens” injuries and these always seem to happen at the most inopportune time. There are also runners who tend to be injury prone. Those frustrated souls who seem to be in my office or with my physical therapist on a regular basis who often follow the letter of the training programs and still seem to get hurt.

Injuries suck…and often make us borderline psychotic! (My husband and children will attest to this fact) So, how do we survive this down time and come back from injury even stronger? Cross-training a.k.a. relative rest is the key! Unless you are in a full body cast from a severe accident, there is an alternative exercise that should at least keep your endorphin addiction under control. Yes, you need to seek permission to bike or swim or core train, light yoga, etc., whatever your doctor says you can do even if it is only upper body, you need to move! Everyday! Sitting on the couch eating chips and singing woe is me will not cut it! And you will lose all the cardio fitness you have built with your running program. A good rule of thumb is to try and keep to your program by performing the alternate exercise for the planned amount of time you were going to run. This may require some circuit training, because if you are anything like me, the first time I tried to swim I lasted all of 15 minutes without thinking I was going to drown; but then I got out of the pool and attacked the stationary bike to finish my planned one hour workout. Flexibility and a willingness to try something else will get your through any injury. The best part is that you may find you even like some of the cross training (remember I did my first tri after breaking my foot).

The power of positive thinking is also relevant in this topic. Stop sitting on the couch feeling sorry for yourself and instead make a new plan, a new goal and a new training program. There is always a light at the end of the tunnel (and no, it is not a train). Cross-train, plan and conquer your injury. You will survive and often times be in better shape afterwards!

RunDoc Does Her First Triathlon

RunDoc Eats Humble Pie!

I did my first triathlon today...just a sprint...and I'm eating humble pie...I blasted through the swim in 6:42 for 300m, then ran to my bike (barefoot on freezing pavement), had a good transition then off to bike 12 miles....turns out I am a slow cyclist (who knew!) I rode 12 miles in 47:21 then practically fell off my bike....almost screamed out "my legs, my legs, who took my legs" as I got off the bike, then tried to run....pathetic...for a person who normally does about a 21 minute 5K or less, I ran a 24:00 and was happy to have that time! I finished 3rd in the old lady 40-year-old age group and was thrilled not to come in last! I know have an enlightened sense of awe for all those triathletes I used to make fun of :) Bottom line...I had fun (and I beat my brother - he had a flat - I'll take it, first time I beat him in over 20 years!)....Next time I'll be better prepared...I think I have the bug....gotta try again....



Run Happy...and try a tri for fun!

Got Heel Pain?

Heel pain is of epidemic proportions in the United States! It is the most common complaint we see in our office. The pain is greatest usually when you get up in the morning, but continues to worsen over time – until it hurts with every step you take and can even ache at night when resting.

This syndrome is most commonly caused by several factors, including, but not limited to: -Tight calf muscles-Increase in body weight-Sudden change in the amount of intensity of exercise-Improper or worn out shoes-Abnormal foot biomechanics (excessive pronation or supination)Due to any of the above factors, the plantar fascia (the ligament that holds up your arch) is pulled or strained so that a portion of this very strong ligament starts to tear or fray like a rope at its weakest point (where it attaches to you heel bone). This tearing causes microscopic internal bleeding in this area. Your body reacts by causing inflammation, which in turn causes irritation to the nerves, bursae and muscles in this area. As the inflammation occurs, the body tries to heal itself by depositing calcium in the area of the tear. This creates the “spur”. Not everyone will have a visible spur on x-ray, especially in the early stages. The spur is not the cause of the pain! It is just a tangible sign that extensive tearing has occurred. The tearing and straining is the cause of the pain and then the nerve becomes inflamed which makes the pain more sharp and long-lasting. The straining must be stopped, along with the inflammation, in order to resolve this problem.

Diagnosis of plantar fasciitis is made with a physical examination including a biomechanical exam. X-ray are recommended to rule out a stress fracture or tumor in the area. Shoe gear is also evaluated. (Don't forget to bring your running shoes to your appointment!)

Treatment initially includes all of the items listed below. If any of these treatments increases your pain, please call or contact the office. It has been estimated that 85% of heel pain can be eliminated by non-surgical treatements; but these take time and effort on the part of the patient and doctor. BE PATIENT! Your heel pain did not appear overnight, and it will take a while to totally eliminate the pain.

