Train Smarter In the Summer Heat!

I declared myself heat tolerant this weekend in my recent Twitter. I did a 3 hour bike ride in 99 plus heat at 5pm in the Texas heat and could still spit when I was done! That’s a success in my book! It definitely took 2 full weeks of suffering in the heat and a good hydration plan to finally feel like my body had made the transition to feeling relatively comfortable in the soaring Texas summer heat.

Dehydration, heat stroke and hyponatremia are your biggest worries while training in the summertime. Whether you are in Texas or Rhode Island, when the temperature soars over 90 degrees, heat illness can seriously hamper your endurance training. Most of us have an “A” race on the calendar in the fall and require a lot of base training in the summer. No way around those long runs and even longer bike rides in the heat. The average triathlete can sweat up to one liter of fluid an hour while training and sweat contains about 3 grams of salt per liter. How can we conquer the heat? Preparation and constant hydration! Diligence is the key! Always stay one step ahead of the hydration curve. Remember that heat illness really can kill you and hyponatremia has taken out more than one healthy marathon runner and triathlete!

Here are some simple tips that will help you train safely in the heat:
1. Hydrate all day long. Drink water throughout the entire day. Most people actually start their training runs already dehydrated. Especially when the temperature reaches triple digits, it is important to always have that water bottle near by.
2. Prepare for your longer training runs and rides. This means dropping water bottles along the route before you start or making the route circle around many times so you can stop and pick up more water at your starting point.
3. Drink a mixture of sports drink and water. Definitely mix it up. I always have a bottle of each on my bike.
4. Consider salt tablets if you are running or biking more than 2 hours. Unless you can carry salty pretzels on your run, salt tablets are a must if you are sweating heavily.
5. Never be afraid to get off your bike and run through a stranger’s sprinklers! You may look like an idiot, but cooling off and wetting your clothing can only help you stay cool! Putting ice down your shirt can also be helpful!
6. Listen to your body. Especially in the beginning of your heat training, listen to the symptoms of heat illness. If you are nauseous, cramping, can’t spit, have dry mouth, notice your hands and wrists are getting puffy and you are starting to feel goofy; STOP! Go home to run or ride another day.
7. Avoid anti-inflammatories if you can. Ibuprofen and Tylenol actually can affect your kidney function. This can increase you chances of suffering from hyponatremia.
8. Sunscreen, sunscreen, sunscreen. A bad sunburn will thwart your normal heat-regulation system. Heavy duty 70 plus water-proof sunblock is your friend!
9. Weigh yourself before and after your training. Replace your weight loss with more fluids.
10. Carry money. You never know when you may get lost and need to stop at a store for more sports drink or water.
11. Train with a friend. They may notice your symptoms of heat-illness way before you do. Denial is never a good companion.

Heat-illness is real! Be smart while training this summer! Follow these tips, heat acclimatize over a period of several weeks and be diligent about your hydration plan while training in the heat. Let’s get to those fall races stronger and without any heat-related training drama! See you on the run!

Denna Kastor Talks About Taking a Break After Breaking Her Foot at the Olympics

There was a good Q & A in Running Times talking to Deena Kastor about her foot fracture at the Olympics. I think it's funny that she broke the same bone I did last year. Her discussion about the need for rest and recharging sounded like an echo. I think it is so important for us to realize we need rest after an "A" race or marathon. Also, as women, we need to understand the relationship between Vitamin D and the uptake of calcium. To read more about Deena's injury click here for the complete article. For more on metatarsal fracture in runners, click here.

Run Happy! Rest easy....and more than anything else...run forever my friends!

To purchase a copy of Dr Crane's new book "If Your Running Feet Could Talk" click here.

Running With Arthritis

Running Forum Questions:

I recently received this email from a runner in Virginia asking a good question on running with arthritis:

“I have been running since I was 13yrs old and I am 42 now. Friday I was diagnosed with osteoarthritis after 6 weeks of no running but cross training on the elliptical. The doctor thought it was tendonitis but after not getting better he decided a MRI would be appropriate. The MRI confirmed it was osteoarthritis. I am starting physical therapy on Monday 3x a week.

My question: Is it possible for a runner who has osteoarthritis to be able to run again. I feel like my world has been rocked and shaken. Running is HEAVEN for me and nothing compares. It is my total stress reliever and if I do nothing else in a day if I've run my day is totally complete. I am the mother of 3 great kids and I guess I should be thankful I can do the cross training now because I get cranky when I don't get to do something. I just feel like this means my running career is over. My mileage before getting injured was about 25 a week.

