2011 Summary
1) Malakoff Penang, 26km, Mar 27, 3:08.41@7.23"/km (2010 3:32)
2) Energizer Night Race (ENR), 21km (actual : 19.82km), Apr 16, 2:21.35@7.09"/min (2010 2:52)
3) Larian Hari Keputeraan Sultan Azlan Shah (LHKSAS), 14km (14.65km), May 22, 1:32:32@6:18"/km, #215/464 (Men's Open), Overall #367
4) SPCA Charity Run, 10km (9.34km), May 29, 53:34@5:51"/km
5) SCKLM, 21km (21.46km), Jun 27, 2:18:31@6:45"/km
6) SAFRA Bay Run, 10km (10.3km), Sep 4, 54:38@5:19"/km, #351/3488 (overall field), #8th Malaysian runner, #46/528 (Mens Master)
7) Tourism Taiping Heritage Run (TTHR), 21km (21.04km), Sep 11, 1:58:25@5:38"/km, #54 for Men's Junior Veteran
8) Adidas King of The Road (KOTR), 16.8km (16.71km), Oct 2, 1:37:30@5:50"/km, #428
9) KWYP City Run, 10km (8.09km) , Oct 16, 41:06@5:05"/km
10) PJ Half Marathon, 21km (20.76km), Oct 30, 2:13:31@6:26"/km, #175 / 337 Men's Veteran
11) Rock to Rock Run, 3.8k (4km), Nov 13, 18:43@4:41"/km
12) Penang Bridge International Marathon (PBIM), 42km (43km), Nov 20, 4:58:22@6:56"/km, 242/1190
13) Standard Chartered Marathon Singapore (SCMS), 21km (21.17km), Dec 4, 2:10:52@6:11"/km,
#929, top6% of the field
2012 Look Ahead
Not many races planned in 2012 as it's still early and i am trying to limit to the number of races but focus on quality (=better timing) and also to better optimize my weekend trips.. 2012 will be a crucial year for my gal, so will imit the travels..
What I have so far..
1) Jan 8th - Multi Purpose Insurance Run 2012 (MPIR) 12km - Padang Merbok (registered)
2) Mar ? - Malakoff Penang 26km
3) May 26th - Sundown Marathon 42km (registered)
4) Jun 24th - SCKLM Marathon 42km
No plans for Bali Marathon in April, Phuket Marathon in June though I would have loved to go to SCBM on 12 Feb 2012 !
Sunday, December 18, 2011
Monday, December 12, 2011
US races !? Fancy them ?? :-)
Stepping into 2012, 2nd half poses an unknown as my assignment may come up and I might be doing my 'tour-of-duty' at the States for the technology transfer ! So I am trying to squeeze in as many races as possible in the first half and we shall see..
If I do really end up in the States in 2nd half, I will surely miss my PBIM 2012, and SCM 2012.. But what the heck ! I am now looking forward to some breath-taking races in US, God's willing, if time permits !!
High in the priority list (based on $ and time affordability also lah sicne I can't be taking time off from my work that much...)
1) Chicago Marathon - Oct 10, 2012
2) California International Marathon (Sacramento) - Dec 2, 2012
3) Tucson Marathon (Tuscon) - Dec 9, 2012
4) Arizona Rock and Roll series - Jan 2013
5) Sedona Marathon - Feb 2013
6) Phoenix Marathon - Mar 2013
and the list goes on and on...
Who says I will miss the races in this part of the world.. LOL !
http://www.runnersworld.com/cda/racelocation/1,7912,s6-239-283-284-0-0-0-0-AZ,00.html
If I do really end up in the States in 2nd half, I will surely miss my PBIM 2012, and SCM 2012.. But what the heck ! I am now looking forward to some breath-taking races in US, God's willing, if time permits !!
High in the priority list (based on $ and time affordability also lah sicne I can't be taking time off from my work that much...)
1) Chicago Marathon - Oct 10, 2012
2) California International Marathon (Sacramento) - Dec 2, 2012
3) Tucson Marathon (Tuscon) - Dec 9, 2012
4) Arizona Rock and Roll series - Jan 2013
5) Sedona Marathon - Feb 2013
6) Phoenix Marathon - Mar 2013
and the list goes on and on...