Conservative therapy can include:
1. Ice (at least 15 minutes twice a day);
2. Stretching (your doctor will give you calf and arch stretching);
3. Anti-inflammatories (either orally or in an injection); and
4. Arch supports/Taping/or orthotics.
Remember that treating the biomechanics of your feet treats the underlying cause where the other treatments are only treating the symptoms! Some people need physical therapy, night splints, and casting for relief. Conservative treatment often takes 4-6 months to eliminate plantar fasciitis.


Surgical treatment is the last alternative, after conservative therapy has been exhausted. Extracorporal shock wave therapy (ESWT) is a relatively non-invasive surgery that is quite effective, but deemed experimental by many insurance companies. If you are interested in more information about ESWT, click on the word underlined above.

There are two common surgical approaches to heel pain: the traditional approach (removes the spur) and the endoscopic approach (lengthens the ligament to reduce the strain and therefore reduce your pain). If your pain is not eliminated by conservative treatment after 4-6 months, we will discuss which approach is best for you.

Remember, the earlier you seek medical help for heel pain, the faster it will go away! If you have pain more than 5-7 days in a row in the same spot, call or contact our office for an appointment.

Need help with stretching? Go to our video Donnie and Dr Crane amatuer video heping you stretch your way to pain relief on YouTube! You are not allowed to make fun of our amatuer photography!

It Happened to Misty May-Treanor, Don't Let it Happen to You!

It has been a rough early fall for Misty May-Treanor, Olympic Beach volleyball champion. She was in the preliminary rounds of "Dancing with the Stars" when she ruptured her Achilles tendon in practice. She had successful surgery on her tendon and hopes to be back to competition soon. Many people have asked "If such a terrible injury happened to such a conditioned athlete, how can I prevent it from happening to me?"

The Achilles tendon is the largest tendon in the human body. It is a large ropelike band of fibrous tissue in the back of the ankle that connects the powerful calf muscles to the heel bone (calcaneus). When the calf muscles contract, the Achilles tendon is tightened, pulling the heel. This allows you to point your foot and stand on tiptoe. It is vital to such activities as walking, running, and jumping. An Achilles tendon rupture is a complete tear through the tendon, which usually occurs about 2 inches above the heel bone.

The Achilles tendon can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses and medications can also increase the risk of rupture.

Rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are racquet sports and basketball, but any forceful push off can cause a rupture. Most ruptures are obvious and the person experiences a sudden and severe pain may be felt at the back of the ankle or calf—often described as "being hit by a rock or shot." The sound of a loud pop or snap may be reported. Initial pain, swelling, and stiffness may be followed by bruising and weakness. The pain may decrease quickly and smaller tendons may retain the ability to point the toes. Without the Achilles tendon, though, this would be very difficult. Standing on tiptoe and pushing off when walking will be impossible. A complete tear is more common than a partial tear.

Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Most likely, although not reported, Misty May-Treanor had a minor chronic tendonitis from her volleyball competitions and then aggravated it with the strain of dancing. "Dancing with the Stars" training has been reported to be significant and quite taxing even to the athletes that are competing!

How can I prevent this happening to me? Treat any tendon symptoms before they lead to rupture! Call your doctor if you have any signs of minor tendon problems including pain with activity, swelling and problems with standing on your toes. Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Prevention centers on appropriate daily Achilles stretching and pre-activity warm-up. Maintain a continuous level of activity in your sport or work up gradually to full participation if you have been out of the sport for a period of time. Good overall muscle conditioning helps maintain a healthy tendon.

What should I do if I think my Achilles tendon is injured? Any acute injury causing pain, swelling, and difficulty with weight-bearing activities such as standing and walking may indicate you have a tear in your Achilles tendon. Seek prompt medical attention from your doctor or emergency room. Do not delay! Early treatment results in better outcome. The majority of people return to normal activity levels with either surgical or nonsurgical treatment. Most studies indicate a better outcome with surgery. Athletes can expect a faster return to activity with a lower incidence that the injury will happen again. Return to running or athletics is traditionally about 4-6 months. With motivation and rigorous physical therapy, elite athletes may return to athletics as early as 3 months after injury.

