Simply How to Get Started Running

I was sharing with a patient that I was running through my neighborhood this morning and how lovely and peaceful the world looked at 6am. I was energetic and enthused about the start to my day, when the patient stopped me and asked a great question. “How do I tap into that energy? How do I, a certified couch potato, get started running?”

Great question! Running is one of the best ways to get started exercising, but it is very intimidating for many people. I encourage all my patients to start or continue to run, so here is a little advice to get you going.

First, make sure you are healthy enough to start running. A trip to the primary care physician or cardiologist is in order if you have any major health problems like diabetes, high blood pressure or a history of heart problems. A trip to the podiatrist, chiropractor or orthopedist is indicated if you have any lingering issues with your joint and tendons. Remember that almost always it is best to walk before you run.  Walking can get your heart rate up and ready your body for running.

Second, you have to realize that the first few weeks of a running program hurts. It gets easier and easier with time, and the old adage of, “if it doesn’t kill you, it will make you stronger”, definitely holds true! If you stick with it for at least 3 weeks, it will become easier and even fun! Promise yourself to stick with it at least 3 weeks!

Thirdly, embrace the “WHY POWER”!! What do I mean by that? Remind yourself daily why you want to start running. Need some encouragement? Here are a few reasons why to start running:

1.     It’s a great way to get in shape and to lose weight! If you start running, most will slim down, strengthen your heart and usually decrease your cholesterol.

2.     Usually you will start eating better as a side effect. It’s amazing how your diet changes when you realize that what you eat is your fuel. Junk food just doesn’t give you great fuel to run. I’m not saying that your diet will become amazingly better overnight, but in most cases it will improve!

3.     You will decrease your stress. Running has an amazing way to decease your stress and help you find peace. Your running time is your little oasis of time during your busy day. I promise you will start looking forward to it.

4.     Runners are fun and very social people. Most runners say hello to everyone who runs by them. You start to make friends on the trail and then invariably become part of a running tribe. You have running in common and that’s all that matters. Racing makes it even more fun! Times are irrelevant to most; it’s a participation thing!

5.     You will start to think better and more clearly. Running clears your mind and allows your consciousness to flow. It’s amazing how you will find solutions to the problems of your day on the run.

6.     You will find your inner tough guy! There is something about running that makes you start ignoring the little negative self talk in your head. You will be amazed on how tough you really are. Running can be transforming and inspiring!

So now do you have enough reasons to get off the couch and get going? The correct answer is YES!!!

Let’s talk about the rules of the road first.

1.     Start slowly. If you can walk briskly for 30 minutes, then you can start with walk:run (step 2 in the program). If you can’t, then you have to start with walking first. Remember that if you start with too much volume and/or speed, you will burn out quickly. The idea is to get started slowly and build a habit for life.

2.     Increase gradually. I tell people to start with no more than 30 minutes and then add no more than 10% each week. Start with 3 days a week then build to 4 after 3 weeks, then 5 after 4 weeks, up to a maximum of 6 days a week. Even God needed a rest day! Too much, too soon, too fast = injury!

3.     Recruit a friend. It is a lot easier to get started and to stick with any exercise program if there is a friend suffering with you and making you feel peer pressure or guilt to continue! Seriously, it is much easier to stick to a program if you have an accountability partner or group. My Saturday morning running group has been running together for more than 10 years.

4.     Get running shoes fitted to your foot type. Visit your podiatrist or a running specialty store and spend the money on an actual pair of running shoes. You will be amazed on how much better you will feel in a great fitting pair of shoes.

5.     Have fun! This is mandatory! Running should be fun and you should enjoy the process. You are pushing too hard if you aren’t having at least a little fun!

So here is a suggested program to get going…..There are lots of programs out there so this is just a suggestion:

1.     You should walk before you run. Briskly walk for 15-20 minutes three times the first week. If this feels pretty good, then increase by 5 minutes three times the next week. Work your way this gradually to 30 minutes three times a week. When you can do this, it’s time for step 2.

2.     Walk 5-7 minutes to warm up, then run for a minute, walk for 5 minutes, and repeat for a total of 30 minutes. Do this 3 times the first week. Add a fourth day of just walking for 30 minutes. Then next week, walk for 5-7 minutes to warm up, then run for 2 minutes, walk for 4 minutes, then repeat for a total of 30 minutes. Do this 4 times the next week. Gradually working the run:walk from 1:5 to 2:4 to 3:3 to 4:2 to 5:1.  Increase slowly as you feel your endurance improving. There is no set timetable. Everyone is different. When you can run:walk 5:1 for 30 minutes, four times a week it is time to increase duration by 10% each week or go to just running.

3.     Now make a goal! Sign up for a 5K! Make a goal to finish 1 hour of running without walking! Put a carrot out there, because now you are a runner! A couple of 5K’s later, sign up for a 10K! You will be surprised on how a marathon now doesn’t sound so crazy! 

Enjoy the run……

Strengthen Your Strides!

