Sunday, December 25, 2011

Merry Christmas

My Christmas morning started with an 8 mile run on a beautiful, crisp, clear day.  I returned and watched my two year old run away from the Elmo that he unwrapped under the tree.  I'm very fortunate to have my health and my family to share this day with.  As I pig out today I can say that I am celebrating and carbo loading at the same time for my 17 mile run tomorrow!

Merry Christmas to all.

Wednesday, December 21, 2011

Better With Age?

Masters Runners, those over the age of 60, are the fastest growing demographic in running.  While these runners are more prone to muscle strains (Achilles tendon, calf, and hamstring being the most common), there is evidence that running "economy" does not deteriorate with age.  Baby Boomers are frequently able to compete well into the 6th and 7th decade of life.

For Masters Runners, it is probably important to take more rest days, stretch, and spend some time with upper body resistance training.

Wednesday, December 14, 2011

#12--Olathe Marathon

Olathe, Kansas
March 31, 2007

While in residency, I was usually able to train for and do one marathon a year.  I was now in my last year of residency and had more time to devote to training, so I decided to take advantage of it.  The Olathe Marathon fit into my schedule, and was an easy drive from Omaha.

I remember we stayed in downtown Kansas City the weekend of the race.  I got up early and drove to Olathe.  It was pouring rain, I didn't have a map or a GPS.  I got lost trying to find the area where the buses took the runners to the starting line.  The start of the race was getting very close.  I raced into a gas station to ask for directions.  The attendant looked at me like I was crazy.  I had enough change in my car to buy a map.  I hurriedly figured out where to go and drove as fast as I could.  I barely caught the last bus to the starting line.

After that, the race was almost anti-climactic.  The course was mostly rural.  The clouds parted and conditions were pretty good.  I felt pretty good that I was running marathon #12.  I was humbled by the guy next to me running #212 or something like that.  Now that guy was crazy!

I finished in just over 4:30.  I went back to the hotel where my wife had been watching movies all morning.  She said to me, "Hurry up and change.  We are going shopping!"  Clearly, the novelty of me running marathons had worn off and she had other ideas for our weekend in the KC area.  With that, I made myself an ice bath and soaked for 20 minutes.  After popping some ibuprofen, I was ready to start what felt like my second marathon of the day.

Monday, December 12, 2011

If you are looking for inspiration, look here

Last month's Runner's World was devoted to common readers who have done uncommon things.  Among the runners featured were ex-cons and cancer survivors.  My favorite story featured Ben Davis.  Ben lost 120+ lbs through diet and exercise.  He has completed multiple marathons and triathlons and shares his story with others struggling with obesity and depression.

He made a video scrapbook of his transformation that became a YouTube sensation, and he continues to chronicle his journey on his blog.  I've included links to both.

LTC 2012 Race Schedule

The Lincoln Track Club has released it's 2012 race schedule.  The highlight is the Lincoln Marathon and 1/2 Marathon, the first weekend in May.  Register early as this race quickly sells out.

This is a great time to set goals for 2012.  Maybe your goal is to run a marathon, or run a PR, or even just to run your first road race.

View the entire race schedule here:

Wednesday, December 7, 2011

America's State of Health

America's health rankings are in, and the results are not good.  Although we have made great progress in treating cardiovascular disease, cancers, and other acute and chronic illnesses, the growing epidemic of obesity and diabetes is threatening the nation's health.

With New Year's fast approaching, it's time to start thinking about a healthier, happier you.

Read the sobering report here:

Sunday, December 4, 2011

Winter Running Gear, Vol. I: Traction

This weekend marked the first snowfall of the season in Lincoln.  The elements really test the dedicated runner in Nebraska.  We deal with heat and humidity in the summer, and cold and ice in the winter.  In the summer I posted my tips for summer running.  During the next few weeks I'll share some things I've learned that should enable you to continue to train through the challenging winter months, and have fun doing it.

As an orthopaedic surgeon, the first snowfall means one thing--falls and broken bones (technically two things, I guess).  I've been very lucky and have never suffered a serious injury from a fall on the ice.  I've had some embarrassing moments and a hard time sitting down for a while, but nothing that kept me on the sidelines for any length of time.

One of the very best things I've discovered are Yaktrax.  They are lightweight metal coils around rubber that can be strapped to the bottom of your shoes.  They provide excellent traction on even the most slippery terrain.  I highly recommend them.  I've included a link to the company website.  You can probably find them at your local running store.  As always, I encourage you to shop at your local running store (Lincoln Running Company here in Lincoln).

For those who prefer a "do-it-yourself" option, try putting metal screws in the bottom of your shoes.  I've included a link explaining how.

Wednesday, November 30, 2011

Don't give up, don't ever give up.

These are the words of the late Jimmy Valvano.  If you've watched ESPN this week you know that it is Jimmy V week.  Jimmy Valvano was the coach of the North Carolina State basketball team in the 80's and early 90's.  He died from cancer.  He left a legacy that includes his Wolfpack team that had one of the greatest runs in NCAA tournament history and the V Foundation, which has donated more than $90 million to cancer research.

I will always remember his speech at the 1993 ESPY's.  It was very touching and inspirational.  I've included a link.

Pronation Explained

Pronation is a difficult concept to understand.  It basically refers to how much your heel and foot roll in when your foot hits the ground.  Pronation is normal.  Some people, however, are "over-pronators" and some people are "under-pronators."  I want to emphasize that there is a very wide range of what should be considered normal.

Runner's World has some nice videos to help illustrate these concepts.

Monday, November 28, 2011

Got Arthritis? Get Moving!

People with arthritis should try to get 20 minutes of moderate exercise daily.  Lower impact activities like swimming and cycling are probably best.

Read about the benefits of exercise for arthritis here:

Saturday, November 26, 2011

Weekend Update

I just got in from an easy 7 mile jog.  As if the turkey, stuffing, and pumpkin pie didn't make me feel sluggish enough, I was forced to contend with wind gusts of up to 45 mph!  We've been really lucky in Lincoln that this fall has been just about perfect.  The colors were vibrant, the days relatively warm, and the winds calm.  Among the many things I'm grateful for this Thanksgiving is the mild fall that we've enjoyed.

I've run in all conditions, from extreme heat to extreme cold and everything in between.  Without a doubt, though, the thing I hate the most is wind.  I'd like to know what conditions you dislike the most.  Vote on the blog.

Fourteen miles tomorrow.  Gearing up for a fast 2012!

Friday, November 25, 2011

#11--Chamber Country Classic

Maryville, MO
June 10, 2006

Once I got to 10 marathons, I started to feel like a "real" runner.  I was able to join the 50 States & DC club.  I've included a link to the club on this blog.

I was still in residency so I didn't have that much time to train.  I learned that I could train for a marathon by doing two or three short runs during the week (3-5 miles each) and a long run on the weekends (start at 6 miles, build to 20 during an 18 wk plan).  I found this schedule very manageable.  By now my wife realized that marathons weren't just a phase, and that I would be gone for a few hours each weekend.  Her understanding has been instrumental.

Missouri was the next border state on my list.  Maryville, MO is a short drive from Omaha.  I remember we stayed at the vacant dorms on the campus of Northwest Missouri State.  $10 for a dorm room the night before the race!  Ah, sleeping (or trying to sleep) in those small, plastic covered mattresses brought back some memories.

This was a small race, with two loops around the town.  There were some very long hills that were a challenge.  The thing I remember most about this race was the fact that it was the first one during which I listened to my iPod.  The distraction was nice, particularly on this small, mostly rural marathon.  Unfortunately, I got so distracted that I missed a turn at one point.  The volunteers tried to correct me, but I couldn't hear them!  One nice man got in a car and drove to track me down and set me straight.  I didn't get that far off, thanks to his help.

This marathon definitely wasn't Chicago or Boston, but it was a small, friendly race that was easy for me to get to, and very economical.  As a resident short on time and money, it was perfect.