Remember that your Achilles tendon is needed for almost all activities! Treat it right and see your podiatrist if you have any symptoms of Achilles tendonitis to avoid an Achilles tendon rupture like Misty May-Treanor!

Larry: My Ultimate Ironman at the Ironman World Championships

Ironman World Championships, Kona, Hawaii

Here's a big cheer that goes out to my friend Larry Branigan!

Larry competed in the Ironman World Championships in Hawaii this weekend. He didn't win, but was a winning example for all of us. Larry is a 62-year-old colon cancer survivor who really can't run any more, but didn't let that stop him. He swam, biked hard, and ran as fast as his body would let him.

He finished in 14:38:33, 25th in his age group and 1494 overall.

Not bad for someone who is just over a year past surgery and nasty chemotherapy. Cancer slowed him down, but never killed his spirit.

So the next time you don't feel like getting up in the morning to run, think of Larry. If he can do it, so can you!

Knee Pain Slowing Your Run to a Crawl?

Patellofemoral Pain Syndrome in Runners

What is patellofemoral pain?

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

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

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

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

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

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

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

Will I ever be able to run again?

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

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

Run Happy!

15 Injury Prevention Tips

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

Causes of injury

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

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

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

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

Top Tips For Injury Prevention
1. Avoid training when very tired. Or hung over!
2. Do not run if you are still stiff or fatigued from your previous run. Get out your bike or swim instead.
3. Avoid peer pressure into running too fast or too long when you are due for an easy day.
4. Pay attention to nutrition and hydration, increase carbohydrate consumption during periods of heavy training.
5. Increase in training should be matched by an increase in resting. Don’t increase yours by more than 10% per week.
6. Treat minor injuries immediately to prevent them becoming serious.
If in pain when training, STOP.
7. Keep to soft surfaces wherever possible. If you must run on the pavement, keep switching sides of the road especially if there is an appreciable curve to the asphalt.
8. Introduce new training techniques and activities very slowly and carefully.
9. Be religious about warming up and cooling down. Adopt a dynamic warm-up and stretch after a session.
10. Wear appropriate running shoes that are not excessively worn. Have two pairs that you rotate.
11. Listen to your body! Monitor daily for signs of fatigue.
12. Have a sports massage on a regular basis.
13. Incorporate core stability exercises into your daily routine.
14. Remember that strength training is great cross training for runners, especially woman.
15. Remember that to achieve your running goals, you need months and years of successful running free of injury and illness.

Pay attention to your body and all of these tips to ensure that you’ll continue to pound the pavement injury free for years to come!

Run Happy!

Running really Does Lengthen Your Life!

Running Over Age 50 Cuts Death Rate in Half!

A 20-year study has shown that running has profound health benefits, cutting the rate of early death by more than half. Researchers found that running slowed cardiovascular disease, cancer deaths, cognitive decline, and poor immunity. The runners experienced no more wear and tear to their joints than non-runners.

At the beginning of the study, with most participants in their 50s, they were running four hours per week. Twenty years later they averaged 76 minutes per week and still felt running helped them maintain their obvious higher quality of health.

Running turns on various genes which are associated with conditioning your body’s energy systems to work better, including the metabolic use of fat and sugar.


Best part, not only did they live longer, but there was no increase in the incidence of arthritis in runners! So much for that theory!

This is awesome! Our lifestyles have now been vindicated!


Run Happy! Run for life! And above all, does this mean I’m really only in my 20’s?????


I am posting the entire abstract and press release so you don't think I'm making it up so I can justify marathon running for life!


Study Title:
Reduced Disability and Mortality Among Aging Runners


Study Abstract:
Background

Exercise has been shown to improve many health outcomes and well-being of people of all ages. Long-term studies in older adults are needed to confirm disability and survival benefits of exercise.


Methods

Annual self-administered questionnaires were sent to 538 members of a nationwide running club and 423 healthy controls from northern California who were 50 years and older beginning in 1984. Data included running and exercise frequency, body mass index, and disability assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI; scored from 0 [no difficulty] to 3 [unable to perform]) through 2005. A total of 284 runners and 156 controls completed the 21-year follow-up. Causes of death through 2003 were ascertained using the National Death



Index.