So many of my patients are coming in asking for exercises to strengthen their feet so they will decrease their overuse injuries and be able to wear more flexible shoes. A recent study showed that 27% of people can run barefoot without any issues and that another 14-17% can learn to run barefoot. The other 60% or so have unstable feet that are prone to injury if they run barefoot. More studies are needed to see if these percentages really hold up, but more flexible running shoes with less heel drop are here to stay. Help yourself by strengthening your feet! These exercises can really help thwart the injury bug and stabilize flexible foot types.

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…….

Why Do My Shins Hurt After I Run?

I ran the Lake Grapevine Runners and Walkers Double Trouble 5K/10K duo this weekend. Fun! Crazy weather! It started out at 78 degrees and was down to 52 when we finished the 10K portion.  Got to love a good cold front! A good time was had by all, and it’s great to see everyone out at the lake.

My funny story for the day was that one of the runners sidled up next to me and asked, “Why do you think my shins hurt after I run?” and “How come they don’t hurt when I’m running?” Of course, my first reaction was “It depends….”, and “Good question. Let me catch my breath and I might have an intelligent answer for you.”

Here was my answer:

Your shins can hurt after running for a variety of reasons. The most common is a shin splint. This is actually a term commonly used to describe medial tibial stress syndrome.  What? Yes, stress causes pain along your shin bone and can even cause a stress fracture. In the early stages the painis actually myositis (irriation of the muscle that runs along the shin bone) and this will “warm up” when you run. Stress fractures don’t “warm up.”

Why does this happen? Most common reason is either worn out running shoes or inappropriate shoes to start with. If you have a very high arch, you need a more cushioned shoe. If you have a flat or low arched foot, you need a more stable shoe. Lots of times you just need to part with your old beloved super worn-out running shoes.

Other reasons can be a change in surface like going from the treadmill to concrete. Or a rapid increase in training mileage or increased speed.

When is it time to stop the home remedies and go to the doctor?

Pain 5-7/10 or in a pinpoint spot can indicated a stress fracture!

Pain that has lasted more than a few weeks with rest, ice and over-the-counter anti-inflammatories.

Lastly, if you have changed shoes, tried stretching and icing and still have pain daily….time to come in for a visit.

Some people need help buying shoes, some people need functional foot orthotics to re-align their gait and some people need to rehab their injury with physical therapy.

So the take home point is that your shins shouldn’t hurt after you run!! If they do, you should take a look at you shoes and training patterns! When in doubt, give us a call so we can take a look and make your shin pain go away!

FAANT gave away cute little Body Glide buddies for your gym bag at the race! Adorable!

Reative Rest Options For Active Running Injury Recovery

It happens to all of us at one point or another. It doesn’t matter if you have the muscles and strength of LeBron James from the Miami Heat or the speed and soccer skills of Wayne Rooney from Manchester United. Sometimes there is just no avoiding it: we all suffer from a sport’s injury at some point in our lives. This week it was Derek Jeter from the New York Yankees still sidelined with his ankle injury from last season!  A running injury does not have to be a death sentence to your cardiovascular fitness, there are alternatives to keep you going while your body is healing whether you have a twisted ankle, plantar fasciitis, or a much too common stress fracture. Do not despair; relative rest can actually be a good thing! 

I love my swim training for triathlon!  Michael Phelps would certainly agree, swimming is an excellent, low-impact alternative to running.  As the water supports your body, your joints do not experience the same level of stress and impact they do during a run. There’s no doubt that swimming is a strenuous sport, allowing you to increase your endurance and reach your cardio fitness level just as easily as running. Besides working out, water is also frequently used for rehabilitation purposes, such as kicking your knees back and forth to build strength and increase range of motion after a knee injury or writing the alphabet with your foot to help the healing process of an ankle sprain. If you are someone who often struggles with shin splints, incorporating a swim into your training regime can help to eliminate this problem. Moreover, swimming is a total and complete body exercise, working everything from your arms and abs, down to your heels and toes.  And who knows, you may even decide to try a tri! 

Hate to swim? Fear of drowning or looking stupid in the pool?  If you are more of a land mammal than a dolphin, biking can be another substitute for running. A stationary bike is a great start following an injury as it enables you to adjust the resistance you’re pedaling against to minimize your pain. As you heal, you can increase the resistance and adjust your speed accordingly, or even switch over to a road bike. Similar to swimming, biking reduces the amount of stress on your joints when compared to running, but can still be used to burn calories and boost your endurance. 