Thursday, November 24, 2011

Turkey Trot

I started Thanksgiving Day today with a nice 5-K race.  The Annual Turkey Trot is sponsored by the Cooper Branch YMCA and benefits the Strong Kids Campaign.  I coasted to a 25 minute finish time.  Read about the race here.

Monday, November 21, 2011

Marathon Deaths, cont.

I found this article from the Runner's World archives.  A nice review of the history and controversy surrounding the safety of marathon running.,7120,s6-238-244-255-12968-0,00.html

Is Marathon Running Dangerous?

The Philadelphia Marathon was yesterday and the headlines today aren't about another course record falling, but about two runners who died of apparent heart attacks at the finish line.  Tragedies like this get attention because it is assumed that marathon runners are in excellent physical condition (generally true) and should be immune to heart disease (not true).

Marathon running and other intense physical activity does carry some small risk.  Most studies put the risk of death during a marathon at 1 in 100,000 or so runners.  Most of these deaths in very young individuals (20s) are the result of structural heart defects.  Coronary artery disease is the cause in most middle aged individuals.

Heart Disease is the #1 cause of mortality in the USA, with more than 200 deaths per 100,000 people annually.  Exercise is known to decrease the risk of heart disease, and most marathon runners have been able to optimize this part of the risk profile.  However, there are many other factors such as family history, high cholesterol, diabetes, and hypertension that play an important role.

More people than ever are running marathons, so at times it may seem routine and common.  We must remember that training for and completing a marathon is an intensely physically demanding endeavor, one that places great stress on the cardiovascular system.  Get an annual check up from your primary care provider, and make sure you are doing everything you can to minimize your risk.

The late Jim Fixx once said, "I don't know if running adds years to your life, but it definitely adds life to your years."

Read the article about the Philadelphia Marathon here.

Sunday, November 20, 2011

Carry these on every run

I've done long training runs in every imaginable climate and setting.  In previous posts I've talked about proper dress, nutrition and hydration among other things for long runs.  In addition to these basic things that most of us remember without thinking, there are some other less obvious things that the well equipped runner should carry.

1. Identification.  You should always carry some form of ID along with an easy to find emergency contact.
2. Phone.  Increasingly small and powerful.  I've used mine to call home for a ride in 100 degree heat when I couldn't make it home.  I can also use my iPhone to keep in touch with my office, find a route w/ GPS, listen to music, and many other things.
3. Money.  You should think about carrying $10 or $20.  I can't tell you how many times I've finished a run and been told to get milk on my way home.
4. Tissue paper.  I found out this one the hard way with a very embarrassing incident in the pre-dawn hours in downtown Chicago involving an alley, the police, and a smelly but thankfully empty elevator ride back to my hotel room.
5. Protection.  This is very important for women.  Try not to run alone in dark or desolate places.  If you do, carry some form of protection.  You just never know.  Small personal canisters of pepper spray are highly portable and can be added to your key chain.

Let me know if you can think of other essentials to share with others.

Saturday, November 19, 2011

Holiday Run 2011

The Country Club Neighborhood Association is sponsoring a non-competitive, adults only fun run/walk to be held on Thursday, December 22, 2011.  The race will begin and end at the Country Club of Lincoln.  The open course will wind through the historic Country Club neighborhood.  The race will start at 7:30 p.m.  Proceeds from the race will benefit the future lighting needs of the old Rock Island Trail between South and Calvert Streets.   Click on the link below to link to an official flyer and entry form.  Entries are due by December 9th.

Doping for Runners

Losing weight is the cheapest form of doping there is”--Dr. Mike Joyner, Mayo Clinic

Readers of Runner's World may recognize this quote from one of Peter Sagal's recent articles.  Peter was trying to see if he could stop or turn back the clock and continue to run PRs despite his advancing age.  He spoke with Dr. Joyner, a noted anesthesiologist and researcher at the Mayo Clinic.  I actually met Dr. Joyner when I was a medical student doing research at UNMC.  He is a sub 3 hour marathoner, so he has plenty of "street-cred," too.

When Peter asked Dr. Joyner how he could improve his running times, Dr. Joyner asked about his body stats and replied, "Lose some weight.  Losing weight is the cheapest form of doping there is."

The reason is VO2max.  Without going into too many boring details, VO2 max represents an individual's maximum oxygen uptake, and is considered the best indicator of cardiovascular fitness.  The units of measurement are ml/kg/min.  So as you see, for the same level of fitness, there is an inverse relationship between VO2max and body weight.

Obviously, there are many factors to consider, but in general, an easy rule of thumb is that losing 1 lb can shave 1 minute off the marathon time, 5 lbs=5 minutes, and so on.  Looking at my own marathon times over the years, along with my advancing waist line, I have found that the rule of thumb works pretty well in the other direction, too.  Like Peter Sagal though, I intend to take Dr. Joyner's advice and start doping and break 4 hours in 2012.

Monday, November 14, 2011

A short break

I've pretty much recovered from the NYC Marathon.  I was very sore Monday.  Each day got better until Thursday when I was basically pain free.  I had intended to take a whole week off, but the blue skies, fall colors, and crisp fall days were too much to resist.  I've eased back into training with an easy 3 mile run Friday, 6 Saturday, and 9 Sunday.  I ran at a slow, steady pace.  My legs feel a little tired, but strong enough to resume training for the next Marathon in mid January.   NYC was my fifth and final marathon in 2011.  I've signed up for 3 in the winter and spring of 2012.  I am hoping to run 6 or 7 in 2012.

Tuesday, November 8, 2011

Why do marathon records keep falling?

New York City marked the last of the Marathon Majors this year.  Course records were smashed in London, Boston, Berlin, Chicago, and NYC.  I've talked before about the astonishing pace with which records seem to be falling.

Sports Illustrated has a great article looking at the reasons behind this trend.  One of the factors driving this seems to be the allure of the marathon as the premier event in running, with lucrative sponsorships and prize money, all of which are attracting the most gifted runners at an early age.

Read the article here:

Monday, November 7, 2011

#30--NYC Marathon

New York, NY
November 6, 2011

The NYC Marathon was the fourth of the so-called "marathon majors" that I have done.  A record 47,000 runners started the tour through the five boroughs.  It was an incredible experience.  I trained hard for the race and hoped to break four hours.  For much of the race I was on track to do so.  My half marathon split was just under 1:58.  I lost my pace on the 59th Street Bridge, but quickly regained my momentum when we entered Manhattan and ran down 1st Avenue.  I still had a chance in the Bronx, but I bonked at mile 20.  That, along with my recurrent IT band issues, slowed my pace the last 6 miles.  I finished in 4:16, but the energy from the crowd dampened my disappointment.

Conditions for the race were perfect.  The sky was clear, winds calm, with temperatures in the 50s.  Kenyan Geoffrey Mutai shaved nearly 3 minutes off the previous course record, clocking an NYC record time of 2:05:06.

I'll never run on the field at Memorial Stadium or stand on stage at a rock concert, but I doubt either experience can match the energy and intensity of 2.5 million spectators cheering you on while you run through arguably the greatest city in the world.

Sunday, November 6, 2011


I just completed the ING New York City Marathon today. 30th marathon total, 28th state.   I had hoped to come in under 4 hours, but it wasn't meant to be.  I'll have a full report this week on this spectacular race.

Wednesday, October 5, 2011

World Record Set

At the Berlin Marathon last weekend, the world record was broken again.  Kenyan Patrick Makau set the new mark, clocking a record time of 2:03:38.

Berlin is considered one of the fastest courses in the world.

I think it is only a matter of time until somebody breaks 2 hours.  What do you think?  Is a sub 2 hr marathon possible?  Vote on this blog.

#10--Des Moines Marathon

September 18, 2005. 4:31:27

It had been over a year since my last marathon, so I was anxious to complete another one.  This was the second race that Roxane and I trained for and ran together.