Please let me know your thoughts. I have searched the internet for help on other runners who are going through what I am and have osteoarthritis of the foot with no luck so far. Thank you so much for taking my comment. I'm praying for a miracle. I know it's not life threatening but it's my mental state I'm concerned about.”

RunDoc Answers:

Let me start my answer with a story. I have a runner in his late 30’s as a patient who had the unfortunate luck to be blown up in the Desert Storm conflict while he was serving in the Marines. He has severe arthritis in both feet from his injuries. He has had at least 5 foot surgeries including a fusion of his subtalar joint in one foot. He ran the 2008 Marine Corps Marathon in less than 41/2 hours. If he can run a marathon on feet that are that bad, I am confident that you can get back to some kind of running.

The name of the game is accommodation. You will need a great pair of orthotics made by a podiatrist that knows what they are doing and specializes in biomechanics. They can fabricate a device that will transfer the stress from the arthritic area to a strong, healthier part of your foot. That coupled with physical therapy, core strengthening exercises and a good pair of running shoes will get you back on the road! For more information on living with arthritis click here!

Run Happy! And Pain Free!

How to Cope With Race Day Jitters!

It’s just a few days from a big race and I’m already anxious. What am I afraid of? Running a bad time? Totally bonking? Looking stupid in front of my friends and patients? Drowning in the open water swim? Getting a flat tire? Perishing on the street? Where does all this performance anxiety come from? After 30 years of competitive running you would think I would have conquered race day jitters, but they are always there…kinds like an old friend…or a fungus….

So, how do I cope with race day jitters? Positive self-talk, preparation, visualization and organization!

A race is just another long training day in the company of a few hundred, or sometimes a few thousand, of your closest friends. Most anxiety comes from fear of the unknown and lots of negative self-talk. Reality – your friends and family really don’t care what your time is, whether you place or not, and the world will not end if you run a bad time! My patients are just amazed this old lady is still racing! Times are irrelevant! Setting high goals will just stress you out! Focus on running your best race that day! Relax! Have fun! Go into the race realizing you have nothing to lose and everything to gain. I treat every race as a learning experience. Even if you get kicked in the face in the swim and lose your goggles, get a flat tire or totally bonk on the run; you learn something you can use another day!

There are many things you can do to stay relaxed. Here are just a few I have learned along the way:

1. Be prepared! Have a pre-race checklist of everything you need. Set out all you clothes and gear the night before and go through the list. This includes checking your bike tires and inflating them. Finding a flat the morning of the race will send your heart rate through the roof. I set everything out on the living room floor then pack my bag. The bike goes on the car the night before after a thorough check. My nutrition is all set out and the coffee pot is prepped!

2. Never change anything the day of the race. This is not the time to try that new pair of Newtons! Stick with your routines. Treat this as just another long training day! Eat what you would normally eat before a long workout. Extra sleep always helps, so go to bed early!

3. Go to the race with a friend. Having your peeps with you can really help diffuse anxiety. Travel to the race together and help each other calm down. DO NOT let your friends make you crazy. Some people actually feed off others anxiety. If this is you, you may be better off with your Ipod as your friend while you set up your transition!

4. Visualize finishing. Visualize the entire race the night before. Go to the race website if you are not completely familiar with the course. Visualize a nice calm swim, a smooth transition, an awesome bike and a killer run! See yourself run a PR. My best races have been played over in my mind a thousand times before they ever happened. Remember what it felt like the last time you had a great race! Embrace that feeling!

5. Get to the race early. Get organized! Find the bathroom and then relax. Warm up and keep up the positive self-talk! Remind yourself that you have done the work and the race is just a celebration of how hard you have pushed yourself and your mental toughness! Claim your reward!

Race day jitters can completely derail your race before it has even started. Don’t let the negativity ruin all your hard work and preparation! Relax! Follow these tips and remember to banish the negative, and stay positive throughout the race! Try to have fun! Whether this is your first marathon or your 100th triathlon, remember to celebrate your training and have a great race!

Fat Parents Have Sick Kids!

I heard a statistic today that startled me. If you are born after the year 2000; you have a one in three chance of having diabetes. One in three! That is truly scary!

A second frightening statistic is that this is also predicted to be the first generation of Americans that will not live longer than their parents.

Why? Both of these sobering statistics are a direct result of childhood obesity and a sedentary lifestyle. What are we doing to our children? We owe them a better future. Politics aside, we are already mortgaging our children's future with our current economic issues and national debt. We are also dooming them to suffer from many chronic illnesses by the lifestyle we are teaching them by being lazy, fat Americans.