 When swimming and biking can’t satisfyingly scratch your itch to run, why not try something completely different? It might not be the first thing you think after an injury, however yoga could be another new and unique alternative to running. And yoga is not just for girls! Some of the best yogi I know are guys who run with us in Grapevine at the Lake Grapevine Runners and Walkers Club! Yoga exercises work to stretch and extend every aspect of your body, including your skin, your muscles, your tendons and your ligaments. All the varying yoga postures will increase the flexibility of your body and ultimately help you to avoid future muscle tears and injuries. Yoga can be utilized as a way to build strength as well. Such stances as the upward dog and downward dog require you to support your body weight with your arms. These postures are then out held for a period of time, compelling the use of your muscles to maintain your balance. The benefits of yoga will not only help you avoid injuries in the future, but will help to perfect your overall running form through improved posture. It is important to keep in mind that some yoga poses will actually irritate your injury, so keep that in mind while you venture into the yogi world.

Last, but never least; you can try circuit weight training. This is combining 3 or 4 different push: pull combinations with light weight training that will increase your heart rate and increase your muscle metabolism at the same time. This is great off season training and recovery training. Think about it, burn fat and build muscle. What could be bad! You may even get some decent looking shoulders, abs and back out of it as well!

 When you do find yourself suffering from a an annoying injury, it can be difficult to accept the fact that you cannot and should not run. Furthermore, that runner’s high, the natural endorphins our bodies create when we run for long distances, can allow us to easily ignore even our most excruciating pains. As addictive as the runner’s high is, I urge you to listen to your body! You will know better than any doctor in the world when something is not right. When your body is sending you signals to take it easy, don’t ignore them. For example, what started out as three to six weeks off may quickly escalate into a year’s worth of recovery time if you push yourself past your limits. Listen!

 No matter what, always stay positive! Don’t forget that you will bounce back from an injury, just like you always have in the past. As long as you have the desire and drive to run, an injury will never hold you back for too long.

Happy Recovery!

Which Hydrates Better: Water or Sports Drinks?

This time of year we seem to be focused on hydration. A heat wave is sweeping the country and runners are feeling like they are running on the face of the sun, even early in the morning.

 Water is by far the most popular fluid choice during exercise. However, sports drinks actually do a better job of hydration, while also providing other benefits that water does not. There are lots of ads out there touting that this drink or that drink are better than water. Is this true?

Yes!

Sports drinks actually do hydrate you better than water. This is because of three things:
 1. The osmolality of most sports drinks is closer to that of your blood, so it absorbs faster.
 2. Most sports drinks contain electrolytes, which help to regulate your fluid balance.
 3. There is sodium in sports drinks that actually makes you thirstier, so you actually drink more.

The ideal sports drink is under debate, but you should chose one that has at least 15mg of sodium and contains at least a little protein. It turns out the protein makes it absorb more too! One study showed that athletes retained only 53% of plain water, 75% of traditional sports drinks and 88% of a carbohydrate and protein mix sports drink.

Water is a great drink choice outside of workouts, but during exercise you're much better off with a sports drink. In this case, there's truth in advertising.

The Road to Ironman Mont-Tremblant Goes Through Lubbock

Janet and I decided we needed a hilly warm up 70.3 race about 2 months before Ironman, so of course we picked the hardest course we could find; Buffalo Springs Lake 70.3 Triathlon in Lubbock, TX.

This was the same weekend that Mont-Tremblant was having their warm up race as a 70.3 on the same course as the Ironman race, but who has the time or the money to go to Quebec twice in one summer? No, we thought, we will drive to Lubbock.

That was our first mistake! We jumped in the car Friday morning and drove the 300 miles to Lubbock. What a beating! There is nothing between Fort Worth and Lubbock but wind farms, crops and cow patties. At one point, we were laughing at all the small towns with population 250ish! Really? We stopped in a Dairy Queen about 100 miles from Lubbock to get a snack. The people in the restaurant looked at us like we had dropped in from another planet.

After a lovely drive (NOT), we checked into one of the nicest hotels in Lubbock, the Holiday Inn (smirk). It actually was not horrible and was clean. Lubbock is not exactly a happening town. There really isn’t much in Lubbock other than Texas Tech and lots of cotton fields. We went to the expo on Friday night and got our numbers. The race shirt was the ugliest one I have ever seen!! A steak dinner and a beer, then off to bed.

Saturday morning we decided to go out to Buffalo Springs Lake and watch some of the sprint triathlon as well as check out the water temperature and the horrendous hills we had both heard about. If you listened to most of our friends, the hills were mountains and we were going to perish on them. Well, the water temperature was about 76 and even though they said it was going to be wetsuit legal, we both decided on speed suits. The lake was gorgeous! The hills were steep, but nothing like the mountains that had been described! We rode out bikes up and down the first 3 hills and decided we would live! A nap then a pasta dinner and we were ready for bed!

4am came really early. We had our breakfast and hit the road about 5am. We ran into a little traffic jam getting into the canyon. Seems there was a race going on! Got to the parking lot and then had to walk our bikes down a gigantic hill to transition. Found our spots and we were ready to go.

Swim waves were interesting. All the women were in one huge wave so the start was a little challenging. Then the majority of the men started just a few minutes later. Needless to say, they ran us right over! I got punched in the eye and was happy I was wearing double swim caps so I didn’t lose my goggles. Then I got kicked in the face and got a bloody lip! Ugh! At least the water was relatively calm and the temperature was very friendly! My swim time was not stellar but I got to transition only bleeding from my top lip!