Des Moines was an easy drive from Omaha.  The host hotel was right at the start and finish lines.  My greatest memory from the race weekend was the pre race pasta dinner.  Dick Beardsley was the featured speaker.  He has an amazing personal and professional story.  He autographed a copy of his book, "Staying the Course: a Runner's Toughest Race" for me.  It is a great read which I highly recommend.  Among other things, he told the story of his "Duel in the Sun" with Alberto Salazar at the 1982 Boston Marathon.  It was one of if not the the greatest races in long history of Boston.

The late summer/early fall date meant for some unseasonably warm temperatures in Des Moines.  The heat got to Roxane a bit at the end of the race and she, very out of character, barked at a volunteer and nearly did the same to a young spectator who was running on the course.

We finished in just over 4 1/2 hours.  Roxane did so with very little training, a testament to her athleticism and determination.  There's a small picture of us after the race at the bottom of the page.

Des Moines has become a popular regional race.  They have moved the date back a few weeks now, so the warm weather can probably be avoided for the most part.  The race was well organized and executed, and represented a good value.  With this being my 10th marathon, I was able to officially join the 50 States & DC club at Des Moines.  I've included a link to the club website on this blog.

Saturday, October 1, 2011

Running Gear, Vol. III

The days are getting shorter, so that means more running before the sun comes up or after it goes down.   I do a lot of my runs on poorly lit trails.  To avoid accident and injury, it's important to have the proper gear.  You need to make sure others can see you, and that you can see where you are going.

1. Wear light colored clothes.
2. Reflective gear is preferred.  A lightweight reflective vest is a great choice.
3. Carry a lightweight flashlight or invest in a headlamp.  I recently purchased the Black Diamond Sprinter LED headlamp.  I love it.  The position and intensity of the lamp are easily adjustable, it fits well around my head, and has a rechargeable battery.  There is also a tiny red strobe light on the back.  I bought mine at

Friday, September 30, 2011

Travel Tips

Running a marathon in all 50 states means a lot of traveling.  To that end, there are some tips to make travel more enjoyable and economical.  Here are a few.

1. Use frequent flier miles-I have a credit card with travel rewards.  I accumulate miles each time I use it.  Since I began using it in 2006, I have earned 17 free flights.  Look for one with a low or no annual fee, with few restrictions on travel.  Some also offer companion tickets.

2. Economize on hotels-When I travel I rarely do more than just sleep in the hotel.  I don't need much, so I usually try to find the best deal. is a great way to book a hotel.  You can choose the dates and location that you want, and "bid" on hotels in the area.  When I ran the Boston Marathon I stayed in a downtown hotel for $75/night for 5 nights.  Most rooms went for three or four times that amount.

3.  Yelp!  I love Yelp.  Before going out to eat or entertain in a new town I will always consult this website, which offers user generated reviews of bars, restaurants, & shopping.  I have never been let down by one of it's reviews.

Monday, September 26, 2011

#9--Country Music Marathon

Nashville, TN
April 24, 2004. 4:42:00

As a medical student, I did a rotation at Vanderbilt University in Nashville, TN.  I really liked the city and hoped to get back.  When I saw an opportunity to run the Country Music Marathon there, I jumped at the chance.

Roxane decided that she would try this whole marathon thing, too, so we trained as a couple.  I generally prefer to run and train alone, but of course I couldn't say no, even if I wanted to.  Besides, this was something that I wanted to share.  If she caught the marathon bug, all the better!

We would do our long runs on the weekend together.  We weren't great partners on the road, I found out.  She is a much more explosive runner, doing better at short distances, while I did better at longer, slower runs.  I don't talk much on a training run.  If anybody knows Roxane, enough said.  In the end, we worked out our "differences" and completed the 4 mos training program.  She was bothered by blisters and poor fitting shoes during much of her training.

The start of the race was delayed by thunder storms.  The clouds eventually lifted and the race started.  Many of the bands didn't show up or stopped early because of the weather.  It was fairly warm and humid by the end, and the course was fairly unremarkable.  Roxane did great.  At mile 19 or so she was smiling and chatting up the other runners.  She said to me, "I feel great.  I'm already planning my next one!"  "Easy, trigger," was my reply.  No sooner had we passed mile 20 when she crashed right into the wall.  Our pace slowed, but we finished together.  Her feet looked like hamburger afterwards, and I am still amazed that she was able to finish.  We enjoyed a post race meal of sweet potato pancakes at The Pancake Pantry, a Nashville treasure.

I was very proud of Roxane for training for and finishing the marathon, and I was happy to share something that was such a big part of my life with someone who is the best part of it.

Wednesday, September 21, 2011

Blisters 101

Blisters can be the bane of the runner's existence.  The cause of blisters is too much friction, usually the result of poorly fitting shoes.  Before you buy a new pair of shoes have your feet measured and examined by a professional shoe salesperson.  Readers of this blog know that I recommend The Lincoln Running Company, or whatever your local running shoe store is.  It's also important to wear clean, dry socks.  My two favorite pairs of socks are Wright Socks, which have two layers that reduce friction between your feet and socks, and Injinji, or so-called "toe-socks."  These are particularly helpful if you are prone to blisters on the toes.  If you develop a blister it's important to keep it clean to prevent secondary infection, and you need to modify your activity to let the blister heal.  I've had good luck with the Spenco Second Skin Blister Kit.

WebMD has a nice article on blisters, here:

Sunday, September 18, 2011

New York State of Mind

I've fully recovered from the marathon in Colorado Springs over Labor Day.  My attention now turns to one of the so-called "Marathon Majors," the ING New York City Marathon.  It's one of, if not the most popular marathon in the world, with hundreds of thousands of applicants per year.  I've applied for entry every year for the last four years through the lottery system.  Runners who don't get in the first three tries are guaranteed entry the fourth year. This is my year.

The other "Majors" are Chicago, Boston, Berlin, and London.  Of these, London is the only one I haven't done.......yet.

I've looked forward to running NYC for a very long time, and hope to run my best race in a while.  I'm shooting for 4:00, which will mean I'll have to cut an hour off my Labor Day time.  Lots of intervals, tempo and pace runs between now and the first Sunday in November!  Yesterday I did a nice 6 mile pace run at 9:15/mile and I'm heading out to to an easy 12 today.  NYC, here I come!

Wednesday, September 14, 2011

#8--Lincoln Marathon

May 4, 2003. 4:21:54

I found it very difficult to train during my intern year.  There are now work hour regulations that limit the hours that residents can work, but these hadn't gone into effect yet.  100 hr work weeks were fairly common on surgery rotations.  Needless to say, my fitness had to take a back seat to patient care.

Things slowed down some in the spring and I was able to resume training.  By now my peers knew that I ran marathons, and a couple of fellow residents, Dave and A.J., were interested in training with me.  They were both good athletes, but novice distance runners.  I really enjoyed "coaching" them and sharing what I had learned.  We had hectic schedules, but were able to get together for long runs on Sundays.  I had never really run with a group before, so it was a nice change of pace.

Race day was rainy and cool.  I didn't know it at the time of course, but at one point I ran right by the house I live in now.  Lincoln is a great 1/2 marathon, but the crowds and enthusiasm fall off quite a bit once the half is over.  My friends and I ran together until the last couple miles.  Dave got this unbelievable burst and pretty much sprinted the last three miles or so.  No wall for him.  He was hooked and has gone on to do more marathons and has even done at least one ultra.  A.J. told me to go ahead and kick the last few hundred yards without him.  Well, with about 5 yards to go he came screaming past me, not leaving me enough time to catch up.  I had been suckered.  There is a very funny picture with two slow pudgy guys leaning across the finish line.  I can't find it but will post it if I do.  A.J. bested me by one second.

It was nice to finish a race in my home state.  The most rewarding thing, however, was running with Dave and A.J. and helping them reach their goal.  I hope I've inspired more along the way.