Who says I will miss the races in this part of the world.. LOL !
http://www.runnersworld.com/cda/racelocation/1,7912,s6-239-283-284-0-0-0-0-AZ,00.html
Friday, December 9, 2011
Plantar Fasciitis - repost from Mok Ying Ren's facebook post
Treatment Plan for Plantar Fasciitis
by Mok Ying Ren on Wednesday, December 7, 2011 at 10:41pm.What is it?
Plantar fasciitis is the inflammation of the plantar fascia. If you wake up in the morning and your first step towards the bathroom hurts, you are likely suffering from this condition. Inflammation suggests the migrating of inflammatory cells towards the area, however, some doctors insist that it is not inflammation as if a biopsy was done, no inflammatory cells can be found. But that doesn't really matter because the pain you feel is an inflammatory type of pain - a pain that gets worse after prolonged rest (such as sleep) and gets better after some walking (or even running).
As seen from the picture (photo 1), the pain is felt near the attachment of the fascia to the heel bone on the inner side of your foot.
Treatment
Treatment can be divided into conservative or surgical. However, surgery is usually not necessary. Thus, lets focus on what you can do for yourself at home.
1. Night Splint (Photo 2)
The night splint is a good device however compliance can be as low as 10% for patients who are prescribed this device. I also sometimes get woken up by it in the middle of the night and remove it. Our plantar fascia is usually lax when we sleep as our foot normally goes into a plantar-flexed position as the foot droops down towards the bed. This means that when we wake up and take our first step, the fascia is stretched, causing pain at the attachment. The night splint works by keeping your foot in a dorsiflexed position through the night and almost eliminates the pain on your first step in the morning. Once again, compliance can be a problem for you.
2. Golf Ball (Photo 3)
If you do not play golf, go run around a golf course and get one or two. The golf ball is used to massage the entire sole of your foot. Put it on the floor while at your desk and roll it around. I once thought that it is good to massage the area that hurts as it does feel better after that. However, Dr Benedict Tan from Singapore Sports Medicine Center told me that by doing that, it is equivalent to rubbing an open wound. You wouldn't rub an open skin wound would you? Similarly, you do not want to aggravate the painful area. Thus, massage everywhere except the painful spot. Have a golf ball with you all the time - at work, at home and infront of the TV.
3. Stretch your calves
The calves are attached to the same heel bone as your plantar fascia. Imagine the heel as the fulcrum. As your calves get tight, it pulls on the heel which in turns pulls on the plantar fascia. Stretch daily and as often as possible. Note that there are 2 calves muscles and you need to stretch both. Stand facing the wall and stretch first with your knee straight (Photo 5) and then with your knees bent (photo 4). You should feel a different sensation each time.
4. Non steroidals Anti Inflammatory Drugs (NSAIDs)
These are different from painkillers like padanol that works on your nerves and "bluffs" your body to thinking there is no inflammation. NSAIDs work directly at the area of inflammation and reducing the reaction there, directly leading to less pain. However, these drugs have their fair share of side effects and you will need to consult a doctor to see if you are suitable for it.
5. Cross Train
At the moment, run less. Cut your mileage and cut your intensity. Running is the ultimate weight bearing sport and it is difficult to find a sport that allows you to bring your heart rate as high as running. Thus, stick to non impact sports like swimming, cycling and water running while your heel recovers. Do as much as you can to retain your fitness especially if you have an important race coming up.
6. Extracorporeal Shock Wave Therapy (Photo 6)
This is a treatment that was once invented to treat kidney stones (now still). It is now approved to treat injuries like plantar fasciitis. By using a shock wave to hit the area, it stimulates recovery and new tissue growth. Institutions like Changi Sports Medicine Centre, Singapore Sports Medicine Centre offer these treatment. I went through 2 cycles with Dr Cormac at the Singapore Sports Institute and found it rather effective. However, response can differ from patient to patient.
7. Insoles
Orthotics can help you with PF especially if you have underlying biomechanical issues such as over pronation. Research has shown that the effectiveness of off-the-shelf insoles are as effective as custom made ones. See a podiatrist to get one and see if it helps. I have gotten a pair from the Singapore Sports Institute and I find that it does help. However, during my runs, I wear off-the-shelf insoles which are usually softer and more comfortable for the heel.