Onto the bike course we went. The first hill is almost as soon as you leave transition and it was almost a 9% grade! Sadistic! After conquering the first few hills it was relatively flat but the wind kicked up as soon as you left the canyon. My swim was so bad I was convinced there weren’t too many people behind me until we hit the third hill, which was another sadistic grade, but this time I was catching the downhill. Now I know what 40 mph feels like on a bike! Scary!! Sadly I reminded myself I had to go back up that grade on the way back! At this point I saw the crowd behind me as I made the first turn around. Whew! I wasn’t in last place. That would be embarrassing! Janet passed me just about the 30 mile marker like I was standing still! Man is she fast on the bike!! The fourth hill is a long winding grade with killer turns and a skinny road. In other words, as your butt is being kicked by the grade you have to watch out for the people coming down out of control on the turns and trying to kill themselves and you. Written on the road was SLOW DOWN on one side and THANK MIKE FOR THE HILLS on the other! You then hit a long stretch of windy farmland in which you began to cook. Literally. My nutrition and hydration were great and I actually had to pee for about the last 25 miles! A good sign!

I had the pleasure of cheering on a few of the hand-cyclists as they were challenged by the hills. Those guys are tough!! Back into the canyon I went after feeling like I was challenged but not beaten, hit the last two hills and wanted desperately to get off my bike!!

Into transition I went, ditched the bike and found a port-a-potty. Running shoes and a little more sunscreen, I was ready to run! Who turned up the heat? As soon as I hit the asphalt, I felt the heat. Thanks Mike for the roving ice carts. He put people on golf carts with large coolers of ice to help with the heat. The hills on the run were not that bad, but were sadistic in the fact that they were long and it was almost 100 when I started running. When I hit the 6 mile marker, the volunteer at the aid station said it was 105! Crazy! The heat was just wafting off the road. I had ice chunks in my bra and down my pants as well as down my back just to keep my heart rate from spiking. It was walk:run the whole way. Walk through all the aid stations then run until your heart rate started to spike again. A beating! I passed Janet at about the 7 mile marker. She wasn’t faring much better than I was. We were both in hunker down and get it done mode.

I was so happy to enter the park and see the finish line, I almost cried. I crossed, got my medal and shirt then headed for the lake. I barely took my shoes off before I dived in. The water felt amazing!

So that was Buffalo Spring Lake 70.3 Triathlon. A butt whipping of a race, but a great challenge on the road to Ironman Mont-Tremblant. The hills were a challenge, but totally doable. The heat is what got you. Now I understand why it is a Kona qualifier. It was harder than Ironman Texas because of the heat coupled with the tough course. Mike, you are a sadist! And , Yes, we will be back!!

PS. Janet won her category, so she got to go home with a really cute buffalo trophy which she named Leonard. ☺ Very cool!

PPS. Video on the way.....soon

The Road to Ironman Mont-Tremblant Goes Through New Orleans

The road to Ironman Mont-Tremblant went through New Orleans this weekend. As many of you know, that follow this blog, Janet decided to go to Galveston and I chose New Orleans for our early season half Ironman. I chose New Orleans because last year in Galveston, I had a really hard time staying upright while biking into a 30 mph head wind. I thought New Orleans would have better weather! God has a sense of humor!

New Orleans Ironman 70.3 was in a word - windy! Crazy, insane windy!! It was also only 67.1! The wind caused the race director, Bill Burke, to have to cancel the swim for the second year in a row. I actually felt bad for the guy since so many people were so upset, but when we got down to the water on Sunday morning, it was obvious that drowning was a risk given the 5 foot and higher waves!

We actually did a run-bike-run triathlon, which was much better than what they did at the Poconos 70.3 last year. At that race, after cancelling the swim, they attempted a time trial start of the bikes starting participants 3 seconds apart. This sounds good in theory, but the roads were very wet and there were crashes all over the place! In New Orleans, they were creative and wanted to keep the relay teams intact, so they made us run 2 miles to start then ride 52 miles (shortened due to road closures) and then run 13.1 miles to finish.

I met my friend Linda, from Arizona, in New Orleans and she was pretty anxious to do her first 70.3. She is attempting Ironman Arizona in November, so she needed a warm up race as well. I made a pact that I would never race without Janet again! Every time I go to a race without Janet, the weather sucks!

The best part of my race was the beginning of the 2 mile run. They started us in pair about 2 seconds apart and I was in the 5^th wave (40 and older women). This wave included all the “old” ladies. I started near the back of the wave and was just completing the first mile when I came upon a woman with an “81” on her calf.  I glanced at her and then realized it was the “Iron Nun”! Sister Madonna Buder is a Catholic nun who has completed over 400 triathlons and is an inspiration to all at The Ironman World Championships every year! (If you haven't read her book, it will inspire you!) I said, “Good Morning Sister!”, just to make sure it was her and then had a short conversation running along with her.  Such a positive person and it was a thrill to meet her. She is still running strong and should be an inspiration to all of us to keep moving! I told her I only hope I am still competing in 40 years!

