Marathon Blog

1. Femoral neck stress fracture: This is a serious cause of anterior groin pain in runners. Usually worse with activity such as running or walking and better when not weight bearing on the hip, femoral neckstress fracture is caused by repeated stress on a bone which causes a small crack to develop. This can occur after increased training loads when runners increase their volume. It may not be visible on an x-ray, and a physician should evaluate persistent groin pain, as more advanced imaging such as an MRI may be needed to diagnose. This type of injury requires prolonged rest from running to heal. Lack of treatment can prevent proper healing of the bone in the femoral neck.
2. Iliotibial band syndrome: This is a very common type of injury that runners experience. The iliotibial band is the large ligament that extends from the hip to the lateral knee. Runners commonly mistake this pain for a knee injury. It is typically felt as pain on the outside of the knee as the IT band tightens and causes friction against the lateral knee. IT band pain can also be felt anywhere along the IT band all the way to the hip. Just like femoral neck stress fractures, it is an overuse injury caused by too much mileage, over-pronation, running on uneven surface, or worn out running shoes. You may need to rest once you notice pain to your IT band. Look at your running shoes and make sure they are evenly worn, as over-pronation may cause more stress on your IT band. Try to run on even surfaces. If you run on a track, make sure to switch directions every few laps. Self-foam rolling is key in treating IT band syndrome as it stretches the IT band.
3. Runner’s knee: Runners knee encompasses a term for any pain in, around or under the kneecap. It can be caused by malalignment of the kneecap or chondromalacia. Chondromalacia is softening of the cartilages under the kneecap where it deteriorates and causes pain. Chondromalacia pain is often worse when going up or down stairs. Imbalances in muscles can also cause abnormal tracking of the kneecap over the femur, causing pain. These muscles can be strengthened by performing Vastus Medialis Oblique or VMO exercises<https://youtu.be/vynEuGZKDEc>. This strengthens the quadriceps muscle so that the patella tracks normally over the distal femur. Runner’s knee injuries may require a reduction in training volume.
4. Shin splints: Otherwise known as medial tibial stress syndrome, the cause is thought to be small tears of the muscle fibers near the tibia or inflammation of the periosteum (outer bone lining). Shin splints cause medial shin pain with impact and running. Stress fractures also cause shin pain. With stress fractures, pain is more localized as opposed to diffuse. If shin pain does not go away with rest, seek medical attention to rule out stress fracture. Runners with shin splints can still run but may need to reduce total mileage as shins heal. Ice shins after each run. Strengthening of the anterior tibialis muscle (in front of leg) is a key component of treating shin splints. Do this by performing dorsiflexion exercises with<https://www.youtube.com/watch?v=ElkXCO7IsgU&feature=youtu.be> and without a resistance band or weight<https://youtu.be/jwxugMF0iSk>.
5. Stress fracture: Fractures of the metatarsals are common sources of pain that require medical attention and rest from running to heal. Persistent pain to the metatarsals should be evaluated by a physician.
6. Plantar fasciitis: Plantar fasciitis is common for runners and presents with pain on the bottom of the foot occurring anywhere from the heel to the forefoot. The large fibrous band that stretches across the bottom of the foot can become inflamed with repeat pounding the pavement. As a runner, you must stretch this fibrous band regularly. A good way to do this is by rolling a tennis ball under your foot to stretch the fibrous tissues.
7. Tarsal tunnel syndrome: This type of foot pain occurs as the nerve that courses behind the inner ankle bone becomes compressed. Compression of this nerve results in arch pain and sometimes, pain in the heel and toes, numbness and tingling. This syndrome is usually caused by over pronation. You may need to see a
   physical therapist or podiatrist to assist with stretching or biomechanical issues.
8. Achilles tendonitis: Overuse can cause inflammation of the Achilles tendon, which can result in pain in the back of the distal leg just above the heel, and can go into the calf. Runners experiencing this should consider taking time off from running to let the tendon heal as it can develop into a chronic tendonitis. Heel drop exercises performed on stairs (eccentric stretching exercises where you stand on your toes while on the stairs and slowly let your heels drop down) may help, along with calf stretching exercises. Strengthening of the calf muscle with calf raises is important as well. Self-massage of the Achilles tendon either by hand or with self-massage stick may also provide relief.