Multivariate regression techniques compared groups on disability and mortality.


Results

At baseline, runners were younger, leaner, and less likely to smoke compared with controls. The mean (SD) HAQ-DI score was higher for controls than for runners at all time points and increased with age in both groups, but to a lesser degree in runners (0.17 [0.34]) than in controls (0.36 [0.55]) (P < .001). Multivariate analyses showed that runners had a significantly lower risk of an HAQ-DI score of 0.5 (hazard ratio, 0.62; 95% confidence interval, 0.46-0.84). At 19 years, 15% of runners had died compared with 34% of controls. After adjustment for covariates, runners demonstrated a survival benefit (hazard ratio, 0.61; 95% confidence interval, 0.45-0.82). Disability and survival curves continued to diverge between groups after the 21-year follow-up as participants approached their ninth decade of life. Conclusion Vigorous exercise (running) at middle and older ages is associated with reduced disability in later life and a notable survival advantage.

From press release:
Regular running slows the effects of aging, according to a new study from Stanford University School of Medicine that has tracked 500 older runners for more than 20 years. Elderly runners have fewer disabilities, a longer span of active life and are half as likely as aging nonrunners to die early deaths, the research found.


“The study has a very pro-exercise message,” said James Fries, MD, an emeritus professor of medicine at the medical school and the study’s senior author. “If you had to pick one thing to make people healthier as they age, it would be aerobic exercise.” The new findings will appear in the Aug. 11 issue of the journal Archives of Internal Medicine.


When Fries and his team began this research in 1984, many scientists thought vigorous exercise would do older folks more harm than good. Some feared the long-term effect of the then-new jogging craze would be floods of orthopedic injuries, with older runners permanently hobbled by their exercise habit. Fries had a different hypothesis: he thought regular exercise would extend high-quality, disability-free life. Keeping the body moving, he speculated, wouldn’t necessarily extend longevity, but it would compress the period at the end of life when people couldn’t carry out daily tasks on their own. That idea came to be known as “the compression of morbidity theory.”


Fries’ team began tracking 538 runners over age 50, comparing them to a similar group of nonrunners. The subjects, now in their 70s and 80s, have answered yearly questionnaires about their ability to perform everyday activities such as walking, dressing and grooming, getting out of a chair and gripping objects. The researchers have used national death records to learn which participants died, and why. Nineteen years into the study, 34 percent of the nonrunners had died, compared to only 15 percent of the runners.


At the beginning of the study, the runners ran an average of about four hours a week. After 21 years, their running time declined to an average of 76 minutes per week, but they were still seeing health benefits from running.


On average both groups in the study became more disabled after 21 years of aging, but for runners the onset of disability started later.


“Runners’ initial disability was 16 years later than nonrunners,’” Fries said. “By and large, the runners have stayed healthy.”


Not only did running delay disability, but the gap between runners’ and nonrunners’ abilities got bigger with time.


“We did not expect this,” Fries said, noting that the increasing gap between the groups has been apparent for several years now. “The health benefits of exercise are greater than we thought.”


Fries was surprised the gap between runners and nonrunners continues to widen even as his subjects entered their ninth decade of life. The effect was probably due to runners’ greater lean body mass and healthier habits in general, he said. “We don’t think this effect can go on forever,” Fries added. “We know that deaths come one to a customer. Eventually we will have a 100 percent mortality rate in both groups.”


But so far, the effect of running on delaying death has also been more dramatic than the scientists expected. Not surprisingly, running has slowed cardiovascular deaths. However, it has also been associated with fewer early deaths from cancer, neurological disease, infections and other causes.


And the dire injury predictions other scientists made for runners have fallen completely flat. Fries and his colleagues published a companion paper in the August issue of the American Journal of Preventive Medicine showing running was not associated with greater rates of osteoarthritis in their elderly runners. Runners also do not require more total knee replacements than nonrunners, Fries said.


“Running straight ahead without pain is not harmful,” he said, adding that running seems safer for the joints than high-impact sports such as football, or unnatural motions like standing en pointe in ballet.


“When we first began, there was skepticism about our ideas,” Fries said. “Now, many other findings go in the same direction.”


Fries, 69, takes his own advice on aging: he’s an accomplished runner, mountaineer and outdoor adventurer.