Tuesday, September 13, 2011

Running Gear, Vol. II

One of the most valuable tools for a serious runner is a GPS enabled watch.  Most of us are fairly detail oriented and want to try to stick to a plan.  We also love numbers and love gadgets.  If a particular program calls for a 5 mile run, most runners want to run 5 miles exactly.  Not more, not less.

A GPS enabled watch allows you to stick to your program, even if you are running a new route or even in a new town.  Some of the most memorable long training runs I've done have been when I've been out of town at a meeting or on vacation, turned the GPS on, and headed out the door.  My Garmin has taken me around Central Park, over the Golden Gate Bridge, and through cornfields in Western Nebraska.

In addition to distance and elapsed time, there are typically many features such as pace, laps, and splits, etc., all of which can enhance your training.  I know I've only scratched the surface of all the capabilities of my watch, the Garmin 310XT.  I think it's worth getting one with a heart rate monitor, too.

GPS enabled watches can be pricey, but I think they are worth it.  I almost feel naked running without mine now.

Wednesday, September 7, 2011

#29--American Discovery Trails Marathon

Colorado Springs, CO
September 5, 2011. 5:00:49

Over the weekend I checked Colorado off the list.  I've put it off to avoid hills and altitude.  Well, I had to do it sometime.  The ADT Marathon was a good choice because it was pretty easy to get to and not as challenging as some races in Colorado.  Although it was a trail marathon, it was not technical and had a net descent from 7000+ ft to around 6000.  With this altitude, one would expect a 5-10% slower time, and that's what I got.  I was very surprised to finish in 5 hrs.  The altitude was a factor, but the biggest thing was I didn't taper real well.  My legs were pretty sore and tired from boot camp the week before.  Downhill races are very tough on your quads, and mine are still very sore.

I posted a picture from the course at the bottom of the page.  The scenery was beautiful.  There were only about 400 marathoners and very few spectators, so there was a lot of time to run alone.  That's fine with me, but not real conducive to running a great time.

I was disappointed in my time, but glad I finished.  I didn't really have any other goal.  I viewed this race as a long training run for the big one this fall, the ING New York City Marathon.  I'll rest this week and then get into a New York state of mind!

Tuesday, September 6, 2011

#29 in the books

I did the American Discovery Trails Marathon in Colorado Springs yesterday. #29 total, 27th state. I'll have a full report later this week.

Monday, August 29, 2011

Running Gear, Vol. I

One of my favorite things about running is it's simplicity.  You can do it anywhere, you don't need a field or court, and you don't need lot of expensive equipment to enjoy the sport.  As my barefoot running posts show, some runners don't even need shoes!

Having the right gear, however, can make the activity more enjoyable.  For a long distance runner, one of the basic necessities is some sort of hydration.  In general, on any run over an hour I always take a water bottle.  On a really hot day, I'll take it on even shorter runs.

For years, my favorite water bottle and belt is made by Ultimate Direction.  The belt fits on your low back and does not bounce around like some belts.  The horizontal holster makes for very easy access, and the bottle itself does not leak.

If you are in the market for a new water bottle and/or belt, I highly recommend it.

Here is a link to the company website.  They have many different bottles, belts, and packs based on your individual needs and preferences.

Saturday, August 27, 2011

Friday, August 26, 2011

#7--Stockholm Marathon

June 8, 2002. 3:52:05

My grandfather emigrated from Sweden in the early 20th century.  As a medical school graduation gift to myself, I wanted to visit my "homeland."  I spent two weeks in Sweden, with one week in the capitol, Stockholm.  Sweden is a clean, efficient, friendly, and beautiful country.  I met many relatives and made some new friends.  Of course, I had to squeeze in a marathon during the trip!

The Stockholm Marathon is considered by many to be one of the 10 best marathons in the world.  I would have to agree.  The scenery is breathtaking and the weather is usually mild.  The course included two loops through this great city.  The highlight was finishing in Stockholm's Olympic Stadium, site of the 1912 Olympic Games.  More world records have been set in this stadium than any other in the world.  I didn't set any records this day, but I did improve my time from Boston by quite a bit, finishing under four hours.

I am often asked which is my favorite marathon of all time.  I don't really have a favorite, but if pressed, would have to say Stockholm.

Wednesday, August 17, 2011

#6--Boston Marathon

April 15, 2002. 4:20:57

This represented the end of a two year pursuit for me.  In 2000 I set a goal to qualify for Boston and reached that goal with the Twin Cities Marathon that same year.  The qualifying time is good for two years.  I was very busy with medical school, so I decided to run Boston the following year.

By this time I had met my wife-to-be and we spent several days touring the historic city.  (She was in OT school and couldn't get any time off.  She told her professors she had scabies and couldn't come to class for a few days!  Nobody asks for proof when you tell them you have scabies!)  This trip was more of a vacation than a race.  We walked on the Freedom Trail, went to a Red Sox game, drank at Cheers, and gorged on seafood.

I took a narrated bus tour of the course.  It was really cool to finally make it here and be surrounded by so many other runners who dedicated themselves to the same goal.  It can be argued that the Boston Marathon is the most famous and prestigious road race in the world.  The great thing about marathon running is the chance to compete in the same event as the best in the world.  Not many people can play in a Super Bowl with Tom Brady or a World Series with Derek Jeter, but I was able to "play in the Super Bowl of Running" for one day.

I was not in great shape for the race and labored to a 4 hr + finish time.  The course was 26.2 miles of history, and I didn't mind a single minute spent on the course.  The entire course was lined with enthusiastic spectators who are as much a part of the race as the runners themselves.  I took a disposable camera with me on the course and tried to capture what I could of the race.   For me, however, the race was fairly anti-climactic.  This was about the destination AND the journey.  To this date, qualifying for and running the Boston Marathon remains my proudest accomplishment.

Sunday, August 14, 2011

LSD is Good For You

No, not THAT kind of LSD.  I mean Long, Slow, Distance.  This is the foundation of any running program, particularly the marathon.  These runs teach your body to withstand the physical pounding of running for hours on pavement.  Mentally, you learn to be patient and to stay focused for the hours that the distance demands.

Long, slow, distance runs improve your endurance and aerobic capacity.  This is the best fat burning training zone to be in, as your body learns to use stored fats as fuel.  These runs should not be done too fast.  If you are using a heart rate monitor, you should stay well below 70% of your max heart rate.  If you are not using a HR monitor, you should be able to carry on an easy conversation without being winded.

The biggest mistake most runners make is doing these runs too fast.  You lose the benefits of training in a low HR zone, and you risk acute and overuse injuries.

To very loosely paraphrase Timothy Leary--shoes on, tune in & slow down.

Saturday, August 13, 2011

Thunder Run 2011

Today was the 2011 Thunder Run.  It was a perfect day for a race-sunny and not too hot.  This is a unique race run on the airport runway.  This makes it seem much longer than a 5K, in my opinion.  Over 400 runners participated in the 5K, another great turnout for a Lincoln Track Club event.

I've been doing some speed work of late, and the 3 weeks of boot camp have me feeling stronger and faster.   I used today's race as a tempo workout.  I jogged an easy mile before the race, and then hovered around the 7:45/mile pace during the 5K before finishing with a mile cool down afterwards.  My time for the race was 24:26.

I don't run many 5Ks, but it is probably one of my favorite distances.

I'm doing an easy 12 miler tomorrow.  Next weekend I'll peak at 20 before tapering before the next marathon.

Tuesday, August 9, 2011

Altitude Running 101

This seems like a strange post from someone living in Lincoln, NE.  There are several reasons why it's been on my mind, however.  I was in Keystone, CO recently for a meeting and went for several training runs.  My heart was practically pounding out of my chest.  My recent post about the Wyoming Marathon also reminded me of the joys of running at altitude.  Finally, my next marathon will be another one at altitude.  Have to check Colorado off the list!

