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Foot Pain! What’s Wrong?

Expert Panel Questions???

“12 Days before Marathon, I have had pain on the bottom of my foot (arch area) for about 1 week. I am stressing mentally :) Any suggestions on what I should do would be appreciated.”

“I ran a half marathon the other day. About 12 hours after I finished, the outside of my foot started hurting. It’s the bottom of the foot on the opposite side of the arch. It has not stopped hurting since, especially when I walk. What is this?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

The short answer to these two questions may be accumulated stress from training at increased intensity and volume of marathon preparation. Damage done to your tissues has exceeded your body’s ability to recover and heal itself. These issues are discussed in “Why does my heel hurt during the power phase of training?” Mechanics out of alignment or a worn-out or improper shoe may exacerbate stresses on the foot. Consider revisiting my article on how to select the correct running shoe.

Regarding why the lateral side of the foot is sore after a run–The short answer here is that you are running on the lateral side of your foot. You may have a cavus (high arch) foot and naturally run on the lateral side of your foot. Running in a stability shoe or using a rigid, high-arch orthotic will make you run more on the lateral side of your foot. Alternatively, you may have a planus (low arch) foot. In this case your shoe may not have enough stability and your posterior tibial tendon may be sore. Your body then tries to protect the posterior tibial tendon by activating the anterior tibial tendon, which inverts the foot and causes you to run on the lateral side of your foot.

Revisit the running shoe article and think hard about what type of foot you have. If pain is not improving, you may have a stress fracture, and you should seek treatment and have an xray.

By Jeffrey Rocco, M.D. Rocco Foot and Ankle Institute 801-644-8795

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Do I have a mild form of asthma?

Expert Panel Question???

“When I run my chest burns like crazy. After a while I start to get light headed and dizzy. Do I have a mild form of asthma?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

In addressing chest symptoms whether related to activity or not it is helpful to think of the 4 body areas in the chest that these symptoms may be coming from: the heart, the lungs, the esophagus or the chest wall. Of these four, a problem with the heart raises the most concern and should be addressed first (for obvious reasons). This is followed by the lungs, the esophagus and then the chest wall.

Any chest symptom associated with activity and especially those that include light headedness and dizziness as the run continues necessitates at least a basic cardiac evaluation i.e. a thorough history including family history, a listen to the heart with a stethoscope and an office EKG (electrocardiogram). If there is any concern based on these tests, additional tests may be needed. Once you are reassured that your heart is ok we move on to evaluating the lungs.

Exercise induced asthma (formally known as exercise induced bronchospam or EIB) is not uncommon in runners – up to 30% in some studies – and could explain your symptoms. EIB is defined as a reduction of 15% in your normal lung function at rest compared to after you exercise. People with exercise induced asthma may or may not have underlying asthma but people with asthma almost always have exercise induced symptoms.

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13.1 Tips to Consider When Running a Half Marathon

The UtahRUNNING.com Expert Panel received a request to provide a list of “7 things to do before running a half marathon,” so that is what I originally set out to answer in this article. However, while running with the high school girls I coach and discussing this topic with them, they helped me realize seven tips were just not enough. In fact, they insisted that I list 13.1 tips for preparing to run a half marathon (makes sense, right?) Thanks, girls, for the inspiration and for making me laugh everyday!

13.1 Tips to Consider When Running a Half Marathon:

1) Train Smart. Be consistent and gradually build your mileage. Work in some interval workouts, tempo runs, and long runs into your training regime.

2) Keep It the Same. The week of the half marathon is not the time to try something new. Don’t change what has been working for you. Obviously, your workouts should be lighter, but you should still run the days that you normally run, stretch, eat relatively the same, etc.

3) Hydrate/Sleep. Besides keeping your routine the same, it is also a good idea to put extra focus on being well hydrated (urine should always be clear) and to get plenty of sleep in the weeks prior to your big race.

4) Plan for Your Race. Before race day arrives, work out the details of your race in your mind. Visualize it–your pace, when to make a move, and how you will handle tough spots in the race (hills, mile 9/10, etc.). Consider different scenarios and how you will react to each one. Come up with some things you could tell yourself or remind yourself of when the pain starts to set in and you need some inspiration. Decide when you are going to refuel and know where the aid stations are in your race (For example: “There is an aid station at mile 7. I’m going to plan on taking an energy gel just before I get there). The night before race day eat a solid meal (pasta, rice, potatoes…whatever works for you). Make sure you don’t eat too late. I like to eat around 5:30 or 6:00 the night before to give my food plenty of time to digest before I go to sleep. The best way to know what and when to eat is to try different strategies with your training runs so you know what will work for you on race day. Have all of your race gear (shoes, clothes, number, energy gels, etc.) ready to go the night before, so you aren’t rushed in the morning.