Hanging on his office wall is a photo he jokingly describes as “me, running around the world in two minutes.” In the dazzling image of blue sky and white ice, Fries makes a tiny lap around the North Pole.


Fries collaborated with Stanford colleagues Eliza Chakravarty, MD, MS, an assistant professor of medicine; Helen Hubert, PhD, a researcher now retired from Stanford, and Vijaya Lingala, PhD, a research software developer.


The research was supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and by the National Institute on Aging.


Study Information:
Eliza F. Chakravarty, MD, MS; Helen B. Hubert, PhD; Vijaya B. Lingala, PhD; James F. Fries, MD Reduced Disability and Mortality Among Aging Runners Arch Intern Med. 2008 August 168(15):1638-1646.Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, California

Guidelines For Childhood Obesity Published

Guidelines for the prevention and treatment of childhood obesity have been recently published. Click on the title to read the entire publication. Quotes are from the published paper, but the opinions are my own. Novel concepts were discussed like better food choices and daily exercise!

The Endocrine Society has issued practice guidelines for the prevention and treatment of pediatric obesity and has published them in the September 9 Online First issue of the Journal of Clinical Endocrinology & Metabolism. The guidelines were cosponsored by the Lawson Wilkins Pediatric Endocrine Society.

"The Clinical Guidelines Subcommittee of The Endocrine Society identified pediatric obesity as a priority area requiring practice guidelines and appointed a Task Force to formulate evidence-based recommendations," write Gilbert P. August, from the George Washington University School of Medicine in Washington, DC, and colleagues. "Accordingly, the purpose of these guidelines is to summarize information concerning the seriousness of pediatric obesity and overweight; the diagnostic criteria; the available treatments and when to apply them; and the available measures to prevent overweight and obesity.”

As part of the recommendation, there are a few really important points that should be emphasized when treating these patients:

To help prevent obesity, clinicians should recommend that infants be breast-fed for at least 6 months and that schools offer children in all grades 60 minutes of moderate to vigorous daily exercise.

Clinicians should educate children and parents regarding healthy dietary and activity habits; advocate to restrict availability of unhealthy food choices in schools; ban advertising promoting unhealthy food choices to children; and redesign communities in ways that will maximize opportunities for safe walking and bike riding to school, athletic activities, and neighborhood shopping.

I know I’m preaching to the choir, but think of how just these two little changes would make such a big difference in our society. This would be landmark in our little part of Texas! My kids at this point only get 2 physical education classes a week! And they can’t ride their bikes to school because there are no sidewalks!

"The objective of interventions in overweight and obese children and adolescents is the prevention or amelioration of obesity-related co-morbidities, e.g., glucose intolerance and T2DM [type 2 diabetes mellitus], metabolic syndrome, dyslipidemia, and hypertension," the authors of the guidelines write. "We suggest that pharmacotherapy (in combination with lifestyle modification) be considered if a formal program of intensive lifestyle modification has failed to limit weight gain or to mollify comorbidities in obese children. Overweight children should not be treated with pharmacotherapeutic agents unless significant, severe co-morbidities persist despite intensive lifestyle modification."

Bottom line: Better food choices and regular exercise! How novel?

Get your kids running with you and make the first step towards a better, leaner society. Encourage your kids to bike, swim, and do regular exercise every day!

Run Happy! And with your children!

Marathon Success Story

Marathon Success Story from Lyn Kelly...reprinted by permission:

