Merry Christmas and Happy New Year!

From my family to yours, Merry Christmas and Happy New Year!

Oral Sunscreen? Try Heliocare to Decrease the Burn!

I just got back from a fabulous vacation over Thanksgiving in Turks and Caicos. Amazingly I came back slightly tan, but no sunburn this time! Liberal use of 50 SPF sunblock and daily dose of Heliocare definitely made all the difference. I lost a very close friend to melanoma last year and this woke me up to the dangers we face everyday in Texas due to significant sun exposure. My dermatologist friend, Dr. Angela Bowers, introduced me to Heliocare and I really think it made the difference.

Runners are notoriuous for getting patchy sunburns. Even if you remember to slather on the sunscreen, you somehow managed to miss your nose? Or the back of your hand? Or the back of your calf? You're not the only one. According to the American Academy of Dermatology, most people apply less than half of the optimal amount of sunscreen, a habit that adds up to a lot of burned patches and uncomfortable rides home from races. The ahi tuna look the day after a marathon is just not good!

If you don't completely trust your sunscreen skills, you might be interested in Heliocare, a supplement that promises sun protection in a pill. Each Heliocare capsule contains 240 milligrams of an extract of Polypodium leucotomos, a tropical fern rich in antioxidant compounds such as caffeic acid and ferulic acid.

Here is some info I took from their website:

Users are instructed to take one capsule every day with water or juice. Two capsules are recommended before heavy exposure to the sun. I took two a day on vacation.

The claims

The company website says Heliocare is an "all natural oral antioxidant which helps protect against UV ray damage and aging." The fine print clarifies that "it is not a sunscreen and should be used in addition to topical skin protection."

The bottom line

No supplement could ever replace the need for sunscreen, but the idea of sun protection in a pill isn't as far-fetched as it may sound., says Dr. John Murray, a professor of medicine in the dermatology department at Duke University School of Medicine in Durham, N.C.

As Murray explains, sun damage is an oxidative process. UV rays can trigger the release of harmful compoundsknown as free radicals, and antioxidants can help protect the skin by mopping up the free radicals before they have a chance to cause mischief. In fact, Murray says, plants contain antioxidants largely to protect themselves from harmful rays.

But taking a pill isn't necessarily the best way to harness the protective power of antioxidants, Murray says. Instead, antioxidants are likely to be more effective if they are applied directly to the skin: In 2008, Murray and colleagues published a study showing that a topical ointment containing antioxidant vitamins C and E helped prevent both visible sunburn and the type of DNA damage that can raise the risk of skin cancer.

"Ingesting a pill doesn't mean that the antioxidants will actually reach the skin," Murray says. For example, you can protect your skin somewhat by taking vitamin E and vitamin C supplements, but "the effect isn't going to be as great as [topical] vitamins E and C."

Murray doesn't recommend any particular product. However, some sunscreens, including Aveeno Continuous Protection Sunblock Lotion and Soleil Expert Sun Care, do contain antioxidant vitamins.

There is solid evidence from the lab and human trials that extracts of Polypodium leucotomos -- Heliocare's active ingredient -- can offer at least some sun protection, says Dr. Salvador Gonzalez, a dermatology researcher at Memorial Sloan-Kettering Cancer Center in New York City who has co-authored at least 17 studies on the plant.

For example, he co-wrote a study published earlier this year that found that a Polypodium leucotomos extract blocked skin-damaging enzymes and helped build up collagen in human skin samples exposed to UV rays. Gonzalez is a paid consultant for Industrial Farmaceutica Cantabria S.A., the Madrid-based parent company behind Heliocare.

"It's important to keep in mind that Heliocare is not a magic bullet against sunburn," Gonzalez says. He estimates that the supplement provides a sun protection factor of 3, which would put it roughly on par with a weak sunscreen. It's certainly not enough to completely prevent sunburn, he adds, but any burns would be slower to develop and less severe.

Oral sunscreen sounded far-fetched to me, but I definitely noted a difference. Reminder: This is not an alternative to sunscreen, just some additive protection!

Dr. Crane is running the Boston Marathon in honor of David Bloom, a beloved physical therapy partner of FAANT to raise money for melanoma research and awareness. For more info or to donate to the cause click here. Dr. Crane is personally matching dollar for dollar your donations! No amount is too small to make a difference!

MyRunDoc Running Boston Marathon in Tribute to a Friend!

I have dedicated the 2014 Boston Marathon to the memory of David Bloom, my long-time physical therapy partner at Restoration Physical Therapy. See the whole story on my fundraising page for the Melanoma Foundation of New England.