Altitude probably doesn't affect endurance performance until you reach almost 5000 ft.  After that, however, your VO2 max (maximum ability to transport and use oxygen) declines about 3% for every 1000 ft of elevation.  There are several basic physiologic principles that explain why.  At altitude, the partial pressure of oxygen declines.  In order for your heart to pump enough oxygen to all of your tissues, your heart rate speeds up.  In order to get more oxygen into your lungs, your breathing accelerates.  You lose water in the form of water vapor from increased respiration.  The above changes affect the pH balance of your blood.  In order to try to maintain normal pH balance, your kidneys diurese.  This leads to further dehydration.

The physiologic effects of altitude begin almost immediately.  Your body responds by making more red blood cells to carry oxygen, but this process takes time.  Full acclimatization takes weeks.  Ideally, one would arrive several weeks before an event at altitude.  For most of us, that's not an option.  Acutely, the best thing to do is drink a lot of water to negate the effects of dehydration, adjust your expectations, and enjoy the views and cool mountain air, however thin it may be.

Wednesday, August 3, 2011

#5--Wyoming Marathon

May 27, 2001.  5:20:19

After I qualified for Boston, I took some time off.  Probably too much time off, in retrospect.  I was into my third year of med school and I really had a hard time finding time to train.  After basically taking the fall and winter off, I was ready to run again.

I've always been goal oriented, and I needed something to get me back on the road.  By now, I had started to think about running a marathon in all 50 states.  I did a family medicine rotation in Chadron, Nebraska in the spring of 2001.  The Wyoming Marathon just outside of Laramie was within driving distance, so I signed up for it.  My training was still somewhat sporadic.  I was limited by time and was having some leg and calf pain.  I later diagnosed myself with shin splints, or posteromedial tibial stress syndrome.  I tend to over-pronate some, and I was running in fairly old and worn out shoes.  Big mistake.  My biggest mistake, however, was just not having enough respect for the course I was about to run.  My previous races had been pretty easy, and I was a Boston Qualifier.  It should be easy, right?

The Wyoming Marathon is basically a trail marathon.  It was in Medicine Bow National Forest.  Very beautiful.  It is an out and back that starts at 8500 ft elevation, downhill to 7000 ft at the turn around, and then back up to 8500 ft at the finish.  It was an incredibly hard course, and remains the most difficult marathon I've ever done, even to this day.  At several points I wanted to quit, but that would have been tough.  You are basically stranded in the middle of nowhere.  The best thing to do is just keep moving towards the finish.

Well, I did finish, but in a record slow time of 5:20:19.  Since that race I've learned a lot.  Don't run a marathon you haven't trained properly for.  Don't run in old and worn out shoes.  Trail marathons in the mountain altitude are tough if you don't live and train there.  Finally, don't get too cocky.  The marathon can be a very humbling experience.

Saturday, July 30, 2011

Does Running Cause Arthritis?

"You are going to wear out your knees running."  Every runner has heard this, usually from non-runners.  However, this statement is based on very little scientific evidence.

Theoretically, one might expect that repetitive loading of joints over years of running might lead to arthritis.  In fact, there is laboratory data that shows that acute and repetitive joint loading may cause changes in articular cartilage (joint cartilage) that are associated with arthritis.  Many investigators have tried to look at this clinically.  While there are a very few number of small, poorly conducted studies that suggest a link between running and arthritis,  the overwhelming majority of studies find no link between running and arthritis in otherwise healthy people.

Human joints have the intrinsic ability to adapt to stress and strengthen in the process.  Moderate running provides this stress, and may lead to improved joint health and longevity.  That being said, running isn't for everybody.  There are certain independent risk factors for the development of arthritis.  These include age, obesity, mal-alignment, and history of trauma or injury.  Running may potentially exacerbate the risks in the presence of these other factors. Before beginning a running program, it's a good idea to consult with your doctor.

Thursday, July 28, 2011

Boot Camp, Wk 1

This is the first week of my boot camp.  It's being led by Steve at Good Life Fitness.  I have always resisted  doing these things.  After all, I'm a marathon runner.  I'm supposed to be in great shape.  The problem is it's easy to get stuck in a rut, and that's where I found myself.  After a positive referral from a fellow runner at the office, I decided to give it a shot.

All I have to say is.....OMG!!!  The first day I couldn't really even lift my arms above my head to wash my hair and I'm embarrassed to say, but I needed help getting my dress shirt on!  The focus on cardio, plyometrics, and core strengthening has been outstanding.

I've been doing some speed work, too, so I decided to compare a speed work out with an hour at boot camp.  I did a hard interval workout in the middle of the day, 90 degrees plus.  My maximum heart rate was less during this workout than it was during a boot camp workout at 5AM.

As runners we are sometimes guilty of focusing too much on running and neglecting other activities.  Cross training can make you a better runner, if done properly.  I expect boot camp to make me a leaner, stronger, faster runner.  I'm not there yet, but I am happy to say that after one week I am now washing my own hair and dressing myself again.

Thanks, Steve!

Sunday, July 17, 2011

#4--Twin Cities Marathon

October 8, 2000. 3:09:52

When I finished the Rock 'n' Roll Marathon, I set my sights squarely on qualifying for Boston.  I had basically spent the last year training.  I was in great shape, and I thought a BQ was within reach.  I read everything I could get my hands on about running.  I was in marathon shape, I just had to get a little bit faster.  I took a week or two off after San Diego, and then began a fairly intense program to try to qualify for Boston.  I incorporated one of Hal Higdon's intermediate programs.  Each week I would do a track workout, an easy recovery run, a tempo run, a long pace run, and a long run.  Every run had a purpose.  The program was challenging but doable.  My peak weekly mileage didn't ever exceed 45 miles.  This was important, because I had just started my third year of medical school (the first clinical year and probably the busiest and most time consuming.  During my surgery rotation I would start rounds at 3:30 in the morning!)

After 18 weeks, I was ready.  I can't remember why I chose the Twin Cities.  Probably because it was within driving distance, and I had a friend that I could stay with.  Race day was clear and cool.  Probably high 30's at the start.  I was a little late getting to the start area, so I had to start towards the back.  There weren't any corrals that I remember.  Anyway, I knew I had to stick to a 7:15 pace at least.  After the first mile, I was already a minute or two behind.  I went to the side of the road and even on the sidewalk at one point in order to pass the slower runners.  I felt great and quickly got back on track.  I remember that I had at least one sub 6 minute mile during the race.  By ~ mile 19 or so I had a comfortable cushion.  At this point, however, the Twin Cities course becomes very tough.  Right after mile 20 there is a steep hill that doesn't end until about mile 23.  I had run plenty of hills, but none like this.  I did my best, but at the top of that climb, I had lost my cushion.  I was now well off pace.  I was crest-fallen, but I had come too far to give up.  The only thing I knew to do was keep running, which is what I did.  I remember looking down at my watch at mile 25.  Although I can't remember the exact time, I do remember thinking that if I had a strong kick, I might still be able to make it.  At that point I went into what was basically an all out sprint for the last 1.2 miles.  I crossed the finish line and looked at my watch.  It said 3:09:52.  I had just qualified for the Boston Marathon.

Thursday, July 14, 2011

Speed Work, Vol. IV: Hills

I believe it was Frank Shorter who once said, "hills are speed work in disguise."  Hills are not something that most runners will set out to run intentionally.  Most runners, in fact, do almost everything to avoid running them!  Shorter said what he did because running hills offers many of the same benefits as the other speed workouts I've discussed.  The basic physiology is the same.  Hill running, like the other workouts, makes you a fitter and stronger runner.  I recommend finding a route with a couple of hills that are 100m or so in length (a city block, usually) and doing a couple of "hill-repeats," or find a rolling course and attack the hills going up.  So next time, instead of avoiding hills, embrace the challenge.  Most races have some hilly parts.  You'll know your work has paid off when you pass others struggling to make it to the top.