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

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

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

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

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

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

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

The race began with The Call’s "Let the Day Begin" ringing through the Appleton, Wisconsin area. The sky was mostly overcast and the temperatures had not seemingly changed, a slight breeze lending a chill to the air on occasion. Everyone seemed to being doing well at the start with jokes of "the first .2 miles are always the toughest" and similar comments being heard. From the onset I was impressed with the crowd support. The Fox Cities area is made up of several small cities such as Appleton, Menasha, Neenah (which is pronounced Nee-nuh, but being a Texan I kept pronouncing it Nee-Nah like Hee-Haw) and Kimberly. Everywhere you went people were out there to greet you, sometimes in droves sometimes just a family or two, but they were there. Most runners had their names imprinted on their bibs so if the crowds could see the name they would call it out as you ran by them. Cheerleaders from the area schools were out in force, doing cheers for you as you went by, creating "tunnels" to run through, or doing the wave for individual runners. It was so encouraging that you couldn’t help but unconsciously speed up as you ran past. It was an exhilarating atmosphere from beginning to end. However, I think the first point where I felt that the race would be different was around mile 3 when another runner named Chris and I stopped for a restroom break. There was a line so after (patiently) navigating that, we had to speed up for almost a mile to catch our crew, averaging a sub-eight minute mile for the duration and I didn’t feel tired. I felt ecstatic.
Gordy was an excellent pacer. He’d run the Fox Cities area for several years and knew every curve, divot and pot hole and directed us accordingly. Another gentleman in our crew was Tom Jensen, a 66-year old runner who was a veteran of 50 or so marathons. I also met Vincent Uzzardo, or "Vinnie" as he introduced himself, a runner from Chicago who was running his first of three marathons in nine weeks. He had run a PR of 3:20, but was using this race as his final long distance run for Chicago. His reasoning? "What’s 6.2 more miles?" You have to love the attitude of marathoners!

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

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

We reached our first hill at Mile 11 and Vinnie and I trudged up it. Gordy caught up with us and told us that we were going too fast and needed to slow down just a little. I’d never been told I was too fast with any pace group; that was another sign that maybe this race would be different from the others. But we still had 15 more miles to traverse and things could change quickly.
We crossed the halfway point and I told Gordy I was thinking, per my plan, about pulling away at Mile 14. He said it was my call, but he suggested that I wait until mile 20 and then take off. I decided that it might be wise to listen to a course veteran so I held off and continued with the group. Besides, I really enjoyed the company. The clouds were starting to clear away so I donned my University of Texas bandana (i.e. "do-rag") and a cheerleader encouraging the runners yelled out, "Go, bandana guy!". My second nickname of the day.

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

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

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

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

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

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

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

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

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

How Long Do Functional Foot Orthotics Last in Runners?

Dr Crane from Foot & Ankle Associates of North Texas answers questions at a local running forum. This is the first in a series of Q&A. If you want her to address any questions in her next series contact her and we will put your question on the list. We are dedicated to your running injury free!

Question #1: How Long Do Orthotics Last?



Run Happy! And Injury Free!

Running Advise Video part Two

Dr Crane at Luke's Locker in Colleyvile part two....make sure to check out part one!

Running Advise Video Part One

Dr Crane at Luke's Locker in Colleyville, TX talking to their new marathon running group.

19 Tips To Run Faster!

We may not all be destined to become elite runners, but most of us feel pretty psyched when we see even small improvements. The older I get the more I look to small improvements for my motivation. The great thing with running, unlike many other sports, is that it’s very simple to objectively measure progress. How are you progressing? Or have you got yourself into a rut?

The following check list may help you pinpoint areas of nutrition, training, motivation, injury prevention, or equipment to address that will help boost you to the next level.