The typical American diet has substantially changed in the last generation. We no longer sit down to family dinners and tend to look for quick, often drive-through solutions. Our generation has more food choices than ever before; but tends to choose the fast, more often less healthy, alternatives. Why? Laziness! We are so busy trying to be super-productive that we don't take care of ourselves or our families. Our children are mirroring our behaviors when they make their food choices.

Exercise? Not most Americans. The minimum recommendation is to engage in moderate exercise at least five days a week or 20 minutes of vigorous exercise (aerobic activity) three days a week, plus to do strength training twice a week. A recent polling showed that only 17% of Americans managed to find the time to lift weights at least twice a week and engage in vigorous exercise three times a week or at least moderate exercise five times a week. Only 50% exercise at all three times a week! What kind of example is this for our children?

Many parents feel our children get their exercise from physical education classes in school, but less that 50% of school children have some kind of physical activity every day in elementary school. This number worsens as they progress in the school systems. Our children's activity level has plummeted dramatically in the last generation due to lack of physical education, lack of unsupervised play, computers, Internet, video games, etc. We can not depend on the school systems to teach our children to exercise and eat right. This must come from the example set by their parents. Right now, most Americans are setting a poor example!

Americans are not suffering from a lack of information. Most know what to do, yet choose not to. Since the early 1980's, the benefits of exercise has been preached on every street corner, yet we don't listen. Nevertheless, the cultural changes in the past decade have been so staggering in terms of decreasing physical activity in every sector of life and increasing the intake of garbage calories and fast food, that nothing short of a major paradigm shift is necessary!

Bottom line: a combination of obesity and lack of exercise contributes to more than 300,000 deaths each year in the United States as a result of heart disease, stroke, diabetes and other conditions. The statistics for the next generation are even more onerous. Only through changing our behavior patterns can we influence our children's future behaviors and reverse this trend.

Dr Crane's New Book Available Now!

Dr Crane's new book : If Your Running Feet Could Talk now available on Amazon.com

Click on the title for more information.

Dr Crane has written a prescription for surviving and avoiding injuries on the run. This book provides practical advice and resources to the running community to keep you running healthy and strong. It is meant for the novice and intermediate runner who needs solid advice on getting started, training programs, aches and pains, and recovery. Persistence and determination is the key to surviving then ultimately avoiding most running injuries. This book couples years of blood, sweat and tears on the pavement with sound medical advice for all runners.

Please enjoy and send your comments for the next version to contactme@myrundoc.com

Run Happy!

Confessions of a First Time Triathlete

This blog is a guest writer...Janet Dixon, my sidekick pedorthist proves how tough she really is. I am so proud of her....here is the story of her first triathlon!

Well folks, I finally did it. I finished my very first triathlon. I also had every possible thing go wrong today as well.....

So - I wake up at 450am. I thought hey, we are close by and since both Dennis and Claire were joining in as a cheer section for me, we can sleep in a bit longer. That was the first mistake.
Woke back up at 515am. Tummy is grumbling - so are you hungry or are you nervous? Suddenly a bowl of cheerios seemed to be the thing to do so I have at it. At this point I am pretty darn calm and ready to roll. I look for Claire and guess what - the 12 year old is still out like a lightbulb. So I chill as I hear Dennis yap at her to get up. She rises - takes a shower, we now are in human form.

Departure time scheduled for 545am. Hmmm - stomach is feeling funny. Here comes the nerves. I make one last stop to the restroom - much better. Time is now 555am.
Arrive to the race and we are guided to the overflow parking lot a block down. Darn it...should have got here earlier. My cell phone rings and it is Marybeth. I decide to mess with her and tell her I am still sleeping. She reacts, I laugh and tell her I am actually in the area.
So, rule number one - GET TO THE RACE EARLY!
Bike and accessories in tow, I head to transition. I am SO GRATEFUL, I elected to have markings done the day before at packet pickup. There was a huge line and it felt great to squeeze right past folks.
Rule number two - GET MARKINGS DONE EARLY IF OFFERED!

I head to transition and all of a sudden, I am nervous. Now remember my deal a few weeks back on getting into the unitard? Yeah...a two piece seemed to be such a better option at this point.
So I rack my bike and I am a happy girl! I find Marybeth who at this point is thinking where the hell is she and I surprise her in my zingy way. One problem, she tells me I am racked at the wrong bike rack....darn it!
Rule number three - MAKE SURE YOUR BIKE IS RACKED CORRECTLY!

