Saturday, January 28, 2012

If you've got an itch, scratch it.

Orthopaedic surgery has become an increasingly sub-specialized field, with many of us focusing on one particular anatomical region.  My area of specialty is the foot and ankle.  I sometimes joke with my colleagues who operate on the upper extremity that "the hand is only good for scratching your foot."

Well, as it turns out, I might be on to something.  A recent study proved that scratching your ankle was more pleasurable than scratching your back or arm.

Read about it here:

Sunday, January 22, 2012

American Olympic Team Set

The U.S. Marathon Olympic Trials were held last weekend in Houston, TX.  The top three finishers in the men's and women's field will represent the USA in the London games next summer.  A strong American team looks to improve from Beijing where the USA was left off the medal stand and attempt to bring home just the 7th medal since 1972.

Thursday, January 19, 2012

Arizona Rock 'n' Roll Marathon, pt. II

Once I realized that I was fortunate to simply have the opportunity to run the race, I settled in at a comfortable pace.  The weather for the race was perfect.  Temperatures were in the 60's and it was overcast.  There were plenty of volunteers and aid stations.  Cheerleaders from the local schools and bands raised the spirits of runners every few miles.

The course is flat and fast, with just two short hills towards the end.  The race starts in downtown Phoenix and proceeds past the endless strip malls and apartment complexes of this desert city.  The course takes you through Scottsdale and finishes outside of Sun Devil stadium in Tempe.  With the exception of the mountain backdrop, the course is not particularly scenic, but I didn't expect anything else so I wasn't disappointed.  I ran a steady 10:30 pace until the last few miles when my left IT band flared up again.  It wasn't as bad as NYC, but I did have to stop and stretch a few times.

There was lots of post race food and the post race party at RnR events is always good.  I didn't go because I had to go meet my family in Scottsdale and I just kind of wanted to get the heck out of there.  I could hear the concert headliner, the B-52's, playing "Love Shack" as I pulled out of the parking garage with #31 (kind of) behind me and in the books.

Bone Density Scans

How often should you have a bone density test?  A new study published in The New England Journal of Medicine provides some answers.

Monday, January 16, 2012

#31--P.F. Changs Rock 'n' Roll Arizona Marathon*

Phoenix, AZ
January 15, 2012

Well, you'll notice the asterisk and question mark for this marathon, which benefited the Multiple Sclerosis Society.  That is because I did not get an official time.  I registered for the race, paid the fee, got a bib number, and collected a medal.  However, I forgot to put the timing chip on my shoe, so I will not get an official time.  That was a microcosm for the whole weekend.

I traveled with my wife and two young boys.  The plane trip was fine.  As we left the rental car place we realized we only had one of our two bags!  We searched and searched, but to no avail.  It was my bag, of course, with all of my running gear!  We checked into the hotel to put the kids down for a nap, and the room, despite being non-smoking, absolutely reeked.   When the kids woke, we changed rooms and I received a call from the lady who had mistakenly grabbed my bag and took it to her hotel.  She happened to be running the race, too, so I picked it up at the expo.  We had a good laugh, and parted ways.  It seemed like the worst was behind me.  It wasn't.

The night before the race I barely slept.  Our youngest was up every hour.  I stumbled out of my hotel a full 90 minutes before the start.  Marathon runners were instructed to park at the finish and take the light rail to the start.  The exit from the interstate was backed up for miles and miles.  Many runners who were being dropped off gave up and got out of the car and ran along the interstate to the start!  I was stuck for an hour or more.  I had hydrated well and was in desperate need of a bathroom.  With none available, I repeatedly filled the empty smoothie cup in my car and dumped it on the road.

The start time came and went, and I still wasn't even parked.  There were hundreds behind me, too.  I finally parked and sprinted to the train stop.  I was relieved to see a few other runners and hear that they had pushed the start back 30 minutes.  I was going to make it.  With a sense of relief, I took my seat.  I quickly looked around at the other runners and saw that they had timing chips on their shoes and I did not.  I had completely forgotten it at the hotel!  I usually put it on my shoes the night before, but our oldest was napping in our room and I didn't get a chance.

Oh well, at least I had my GPS.  We were dropped off at the start with a minute to spare.  I entered my corral and turned on my GPS watch.  "Locating satellites........"   Forever.  This was going to be my unofficial official time.  I stepped out of line and waited.  And waited.  All of the other runners went by, and the clean up truck followed.  I finally gave up on my watch and crossed the start line, the very last runner that I could see.  My watch finally found a satellite about a quarter mile into the race.

I was pretty bummed out.  I started a light jog, but just wasn't feeling it.  I briefly thought about pulling out of the race.  What was the point, I thought?  Right at this moment I looked to the side of the road and saw a man in a wheelchair with his wife beside him.  She was holding up a sign that said, "Thank you for running for MS."  I realized then, that the only reason I needed to run that day was simply because I could.

Wednesday, January 11, 2012

Is Marathon Running Dangerous? Follow-up.

A few months ago I posted on the recent and high profile deaths of a few runners during the fall marathon season.  Now comes a report from The New England Journal of Medicine on the subject.

The study confirmed my previous post, that is, that the overall risk is low, and generally limited to those with pre-existing, and sometimes undiagnosed heart conditions.

Read about the study here:

Tuesday, January 10, 2012

Carbo Loading

As I prepare for the Phoenix Rock 'n' Roll Marathon this weekend, I need to start carbo loading.  I'd like to review why we need to carbo load, and how to do so properly.

When we run, our bodies need fuel.  The basic sources are carbohydrates, fat, and protein.  Protein is necessary for recovery AFTER exercise, but we use very little of it as fuel DURING exercise.  Likewise, fat is an inefficient fuel source during aerobic exercise.  The most efficient and readily available fuel during aerobic activity is carbohydrates, which our body stores as glycogen in our muscles and liver.