Saturday, July 9, 2011

Speed Work, Vol. III: Pace Runs

Pace runs are really important if you are trying to run a particular time.  Let's say you want to break 4 hours, or want to qualify for your age group at Boston.  There is a particular pace that you are going to have to run.

Pace runs teach your body to recognize the pace, and to be comfortable maintaining that pace when you are getting tired.  I think the best way to do a pace run is the day AFTER your long run.  The pace run should be about half the distance of your long run, but done at a faster pace.

For example, let's say you want to break 4 hours.  Your goal pace is ~9:15/mile.  Do your long runs 30-60 seconds per mile slower than this goal pace.  The pace run should be done at 9:15.  The pace run should be moderately long, about half of your long run for the week.  So if your long run is 14 miles on Saturday, follow this with a 7 mile pace run on Sunday.  Your body will learn to maintain this goal pace, even when you are fatigued.  When marathon day rolls around, your goal pace should be second nature and you should be able to maintain it, even in the last few miles of the race.

Friday, July 8, 2011

Thank You

Since my blog has gone live I've had more than 1,000 page views.  I have regular followers locally, across the country, and even have regular viewers in Germany and Malaysia!  To those who visit the site, I'd like to say thanks.  Running has meant a great deal to me and I really enjoy sharing my expertise and experience with others.  I'd like to make this Blog as valuable as possible.  I've created a poll that you will see on the left hand side of the screen.  Please take a moment to vote and tell me what you enjoy reading on the blog, and what you'd like to see more of.  Thanks again.

Wednesday, July 6, 2011

Speed Work, Vol. II: Tempo Runs

In an earlier post I espoused the virtues of the Yasso 800's.  Today I will discuss one of my other favorite workouts, the Tempo Run.  Like the Yasso repeats, tempo runs are simple and effective.  Basically, a tempo run teaches your body how to run fast when you should be getting tired.  It does so by raising your lactate threshold.  Lactate is a by-product of muscle activity.  It's accumulation causes soreness and fatigue.  By raising your lactate threshold,  you use oxygen more efficiently, and raise the point at which your body produces and accumulates lactate.  By doing so, you prevent or delay the onset of muscle fatigue and soreness.

I recommend doing tempo runs once a week.  Start with an easy mile warm up, then run 20-30 minutes at tempo pace.  Finish with an easy mile run.  There are many ways to determine your tempo pace.  One way is to add ~20 seconds to your 10-K pace.  For instance, when I was training for the Twin Cities Marathon I ran a 10K in 38:15 (6:10/mile pace).  My tempo pace was therefore 6:30/mile.  I usually do these work outs on the treadmill because it is easy to program in the exact pace and stick to it.  The treadmill also offers a nice break from the impact of asphalt and concrete.

Tempo runs will make you a faster and stronger runner, regardless of your distance or goal.  For more information on tempo runs, Runner's World has several good articles in their archives.

Tuesday, June 28, 2011

No Pain, No Gain?

Overuse injuries in competitive and recreational athletes are some of the most common conditions I treat.  These include muscle strains, tendonitis, and stress fractures.  The athletes at risk for these injuries are those who compete year-round with little or no break in between sports or seasons, and those athletes who increase the intensity of their training too quickly.  A rule of thumb for distance runners, for example, is to not increase weekly mileage more than 10% per week.

When evaluating these athletes, I try to determine the underlying cause of the injury and decide whether or not continuing to play or train will result in harm or disability.  The prescription usually involves a period of rest, activity and training modification, therapy, and occasionally a period of immobilization.  I try to keep the athlete as active as possible while recovering, including low impact cross training activities whenever possible.  Swimming and stationary biking are ways to maintain aerobic fitness, while letting injuries heal.

Unfortunately, sometimes the prescription will prevent the athlete from competing for a while.  This can be difficult for young athletes, in particular, to come to terms with.  Sports are fun and offer many great life lessons--team work, hard work, dedication, and commitment to name just a few.  Sports can also teach us how to deal with disappointment and adversity, including injuries.  The true test of an athlete's character isn't how he or she handles success, but how the athlete deals with that adversity.

Thursday, June 23, 2011

#3--San Diego Rock 'n' Roll Marathon

June 4, 2000.  3:27:55

After the Dallas White Rock Marathon, I just wasn't sure that my knees would hold up for another marathon.  I took several weeks off to rest.  I worked on some strength training (an area most runners, myself included, neglect) and did some biking.  My passion was now running, however, and I couldn't wait to get back on the roads.  I competed in more weekend road races, and even managed to place in my division a few times, winning a watch in the Mike Doucy Stars of Texas 10K.  It remains one of my proudest possessions!

I wasn't doing any speed work per se, but the road races were even better.  I was in "marathon shape," already, and just kept getting faster.  A friend of mine in Dallas mentioned that he was going to be running the San Diego Rock 'n' Roll Marathon in June.  The RnR series were relatively new at the time, and the idea of being supported by 30 some bands on the course was appealing in the days before iPods were common or even allowed at races.  I had an old college friend in SD whom I had not seen in a long time.  I'd never been there, so it seemed like a great excuse to go.

The trip was great.  I went to the Zoo and Sea World, and my friend took me sailing the day before the race.  Race day was hot for San Diego, and the course was hilly in places.  There were nowhere near 30 bands as advertised, but the entertainment was fun.  I ran a very strong race from beginning to end, running the second half faster than the first.  Training all year in the Texas heat and running all of those road races had really paid dividends.  I felt like I had plenty of gas left in the tank at the end of the race.  Also, I had no pain anywhere in my body!  I looked down at my watch--3 hrs, 27 minutes, 55 seconds.  In just my 3rd marathon, I had cut nearly an hour off of my debut time.  I was starting to feel like a real marathoner!  

I celebrated that afternoon by eating fish tacos on Pacific Beach (PB for those who live there).  I had always heard people talking about qualifying for the Boston Marathon.  I began to wonder, what would that take?

Tuesday, June 21, 2011

Speed Work, Vol. I: Yasso 800s

As I began to do more road races I would hear people talking about "speed work."  I was a novice on the subject, but quickly educated myself.  Speed work can take many shapes and forms.  One of the most effective workouts is the so-called "Yasso 800's" named after Bart Yasso.  The workout is simple and effective, and can help you reach any marathon goal.

The workout is done on a track and starts with an easy mile warm up.  This is followed by a series of 800 meter intervals.  The pace of the interval depends on your goal marathon time.  Let's say, for instance, that your goal marathon time is 3 hrs 30 minutes.  You should run the 800 meter interval at 3 minutes and 30 seconds.  Recovery between repeats consists of an easy 400 meter jog.  Start with 2 or 3 intervals and work up to 4-6 intervals.  Finish the workout with an easy mile jog.

The workout is tough and should be done no more than once a week.  It should be preceded and followed by a relatively easy run.  If you are able to consistently hit your target pace during the intervals, you should be very close to nailing your marathon pace on race day.

Here is a link to read more about Yasso 800s.

Father's Day Thoughts

I started out the day with a nice 9 mile run on the MoPac trail.  After a couple of light weeks, I'm building my mileage base back up.  I spent the rest of the day relaxing and being spoiled by my wife and son.  

My job keeps me away from my family more than I would like, so I feel guilty leaving them to go on a long training run on the weekends.  I'm lucky to have a wife who understands my compulsion.   She knows that running makes me a better person--a better husband, dad, surgeon, and friend.

When my son is old enough to understand what it means to run a marathon in all 50 states, I hope he will be proud of me.  I also hope that he learns to dream big, set lofty goals, and to work hard to make his dreams a reality.