Now that you’ve decided on the half marathon, how do you train for it? There are lots of programs available online for half marathon training. Here are a few considerations for choosing a plan and training for the half marathon:

Starting point: Make sure the first week of the training plan is consistent with your current mileage base. Most programs assume a “beginner” runs 8-10 miles per week. Don’t choose an intermediate program if you are really a beginner. On the other hand, if you have raced the half marathon before, choose a more advanced program that will give you the challenge of speed work and hill training so you can race more aggressively and better your previous time.

Calendar time: Look at your calendar and make sure you have enough time to complete the training before your goal race. You definitely don’t want to try to shorten the program to fit it in with the date of your race. If you don’t have enough time, choose a different goal race.

Weekly running program: Choose a program that includes one longer run per week and at least two shorter runs per week. The long run should ramp up to a maximum of around 12 miles or two hours of running. Your last long run should be approximately two weeks before your race. After you complete that last long run, your program should include a taper, a reduction in weekly mileage while maintaining the speed/intensity of the runs.

Race conditions: Train on surfaces and terrain that are similar to your goal race terrain. Find out if your race is hilly or flat, asphalt or crushed gravel, hot or cold temperatures, morning or evening, and train under conditions as similar as possible to your goal race. If you can’t do all of your training under race conditions, at least do your long runs that way.

Fueling and hydration: For the half marathon, you will definitely need to come up with a hydration strategy that works for you. Determine how frequently you will consume fluids and how much fluid you will consume. It is usually best to drink at the frequency at which water stops will be available on your goal race course. This information should be available on the race website. You may also find you perform better by ingesting some carbohydrates during your long runs – experiment with sports drinks, gels, blocks, etc. to see what works for you. Practice and refine your hydration and fueling strategies during your long runs.

Whether your end goal is to complete a half marathon or to use it as a stepping stone to the marathon, enjoy the race and be proud of the great accomplishment of completing a half marathon!

Laurie Lasseter
Marathoner
ACE Certified Personal Trainer
RRCA Certified Running Coach
Edward-Elmhurst Health & Fitness Centers
www.EEHealth.org/fitness

With the Healthy Driven Naperville Marathon & Half Marathon approaching, it’s time to review the rules of the road when it comes to race etiquette. You might not be aware of some of the written and unwritten rules when it comes to long-distance running events, especially if you’re a first-timer. No one knows better what to do – and not to do – on race day than the Road Runners Club of America. Prepare yourself by checking out their comprehensive list of pre-race, in-race and post-race etiquette advice, and then relax and enjoy your remaining pre-race days. You’ve done all you can to get ready. All that’s left is the run!

It’s been great working with you throughout all these months of training. Thanks for your time. I’ll be rooting for you. Good luck!

Laurie Lasseter
Marathoner
ACE Certified Personal Trainer
RRCA Certified Running Coach
Edward-Elmhurst Health & Fitness Centers
www.EEHealth.org/fitness

Now that you are just a few weeks away from your goal race, it’s time to taper and allow your body the rest it needs to repair and rebuild muscle and tissue, replenish muscle glycogen stores, restore optimal hydration levels and reduce stress hormone levels.

There are many approaches to tapering and everyone responds differently. It may take some experimentation to find the best approach for you, especially if you’re new to marathon tapering. There are several aspects to a successful taper covering all areas of your life:

Sleep: Small changes make race day easier.

• Shift your sleep schedule to race-day wake-up time requirements over the final week before the race. That way when you wake up on race morning, your wake-up time will feel natural.
• Don’t worry about insomnia the night before the race. Make sure you get a good night’s sleep two nights before the race and you’ll be fine.

Other exercise: Don’t begin a new exercise program within 4-6 weeks prior to the race. Specifically, avoid starting any of the following:

• New sport
• New cross-training mode
• Major, physical house project
• Weight training (Note: if you already weight train, maintain current weights, repetitions and sets for the 4-6 weeks prior to the race. Don’t increase weights, etc. Stop 5-7 days before your race.)

Stress: Try to limit significant life stresses during the month prior to the race. If possible, avoid job changes, household moves, significant travel and other disruptions to your normal lifestyle.

Running mileage: Follow a two- or three-week taper, depending on your experience level. For both methods, maintain the intensity (speed) of your runs, but reduce running volume (distance covered).