8. Taping
Low-Dye taping (Photo 7) is a technique i tried. It is a well documented taping technique which was invented by Dr Ralph Dye to off load the plantar fascia. Check out this video: http://www.youtube.com/watch?v=V_SEfgm6uZU. I find that it does not seem to work well for me. Thus, I abandoned the taping after a few days. It is also very messy as you can see it requires lots of tape. You can get the tape from Watson's, called leukoplast. (Photo 8). Try it - it may work for you.
9. Footwear
Now you need to think if your office shoes is suitable for your feet. For me, I prefer to wear crocs which has a very soft sole and thus very cushioning for the point that hurts. It is also wise to wear a shoe with good support in your home to ensure your feet gets the necessary support. You may choose to buy off the shelf heel cups to add cushion to the heel area to provide it some comfort. I personally use the Dr Scholl heel cushion (Photo 9) from Watsons as it not only cushions the heel but also provides a certain extent of arch support.
Summary
These are techniques that I used to cope with my injury in the past 3 months and allowed me to complete a marathon safely. I hope that these techniques can help you too. However, in some situations, the injury make take months to recover. But most importantly. you MUST not give up and PERSIST in doing the above. I wish you all the best and hope you can get back onto the roads.
Disclaimer: This is a compilation of my knowledge as a medical student and my experience as a runner. Please use this only as a guide. If pain persists, please consult your doctor to get a proper diagnosis and treatment.
Photo 1
Photo 2
Photo 3
Photo 4
Photo 5
Photo 6
Photo 7
Photo 8
Photo 9
by Mok Ying Ren on Wednesday, December 7, 2011 at 10:41pm.What is it?
Plantar fasciitis is the inflammation of the plantar fascia. If you wake up in the morning and your first step towards the bathroom hurts, you are likely suffering from this condition. Inflammation suggests the migrating of inflammatory cells towards the area, however, some doctors insist that it is not inflammation as if a biopsy was done, no inflammatory cells can be found. But that doesn't really matter because the pain you feel is an inflammatory type of pain - a pain that gets worse after prolonged rest (such as sleep) and gets better after some walking (or even running).
As seen from the picture (photo 1), the pain is felt near the attachment of the fascia to the heel bone on the inner side of your foot.
Treatment
Treatment can be divided into conservative or surgical. However, surgery is usually not necessary. Thus, lets focus on what you can do for yourself at home.
1. Night Splint (Photo 2)
The night splint is a good device however compliance can be as low as 10% for patients who are prescribed this device. I also sometimes get woken up by it in the middle of the night and remove it. Our plantar fascia is usually lax when we sleep as our foot normally goes into a plantar-flexed position as the foot droops down towards the bed. This means that when we wake up and take our first step, the fascia is stretched, causing pain at the attachment. The night splint works by keeping your foot in a dorsiflexed position through the night and almost eliminates the pain on your first step in the morning. Once again, compliance can be a problem for you.
2. Golf Ball (Photo 3)
If you do not play golf, go run around a golf course and get one or two. The golf ball is used to massage the entire sole of your foot. Put it on the floor while at your desk and roll it around. I once thought that it is good to massage the area that hurts as it does feel better after that. However, Dr Benedict Tan from Singapore Sports Medicine Center told me that by doing that, it is equivalent to rubbing an open wound. You wouldn't rub an open skin wound would you? Similarly, you do not want to aggravate the painful area. Thus, massage everywhere except the painful spot. Have a golf ball with you all the time - at work, at home and infront of the TV.
3. Stretch your calves
The calves are attached to the same heel bone as your plantar fascia. Imagine the heel as the fulcrum. As your calves get tight, it pulls on the heel which in turns pulls on the plantar fascia. Stretch daily and as often as possible. Note that there are 2 calves muscles and you need to stretch both. Stand facing the wall and stretch first with your knee straight (Photo 5) and then with your knees bent (photo 4). You should feel a different sensation each time.
4. Non steroidals Anti Inflammatory Drugs (NSAIDs)
These are different from painkillers like padanol that works on your nerves and "bluffs" your body to thinking there is no inflammation. NSAIDs work directly at the area of inflammation and reducing the reaction there, directly leading to less pain. However, these drugs have their fair share of side effects and you will need to consult a doctor to see if you are suitable for it.
5. Cross Train
At the moment, run less. Cut your mileage and cut your intensity. Running is the ultimate weight bearing sport and it is difficult to find a sport that allows you to bring your heart rate as high as running. Thus, stick to non impact sports like swimming, cycling and water running while your heel recovers. Do as much as you can to retain your fitness especially if you have an important race coming up.
