Saturday, January 17, 2009

Got Heel Pain? Video Blog

RunDoc discussed heel pain and its many causes as well as treatments



For more information on adult heel pain, click here!

For more information on pediatric heel pain, click here!

Friday, January 9, 2009

Cold Weather Slowing Your Runs?

In Texas, the saying goes that if you don’t like the weather; wait 5 minutes, it will change. This week alone it’s been 70 degrees and 24 degrees. No wonder the whole world is sniffling. Personally, I hate the cold. I’m a tiny person so I’m very cold intolerant. My bike goes inside on the trainer when the weather hits 40 degrees and I look like an Eskimo running. How do we keep motivated during the winter? Things seem to change for me when it’s cold outside. It seems much harder to get out of bed, much harder to run out the front door and a whole lot harder to finish a long run.

In spite of my obvious aversion to cold temperatures, I have trained for years all winter long. In Texas, this means crazy temperature swings. As a teen, in Rhode Island, it meant bitter cold and snow. In fact, I can remember as a high school cross country runner racing in snow and ice and wearing shorts (like an idiot). Training in the cold can make you tougher, but take some advice and dress for the elements. Thank God they finally invented cold weather gear that does not weigh a ton and make you look like you are ready for skiing, not running!

The real goal of cold weather running is to maintain motivation, not get too cold and not get too hot. Easier said then done! One solution to this is to just head indoors and stick to the treadmill. I absolutely despise running on treadmills much more than running in the cold, so unless it’s raining; I’m outside. In addition to the boredom, the repetitive motion of the treadmill can put you at risk for other injuries such as stress fractures. It’s best to have some variety.

The key to staying comfortable and cold weather condition is to be prepared for changing temperatures. Dress in layers and don’t be afraid to overdress. Wear a hat and gloves. I even pull out chemical finger warmers if it’s really cold. If it all possible try to run small loops somewhere near your car or a place where you can discard layers if you start to get hot. You don’t want to be nine miles from home and running with hat in hand, sweating with two jackets tied around your waist.

If you are overloaded with too many layers, you can just as easily overheat when it’s 30° outside. This will make you nuts because you will lose the energy needed to finish your run, just like a hot day, and you may become soaked with sweat be more prone to thermal injury such as frostbite. As soon as your run is over, do not stand around outside. Immediately change into dry clothing. Your core body temperature will drop precipitously immediately after a run. This is why they always shroud you in a blanket at the finish of a marathon, even when it’s hot outside.

Aside for making sure that your temperature is regulated, there are special environmental considerations when running outside in winter. If it happens to snow where you run, you obviously have to watch your step. Be very careful running on ice. Running on snow is easy, but ice will put you on your back before you know it. If you’re lucky it’ll just be an embarrassing fall, but you can get seriously injured this way.

Always wear a hat to keep your head warm. This can be a baseball-style cap, but once it gets colder than about 40° however, you will likely have to switch to a knitted cap that will do a better job of keeping your head warm. It likely goes without saying that you should avoid natural materials such as cotton, that retain moisture and can put your risk of getting too cold. Always use synthetic materials.

As a general rule, you can get away with shorts or tights and a long sleeve T-shirt when it’s in the 50s. If it drops down into the 40s, you need to add a hat, gloves and an additional layer on top. A vest is a nice addition. Once it gets down into the 30s, it’s better to stick with tights or pants and wear three layers on top, as well as hat and gloves. If you’re brave enough to run when it’s in the 20s, you might also want to wear a jacket on top of your many layers. Unless you really like to torture yourself, or live in Alaska, it’s probably better to just stay inside when the temperature drops into the teens.

Keep in mind, your body can become acclimatized to colder temperatures if exposed to them often. However, for people like most of us who are only rarely exposed to cold temperatures, they’re more likely to be a poor judge of when frostbite or other cold injuries are starting to set in. Use common sense. Texas weather is nutty, so the layered look is a must this time of year!

Sunday, January 4, 2009

Walking Program to Kick Start New Year's Resolution

Many of our patients, much like their estimated 75 million obese neighbors, are stuck in a never-ending, life-threatening cycle: Obesity aggravates the pain in their feet; sore feet make it almost impossible to exercise for weight loss; and without exercise, their weight continues to increase which puts them at risk for worsening of diabetes, heart disease, high blood pressure, stroke and other life threatening diseases.

It’s the New Year and more than 50% of New Year’s resolutions have something to do with weight loss. This includes a resolution to exercise on a regular basis. Do not let foot pain thwart your resolution to exercise! The best way to break the pain cycle is to seek help from your podiatrist. Often simply placing you in the correct shoes with arch supports or custom foot orthotics will decrease your foot pain and fast track your resolution to exercise.

Many of our patients have not exercised in years, so they have many questions on how to get started. Before starting any program, it is important to discuss exercise with your doctor to see if you have any restrictions due to heart disease, diabetes, or arthritis. Get a physical! It’s a great way to start off the year. After your physical, visit your podiatrist to discuss your foot and ankle aches and pains.

There is no perfect exercise program for anyone, but if you are more than 20 pounds overweight, I recommend you start with a walking program that also has a strength and flexibility component worked in. What does that mean? Start with walking, not running, and add stretching and a little weight training to balance your program. If you need help with program specifics, consult a personal trainer or physical therapist.

Walking really is the easiest and least expensive exercise program that can be done indoors or outdoors; and this can progress to a running program as you lose weight and get healthier.

Did you know that inactivity is the second leading preventable cause of death in the United States, second only to tobacco use?

Need more motivation? Here are six great reasons other than the obvious physical fitness improvements to start a walking program:

1. Walking prevents type 2 diabetes. The Diabetes Prevention Program showed that walking 150 minutes per week and losing just 7% of your body weight (12-15 pounds) can reduce your risk of diabetes by 58%.
2. Walking strengthens your heart. In one study, mortality rates among men who walked less than one mile per day were nearly twice that among those who walked more than two miles per day. Women in one study who walked three hours or more per week reduced their risk of a heart attack or other coronary event by 35% compared with women who did not walk.
3. Walking is good for your brain. In a study on walking and cognitive function, researchers found that women who walked the equivalent of an easy pace at least 1.5 hours per week had significantly better cognitive function and less cognitive decline than women who walked less than 40 minutes per week. Think about that!
4. Walking is good for your bones. Research shows that postmenopausal women who walk approximately one mile each day have higher whole-body bone density than women who walk shorter distances, and walking is also effective in slowing the rate of bone loss from the legs.
5. Walking helps alleviate symptoms of depression. Walking for 30 minutes, three to five times per week for 12 weeks reduced symptoms of depression as measured with a standard depression questionnaire by 47%.
6. Walking reduces the risk of breast and colon cancer. Women who performed the equivalent of one hour and 15 minutes to two and a half hours per week of brisk walking had an 18% decreased risk of breast cancer compared with inactive women. Many studies have shown that exercise can prevent colon cancer and even if an individual person develops colon cancer, the benefits of exercise appear to continue both by increasing quality of life and reducing mortality.

I don’t know if we’ve convinced you yet, but a walking program is a great way to start the New Year! Write down your fitness goals. Put a sticky note on your bathroom mirror that asks, “Did you exercise today?” or a picture of yourself 20+ pounds lighter. Come visit Janet at Healthy Steps and get a new pair of shoes to start your program. (She gives great advice as well). Make 2009 your year to keep your New Years resolution and become your ideal self!

Walk or Run Happy! Moving in the Right Direction!!

Sunday, December 28, 2008

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!!

Wednesday, December 17, 2008

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!

Tuesday, December 16, 2008

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!

Sunday, December 14, 2008

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.....