Two-week taper (beginner marathoners and all half marathoners):

• 30% mileage reduction, week 1
• 60% mileage reduction, week 2

Three-week taper (intermediate/advanced marathoners)

• 30% mileage reduction, week 1
• 50% mileage reduction, week 2
• 65% mileage reduction, week 3

You should run little or no mileage 2-3 days prior to the race. If you feel you must run to loosen up the day before the race, don’t run more than a mile.

Fueling and hydration: Prior to the race, either follow a normal diet (during which your mileage reduction will allow you to store glycogen) or a ‘carbohydrate-loading’ approach. Regardless of which approach you take, follow these guidelines 2-3 days before your race:

• Stay well hydrated throughout the week
• Drink water freely and often during the 24-48 hours before the event
• 2-3 days before – eat low-fiber, low-glycemic index foods
• 1-2 days before – consider avoiding fried foods, red meat, dairy, nuts, roughage to avoid gastric distress

How you will feel: The reduction in physical workload will take an unexpected toll on you. Your body is used to exercise and your body will react to its absence. You will likely experience symptoms such as:

• Feeling ‘antsy’/hyperactive/anxious
• Feeling bloated, fat and sluggish
• Irritability

If you feel any and all of this – good job! Your taper is going according to plan and you’re on track to be able to do your very best on race day. More important than anything, stay relaxed. If you have followed a well-designed training plan and have prepared well, you are ready to have a successful goal race!

Laurie Lasseter
Marathoner
ACE Certified Personal Trainer
RRCA Certified Running Coach
Edward-Elmhurst Health & Fitness Centers
www.EEHealth.org/fitness

By now, you’re probably ramping up your long runs in preparation for either the marathon or half marathon. Hopefully, everything is going great! But even if it is, it’s likely you’ve had at least one long run that didn’t go as well as you had hoped. Prepare for your next one by brushing up on some key long run challenges and solutions:

Dehydration: If you experience symptoms like lightheadedness, headache, fatigue, muscle cramps, chills, constipation, dark urine, or slowing or stopping of the sweat rate during your long run, chances are you are becoming dehydrated. Follow these hydration guidelines:

• Every day: ½ ounce of water for every pound of body weight per day (includes liquid in food)
• Two to three hours before the long run: 17-20 ounces of water or electrolyte drink
• 10 to 20 minutes before the long run: 7-12 ounces water or sports drink (glycogen + electrolyte)
• During the long run: 7 to 10 ounces sports drink (glycogen + electrolyte) every 10 to 20 minutes
• Post-long run: Replace 120-150 percent of fluid loss with water or 100-125 percent of fluid loss with a sports drink (glycogen + electrolyte)

Heat/humidity: If you’re following the hydration guidelines and still experience dehydration symptoms, you may be trying to run in conditions that are dangerously warm and/or humid. Marathon performance degrades by at least 10 percent in temperatures over 85 degrees. Depending on the humidity, temperatures over 80 degrees can be dangerous for a long run, especially if you aren’t acclimated to the heat. If the long run forecast calls for these types of conditions, consider these options:

• Start early. Get the majority of your run in before the heat of the day. Avoid 80+ degree temperatures by starting at 5 or 6 a.m.
• Run on a different (cooler) day. Doing your long run a day or two earlier or later won’t ruin your training plan – just adjust your other runs that week accordingly. Remember, your long runs are most important in training for the marathon or half marathon, so adjusting other runs to have long run success is a good trade-off.
• Find a shaded route. Running in the shade helps you stay a little cooler on days that are hot, but not too hot.
• Run on an indoor track or treadmill. I know it’s boring, but at least you’ll have conditions under which you can finish your long run. If there are Excessive Heat Warnings (or Air Quality Alerts, especially if you have breathing issues), this may be your only option.

Low energy/fueling issues: If, during your long run, you feel hungry, irritable, shaky, dizzy or confused, you may not be fueling adequately to maintain your glycogen stores during the run. Follow these guidelines for long run fueling:

• Two hours before the long run: Eat a simple carbohydrate, low-fiber, low-protein snack, such as a bagel with a small amount of peanut butter. You’ll need to experiment a bit with the pre-run snack to see what works best for you and your digestive system.
• During the long run: Ingest 30-60 grams of carbohydrates per hour via a sports drink (glycogen + electrolyte). See the hydration recommendations above.
• Within 30 minutes of a long run: Refuel with a protein- and carbohydrate-rich snack, such as a fruit and yogurt smoothie or a bagel with peanut or almond butter.