Ok, so I feel pretty stupid and I am still in need of facilities - big time.
I look for Dennis and Claire and calm down. I tell myself, look nimrod, this is just to see what happens, to finish the race in one piece then look to see where I can improve for the future. Remember, I am and will complete a half ironman in less than six months
So facilities time - of course, as usual, there is a women's restroom line but not for the dudes. So unfair I thought. Finally, the visit to the facilities is complete. I feel fabulous!

The wait for the pool was interesting. Triathletes come in all shapes and sizes. I told myself to stop worring about what I looked like in my second skin. By the time September rolls around, I will have hopefully lost a few rolls of my own if you know what I mean.

The swim begins, I jump in. Water feels great! I start to swim....I am excited, I am doing this, I have propellers for feet, I am so glad to be doing this....I don't breathe! All of a sudden a foot nails me in the right side of my neck. Right where I had a neck injury. Right arm immediately goes numb. I almost call it and get out of the pool - no, I tell myself, you can manage this now breathe and move it!

Rule number four - PACE YOURSELF IN EACH LEG OF THE RACE.
After 150 yards Janet is tired....Janet can't breath right, Janet went out WAY TOO FAST! So, I flip over and backstroke the rest of the race. I don't care, I am not taking first place - I am here to finish. Ok I thought, I will pace more during swim training - I just learned to swim starting three months ago so I don't beat myself up for this.

Ah, transition! I found my bike - good sign. Wait - where is my computer at? Crap, it's in the bag. What felt like an eternity I finally found the Garman. I am feeling disorientated - I can't get the stupid Garman on my bike! So with computer in hand, I begin the ride.
Rule number five - HAVE AMPLE TIME IN TRANSITION TO ENSURE EVERYTHING IS LINED UP.

So off I go on the bike. Ah, things feel much better. As I cycle, the Garmin magically fits on the holder and I grab something to drink. YES! I watch my pace climb to 18, good - now hold it I thought. Hmm - did I fail to mention it was a very WINDY day? Oh wait, it gets better. Half way through my chain falls off! Can you believe this? Luckily, I got the oily thing back on - gross I thought. Yep - that affected my ride a bit however, the bike portion I can tell is going to always be my favorite part of a triathlon.

Transition #2
I was completely ready to jump off my bike at the right time and I did. I was impressed. When my feet hit the ground - oohhh what a weird feeling! Trying to run after cylcing is really weird. My brain was ready however my feet were not. I racked the bike - no idea if it was right or not, threw on my running visor, grabbed my running belt. SNAP - running belt and bib number detach from one another. So what, it's still hanging on by one loop - move your arse I tell myself.
Ok - so what rule are we on? Ah yes,

Rule number six - YOU MUST STAY CONSISTENT IN EACH AREA OF A TRI AND TRAIN APPROPIATELY. Yep, all those days in the pool, cycling...what about running? Hmm - my bad.
Running at this point was mute. I ran the first loop and suddenly I was tired. Oh gosh I thought to myself, I am going to walk during a measly 5k? What a hosebag I thought to myself. So, I walked a bit. Then I felt bad...then I got mad. Why didn't you prepare - what is wrong with you - if you come in last, you will let Marybeth down - where are your expectations - you are embarrasing yourself. All this past through my head then my stomach took over...I was hungry. Where is my gel? Yep - BACK AT TRANSITION! Sooo......Rule number seven - make sure you have adequete nutrition for each stage of the tri. So much for the cheerios and one goo before the swim - I want to eat. In fact, I want to chew off my right arm...I AM HUNGRY CAVEMAN GIRL....

Then I see members of the running club yelling out my name, starting running you goober I thought, you can't look that bad to your running group. So I pick it up until over the hill, I start to walk. Darn it...

Second loop felt like mile 19 of a marathon. I am amazed how hungry I am. Marybeth shows up. Springy and happy like she just woke up - note, she finished a half hour ago - she runs me in. She tells me we get a medal. We do? I didn't know that. Well, heck , I have to start running!
Now on top of starving, I mentioned previously I had a cervical injury. I lose my right index finger feeling. I don't want to stop however I fess up and tell her I have to walk. I feel like I am the biggest dope for walking. The throbbing stops, I try to run - comes back.

Finally, the last hill - I slow jog it in. I finish.
I thank Marybeth for her kindness and spirit. I look over to my right and see Dennis and in an instant, all of the insanity that happened during the race didn't matter. I find Claire - I am good. I did it...slowly, but I did it.

I will be a half ironman - you watch. It will probably scare a few people, it will surprise many. I am hooked. Next tri - no walking and I will forever have the above seven steps inbedded in my brain.

I learned today.
I am a triathlete.
I am caveman...girl!

Now go out and do something good for yourself today, I will be running a bit more...... ;)