Thursday, August 24, 2006

Running Q & A

Culled from the maggot files:

Q: I heard that you have to get expensive shoes fitted by a running professional or else you’ll end up with an injury.

A: This is only true if you are a fancy-schmancy, very high-mileage runner (in which case you don’t need this whole Q&A section, so why are you even here?). Most of you beginning to intermediate runners without significant orthopedic problems just need to make sure that your shoes:
1. fit you well (usually you’ll require a half-size larger than you wear in regular shoes)
2. are cushy
3. are intended for running
4. feel good when you run rather than when you walk (yes, you must run around when trying them on, preferably not on carpet. Yes, this feels idiotic)
It’s best to go to a real running store if you can, but you don’t need to break the bank. (Unless you’re the type of person who is more likely to actually do something if you’ve dropped a big chunk of change into it, in which case, go ahead, knock yourself out.)

Q: Do I really have to wear a sports bra?

A: Yes, unless you’re a man (and don’t have man-boobs). Yes yes yes. Please get those things under control. Even the Itty-Bitty Titty Committee members will bounce when running. As for the well-endowed, the bounteous provides this product plug: “Big-boobed runners: I got one word for y’all: Enell.”

Q: My knee/hip/foot hurts. Can I still run?

A: My rule of thumb is, if the running is either too painful to do OR seems to be making something WORSE, then no, and you might want to see an orthopedist. Otherwise, yes.

Q: My underwear scrunches up into my ass when I'm trying to run.

A: Gotta go commando. No panties for running. They either scrunch, wad, or give you VPL in your running tights.

Q: Why do my shins hurt?

A: Probably from shin splints, a poorly understood but usually temporary and nondangerous condition often seen when increasing mileage. If it’s not too bad, just stop increasing mileage for awhile, make sure your shoes are supportive, and ice your shins after running.

Q: Will running (especially on pavement) give me arthritis or otherwise damage my knees or hips in the long run?

A: No. This is a perennial favorite warning from smug couch potatoes – “you’re just going to ruin your knees!” There has been a lot of research in this area, and even among elite high-mileage runners, the opposite appears to be true. (The biggest risk factor for developing arthritis? Obesity.) It’s hard to link to studies since they’re mostly not open source, but here are a few choice quotes:
... [I]t appears that long-distance running does not increase the risk of osteoarthritis of the knees and hips for healthy people who have no other counterindications for this kind of physical activity. Long-distance running might even have a protective effect against joint degeneration.

The presence of radiographic hip [arthritis] and the progression of radiographic knee [arthritis] was similar for older runners and nonrunners. Lumbar spine bone mineral density remained higher in runners.

Older persons who engage in vigorous running and other aerobic activities have lower mortality and slower development of disability than do members of the general population.

… [O]ur observations suggest that a lifetime of long distance running at mileage levels comparable to those of recreational runners today is not associated with premature osteoarthrosis in the joints of the lower extremities.

498 long-distance runners aged 50 to 72 years were compared with 365 community control subjects to examine associations of repetitive, long-term physical impact (running) with musculoskeletal disability ... Runners had less physical disability than age-matched control subjects and maintained more functional capacity … Runners sought medical services less often, but one third of the visits that they did make were for running-related injuries. … Runners demonstrated better cardiovascular fitness and weighed less. … Musculoskeletal disability appeared to develop with age at a lower rate in runners … than in community control subjects ... These data suggest positive effects of systematic aerobic running activity upon functional aspects of musculoskeletal aging.
Q: Isn’t it bad to exercise where there are a lot of cars and air pollution?

A: If you have a choice, it’s best to run where you’re not taking bong hits from the tailpipe of a diesel bus. And if you have asthma, you may have more trouble on days when the ozone level is high. But overall, it’s still a lot healthier to run in a city than not to run at all. There’s not a lot of research in this area, however.

Q: When can I start running faster/farther than an arthritic sloth?