Fundraising Websites - Crowdrise

To Stretch or Not To Stretch Before Running

Why do most men forego stretching and then wonder why their Achilles tendons, plantar fascia and hamstrings bother them? They also see to forget to warm up in the winter! Alright, to be fair, its not just men……many runners seem to be too busy to warm up or stretch but seem to have time to visit my Grapevine, TX office when they can’t run from tendon pain!

In all fairness, it seem that the jury is still out when it comes to stretching in the running community. To stretch or not to stretch? That is the question…..

I have been running for more than 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 friend’s 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!

Do You Have Subluxing Cuboid Syndrome? A Pain in the Outside of Your Foot!

Do you have pain and weakness along the outside of your foot? Perhaps you have a history of a traumatic sprain from landing on another person’s foot or falling off a curb. Maybe there is no history of acute trauma but gradual onset of pain over a period of time that doesn’t respond to physical therapy, injections or anti-inflammatories? Sounds like cuboid subluxation syndrome!

What Causes Cuboid Subluxation Syndrome?

Injury to the joints and ligaments around the cuboid bone during an inversion ankle sprain results in cuboid subluxation syndrome. Cuboid syndrome is a common cause of lateral foot pain in the athletic population and is often misdiagnosed or mistreated. It is a minor disruption or subluxation of the structural integrity of the calcaneocuboid portion of the midtarsal joint.

An athlete with a cuboid subluxation will complain of lateral foot pain and weakness in push-off. The pain often radiates to the plantar aspect of the medial foot, the anterior ankle joint or distally along the fourth ray. It is common in ballet dancers and runners.

During a physical exam, there is pain upon palpation on the plantar surface of the cuboid. Sometimes the subluxation can be reproduced, but not often since it is usually subtle. It is important to be aware that diagnosing cuboid syndrome via radiographs, computerized axial tomography (CT) scans or magnetic resonance imaging (MRI) is difficult because of the normal variations that exist between the cuboid and its surrounding structures, and the minimal amount of subluxation that is usually present.

What else could it be? 


• ·      Sinus tarsi syndrome

• ·      Lateral process fracture of the talus

• ·      Acute tendinitis of the peroneus longus tendon

• ·      Fracture of the anterior process of the calcaneus
• ·      Malalignment of the lateral ankle and subtalar joints

• ·      Fractures (including stress fractures)

• ·      Gout
Inflammatory and noninflammatory arthritis

• ·      Tarsal coalitions (in adolescents)

Once one has diagnosed cuboid syndrome, reducing the subluxed cuboid is the first step in the treatment process. Clinicians may employ a manipulative technique, which is often defined as a low-amplitude, high-velocity mobilization at the end of joint range, to restore proper joint congruency.

Afterward, patients should use a cuboid pad in conjunction with a taping technique to maintain the cuboid reduction and give the arch added support.
 Keep in mind that the cuboid pad may at times spontaneously adjust a mildly subluxed cuboid by its upward thrust.
Long-term treatment is a semirigid orthotic with a cuboid pad placed on the device. Physical therapy techniques are often used to return normal foot function. Patients may gradually return to sports activity when the pain subsides.

Keep in mind that cuboid subluxation following a second-degree or third-degree lateral foot sprain requires special care in order to prevent the development of a chronic condition. If one suspects a cuboid subluxation after a lateral foot sprain, reduction is not attempted until the swelling and bruising have significantly diminished and the possibility of a fracture has been ruled out.

Bottom line: after an inversion sprain, if you still have lateral foot pain once the swelling has gone down, you may have subluxing cuboid syndrome. An evaluation and treatment of a subluxed cuboid is essential in order to restore normal joint range of motion, alleviate pain and improve foot function.

It's Time For Dallas Athletes Monster Triathlons 2013

Halloween season means it’s time for the Dallas Athletes Monster Triathlon series. Unfortunately it’s also very cold outside in the wee hours of the morning! The start of the Denton version of the sprint series was very chilly, but a fun time was had by all! Lots of great costumes and Halloween cheer!

This weekend is the kid’s triathlon on Saturday and the Keller sprint on Sunday! The kid’s tri is always a blast! I love to see parents contaminating their children in a good way! The kids are of all ages and there is always a few tots on tricycles to warm all of our hearts.

I’m looking forward to more good costumes and pancakes on Sunday morning! There are lots of first timers signed up so don’t be scared! You too can try a tri!

Happy end of the season for most triathletes! Join us at Monster this weekend for a monster mash!!!

On to marathon season…….