1. Fuel right before runs - have a low fat meal or snack containing low glycemic index carbohydrates 1-3 hours before your run. I personally like oatmeal mixed with Cheerios before my morning run.
2. Core strengthening – Pilates, yoga or simply core strengthening weight workouts. Personalized programs help to strengthen core and major muscle groups important to running, as well as lengthen out tight areas. A more fluid moving, stronger, less injury prone body is the result.
3. Cross-train - even the worlds’ fastest female marathoner-Paula Radcliffe-does some of her sessions on a Nordic track (a machine which mimics cross-country skiing). Water running and cycling are also useful to maintain cardiovascular fitness without the constant impact and injury risk. I finally bought a bike a month ago and I love it!
4. Refine your running technique – Your podiatrist or physical therapist can help you with gait analysis. Improving technique can not only make you a better runner, but you may feel less soreness and reduced injuries.
5. Aim to be a healthy weight - a BMI (body mass index) of 20-25 gives us a rough indicator. Running becomes more difficult when we gain weight, conversely, becoming underweight may negatively affect performance and health. I can admit that I actually have gained weight and became faster!
6. Increase milage gradually - the general rule is no more than a 10% increase in mileage each week. This decreases the injury risk, and gives the body time to adapt to increased stress and improve.
7. Wear appropriate shoes - that are comfortable and functional for your foot type; and above all learn to recognize when they are past their use-by-date to help avoid injury. Five hundred miles or 6 months are the expiration dates on running shoes!
8. Start runs hydrated - and carry sports drink or gels on runs that are longer than 60-90 mins. Losing even 2% of our body weight through sweat can affect performance. Providing carbohydrate and electrolytes during longer races, will also be a huge benefit to your final time. Weigh yourself before and after a run. Make sure you replace your fluids!
9. Run with a group - if you find it difficult to stay motivated, running with a group, or a running peep can give you a time and place to be consistent with your running.
10. Get in the zone - Load your mp3 with music that uplifts you. Buy run gear you feel great and comfortable in, or map out new run routes to stay inspired. Mix it up!
11. Find a great massage therapist - regular massage improves mobility and flexibility of the muscles, increases blood flow, and relaxes the muscle. All this means recovery from a hard session or race (normally 48-72 hrs) can be reduced by up to 50%! A good massage therapist can also pinpoint problem tight areas before they become injuries. I love mine although I scream when she hits my sore spots!
12. Learn to run faster - do 1-2 runs every week that challenge your pace. This may be an anaerobic threshold run where you hold a faster pace for eg 20mins during your normal run. Other options are hill fartlek sessions-where you run an undulating loop, pushing hard on the uphills-or interval sessions – where a shorter distance is run hard, with a few minutes of jogging between eg 5-6 x 1mile or 6-8 x 800m.
13. Find a mentor or supporter - this may be someone you admire as a runner, or who makes you feel enthusiastic about your running goals. It may be your coach, partner, or another runner who you catch up with regularly to talk life and running.
14. Set goals with training and racing and follow a program. Like anything in life, we are more likely to be successful with a clear vision and tactics.
15. Eat right after runs - consume a meal or snack containing 1-2g carbohydrate/kg of body weight and some protein immediately after runs longer than an hour. I personally drink an Ensure or protein shake as soon as I stop sweating! Glycogen (the muscles main energy source for running) is replaced much faster in this period immediately post training.
16. Utilize and learn to love ice-baths - or cool water soaks, especially after long or hard runs. The effect on recovery is amazing.
17. Race - there’s nothing like a race situation to push you to the next level, while also giving you a sense of accomplishment. It’s amazing how the legs find a new gear to train at as well!
18. Learn to train easy - we are not invincible, and do not become great by running hard every day. In fact injury and chronic fatigue is the more likely outcome! Recovery runs or easy days are crucial to gain the benefits from our harder runs. Do a daily check…are you fatigued when you wake up? That’s a day to pull out your bike or run easier.
19. Enlist specialists - get professional advice when needed from qualified and respected Sports Podiatrists, Nutritionists, Physical Therapists, Sports Physicians, Chiropractors, Exercise Physiologists, Coaches, and even Sports Psychologists!

We are unique individuals, and one formula will not be right for everyone. It takes time to figure out what works best for us, but the important thing is that you learn from experience, and enjoy the process of becoming a better, stronger runner.

Run Happy! And Injury Free!

To Stretch or Not To Stretch? That is the Question!

Stretching 411

The jury is still out when it comes to stretching in the running community. I have been running for almost 30 years with multiple coaches on numerous competitive levels, all of them told us to stretch daily to get faster and avoid injury. Yet many incredibly competitive runners never stretch and never seem to get injured. Is there any proof that this common recommendation is actually valid? What do the studies say about stretching? Does it really prevent injury? Will it make me faster? Again, the experts really don’t agree on much! In most arguments between stretchers and non-stretchers, it inevitably comes down to "stretching helps prevent injuries" and "stretching is a leading cause of injuries in runners".

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

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

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

The Do’s and Don’ts of stretching:

Do

1. Warm up prior to stretching. Walk or slowly jog at least 10-15 minutes prior to stretching.
2. Slowly add stretching to your workout slowly. Gently stretch a little more each day. Your muscles can actually stretch almost 1.5 times their length, but if you try to achieve this all at once you will hurt yourself!
3. Relax. Tension makes it almost impossible to stretch effectively
Breathe. That may sound easy but try to breathe from you diaphragm or stomach
4. Make it a routine, try to stretch every day, even if you don’t run. Follow the same order of stretches every time for consistency
5. Listen to your body. Some days, less is more!