After the short run to warm up, we jumped on our bikes to brave the wind. Crazy, insane and, at times, dangerous wind! I was trying to maintain 19-20 mph but no such luck. I worked very hard to keep 17.8 mph average into a 25mph+ head wind! It seemed like the wind was in your face no matter what direction you were going in! There were only 4 hills on the entire course, (Louisiana hills also known as overpasses ha ha) and at the top of one of them, a gust practically threw me off my bike. The bike actually felt like it went airborne for a second! I finished the bike in one piece and was happy to start running.

Then someone turned up the heat! The run was a double loop with awesome crowd support and plenty of aid stations! Thankfully lots of water and wet sponges since it was so hot! Very flat with a few small hills but overall a nice rolling course.  The casts of characters were out, just like most races. We had 3 Spidermans, guys in jester suits, and my favorite….guys running in their wetsuits with goggles and all, probably protesting the no swim!

I was happy to wave to Sister Madonna on the run and shamefully happy she was on the other side of the road about 5 miles behind me (who wants to get beaten by an 81 year old!!). I finished strong and with a smile. Legs of jelly from pushing hard on the bike made for a slow run, but overall a good day! No pesky plantar fasciitis showed up, so I think I have cured myself with EPAT finally! I have some work to do before I am ready to tackle the mountains in Quebec, but I earned my post-race beer today! Linda finished not so far behind me with a big smile!

Next up….Buffalo Springs 70.3….

The Long Road to Ironman Mont-Tremblant FAANT Girls' Style!

The road to Ironman Mont-Tremblant in Quebec officially starts for the FAANT girls this weekend. It’s finally time to admit that I better get my butt in gear and get training a lot harder. Janet has been in full gear for about 6 weeks or so….I’ve been lazy until the last two. Looking at the calendar, we have only 20 weeks to go and the challenge is mighty! For anyone who wants to laugh at us or is just curious, go to www.ironmanmonttremblant.com and take a look at the elevations on the bike course. We must be out of our minds. We live in almost the flattest state in the union, so we pick the Ironman with the most hills we can find J

Today’s video blog is just a taste of what we have in store for our friends! In two weeks, I am “participating” in the Ironman 70.3 in New Orleans and this should be a good barometer of how poor my fitness is at this point! Janet and I will be racing in the 70.3 in Buffalo Springs (Lubbock, TX) at the end of June! Hopefully by then it won’t hurt so bad!

A 50 mile bike ride (Janet actually continued and did something on the order of 100 miles) on Saturday followed by an hour or so open water swim on Sunday with a short run afterwards sounds like a great Easter weekend! Thanks go out to all our friends from Lake Grapevine Runners and Walkers who joined us!

That’s all for now….I hope you enjoy this next adventure with us.

For more, follow us at www.myrundoc.com (Crane) and www.healthystepsdfw.blogspot.com (Dixon). I promise it will be good for a few chuckles along the way.....

Can Compression Socks Make You Run Faster?

Podiatrists have been prescribing compression socks for years to treat things like chronic edema, lymphedema, varicose veins, and to prevent deep venous thrombosis; but recently they have started showing up on perfectly healthy runners. Yes, sometimes compression socks are used to treat shin splints, but do they make you faster? Can you run longer in compression socks? Many runners and triathletes swear by wearing compression they feel faster and recover better. Do they really work? Is there any scientific evidence that they really work? Or is this just more running lore?

In 2007, one study showed no increase in endurance or speed, but they were shown to stimulate blood flow, helping legs recover faster from a hard run. OK, so they help recovery, but can they make me faster? That early study didn’t think so, but that’s why we kept looking.

Most theories about how compression socks improve running performance focus on the physiological and biomechanical support of the lower legs.

It is assumed that compression socks may enhance venous return to the heart through a more efficient calf muscle pump, leading to increased endurance capacity. And there is the notion that because muscles are kept more compact, balance and proprioception are improved and muscle fatigue is minimized. Sounds reasonable, but again, what does the research show?

It wasn’t until 2009 that a German study clearly showed that they enhance performance during hard runs. And research done in South Africa and New Zealand both show that knee-highs also improve recovery by boosting blood flow in the extremities. In fact, even compression socks (not your Grandma’s TED hose) have been shown to increase resting arterial circulation by 30% and 40% under physical strain. Many compression sock companies even tout that they have studies that shoe an increase in running efficiency by 5%, which can equate to taking 12 minutes off a four-hour marathon. Crazy? Maybe not?

Yet they still aren't for everyone. One German study conducted on super-fit elite athletes (not most of us in the back of the pack) reported no performance payoffs from compression. According to the study, the socks work better when they're squeezing more performance out of non-elites (you and me).