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Runner’s Knee

Expert Panel Question???

“After a run my knee begins to hurt fairly badly. It hurts a little during the run but mainly after. Is there a certain type of shoe that would help with my knees or is the only solution not to run?”

Answer!!!

Knee pain is probably the most common injury complaint in runners and has a variety of causes. The most common, Patellofemoral Syndrome, actually also goes by the lay name “Runner’s Knee”. It is more common in women but can occur in men too. It is characterized by pain in the front of the knee, is worse going up and down stairs, during squats or lunges and often results in a deep ache in the knee after a prolonged knee-bent position (such as sitting in a class, movie, car or on a plane). The fact that your knee pain is not so bad during your runs but afterward makes this the most likely problem although it can get bad enough to become an issue during runs too. It is thought to be an injury that occurs to the under surface of the knee cap (the patella) when the knee cap and the bone below it (the femur) are not in alignment.

The under side of the patella has a small ridge running vertically through the middle of it and the femur below has a corresponding groove. These two should remain lined up as the knee bends and straightens. A misalignment between the patella and the femur can be due to genetic factors, biomechanical problems or the result of muscle imbalances. Since we can’t do much to change our genetics, the focus is on the muscle imbalances and biomechanics. As a one directional sport i.e. straight ahead, even elite runners are notorious for developing muscle imbalances.

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Dear New Runner

Expert Panel Question???

Question: “I’m interested in starting running, but I find it a little intimidating. How do I start?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

Dear New Runner,

What an exciting time to be starting with your running. There are so many opportunities for runners these days. There are road races and trail races in almost any distance, there are groups of all levels to train with, there are team relay races which can be a lot of fun, there are some great local places to train, and there are a lot of advancements in training technology.

I can understand how it might feel intimidating or even a bit overwhelming to get started. Here is my advice for you:

1) Make your running whatever you want it to be. It has to be about you and what you like. There is a wide range of possibilities from training for races to training for health and fitness. Find something to run for – you will feel the satisfaction from running much more if you have a purpose. I like to pick a race in the future and work toward that race. It might be 3 months away or a year away, but it gives me some focus and it helps me to stay committed. I also make running plans week to week that help me get ready for the future race.

2) Set some goals. It comes back to the advice given above – the importance of running with a purpose. Not only does it make running more fun and have more satisfaction, it also helps you to stay committed through the tough days. I would start with something simple – like completing a 3 mile run without walking (or a 6 mile run, or whatever your level is). Then figure out why you are doing this, and go from there. After setting a goal to finish my first marathon, then working toward that goal, then accomplishing that goal, the feeling was indescribable. It will give you strength and confidence and it will empower you as a runner and a person. And it will make you want to set new goals and accomplish them–it is kind of addicting.

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Best Way to Recover After a Long Run

Expert Panel Question???

Question: “What is the best way to recover after a long run?”

(ask your questions to the UtahRunning.com Experts here)

Answer!!!

After completing a long run, your first priority is to REFUEL. Since your body’s muscles are depleted, it is important to get something in your body to begin the refueling process as soon as possible – the sooner the better but definitely within an hour. I approach Recovery Nutrition in stages, aim for 3 eating episodes over a four-hour period.

Stage 1: As soon as possible. Often this first eating episode involves a drink containing readily available-easy-to-digest carbohydrate with small amounts of protein (10-20g). The carbohydrate helps replenish depleted muscle stores and the protein helps initiate the muscle rebuilding process. Choices include sport drinks, smoothies, recovery drink mixes, or chocolate milk). Drinks serve the dual role of re-hydration and nutrient replenishment; however, don’t feel limited. Sport bars/gels, bagels, cereal, yogurt, crackers, and PB&J sandwiches are all examples of readily available carbohydrates, with some protein, that you should be consuming within 30 minutes of completing a long run. What you choose depends on where you finish your run, convenience, and how you feel. If your run is more than 90 minutes, you should also be consuming some carbohydrates during the run – this will hugely impact how you feel after the run and how quickly you recover.

Stage 2: Within 2 hours of completing your long run, aim to have a meal. This should be a balanced meal, replete with carbohydrate, protein, and small amounts of healthy fat.

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