Tuesday, June 14, 2011

#2--Dallas White Rock Marathon

December 5, 1999. 3:41:06

I spent a year doing research between my second and third years of medical school.  I worked in a lab in Dallas, TX.  I enjoyed my time there and learned a lot (mostly that I didn't want to do research for a living--too slow).  I was still running 4-5 days a week, mostly for fitness and fun.  I joined the Cross Country Club of Dallas.  The Club was very active and sponsored races nearly every weekend.  I had nothing better to do, so I ran most of them.  I wasn't focusing on it, but I got a LOT faster.  One of my recommendations if you are trying to run a faster marathon is to compete in as many road races as you can.  You'll be doing speed work and not even realize it.  You almost can't help but get faster.

After Chicago, I really didn't think I'd ever do another marathon.  I had done it, right?  What's the point?  Well, the thought occurred to me, I wonder if I could break 4 hours?  With all the road races I was doing I was running sub 9 minute miles easily and my IT band issues seemed to be behind me.  I signed up for the local marathon, the Dallas White Rock Marathon.

Race day was very cool for Dallas, but ideal conditions for a marathon.  The course included a loop around White Rock Lake, my favorite training spot in town, so I felt like I had the home court advantage.  My pace was quick, and for the first 17 miles I was on pace for a 3:30 marathon!  Then, out of nowhere at mile 17, sharp pain on the outside part of my knee.  I knew exactly what it was--IT band syndrome again!

I didn't stop or even walk.  I just endured 9 miles of sharp, intense pain.  I finished in 3:41:06.  I was a little disappointed that I had to slow down, but mostly I was overwhelmed with a feeling of satisfaction.  I couldn't possibly have run even one second faster that day.  I gave it my all and was totally spent.

I really enjoyed both of the marathons I did and was proud of the accomplishments.  Unfortunately, it seemed that my old nemesis (IT band syndrome) would prevent me from doing any more.

Saturday, June 11, 2011

Run 4 the Homeless, Pt. II

Run 4 the Homeless 5K was a big success today.  Over 600 runners and $26,000 raised for the People's City Mission.  Thanks to those who donated.  Good job, Lincoln!

I was towards the back of the pack, coming in just under 30 minutes.

You can still donate to the cause.  Follow the links from the post about the race last week.

Friday, June 10, 2011

Injury Prevention 101

I love taking care of runners, because we are dedicated and passionate.  It is gratifying to help somebody return to or continue doing something that I know means so much to them.  With that being said, I'd be glad if I never saw another runner with an injury in clinic, because that would mean they were out doing what they love instead of trying to recover.  Unfortunately, injuries do happen.

Some of the more common ailments I see are patellar tendonitis, achilles tendonitis, and plantar fasciitis.  Without going into boring details, a great number of these "-itises" can be treated with some simple stretching exercises, or better yet, prevented all together.

I've included a link to our patient education page that demonstrates proper hamstring and calf stretching exercises.  Try to make time to incorporate these stretches before and after your daily run.

Happy Running!

Thursday, June 9, 2011

Barefoot Running

This is something I get asked about ALL the time.  Throughout human history most running was done barefoot or at least done in shoes with very little support compared to what we see today.  Even today, billions of people in many parts of the world still wear sandals or go barefoot, much as our ancient ancestors did.  So, which is the right way?  The answer is not so simple.  People who run barefoot do so in a way that is very different than people who wear cushioned, supportive shoes.  Simply, barefoot runners tend to be mid and forefoot strikers, while shod runners tend to be heel strikers.  In general, barefoot running probably does cause less "shock" to the body.

The problem is when somebody goes from one extreme to the other too quickly.  I recently saw a guy in clinic who was training for the Lincoln Marathon.  He trained for months in cushioned shoes without any problem, but 2 weeks before the race switched to a minimalist, barefoot style shoe.  Needless to say, he ended up in my clinic for a host of foot aches and pains.

If you are going to switch to barefoot running, you need to do so gradually, because your form will change completely.  Your body is very adaptive, but it needs time.  Remember, the Tarahumara of Born to Run fame have spent their entire existence on the planet running long distances in sandals.

Moreover, I think you need to have a good reason to switch.  I am very curious about barefoot running and I've heard all the propaganda, and a lot of it makes sound scientific sense.  I haven't done it because I really haven't needed to.  If it ain't broke, don't fix it.  I've run thousands and thousands of miles relatively pain and injury free, so I can't see a good reason to switch.  On the other hand, if your running is constantly hampered by nagging injuries, barefoot or minimalist shoe running may be something to consider.

There is a great article in the New York Times about this.  I've included the link.  Special thanks to Eric and Melanie for sending it to me.

Wednesday, June 8, 2011

Post Marathon Blues

This is week 2 of recovery from the Vermont City Marathon.  I ran a 10K last weekend, have a 3K this weekend, and will start my first "Boot Camp" in 2 weeks.  I've kept busy and avoided the post marathon let down.

I was very well prepared for my first marathon.  I had trained intensively for the race, and there were no surprises or challenges that I wasn't up for.  I broke through the wall at mile 20 without any problem.  The one thing I wasn't prepared for was the feeling afterwards.  I was very proud of my accomplishment, but I felt like something was missing.  You spend 18 weeks training for something and obsessing over every detail and then one day, poof, it's gone.  I wasn't prepared for the void that was present after the first marathon.

I've never really read about this phenomenon anywhere, but it makes sense I suppose.  There are many ways to deal with it.  If you know you are going to be running another race, sign up for it so you have another goal to work towards.  If not, change something up in your training.  Work more on strength and cross training, run a new course, or try running with a different group.  Your goal can also be to take some time off, spend time and do something special with your family.  They deserve it!

Saturday, June 4, 2011

Run 4 the Homeless

I'm still in recovery mode from the Vermont City Marathon last weekend.  I ran the 33rd Annual Havelock Run today.  Our team from Nebraska Orthopaedics raised money for the Arthritis Foundation, as we did last year.  We had full teams for both the 3K and 10K races.  The turnout and support was amazing.  The running community in Lincoln is as good as there is anywhere.

While on the course I saw signs advertising a Run 4 the Homeless next weekend.  The race benefits the People's City Mission of Lincoln and goes to help support those in our community much less fortunate.  I've included a link to the Mission's website, and have created a page where you can donate to the Mission.  Please consider joining me in donating to the People's City Mission.

Friday, June 3, 2011

#1--Chicago Marathon

October 11, 1998.

My first marathon (& last without body glide!)  I had only been running for a year and a half.  I had done a few local 5Ks and the Bolder Boulder 10K up to this point, but I knew next to nothing about distance running.  I was amazed that people actually could run 26.2 miles.  It seemed almost super human to me at the time.  I researched marathons some more and discovered that if you were in reasonably good shape and had a "base mileage" of 15-20 miles/week, the marathon was within your grasp.  With enough time and training (4 months on average) you can go from running 3-5 miles per day to completing the marathon.

I've always enjoyed testing myself and this seemed like the ultimate test.  I was a second year medical student at the time.  I would often have to run at 5 in the morning or 11 at night, but I don't think I missed a single training run.  The marathon consumed me.  In my limited free time, I read everything I could about running.  I've mentioned Hal Higdon's programs before.  His weekly novice program became my bible.  

Chicago was a great choice for a first marathon.  It's truly one of the great cities of the world, and was cheap and easy for a med student with limited time and money to get to.  I stayed with a friend from college who couldn't understand why the guy who used to go to Leavenworth Cafe every night after the bars closed was now running marathons.

Marathon day was perfect.  Mid 50's, sunny.  Chicago is a flat, fast, well organized and supported race.  My running had always been hampered by IT Band Syndrome, and this race was no different.  I held back for the first half of the race, running very cautiously.  If you've suffered from IT band syndrome, you know that the pain can come on very suddenly, and can bring your run to a screeching halt.  By mile 11, however, the endorphins started to kick in, my pace quickened, and my knee pain melted with the miles.

My time was slow, 4:23:59, but I finished.  That was my only goal.  I was sure I would never run another marathon. 