Lots more studies to come, but if donning some hot pink knee socks will take 12 minutes off my marathon time, bring them on!

New Study: Foot Orthotics Can Prevent Running Injuries

The top three questions runners ask about custom foot orthotics are:
1. Should they use orthotics in their shoes while running if they don’t have an injury?
2. If they have fatigue in their legs while running or a jacked up gait, they often wonder of orthotics will help?
3. Should they wear orthotics forever after an overuse injury?

The answers are yes, yes and yes!! A new study showed that orthotics have a significant benefit in reducing running injuries as prophylaxis. It makes common sense, that if you have an underlying biomechanical deficit, orthotics give you better alignment so therefore should reduce overall abnormal stressors and subsequently injuries. Now there is a new study that shows just that! Piggy-back that on years of biomechanics research and the answers get much more clear.

This study demonstrated that the subjects who wore orthotics had "a significantly reduced rate of exercise-related lower limb injury across the training period". The authors emphasized that participants were not treated for an injury with orthotics, but were prescribed orthotics to prospectively reduce the risk of injury. In addition, they believe that these "preventative results can be cautiously extrapolated to a recreational running setting and should be considered by sports and exercise medicine professionals."

We generally prescribe foot orthotics to treat specific injuries. This study indicates that orthotics can be a valuable prophylactic tool for injury prevention, supporting orthotic use in at-risk populations (e.g. runners) for medial stress syndrome, iliotibial band syndrome and Achilles tendinopathy. Considering the results of this study and the results of a previous study on the use of orthotics in runners by Mundermann, it is recommended to use at least a pre-fabricated Powerstep orthotic which incorporate a medial heel skive and rearfoot post, as a cost-effective means of providing prophylaxis with corrections proven effective in runners. Runners with a previous history of these injuries and/or those that develop symptoms would be good candidates for custom orthoses based on the results of these two studies.

Franklyn-Miller A, Wilson C, Bilzon J, et al. Foot orthoses in the prevention of injury in initial military training: a randomized controlled trial. Am J Sports Med 39(1):30-37, 2011

Mundermann A, Nigg BM, Humble RN, et al. Foot orthotics affect lower extremity kinematics and kinetics during running. Clin Biomech 18(3):254-262, 2003

Spring is in the Air in DFW...Time to Dust Off the Running and Cycling Shoes!

So Spring is in the air in the DFW area! Time to dust off your bike and running shoes and head outside. Forego the treadmill or the trainer for fresh air! Yea!

So if you are like me, it’s also time for new running shoes. The battered winter pair have had it! How long are running shoes good for? About 500 miles or six months, whichever comes first! Now an aside about the recent craze in minimalist shoes, just because they are “minimal control and cushion” does not mean that they last longer and don’t need to be replaced. In fact, I found my more minimal shoes seem to wear out faster.

So you haven’t reached the 500 miles or six month expiration date because you have been lazy the last few months of winter? Please at least decontaminate your shoes! Take a spray anti-fungal (my favorite is Mycomist) or use a shoe sterilizer (like Steri-Shoe) and get rid of the cooties that have been growing in those idle shoes. Don't have something to decontaminate your shoes? Stop by Healthy Steps and they can hook you up! This is especially important for cycling shoes that have been sitting in the closet or garage all winter. Cultures of these kinds of shoes show fungus among us, as well as, staph, strep and nasty pseudomonas bacteria!

Also time to take a look at the sock collection. Socks don’t last forever and tend to shrink. If your socks are too small, you can get black toenails and even lose toenails just from the pressure of the socks! If your socks are more than a year old, toss them and buy yourself a spring treat of new socks!

And last, but never least, it’s time for girls to take a long look at their jog bra collection. Just like socks, these bra tops need to be replaced about once a year if you expect any supports for “the girls”.

Enjoy this first taste of spring coming to Dallas-Fort Worth….who knows, next week it could snow; but my money is on spring is here to stay! Enjoy it before the sultry summer descends upon us!

Doctors Can Get Hurt Too!

Confessions of Myrundoc: Do as I Say, Not as I Do.....

Time to come clean. Yes, I too can fall victim to a running injury. And yes, of course it's a foot related issue. Turns out the old adage is true that doctors are the worst patients, just like plumbers often have leaky pipes at home :) in fact, I think doctors are the worst patients only trumped by pilots. Yes, it's a control issue!

Because I'm the local authority on running injuries I of course started to treat my injury when it was in its mild form....Not! No, I did like most of my patients and ignored it until my foot hurt so bad the day after a race that I could barely out my heel on the ground. Yes, I suffer from the dreaded and incredibly common plantar fasciitis in my left foot. Why? A combination of the perfect storm.