A: Patience, grasshopper. I mean, maggot. Running slowly is fantastic for your health; running faster adds very little to this. Almost everyone errs on the side of increasing too quickly, and then you're in trouble. If you must have numbers: once you're spending your whole 30 minutes running, wait a couple of weeks, and then you can start going EITHER 10% farther per week (not per run) or 3% faster per run (I can't do that math without hurting my brain, but if you're a numbers junkie, I suppose you won't mind).


mamamarta said...

can i just emphasize how important it is not to go overboard when increasing your time/mileage? it's so easy to do, especially when you're over that "i'm not a runner i just play one for 30 minutes 3 times a week" hump, and you really start feeling your oats. as in "wow! this is great! maybe i'll run a race!" and you push yourself, and it feels *great* and so you push yourself more and it feels even better, and so you push yourself even more, and suddenly you have an injury.

general guidelines i've heard are to add about 10% of your distance to your longest run each week. another suggestion is no more than 10 or 15 minutes to your longest run each week.

these guidelines have kept me injury-free while training for several long races. the first scenario? yeah, no so much. plantar faceitis put me out of commission for several months, and still plagues me -- it doesn't stop me from running, but does keep me in pricey shoes with special insoles...

oh, and one other thing, for those of you like me who are s-l-o-w and always will be. try not to be plagued by the obsession in the running community with speed. i know i struggle with this. i've been running regularly for over 4 years, i've run a half marathon and a marathon, but i don't think i've ever run a mile in less than 9 minutes, and generally i run around 11 minute miles on good days. and somehow i always feel like i need to apologize for that -- like i'm not a real runner, because i run so slowly. go figure. anyhoo, i just hope others can avoid this plague, because it's ridiculous!

Mignon said...

Well HA! I don't need you Sargeant Doctor Mama and your running bootcamp any more! I got on three soccer teams and now I'm burning my jogging shoes. Mostly because of the stench, but really I just never liked it. In fact I hated it. Every step. But I did it, and I didn't lose any weight, but I can see my thigh muscles again and I don't get a double chin every time I look down to wipe my butt.

So Thanks for the kick in the ass, but no thanks any more.

Anonymous said...

Oh stop it. You're almost making me think I should take up running again. I ran during university (around the time of the last ice age) but I stopped because...ummm... I didn't like it.

With school fast approaching and a whole 2 hours a day to myself I might just might be tempted. (For those who suggest get a babysitter, I try. But they seem invisible when I need them most. Like today.)

KDF said...

I've been on the running thing for 4 weeks now. VERY SLOW but endurance has improved significantly. But what does it mean when you get ankle swelling on both sides of your tendon, on both feet? I assumed it was a repetitive stress thing and grounded myself for a week and it hasn't come back, but what the hell was it? I called it SKANKLES.

Anonymous said...

It is funny. I tell people I am going for a run but in realty I am going for a very slow jog or a very fast walk - it depends on how you look at it. I don't think I will ever get faster than a 10 minute mile and that is on a really good day.

Kristie said...

is walking briskly or slow jogging as good as running? i mean, if you are still able to get your heartrate up and break a sweat?

another question- is it in my head, or do i feel less pain in my knees (i have rheumatoid arthritis everywhere) when i only walk briskly/jog slowly, or is it b/c i am not working out as hard?

DoctorMama said...

mamamarta -- good advice. And running is running. Never let anyone tell you different.

mignon -- if you're happy, I'm happy, but I will tell you that soccer players DO tend to end up with worse knees in their old age. Just so you know. You're welcome back in the fold anytime ...

mj -- if you do it the way I suggested back in my original post, I bet you'll end up liking it.

kelly -- yes, that's a classic case of skankles. Glad it's better, anyway.

tiffany -- you ARE going for a run!

kristied -- slow jogging IS running. Fast walking, well, the thing with that is that almost no one can really do it properly -- i.e., get their heartrate up etc. Most everyone ends up ambling. If you can really do it, more power to you. It IS less stress on your knees when you don't leave the ground and pound back down.