Wednesday, June 1, 2011

The Heat is On

With Memorial Day behind us, summer has pretty much begun.  In southeast Nebraska, that means heat and humidity.  I actually really enjoy running in the heat and working up a good sweat because, to paraphrase Dr. George Sheehan, "sweat cleanses places a shower can never reach."

One must be smart about summer running, however.  At the Vermont marathon, two runners had to be pulled off the course because of heat stroke.  Both runners had temperatures greater than 105 degrees F.  Several years ago at the same race, a runner was in a coma for 12 hours after the race.  He returned to finish the marathon this year!

I've posted links to a Mayo Clinic article on heat stroke, and some helpful tips from Jeff Galloway of Runner's World related to summer running.

Monday, May 30, 2011

Rules for Rapid Recovery

As I hobble around today I thought I would share some tips for recovering from the marathon. 1. Fluids, fluids, fluids. Drink plenty of water. Carry a bottle with you the rest of the day. 2. Fuel. Within 30 minutes eat some fruit and easy to digest carbs. Bagels are popular choice. You should also consume meals high in protein the day of and after the race to help rebuild broken down muscles. 3. Icebath. As soon as you can, get into an ice bath up to your waist. It's 90 seconds of pure torture, but after that your legs will feel numb. Spend 20 minutes in the bath. It helps ease the swelling and muscle inflammation. 4. Compression. Calf high compression stockings help your legs feel less fatigued. 5. Meds. For the first day or so, I will take full doses of advil and Tylenol. 800 mg of advil with food three times daily, and 1000mg of Tylenol four times daily. 6. Sleep. You'll need more than the usual amount of sleep for several days. Plan to go to bed early if possible.

#28--Keybank Vermont City Marathon

4:47:35 Burlington, VT With temperatures reaching into the 70s with 90% humidity at the start, the conditions were far from ideal for this one. However, it remained mostly overcast, and much of the course was in shade. This is a popular, New England holiday marathon and it's easy to see why. Burlington is a very cool town, with lots to see and do. From the expo to the post race party, Burlington can be proud of this marathon. Crowds were out in numbers and enthusiastic. At one point on the course in one of the residential neighborhoods, there was a large American flag hanging from the trees in the middle of the streets. Most if not all runners slapped the flag on their way by. It was a touching reminder of the sacrifice that so many have made on our behalf. As you enjoy this Memorial Day, turn your thoughts to those brave men and women who have given their lives to serve and protect this great nation of ours.

Sunday, May 29, 2011

#28 in the books

Just completed #28 in Burlington, VT. I'll have a full report later. Off to the cheese factory now!

Tuesday, May 24, 2011

Taper Talk

With my next marathon only a few days away, I thought it would be a good time to talk about tapering.  Most marathon training programs have a weekly mileage peak around 2-4 weeks before the race.  I think three weeks is ideal, but this can be moved by one week in either direction if work, travel, or family commitments preclude a 20 mile run exactly three weeks before the race.  Tapering is critical to any successful program.  One of the many challenges in marathon running is showing up to the starting line healthy and fresh.  Many novice runners experience a great deal of anxiety the weeks before the marathon and question whether they have trained enough.  It can be difficult to resist the temptation to get one last long run in the week before the race.  I've seen people who make the mistake of running 16 miles just a few days before the race!  It's important to trust that the fitness gains you've made over the course of a 16-18 week program will carry you through on race day.

My typical taper looks like this:

Week     M            T     W     T     F             S      S
3            REST      5      4      4     REST      8     12
2            REST      4      3      3     REST      6      8
1            REST      3      2      2     REST  REST  RACE

This program has been adapted from Hal Higdon's website.  I've posted a link to his website on this blog.  

Saturday, May 21, 2011

Eat Slow, Run Fast

It wasn't until I started running marathons that I ever thought of food as fuel.  In the middle of a 26.2 mile run, however, you realize the relationship between what you put into your body and the kind of performance you get out of it.

Last night I attended the Community CROPS Rooftop Garden Party.  I helped sponsor the event, which raised money for the organization.  Community CROPS (Combining Resources, Opportunities, and People for Sustainability) is a program that helps people work together to grow healthy food and live sustainably right here in Lincoln, Nebraska.  

The "Slow Food" movement has been around for years.  It's a philosophy that encourages sustainable farming and ranching practices, while emphasizing local products and businesses.  As a physician and endurance athlete, I understand the importance of healthy food to one's well being and physical and mental performance.  "Slow Food" is about more than that, though, as it also helps you understand and connect with the people and things around you.

One of the great ways to experience the "Slow Food" movement is by visiting a local Farmer's Market.  There are a record number of Farmer's Markets thriving around the country.  You've probably already done this without even realizing that you were participating in any sort of movement!

So, visit your local Farmer's Market, Eat Slow, & Run Fast!

Thursday, May 19, 2011

Monday, May 16, 2011

Long Run 101

This weekend was the peak for training for my next marathon.  I ran five miles three days during the week and 10 miles Saturday and 20 miles Sunday.  What exactly constitutes a "long" run is somewhat a matter of debate, but for the sake of simplicity, I'll define it as any run over 10 miles.  The long run is the key to any successful marathon training program, and most programs will peak with a long run ~20 miles 2-4 weeks before the race, then taper until the race.

I think some of the keys to a good long run are:
1. Try not to do too much the day before.  Stay off your feet as much as possible.
2. Drink a lot of water the day and night before.
3. Eat well.  High carb meals which are easy to digest.  Pasta is the obvious choice.
4. Get up early.  You can avoid the heat of the day, and there is nothing quite like seeing the sunrise on a cool, calm morning.
5. Don't overdress.  You should feel a little chilly at rest before the run.  Also, dress in layers that can be easily shed as the temperatures rise.
6. Pace.  Your pace should be 30-60 seconds per mile slower than your goal race pace.
7. Hydrate.  I generally take enough water or gatorade to be able to consume ~6 oz every 15-25 minutes.
8. Gels.  I will consume an energy gel approximately every 45 minutes during a long run.  GU is my favorite
9. IPOD.  You're favorite music can pick you up when you are feeling sluggish.  Lately, I have been listening to audiobooks.  Perfect for long, slow runs.
10. Group runs.  I usually train alone for the simple fact that nobody I know is training for the same thing at the same time, but running with a friend or a group is a great way to make the time fly by and catch up with an old friend or make new ones.
11. Recover.  A topic for another post, but you should drink plenty of water the rest of the day and recover with carbs and protein soon after your run.

Friday, May 13, 2011

Are you getting enough (or too much) calcium and vitamin D?

Calcium and vitamin D are vitally important for good bone health.  Many fractures are the result of osteoporosis, or poor bone density, which can be the result of nutritional deficiencies in one or both of these elements.  We need adequate levels of both.  Children, pregnant, lactating, and post-menopausal women have the greatest need for calcium and vitamin D.  I've found that many men are unaware that they are at risk for osteoporosis, but men are not immune and should be sure they are getting the proper amounts.  Too much of either can have deleterious effects, however, and you should avoid taking more than the recommended amounts.   The Institute for Medicine has updated the recommendations for calcium and vitamin D.  Here is the link:

Wednesday, May 11, 2011

Doc, I got a heel spur

That is one of the most common things I hear every day in my clinic.  Most of us will be affected by heel pain at one time or another in our life.  While it is true that many people do in fact have heel spurs on xray, more often than not the spur is a red herring and not the true source of pain.  The heel pain that we suffer from is usually from plantar fasciitis.  The plantar fascia is a thick band of tissue that runs from the heel to the balls of your feet.  With plantar fasciitis, the tissue becomes inflamed and painful.  The pain can be quite severe and disabling.  Although the condition may persist for months or years in some cases, it is generally self limited.  Simple stretching techniques are usually quite effective.  Other conditions can mimic plantar fasciitis, including stress fractures of the calcaneus or heel bone.  A thorough history and physical examination is usually all that is required to make the diagnosis.  Here is a very nice study on plantar fasciitis treatment from the Journal of Bone & Joint Surgery: