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: