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Keyword: training

Guest Post by:
Stephanie Davey, ATC
Certified Athletic Trainer
MUSC Health Sports Medicine

Good News!  The Cooper River Bridge Run is only six weeks away. So if you’ve started your training, the end is near. If you haven’t started, there is still time! The first thing, after deciding to sign up for the race, is to set a finishing goal. The goal will help you to focus your training to enhance performance and prevent injuries.

If this is your first race and you haven’t been running, your main goal should be finishing. Beginning with a walk/run program will help minimize your injuries and help keep you motivated. Aim to run four to five days per week. Your runs should last 30 to 60 minutes with your longest training run being around five miles. The ratio of walking to running depends on your level of fitness. A good place to start is 1 minute running:1 minute walking. As you progress, increase your running by a minute or two every few runs.runners on the beach

In addition to your training runs, you also need to incorporate cross training, strength training and rest days. Cross training should be a low impact activity such as cycling, swimming or training on an elliptical. Your cross training should last at least an hour. It will help increase your cardiovascular endurance without the additional wear and tear on your body. This will also keep your legs fresher and increase your performance on your runs. Strength training should be a balanced program that incorporates your upper and lower body and your core. Squats, lunges, calf raises, planks and push ups are good exercises to start with. Focus on higher repetitions and lower weight where you can maintain correct form. If you’ve previously done yoga or Pilates, feel free to continue. Both could be used as strength or cross training. Lastly, you should have at least one rest day. Rest days allow your body to heal from the wear of training. If you don’t give your body a chance to heal, you risk an injury. If you feel you need to do something on your rest day, try going for a walk or gently stretching.

Good luck and most importantly "Have Fun!"

Guest post by:
Lindsey Clarke, MS, ATC, CMT
Athletic Trainer
MUSC Sports Medicine

138,336 feet doesn’t sound too far, right?  How about 26.2 miles?  That sounds much farther, but it’s the same distance…and that is the official distance of a marathon.  The distance was originally set at 24 miles to commemorate the Greek soldier called Pheidippides, who ran 24 miles from a battlefield in Marathon to Athens to deliver news of victory. Those extra 11,616 feet, or 2.2 miles were added by decree of the International Olympic Committee at the 1908 Olympic Games in London, England, so the race would finish in front of the Royal box at White City Stadium.  The distance of 26.2 has been regulation since.  That kind of mileage is no joke.  Legend has it that our man Pheidippides died promptly after his run to deliver his message.  Training for a marathon takes intense preparation, dedication, and skill.  I’m not saying you’ll die if you run a marathon without training, but the chances of you having a successful and enjoyable race will greatly increase if you’re properly prepared!  Depending on your experience, training for mileage like this can take anywhere from 4-6 months, and up to a year for less experienced runners.  This is definitely not a race you can just sign up for and give it a go.  There are a number of variables that can determine the outcome of your training efforts, and eventually, your race day.

Diet.  Throughout training, your diet plays a significant role in helping you perform and recover.  In making food choices, it’s always best to stick with what you know works. You do not want to experiment the day of the race.  A well-rounded diet of lean meats, legumes, dairy, fruits, and vegetables is a great way to set your self up for success come race day.  Foods with a moderate to high glycemic index are your best choices before a race.  Glycogen stores will deplete over long distances, so practice during your long and semi-long runs with the sports drink and energy gels you intend to refuel with during the race.  While staying hydrated is key to performance, marathoners often get into trouble by over hydrating (hyponatremia).  This can be quite serious.  As you become dehydrated, less oxygen, fuel, and electrolytes are delivered to working muscles, resulting in fatigue, injury, and possible cardiac implications.  In addition to fluids, there are significant nutrient losses during races lasting 1-4+ hours.  It is best to take advantage of a sports drink containing carbohydrates and electrolytes to offset these losses during your race.

Race Prep.  Select the shoes, socks, and attire you'll wear in the marathon. The shoes should be fairly lightweight, but provide good support.  Do not wear brand new shoes the day of your race. You should do a mid-long distance run in your shoes at race pace to determine whether you'll develop blisters or sore feet. If the shoes bother you on this run, get yourself another pair.  Many running specialty stores offer gait analysis which may be helpful in determining which shoe is best for you.  It may not seem so, but attire is very important.  Be aware of weather conditions, and dress accordingly. Non-cotton/technical moisture-wicking fabric is essential for comfort and prevention of chaffing.

Training Habits.  Research your race and determine the terrain.  If at all possible, start doing runs on the same topography as the marathon. If your race is hilly, incorporate hills or incline work to your training.  Flat may sound easy, but you’ll be using the same muscles the entire time, so you must be prepared.  If at all possible, run at the same time of day as the start of your marathon. As a result, your body's rhythms (especially your bathroom routine) will be in sync with the demands of the marathon come race day.

Pre-Race Habits.  Extra sleep prior to a race is critical. Your body will really appreciate it the day of.  The day before, continue eating as you have in the week leading up to the race, but increasing your intake of up to 5.5 grams of carbohydrates per pound of body weight.  For longer races, your body will require more fuel.  A more substantial meal is warranted approximately 2 hours prior to start, so set that alarm just a little extra early.  In addition to your meal, it is good practice to have a light snack 1 hour prior to the race.  A granola bar, energy chews, GU, etc. are good options for more sustained energy release and a lower possibility for GI distress.  Maintain the hydration practices you’ve been following during training.  Consume three to six ounces of fluid (water and sports drink) every 15 to 20 minutes to replenish carbohydrates and electrolytes and prevent dehydration.  An hour prior to start, find a quiet place to spend a few moments reviewing your race plan and motivation.  Remind yourself of why you're there and be confident in the months of effort you’ve put in.

Post Race.  While every fiber in your body may be screaming for rest…keep moving.  Gentle stretching and lower intensity cardiovascular movements, such as walking, for up to 60 minutes after the race, will help diminish a lot of post-race stiffness.  Replace fluids, drinking enough so you have to use the bathroom within 60 to 90 minutes after your run (approximately 8-24oz).  Post race practices are very important in regards to recovery. Replacing fluids lost and replenishing glycogen stores are crucial and the window of opportunity is small. It is best to consume a recovery ‘meal’ within the first 30 minutes after completion of the run. The optimum ratio is 3:1 carbohydrates to protein. Depending on your preference, this meal can take the form of nutrition bars, recovery sports drinks, or even chocolate milk. For a long run such as this, you should also take in a full meal within 2 hours of completing your race that contains lean proteins, carbohydrates, and maybe even a post-race treat…you deserve it!  And finally…CELEBRATE!!!  You’ve completed a major accomplishment.  You have earned your bragging rights as being part of the 0.5% of Americans that have run a marathon. Be proud of all of your planning and sacrifices.  Wear that race t-shirt with pride and make sure to slap your little black and white 26.2 sticker on your car when you get home!

Guest Post by:

Shane K. Woolf, M.D.
Chief, Sports Medicine Service
Medical University of South Carolina

Summer has arrived and folks of all ages are spending time outdoors pursuing their favorite active pastimes.  Tennis and golf are two of the more popular activities with about 12 and 30 million participants each year, respectively, in the United States.1  As our population ages, many participants fall (reluctantly) into the category of ‘mature’ recreational athlete. For these folks, staying healthy and avoiding injury is paramount to enjoyment of their favorite sport. The positive health benefits of athletic activity are quickly lost when injury occurs. Fortunately, some simple preparation and training tips can help to reduce your risk of injury in either sport!tennis player

Stay Flexible

Keeping a regular flexibility routine either through yoga or simple ‘sitting-on-the-floor-in-the-living-room’ stretches can help keep your joints, tendons and muscles ready for action in both tennis and golf. The shoulders and upper limbs as well as the trunk/back are under significant stress during the swing of a club or racquet.  Torque exerted during rotation of the torso or shoulder in order to make contact with the ball, can be among the highest stresses the human body might experience. It is a little like wringing out, or even whipping, a damp towel, if you think about it. Limber ligaments, tendons and muscles are more forgiving, allowing the necessary rotation to achieve motion and also to tolerate these stresses without resulting in a strained muscle or sprained ligament.