Don’t
1. Don’t bounce!! Bouncing risks pulling or tearing the muscle you’re trying to stretch and relax. Muscles must be stretched gradually.
2. Don’t hold your breathe
3. Don’t stretch if it hurts
4. Don’t forcibly stretch an injured muscle, gentle and less is more
5. Don’t hurry through your routine
6. Don’t listen to your friends opinions about the best technique for stretching Try them all and decide what works for you

Bottom line: Most experts agree that stretching reduces muscle soreness after running and results in better athletic performance. Gentle stretching after a race or intense workout can also promote healing and lactic acid removal from the muscles. Stretching is most effective when performed several times each week; a minimum of one stretching session per week is sufficient to maintain flexibility.

Most coaches and runners believe in stretching before and after every workout. The experts never agree on much, but the majority seems to feel that stretching is beneficial to runners if done properly. So follow the precautions outlines and always warm up prior to stretching. Your body will thank you and who knows, you may even get a little faster!

Run Happy! And warm up and stretch before!

Novice Marathon Training Advice

Most people get hurt running too much, too soon, too fast. The marathon is just that….a marathon. The training should be done over a 4-6 month period. Put in the time, put in the mileage, and be smart so you will get to the finish line (and be able to walk the next day). Marathon running is like everything else worth doing in life, nothing comes easy and nothing comes free! You have to put in the time and sweat or you will feel the effects of your under-training at the famous “wall” between 18 and 22 miles. I’ve been there, and it’s not pretty….at Chicago in 2004 I thought I was going to perish on the street at 24 miles due to lack of training the last few weeks before the marathon (and a stomach bug the week before)…that was the most painful 4:07 I ever ran….

So what is good training? What program should you follow? Take my advice, if you have never run a marathon before and your goal is to finish your first; join a training group. It’s amazing how much easier those long runs are when you have a group of like-minded (usually completely insane) people to run the distance with. Several national groups are available in most cities and in my personal experience, the Galloway walk-run program and Team-in-Training from the Leukemia/Lymphoma Society seem to be the two best at getting novice runners to the finish line. Local running stores often have good support groups as well. In the DFW area, both Luke’s Locker and Run-On have good training programs. The worst thing you can do is download a program from the internet and try to follow it without any support group. Most people don’t have that much will-power and tend to either quit or get hurt following a half-hazard schedule. Individual training is fine for those of us who have been running marathons for years, but I even like getting my group together and finding a common goal. It’s like group therapy….when you’ve been to hell and back with a group of people, that bond is amazing…I’m closer with my running peeps than most of my family.

Having trouble getting started? Buy a book on marathoning or one that is particularly inspiring. My personal favorite is Jeff Galloway’s Marathon. He gives good advice for the novice runner and helps you to have realistic expectations of your projected finishing time. My most valuable tip on getting started is to find a goal. Pick a race that is 6 months or so in the future. Enter! Write a goal time down on a business card and then write intermediate goals for local 5K’s, a 15K and a half-marathon along the way. Put this card is your pocket or purse and carry it with you everywhere. Look at it daily! Put a sticky note on your bathroom mirror asking “Did you run today?” And keep a detailed log of your running. Either on the computer or handwritten, nothing is more motivating than not wanting to fill in a zero!

So now you’ve started…the first few miles are under your belt and you no longer feel like you are going to throw up after running just a few miles. You have your program, your log started and goal card in your pocket. And two pair of shoes…oh yeah…we forgot to talk about shoes (see Shoe Advice from Dr Crane). Now you are ready…oh yeah, what about stretching (see Stretching 101 from Dr Crane). Truly, you must be ready to go now….oh yeah, my foot is starting to hurt me when I first get up in the morning. I guess there is more to this running thing than just getting out of bed in the morning and lacing on the shoes….but they do say that the hardest part of a marathon training program is the first few steps out of bed or off the couch! Good Luck and Happy Marathoning….need more tips, peruse the website (my favorite is “The top ten things people do to hurt themselves” or send me an email…..and remember, don’t try anything new on race day…same food, same socks, and shoes with at least 50-75 miles on them….