When runners talk about hitting "The Wall," what they are usually experiencing is depleted glycogen stores, and they are now forced to rely on fat and protein catabolism.

To avoid hitting the wall, you want to be able to burn glycogen as the primary fuel during the race.  This is one reason why carbohydrate drinks, gels, and so forth are beneficial during the marathon.  This is also the reason why carbo loading is popular and important.

During the last week of training, your training tapers such that you are burning less and storing more glycogen, simply as a result of decreased mileage.  The final three days or so before the race, you want to "top off" your glycogen stores by consuming approximately 90% of your calories as carbohydrates, approximately 4 grams per pound of body wt (800 grams of carbs for a 200 lb person, for example).

Carbo loading, then, means that carbs are to be emphasized in your diet in the days leading up to the race.  Pasta, rice, potatoes, and breads are favorite choices.  Low fiber fruits such as bananas are good, too.  Carbo loading will also cause you to retain water, so you get the added benefit of hydration leading up to the race.  Don't be surprised if you gain a few pounds during the days of carbo loading.

Carbo loading does NOT mean you should gorge yourself the days before the race.  To do so will leave you feeling sluggish and slow.  Eat about the same number of calories, just shift to carbs (~90%).

Sunday, January 8, 2012

Saturday, January 7, 2012

Taper Talk

With my next marathon only a week away, I've been tapering for the last couple of weeks.  I'd like to review how to taper properly, and why it is so important.

To train properly for a marathon puts an enormous amount of stress on the body.  You need to taper the last 2-3 weeks to make sure you have fresh legs for the race, and are prepared to perform your best.

Tapering ideally starts 3 weeks before the race, but can be compressed down to two weeks if need be.  The distance of each run should be decreased by ~25-33%.  For example, my midweek runs decrease from 5 to 4 to 3 miles the weeks before the race.  My Sunday long run, after peaking at 20 miles, drops to 12 and then 8 miles the week before the race.

Tapering gives your muscles, ligaments, and tendons a chance to heal before the race.  With proper carbo-loading, you replenish your body's storage of glycogen, the key fuel upon which you rely during the marathon.

Many runners resist tapering and do not do it properly.  That's a mistake, because the taper is critically important to any training program.

Here's what my two week taper looks like, after a 20 mile long run.

M     T     W     T     F     S     S
rest   4     3       3     rest   6     8
rest   3     2       2     rest   rest race

2012 NYC Marathon

Applications for the 2012 NYC Marathon are now being accepted online. 

Visit for details.

Friday, January 6, 2012

LTC Meeting

Just a reminder that the Lincoln Track Club Annual Meeting is this Sunday afternoon.  There is a renewal run at 4:30 with dinner and meeting to follow.

Details at:

Thursday, January 5, 2012

#13--Brookings Marathon

Brookings, South Dakota
May 12, 2007

This was my last marathon during residency.  I was set to graduate in a few months, and was very busy studying for boards, getting my license in Florida, and making plans to move and begin my post-graduate fellowship.  I wanted to do one more race before I left, and South Dakota was an easy choice.

Brookings is a very nice college town, and the thing that stood out to me most about this was the volunteers and how proud they were of their town and race.  Race conditions were perfect, and the course was nice, mostly running through the campus and the towns many parks.

I had been sick leading up to the race, and didn't run for the last 10 days or so leading up to it.  I carried a fanny pack full of cold medicine and inhalers.  I'm glad the medical director on the course didn't see me, or he might have taken me off the course.

Needless to say, I didn't run a great race.  I finished in just under 5 hours.  I went back to the hotel, took an ice bath, and then hopped in my jeep and drove the 4 hours back to Omaha.  My wife was waiting for me there with a rake and a bunch of mulch.  She was watching WAY too much HGTV then.

Here's a link to the race website.

Tuesday, January 3, 2012

New Year's Goals

Half of Americans make New Year's Resolutions, but fewer than half of those are maintained at 6 months.  How are you doing on your New Year's Resolutions?  Unfortunately, it's a fact that most resolutions fail--most of them quickly.  I've always preferred "goals" to "resolutions."  To me, the latter term implies some sweeping change that can be too difficult to measure and attain, while the former tends to be more familiar and a little easier to grasp.

To be effective, resolutions or goals should have four characteristics.

1. Concrete--Don't say, "I'm going to exercise more," or "I'm going to get organized."  What does that mean, really?  To be effective, the goal needs to be concrete.  "I am going to exercise for 60 minutes a day, 5 days a week," for example.

2.  Realistic--One of the most common reasons people give up their goals is that they set themselves up to fail.  If the goal is unrealistic, there is temptation to throw the whole thing out the window after the first couple setbacks.  For people who don't exercise much to begin with, I don't suggest making a goal to work out every single day.  If something comes up and you miss a single work out, the goal is shot.  Life happens, make the goal realistic.

3.  Measurable--The only way to know if you are meeting your goals is to have some way to measure them at regular intervals.  The best goals are measurable.

4.  Have a plan--Write out a plan.  Include the goal, how you will measure it, and when you want to achieve certain benchmarks.   Consider giving yourself a reward for achieving them.  Buy a new pair of jeans when you've lost 10 lbs, or something like that.  Anticipate stumbling blocks and think about how you'll handle the challenges that will inevitably come up.

A few of my New Year's Goals:
-Run 8 marathons in 2012
-Run under 4:00 in a fall marathon
-Post on this blog at least two times/week
-Get back to my high school weight for my 20 year reunion (I might be breaking some of my own rules with this one!)