Anonymous said...

Damn. I was hoping you'd answer the question of what to do when you have to go #2 during a long run. :-)

Megan said...

Yup, another maggot reporting for duty. I, too, have been inspired and have registered for the Chicago 1/2 in a few more weeks (yikes!). Thanks for the kick in the jogging shorts Doc. (AND please do tell about how to cope with the #2 dilemma while on a long run!)

Sherry said...

Thanks DrM!
I can now run the half hour without too much trouble (the only day I really had trouble was when I put my running music on shuffle instead of the way I had it organised - disaster!)
The new challenge is going to be the change in location for the next two weeks (Cornwall - hills - and then Sri Lanka) and then the colder weather making it hard to breathe nonsense.
I've been running in shorts so far - but plan to invest in running tights; any recommendations/advice?

Anonymous said...

My $.02. I’ve always tried to be a runner because it is one of the easiest and cheapest ways to exercise. However, I would always start out strong, go too fast and too long everyday to where it became a miserable task. I tired through sheer willpower to make myself reach unrealistic goals and push myself with no real plan of action. The last time I ran I ran 9 miles because I pushed myself and I ended up straining the muscles in my feet so much that I could barley walk for three days. That was five months ago. I haven’t exercised since.

I read this article on Monday and have since run twice this week. Once on Tuesday and again on Thursday and did as Doctor Mama suggested. I ran slow, very very slow. Almost slower than I had been walking to warm up. I ran at this meager pace for 30 min. At the end of 30 min I had broken a sweat and I was breathing hard, but I was not out of breath. I cooled down with a short walk and stopped.

I’ve noticed something these past few days. I feel great. I feel energized. I am excited to go running again tomorrow. I have never been excited about running. I’ll say it again. I am very excited to go running tomorrow. I plan to increase my speed every two weeks but continue the 30 min for 3 months. By going slow, I am ensuring that I won’t push myself too hard, but I’ll still be exercising for the three months. The last time I pushed myself to feel the burn I was a miserable slob for 5 months. Do the math, go slow but just do it and it will work out the way Doctor Mama has suggested.

Thanks, DM

Anonymous said...

What is VPL?
Veritable Panty Line?

Anonymous said...

Can anyone suggest a good pair of running shorts? Mine ALWAYS ride up--on a good day, this just means I'm constantly yanking at them, and on a bad day, I have painful chafed legs. Will a longer short help, or is it better to go short?

DoctorMama said...

VPL = Visible Panty Line.

Re: having to go #2 ... er, this has never happened to me in all my years and miles. Anyone?

Yay, megan! and sherry! and jess! and free cone!!!

Anonymous said...

I just wanted to say Thanks for your encouragement to get out there and run. I just got back on my treadmill today after looking at it sit in the corner for months. I feel so much better about myself after spending just 20 minutes on there, and exercising definitely helps to fight off depression. So, thanks again from a longtime reader...delurking.

Anonymous said...

The posts on running advice are some of my favorites. Very helpful, thank you, please continue these posts occasionally!

How often do running shoes need to be replaced? I've heard 500 miles or 6 months. Some people have two pair, and alternate to let each pair "rest." Or are those rules just for the crazy high mileage, fast runners?

amusing said...

TO: Sgt. Dr. Mama Sir
FR: Maggot Amusing
RE: Reporting for duty
I did it. I thought it was cool out (but it's muggy and wet). The kids are gone. It's dark and I set aside my fear of being shoved into the back of a minivan and never seen again. I went out in rubber-soled shoes to move. Let's not stigmatize it with a name like running or jogging or slogging.

It always take me a bit to catch my wind, like there's a bubble in my lungs that has to pop before the air works. But after ten minutes oxygen seems to work.