6. Extracorporeal Shock Wave Therapy (Photo 6)
This is a treatment that was once invented to treat kidney stones (now still). It is now approved to treat injuries like plantar fasciitis. By using a shock wave to hit the area, it stimulates recovery and new tissue growth. Institutions like Changi Sports Medicine Centre, Singapore Sports Medicine Centre offer these treatment. I went through 2 cycles with Dr Cormac at the Singapore Sports Institute and found it rather effective. However, response can differ from patient to patient.
7. Insoles
Orthotics can help you with PF especially if you have underlying biomechanical issues such as over pronation. Research has shown that the effectiveness of off-the-shelf insoles are as effective as custom made ones. See a podiatrist to get one and see if it helps. I have gotten a pair from the Singapore Sports Institute and I find that it does help. However, during my runs, I wear off-the-shelf insoles which are usually softer and more comfortable for the heel.
8. Taping
Low-Dye taping (Photo 7) is a technique i tried. It is a well documented taping technique which was invented by Dr Ralph Dye to off load the plantar fascia. Check out this video: http://www.youtube.com/watch?v=V_SEfgm6uZU. I find that it does not seem to work well for me. Thus, I abandoned the taping after a few days. It is also very messy as you can see it requires lots of tape. You can get the tape from Watson's, called leukoplast. (Photo 8). Try it - it may work for you.
9. Footwear
Now you need to think if your office shoes is suitable for your feet. For me, I prefer to wear crocs which has a very soft sole and thus very cushioning for the point that hurts. It is also wise to wear a shoe with good support in your home to ensure your feet gets the necessary support. You may choose to buy off the shelf heel cups to add cushion to the heel area to provide it some comfort. I personally use the Dr Scholl heel cushion (Photo 9) from Watsons as it not only cushions the heel but also provides a certain extent of arch support.
Summary
These are techniques that I used to cope with my injury in the past 3 months and allowed me to complete a marathon safely. I hope that these techniques can help you too. However, in some situations, the injury make take months to recover. But most importantly. you MUST not give up and PERSIST in doing the above. I wish you all the best and hope you can get back onto the roads.
Disclaimer: This is a compilation of my knowledge as a medical student and my experience as a runner. Please use this only as a guide. If pain persists, please consult your doctor to get a proper diagnosis and treatment.
Photo 1
Photo 2
Photo 3
Photo 4
Photo 5
Photo 6
Photo 7
Photo 8
Photo 9Running Doc's steps to avoid sudden collapse - repost from NYDaily News
Running Doc's steps to avoid sudden collapse
Tuesday, November 01, 2011
Dr. Maharam: I have noticed that most half-marathon and marathon deaths seem to be happening before the finish. I understand there is discussion about research on this but do you have any thoughts as to why runners are collapsing at this specific spot? - LeeAnn, Wheeling, W. V.
LeeAnn: I am so glad you asked. We at the International Marathon Medical Directors Association have been discussing this. Given the recent death at the LA Rock n Roll Half Marathon last weekend, I now get a chance to explain what medical directors are doing. The race course is really the safest place to be on a race day unless you are standing in the middle of an Emergency Room. We are all stationing paramedic units at that very spot - what we call the "X-Spot" where runners first see the finish line and know they are going to finish.
The prevailing theory about sudden death (fatal cardiac arrhythmia) in healthy patients in an endurance event, as we have discussed here before, is that either a caffeine load of more than 200 mg has caused enough decreased blood flow to disrupt an ischemic area’s electrical rhythm, or the release of muscle byproducts has caused a small plaque to activate platelets and a small clot to form in a coronary artery. Either of these things can cause a fatal arrhythmia. Limiting caffeine and taking a baby aspirin should help eliminate these possibilities.
The X-spot is where a runner knows he (or she) is going to finish the race, or where he can see the finish line and push to a hard sprint finish. This adrenaline rush, we think, might push the electrical system of the heart to an arrhythmia if the muscle is ischemic by one of the two mechanisms described above or if the participant has underlying heart disease. Not pushing yourself that last mile and taking it as you have the last few miles might make participating safer. So would encouraging announcers not to goad runners by saying things like, "If you can hear my voice you can break 4 hours!"