Maintain CORE strength

So what exactly is the ‘core’ that I keep hearing about, you ask? Think of it as the central framework and support structure for your whole body. The core is centered about your spine, abdominal musculature and pelvis. It is important for correct posture, balance, coordination, and is the key to many athletic moves. Consider a core routine as your Central Orthopedic Rehabilitative Exercise program. This would include abdominal strengthening, lumbar spine strengthening, hip strengthening, and balance training. Yoga and Pilates can be useful to achieve this. The web is also a fine resource for DIY core stability exercises such as planks, bird-dog/airplane, side-bridges, exercise ball activities and balance exercises. A fitness instructor at your local gym or wellness center can also help get you started in the right direction.

Keep the Arms and Shoulders Strong

Repetitive power gripping and the swing of a club or racquet can cause microtrauma to the rotator cuff tendons, biceps, and the extensors or flexors of the forearm (ie tennis elbow – lateral epicondylitis, and golfers elbow – medial epicondylitis). The backhand tennis swing coupled with wrist weakness has been linked to development of elbow pain. The soft tissues in older athletes are more likely to be degenerative and also more likely to be damaged with both repetitive use as well as improper mechanics. Similarly, the medial, or inside edge, of the elbow is under stress when forearm flexors are engaged during a golf swing.

Some keys to avoiding injury are flexibility of the forearm muscles, balanced strength from shoulder to wrist, and gradual increase in play. As anyone who has had a sudden increase in the number of sets or holes played will attest, these muscles are usually not happy for a few days afterward. 

Stay Hydrated

The hot days of summer can be especially dehydrating after even a short period of activity. Realize that the heat index will effectively make a hot day much hotter physiologically due to the effect of humid air on the body’s cooling mechanism. In dry climates, evaporative fluid loses can happen with little notice, thus resulting in dehydration without much warning. Dehydration can impair the cardiac, renal, and neurologic systems. Performance is diminished at best, and serious health risks can happen with deeper levels of fluid losses. Take regular water breaks or indulge in a sports drink, but be careful with the caffeinated beverages and avoid that adult beverage until AFTER your round in the hot sun. Alcohol and caffeine can worsen the effects of dehydration.

Consider a Medical Consultation Prior to Starting a New Activity

For mature athletes, especially those with existing conditions like diabetes, heart disease, lung disease, asthma, obesity, among others, it is advisable to consult with your primary care provider before engaging in a new or more strenuous activity (eg joining a competitive tennis league after a year of inactivity). Medical issues are not necessarily going to keep you off the court or course, but having your health optimized can make for a safer and more enjoyable experience. Primary care sports medicine physicians are especially in tune with your athletic passions and how to address the ailments that need to be considered. Similarly, existing bone and joint problems may be manageable in ways that allow sports participation, even without surgery. A visit with an orthopaedic sports medicine specialist to discuss your injury may help you find a way to get back into the action!

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1 www.usta.com, www.usga.org

Guest post by:
Emily A. Darr, M.D.
Assistant Professor of Physical Medicine and Rehabilitation
Department of Orthopaedic Surgery

Deanna Roberts, MS ATC
Department of Orthopaedic Surgery

So you've been training hard for an upcoming race and you're starting to feel an aching pain in your knee. Or maybe you're a new runner that's been increasing your mileage at the expense of a sharp pain in both your shins. Running injuries are a common part of the sport, and unfortunately, up to 82% of runners will experience one at some point in their training. Given this alarming rate of injuries, awareness of such injuries can be important in prevention, diagnosis, and treatment.

Bridge RunThe knee is arguably the most common site of injury with patellofemoral pain syndrome, AKA “runner’s knee”, affecting around 40% of runners. This is characterized by pain around and under the kneecap. Other common injuries include medial tibial stress syndrome, AKA “shin splints” which is an inflammation of the muscles and tendons of the lower leg characterized by a sharp pain, usually on the inside of the shins, Achilles tendonitis, plantar fasciitis, and IT band syndrome, which is pain on the outside of the knee that is caused by repetitive rubbing of the IT band against the outside of the knee.

Sometimes risk factors have a clear link with a particular injury, and sometimes there is a less clear link. Risk factors for which there is clear association with injury include:

  1. Increasing your mileage. Injury is more common when running over 20 and then 40 miles per week.
  2. Recent increase in training intensity
  3. Being new to running

Some risk factors which have a more loose association with injury may include:

  1. Changing your footwear or wearing improper footwear
  2. Running on harder surfaces
  3. Poor habits of warming up prior to running and stretching soft tissues
  4. Muscle imbalance and compensatory patterns

When dealing with an injury, it is best to listen to your body. Be sure to schedule rest days during your training, and take a few days off if your pain is worsening. If you are dealing with an injury that requires a few weeks of rest, pencil in some cross training days to maintain your cardiovascular conditioning. 