Gastric distress/upset stomach: If you are getting nauseous or experiencing stomach cramps, diarrhea or constipation, you may need to adjust your pre-run eating. To avoid digestive upset during long runs, it is best to avoid sugar, high-fiber, lactose-containing dairy and dietary fat prior to your long runs, at least until you understand how your digestive system responds to these foods. During your run, keep your tummy happy by avoiding caffeine and excess sugar. Keep in mind that constipation can result from dehydration and that diarrhea can result from heat exposure.

Mental fatigue/boredom: If you’re just getting sick of running for so long and want to stop, you may be suffering from mental fatigue or boredom. To combat boredom, try these tips:

• Run with a group/running buddy. This can provide great distraction for you mentally and can help the time pass by more quickly.
• Try visualization. Visualize running in your actual goal race. Think about the supportive crowds and how proud you will be when you finish that race.
• Take a more interesting route. You may want to vary your long-run routes. If you are using the same trail as you ramp up your long run you may be getting bored with the course. Try a new route, but make sure you have a strategy for fueling and hydration based on that new course.

Running out of gas/pacing issues: If you are slowing considerably at the end of your long run, you may be starting out too fast. If you are a new marathoner and aren’t trying to do a specifically paced long run, start slower than your long run goal pace for a few miles. This should allow you to finish strong.

Laurie Lasseter
Marathoner
ACE Certified Personal Trainer
RRCA Certified Running Coach
Edward-Elmhurst Health & Fitness Centers
www.EEHealth.org/fitness

We’ve written a lot about marathon preparation and training, but I’m sure many readers aren’t interested in training for and running the marathon at this point in life. For those of you not planning for 26.2 this year, there are many benefits of running and training for the half marathon.

Physiology: One of the most important differences between the marathon and the half marathon is that the human body cannot store enough glycogen (the body’s favorite go-to energy source) to finish a marathon. The good news is the human body has plenty of glycogen to finish a half marathon. This means, for the half marathon, you won’t need to do all of the super-long training runs designed to teach your body to burn fat as a fuel for exercise. As a result, you’ll also find the half marathon long runs don’t take as much out of you and are easier to recover from than marathon long runs.

Time (per week): Given the distance difference between the half marathon and marathon, you’ll need to devote much less time to half marathon training. Your longest training run for the half marathon will likely be 12 miles or two hours. This is much less time-consuming than building up to a 20- or 21-mile training run as is necessary for the marathon.

Time (per year): Depending on your starting running fitness level, it will take much less calendar time to train for a half marathon as compared to the marathon. As an example, if you’re currently running 8-10 miles per week and have been doing so for two or more months, it will take you about 12 weeks to train for a half marathon. From this same starting point, it will likely take you about 24 weeks to prepare for the marathon.

Physical demands: The long runs and mileage demands of marathon training, along with the calendar time necessary to prepare for the marathon, take a toll on a runner. A runner training for the marathon needs to pay close attention to diet/nutrition, rest/sleep and stress levels in order to stay healthy through the marathon training process. The half marathon places much less demand on the body. Of course, it still makes sense to take good care of your body during half marathon training, but there is a lot more wiggle room. Added post-race bonus: You’ll recover more quickly from a half marathon and have less risk of injury due to less wear and tear on the body.

Psychological demands: Due to the difficulties of marathon training, there are a lot of psychological demands on the runner. The training can create a lot of stress and consume so much time and energy that it interferes with other aspects of your life. If you have a lot going on in your life, you may have trouble finding the time for marathon training. Half marathon training creates much less mental stress for you and your family.

Marathon transition: If you are a relatively new runner, you may eventually want to run a marathon. The half marathon is a great stepping stone and an excellent way to prepare your body for the rigors of marathon training. If you are a new runner, consider running the half marathon this year and the marathon next year!

Next: Training for the half marathon

Laurie Lasseter
Marathoner
ACE Certified Personal Trainer
RRCA Certified Running Coach
Edward-Elmhurst Health & Fitness Centers
www.EEHealth.org/fitness