I would like to blame it on the White Rock Marathon, you all remember that glorious day.....45 degrees, pouring rain....but if I'm honest, it started way before that. I ran the DRC Half in November with bronchitis (also a brilliant move) then barely trained the rest of that month as I was getting over my upper respiratory infection. Couple that with an incredibly busy November and December in the office and the OR; you get poor training schedule, exhausted body and depressed immune system. Oh yeah, I also ran the White Rock Half marathon in the pouring rain and had to run the Bold in the Cold Half marathon because my running club was putting it on and the medal was cool.

Long story short, what started as a little tightness at the Phoenix Turkey Trot over Thanksgiving (oh yeah, ran that too, then climbed Camelback Mountain the next day), became a swollen, sore foot by the first weekend in January.

So what do I do? I stopped running. This wasn't really a choice since I could barely put my foot on the ground the day after Bold in the Cold. I started icing, taking Advil and lots of stretching. I looked at my shoes and realized I had five pairs I was working on and all of them were dead. My orthotics were 3 years old and needed replacing. I started wearing nothing but a brand new pair of running shoes to work and clogs on the OR. I even let my partner give me a steroid injection. And I got in the pool and on the elliptical and bike so I didn't gain a million pounds!!

A month went by and I was somewhat better. Maybe 50% but still couldn't run. I was now starting to get annoyed and my staff wanted me to get back to running so I would stop being cranky! Onto EPAT....why have technology if you aren't going to use it? What is EPAT. Yes, I had the EPAT procedure performed the first week in February and yes, it hurts like hell but way worth it. I was about 70% better after the first treatment and 80% after the second. I still did the night splint (incredibly annoying but effective for the first thing in the morning owie), had gotten a brand spanking new pair of custom orthotics and still wearing nothing but running shoes, clogs and a two inch heel when necessary.

I went for my first run in 6 weeks yesterday in Napa Valley, CA. I was in wine country for a conference and my foot was feeling so much better. I did 4 miles of walk run and did pretty well. Tight but not painful! I'm going to have my third EPAT this week and I think that should do it. Maybe I will let the staff video it so you can all join in.

What did I learn? Listen to my own advice. If I had started stretching, icing and looked closely at my shoes and orthotics at Thanksgiving; this whole saga probably could have been avoided. Stubbornness and the fact that when I close my eyes I'm 19, did not help me recover. Thank God for technology! The EPAT certainly saved the day for me. I'm sure two months of physical therapy would've had the same result, but time was short and technology available! Bring on the triathlon season! First race St. Pat's Sprint Tri in Keller on March 10th!

Video Blog: Does Running in the Rain Make You Sick?

You asked for more video blogs, so here is the beginning of a new series :)



So enjoy running in the rain! Jump in puddles!! Have fun!

Does Running in The Rain Make You Sick?

It’s one week after the cold, wet rain permeated the White Rock Marathon. Lots of people, including my mother, have asked me if I caught pneumonia from running “The Rock”?

So, does running in the rain make you sick? This is one of those questions that seems to be doomed to getting inconclusive answers forever. Especially when it comes to the opinion of Mom!

People usually do get sick more when the weather is rainy. That's because they stay indoors more, and indoors is where cold and flu viruses spread because of increased contact between individuals. On a sunny warm day, everybody goes outdoors, where there is (obviously) more space, better ventilation, and less physical contact with large numbers of other individuals.

Catching an infectious disease such as the common cold requires direct exposure to the pathogen (virus). Exposure comes in the form of close contact with an infected individual. Going into cold and rainy weather will not make you sick unless you also get colonized by the pathogen while you're out there.

There have been reports that cold temperature itself reduces the effectiveness of our immune system, but even that's not sufficient alone - you'd still need exposure to the virus.

Bottom Line:

"I'll get sick if I stand out in the rain or go out into the cold without a hat on" - Fiction

"Cold and rainy weather causes virus infections to spread more rapidly than usual" - Fact, due to people staying indoors more

Prevention:

Wash your hands, stay away from people who are sick, and feel free to run and play in the rain, just like we did last Sunday at the White Rock Marathon. Run Happy....and remember to jump in puddles after the 6th mile when your feet are already soaked!

Can You Name 11 Things to Know About 11/11/11?

Do You Know 11 Things to Know About 11/11/11?

1. Did you know that tomorrow, November 11, 2011, happens only once every 100 years? Cool! And No, I don’t think anyone is predicting that the world is ending on that date!

2. It’s your lucky day! Brush it off as nothing more than a prime number, but some people look to the number 11 for good luck. What makes 11 more special than, say, 4, 15, or 3,856? Numerologists associate the number with balance and congruency, and math whizzes think it’s interesting because of little facts like this: If a number is divisible by 11, reverse its digits and that will create another multiple of 11 (for example, 1,056 is divisible by 11 — reverse it to 6,501, and that’s also divisible by 11).

3. Or is it your unlucky day? For every person on Team 11, there’s also someone who wants nothing to do with what they believe is actually an ill-fated digit. The 16th-century scholar Petrus Bungus said that 11 "has no connection with divine things, no ladder reaching up to things above, nor any merit" — and because of this, many numerologists of his time considered the number to represent pure evil.