Pay attention to your training plan. If you notice a flare up in pain when running on the road, stick to a surface with more give like a turf field or soft track. Run on the side of the road that feels more comfortable and stick to flat courses if running up and down hills exacerbates your pain. When returning from a rest period, increase your training volume by 10% intervals to avoid overtraining and re-injury.

Can I run through an injury?

Dr. Bob Wilder’s Rules for Runners can quickly assess whether you should continue through pain.

  1. On a 10-point scale, pain during the run should be no greater than 0-3.
  2. Pain should not be severe to the point where you limp during or following the run.
  3. The long run should not be more than half the regular weekly volume.

Make sure to warm up before your run with dynamic stretching exercises that warm up your muscles and increase your heart rate. Include a cool down with gentle stretching exercises that focus on the main muscle groups worked during your run.

Running footwear has been a hot topic in recent years including minimalist shoes and barefoot running. Every foot is unique and every running style is different therefore a visit to a running store where a professional can assess your feet and help you decide on the best running shoe for you is well worth it.  Interestingly, studies have shown that when runners wear more expensive shoes promising more cushion or support, they suffer more injuries than runners who opt to wear cheaper footwear. There are no studies that show that running shoes actually prevent injury. Remember that the most important factor in finding a shoe that fits is to make sure it is comfortable when running, not just when placing it on your foot at the store.

If an injury continues to linger or worsen, see a sports medicine physician for further evaluation. He or she can provide you with a proper diagnosis and appropriate rehabilitation plan to get you back on the roads!

Running is a great form of exercise to engage in, whether it be in sport, with a running group, or participating in a color run with friends. These days, the possibilities are endless and so are the opportunities! With the proper training, equipment and rest, you too can have fun and be pain free during your run!

Guest Post by:
Stephanie Davey, ATC
Certified Athletic Trainer
MUSC Sports Medicine

bridge river run image
Runners Ready for the Cooper River Bridge Run

So you’ve decided to run a 5K or 10K race. There are a few things to consider before you start your training. First, select a quality running shoe. Find a reputable running store to have your foot properly fitted. Many shops have treadmills and will let you run in them prior to purchasing them. The shoe should fit you and your specific foot needs.

 

Second, you need to decide when and how long you need to train. If you’re new to running, you should start you’re training program eight weeks prior to the 5K race. There are many training plans available online to help guide your training. Every good running program should include running, strength training, stretching, and rest. Depending on your fitness level, you can start with a run/walk program. These programs slowly increase running while decreasing the walking until you’re running the entire time. Strength training should be balanced between lower extremity, upper extremity and core exercises. A proper strength training program will not only make you stronger and faster, but it will also aid in injury prevention.

Stretching should happen both before and after your workout. Start your workout with gentle dynamic stretching to warm up your body. These stretches should not only warm your muscle, but should also start to slowly raise your heart rate. After your workout, plan on at least ten minutes of gentle cool down stretching. Give special attention to your calves, hamstrings, quadriceps, hip flexors, and gluteus muscles. These muscles do most of the running work and are the most prone to injury.

The last part of your training program is rest. Depending on your mindset, it could be the most important part. You should have one to two non-running days built into your program. If you do two days, one of these days can be easy cross training such as cycling, the elliptical trainer, yoga, or Pilates. The second day could include some gentle stretching. Rest helps keep your body fresh and injury free.

Unfortunately, injuries are part of running. While not all are preventable, most injuries can be prevented with a proper training program. If you start to have pain, listen to your body. You can modify any program by adding cross-training or rest days. If an injury lingers, consider seeing an orthopedic doctor for a diagnosis and specific plan to rehabilitate.

Hopefully, you enjoy your training. If you don’t, find a way to modify it. That could mean finding a training partner, or finding a new location. If you normally run on a treadmill, try running outside. Running groups are popping up all over the place. These groups usually have varied interests and have runners at all levels. A group can not only make running more fun but will help hold you accountable!

 

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