And now I'm all sweaty and I'll go do some sit ups and drink some orange juice. I thought of you the whole time, Sarge. Well, you and some at-this-point-unknown-guy-I'll-meet-sometime-and-need-some-stamina-for. (Are you going to help me with that next, Sarge?)

Hugs & kisses from a sweaty grunt. Feels good. I'm all tingly.

DoctorMama said...

Amanda/MayhemMama—RE: how often running shoes need to be replaced. 350-500 miles is the rule of thumb, depending on the sturdiness of the shoes, the type of surface you run on, and your weight. I’m light but run on concrete. When I’ve had sturdier shoes I get to the 500 mark, but otherwise they usually start to feel kind of deflated after 9 months or so. The only reason I’d get two pair is if you found the PERFECT ones and wanted to keep them at the same stage.

TO: Maggot Amusing
FR: Sgt. Dr. Mama Sir
RE: Reporting for duty
At ease, Maggot. You done good.
And as a matter of fact, I think my next post is going to be about how I scored TrophyHusband. (Spoiler Alert: by running.)

Anonymous said...

DM, many thanks for these posts! Very helpful and motivating. I have a question and an observation. The question: I have an uncle who is a doctor, a marathoner, and incidentally a jerk. He told me in high school that I shouldn't run because I have Morton's foot -- second toe longer than great toe. He said it would trash my ankles first and then my knees. I have been running happily according to the DM plan and thinking, "Ha ha, Uncle Jack! You are not only a jerk, you are an incorrect jerk!" Except knees have been hurting for a few days now.

I bumped up my distance from 1.5 mi to 2 and a bit because I could! and it felt good! Maybe I will try easing the distance back down and see how the knees feel. Any thoughts on the mutant foot question? (My feet don't look freakish and I have no knee problems in my everyday life -- I walk a lot with no joint ailments at all.)

Comment: I learned last year that I have a benign heart arrhythmia. A beta blocker makes it possible for me to run; without it, my pulse is in the 180s after 100m. I used to try to run and I would think, "What's the matter with me? Why is my pulse so fast?" I have no idea how common arrhythmias are, but I could have saved myself a lot of frustration if I'd stopped assuming my heart was flying just because I was lazy and out of shape.

Anonymous said...

Thank you for more inspiration. I started running six months ago and ran 10k yesterday, unbelievably. I too had agonising shin splints and my top tips are: 1) don't get so hungover that you end up missing a run and running two days in a row, thereby putting more pressure on your shins than they might like and 2)(against DoctorMama's advice but it worked for me) s-t-r-e-e-e-e-t-c-h your calf muscles before and after every run.

Anonymous said...

I am a high school runner and I have a hard time taking time off after the season ends. I like to cross-train and was wondering if you knew if certain activities, such as swimming, were better than others for cross-training.

Anonymous said...

Hello DoctorMama,

I've been running for 5 or 6 years for fitness and I can run 3 miles in 21:30 and I can still catch my breath. My target is 17:00 for that and it seems there is a kind of stagnation in my progress: I could run 5k in 23:00 3 years ago and that's about the same if the term 3 miles is translated back to kilometres.

The reason for the stagnation is not because I can't catch my breath, it's that every time I run, I feel pain in the leg, a part that I checked and think is called the Gastrocnemius and Peroneus longus (somewhere in between the two parts I think).

I've tried with two pairs of trainers to the same effect. At first I thought I didn't have enough carbo, and it seems false (but a healthy dose of pasta does help sooth the pain afterwards). I've plenty of stretching before I begin my workout (around 2 minutes on 4 sets of workouts on different parts of the leg), but the problem is still there.

Can you think of any possible explanations to this?

oh btw: I am 178cm tall, weigh around 190lbs, and am a large guy, if this piece of information helps.

Many thanks in advance.


running tights said...

I have been running 10k races since 2001 and I have never had an injury. I think that the secret is not push my body to do things I cannot do. My time is always around 60 minutes and I am happy with that. Last winter I didn't gain weight as usual :), so this spring I am having times a bit better.