I am looking forward to our next IMMDA meeting when our group will be outlining a worldwide study on sudden death in our sport. As of now we only have some small evidence from a few studies and a lot of anecdotal evidence and theory. Our study should put more science into our recommendation.
In the meantime, as I've said repeatedly, we continue to advise the following on race day:
1. Take a baby aspirin (81mg) the morning of the event.
2. Limit caffeine that morning to less than 200 mg.
3. Take the last mile like the previous without a fast sprint.
These recommendations make sense to me and my fellow marathon medical directors. When our patients ask us, "How can I prevent becoming the next one?" our advice - right after urging them to get a comprehensive physical - consists of the three steps listed above. I hope you follow this advice, in conjunction with your physician, as well.
***
Lewis G. Maharam, better known as Running Doc™, is the author of the Running Doc's Guide to Healthy Running. He is the medical director of the Rock 'n' Roll Marathon series and the Leukemia & Lymphoma Society's Team in Training program. He is past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
http://articles.nydailynews.com/2011-11-01/news/30347967_1_lewis-g-maharam-sudden-death-caffeine
Tuesday, November 01, 2011
Dr. Maharam: I have noticed that most half-marathon and marathon deaths seem to be happening before the finish. I understand there is discussion about research on this but do you have any thoughts as to why runners are collapsing at this specific spot? - LeeAnn, Wheeling, W. V.
LeeAnn: I am so glad you asked. We at the International Marathon Medical Directors Association have been discussing this. Given the recent death at the LA Rock n Roll Half Marathon last weekend, I now get a chance to explain what medical directors are doing. The race course is really the safest place to be on a race day unless you are standing in the middle of an Emergency Room. We are all stationing paramedic units at that very spot - what we call the "X-Spot" where runners first see the finish line and know they are going to finish.
The prevailing theory about sudden death (fatal cardiac arrhythmia) in healthy patients in an endurance event, as we have discussed here before, is that either a caffeine load of more than 200 mg has caused enough decreased blood flow to disrupt an ischemic area’s electrical rhythm, or the release of muscle byproducts has caused a small plaque to activate platelets and a small clot to form in a coronary artery. Either of these things can cause a fatal arrhythmia. Limiting caffeine and taking a baby aspirin should help eliminate these possibilities.
The X-spot is where a runner knows he (or she) is going to finish the race, or where he can see the finish line and push to a hard sprint finish. This adrenaline rush, we think, might push the electrical system of the heart to an arrhythmia if the muscle is ischemic by one of the two mechanisms described above or if the participant has underlying heart disease. Not pushing yourself that last mile and taking it as you have the last few miles might make participating safer. So would encouraging announcers not to goad runners by saying things like, "If you can hear my voice you can break 4 hours!"
I am looking forward to our next IMMDA meeting when our group will be outlining a worldwide study on sudden death in our sport. As of now we only have some small evidence from a few studies and a lot of anecdotal evidence and theory. Our study should put more science into our recommendation.
In the meantime, as I've said repeatedly, we continue to advise the following on race day:
1. Take a baby aspirin (81mg) the morning of the event.
2. Limit caffeine that morning to less than 200 mg.
3. Take the last mile like the previous without a fast sprint.
These recommendations make sense to me and my fellow marathon medical directors. When our patients ask us, "How can I prevent becoming the next one?" our advice - right after urging them to get a comprehensive physical - consists of the three steps listed above. I hope you follow this advice, in conjunction with your physician, as well.
***
Lewis G. Maharam, better known as Running Doc™, is the author of the Running Doc's Guide to Healthy Running. He is the medical director of the Rock 'n' Roll Marathon series and the Leukemia & Lymphoma Society's Team in Training program. He is past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
http://articles.nydailynews.com/2011-11-01/news/30347967_1_lewis-g-maharam-sudden-death-caffeine
Philly Marathon deaths raise questions - repost from NY Daily News
Philly Marathon deaths raise questions
DR LEWIS MAHARAM
Monday, November 21, 2011
Dear Running Doc:
Given the two deaths at the Philadelphia marathon this past weekend, please fill me in why young people can have heart attacks. Im really worried I'll be the next one. What can I do? Stephen L. Great Neck, NYC.