4. Wedding bells will be ringing! You don’t need good luck to make a marriage last — you need love, respect, and hard work. But maybe it can’t hurt to get hitched on 11/11/11. In fact, more than 24,000 couples across the United States plan to wed this Friday, according to WeddingChannel.com — compared to about 1,500 couples who get married on an average Friday in November and 2,667 pairs who tied the knot last Valentine’s Day.

To prepare for the influx of marriage applications, the marriage license bureau in Las Vegas has even announced that it is increasing staffing on Nov. 11, according to USA Today.

5. There could be a baby boom, too. At Baylor Grapevine, there are already quite a few C-sections on the schedule for tomorrow! What’s even better than having an 11/11/11 anniversary date? An 11/11/11 birthday. And back in February, some parents-to-be did their darndest to conceive a child who would be born on the lucky day. Couples who enjoyed a Valentine’s Day romp could be in luck, as a baby who was conceived around February 18 could very well be born on Nov. 11.

6. Nov. 11 is also Veterans Day. It may be getting overshadowed this year by weddings and gambling, but Veterans Day is celebrated annually on Nov. 11. The United States honors its war veterans on this day to commemorate the signing of the armistice that ended World War I, which went into effect on the 11th hour of the 11th day of the 11th month. This 11/11/11, don’t forget to pay your respects to those who have served our country.

7. And it’s Corduroy Appreciation Day! It’s time to don your favorite pair of cords, since Nov. 11 is also National Corduroy Appreciation Day. It’s been celebrated annually on this date for the past few years, as 11/11 most resembles the lines of the fabric. And since this year there’s an extra 11 in the mix, corduroy fanatics everywhere will be celebrating in a big way: According to MSNBC, events include the Chicagoland Corduroy Appreciation Ball in Chicago and the Annual Grand 111111 Meeting in New York City.

8. Break out the origami and heavy metal. Okay, so it’s Veterans Day, Corduroy Appreciation Day, and thousands of couples’ wedding days. But Nov. 11 is also Origami Day in Japan (where the paper crane symbolizes peace), as well as National Metal Day, when VH1 will be honoring heavy metal music (rumor has it, the original lineup of the band Black Sabbath, including Ozzy Ozbourne himself, may reunite for the momentous occasion).

9. It’s a great day to jet set. Come Friday, Americans will be doing more than tying the knot and sporting cords — plenty of people are also going on vacation to take advantage of the once-in-a-lifetime 11/11/11 deals offered by travel Web sites to celebrate the day. Where is everyone headed? According to Viator.com, the Grand Canyon is one of the top destinations, as well as Paris, New York City, and Niagara Falls.

10. The last 11/11/11 made weather history. Though few people are old enough to remember the last 11/11/11, it was also famous for the Great Blue Norther, one of the biggest cold snaps — a dramatic temperature fluctuation — in U.S. history. For many Midwestern cities, this date in 1911 was only time when record-high and record-low temperatures were broken on the same day.

11. 11/11/11? There’s a Facebook group for that. If you’re feeling like the lone 11/11/11 reveler in your circle of friends, look no further than the 11:11 Facebook fan page. This group of more than 643,000 people from around the world is counting down to 11:11 a.m. on this momentous 11/11/11. Cheers!

Crazy, but I’m sure someone is having a special 11/11/11 race somewhere today! Maybe we should’ve planned that! 11 miles on 11/11/11!

Happy November 11, 2011!

Ps. Most of this was taken from a fun article on http://www.everydayhealth.com/ Thanks guys!

Can I Run on a Stress Fracture?

Lots of good questions in my Grapevine, Texas office and on the website this week. It is definitely marathon time of year! Lots of aching feet and legs from erratic training and “too much, too soon, too fast syndrome”.My favorite is “I have XYZ Marathon in a few weeks, Can I run on a stress fracture?” This was actually asked three times in two days by a patient and once in an inquiring email on www.myrundoc.com

Of course, my answer was, “Really?.....” Ok, so you think you are a tough guy and can run through a stress fracture, but this is a very bad idea!

1. Hurts like hell!



2. Probably break it into many more pieces



3. Probably end up not running for months



4. May end up on my operating room table for pins, plates and/or screws!



5. Are you really that stupid???

Seriously? A stress fracture is a small crack in the bone that hasn’t fractured all the way through. Guess what happens when you run on it? It breaks all the way through!

So, if you are running in the Olympic marathon and think you are amazingly tough, then try it; but bottom line: NO! You can’t run on a stress fracture! If you try, you probably won’t be running for quite some time after that race, so it better be worth it!

Learning point: If you even think you may have a stress fracture, an x-ray is indicated pronto! Remember that they often do not show up on plain films for up to two weeks after the injury. The tip of my index finger is usually right! Give us a call and we can squeeze you in. The best part of having 5 doctors at Foot & Ankle Associates of North Texas in Grapevine, is that we can always find an emergency spot with one of our doctors!