Thanks for writing, Stephen. Whenever a runner goes down, we get this same question. My office telephone has been ringing off the hook and I've been getting tons of letters in the wake of the tragedy in Philadelphia in which two runners went down: Their identities haven't been released yet, but a police spokesman said one was a 21-year-old Asian male and the other was a 40-year-old white male.
As I said in my first column for the Daily News, asking the the right questions is the first step in understanding any issue:
What is “sudden cardiac death” and what is its incidence?
Physicians define “sudden death” in young athletes (women as well as men, ages 35 and younger) as a nontraumatic, nonviolent, unexpected death due to cardiac causes within one hour of the onset of symptoms.
One study estimated that the incidence of sudden cardiac death in unscreened men during exercise is 1 in 280,000 per year. In studies of the risk of death in marathons, it's been estimated that one death would occur in 50,000-88,000 marathon finishers.
In a study I published with Dr. Steve Van Camp in 2004, we found that the risk in distances between 10-K and half-marathon was significantly lower: 3.1 deaths per million finishers. There have also been reports of one sudden cardiac death per 4,000-26,000 in active men; 56X greater risk during exercise in sedentary men and only 5X greater risk during exercise in active men.
What is an enlarged heart?
Exercise causes normal blood flow and electrical changes seen on an EKG. During intense aerobic exercise, the oxygen consumption of muscle tissue increases and cardiac output must rise to meet the demands. Over time, aerobic training results in increased left ventricular mass, decreased resting heart rate, increased ventricular stroke volume, and increased cardiac output, among other effects. This is called an “Athlete’s Heart” — it is normal and nothing to worry about.
But there are enlarged heart conditions that can lead to sudden death. Although more than 20 pathologic entities have been identified as causes of sudden death in young athletes, a few lesions are responsible for most of these deaths that are reported:
Hyperpertrophic Cardiomyopathy
Although rare in the general population (0.1% to 0.2% prevalence), this is the most common cause of sudden cardiac death in young athletes It is inherited and 60% of individuals with this have an affected first-degree relative. On autopsy, patients with hypertrophic hearts are found to have a larger-than-normal heart with a distinctively enlarged left ventricle. Hypertrophy of the ventricular septum is often disproportionate to that of the left ventricular free wall, an asymmetry not seen in the “athlete's heart.” In addition to the increased size, the asymmetric thickening of the septum may act as an obstruction to the flow of blood into the aorta during pumping. Microscopic changes include abnormalities of the small arteries and "myocardial disarray," a bizarre arrangement of muscle cells with diffuse interstitial fibrosis.
The hallmark physical examination finding is a murmur that decreases in intensity with the athlete lying down. This contrasts with functional outflow murmurs common in athletes, which increase in intensity with lying down. Approximately 90% of patients with hypertrophic hearts have abnormal EKG results. In many, but not all, cases, this can be diagnosed by echocardiographic findings.
Despite the above information, individuals may present with sudden cardiac death as their first and only symptom of a hypertrophic heart.
Coronary Artery Abnormalities
A variety of inherited coronary artery abnormalities combine to represent the second leading cause of sudden death in young athletes. Only about one third of affected individuals are thought to be symptomatic (experiencing angina, syncope, or shortness of breath with exercise) before sudden death. The mechanism of sudden death in all cases here is thought to be an arrhythmia (abnormal heart rhythm) triggered by heart tissue ischemia or infarction (heart attack). Some cases may be suspected on echocardiography, but a definitive diagnosis is made by coronary angiography, computed tomography, or magnetic resonance imaging.
Myocarditis Acute
myocarditis is an inflammatory condition of infectious origin. Coxsackie B virus causes more than 50% of all cases, but a variety of causes have been implicated. Symptoms are often overshadowed or preceded by symptoms of viral illness such as vomiting, fever, nausea, diarrhea, and muscle aches. However, many individuals are asymptomatic, and again sudden death may be the only presenting sign. The infected myocardium becomes inflamed, creating an unstable site where a potentially terminal arrhythmia may arise. In other cases, involvement of the conduction system may lead to a fatal heart rhythm as well.
Marfan Syndrome
Marfan syndrome is an inherited connective tissue disorder occurring in about 1 in 10,000 people. Affected individuals are at increased risk for sudden death as the result of progressive dilatation of the aortic root, ending in complete dissection or bleeding internally.
The diagnosis of Marfan syndrome is based on a good physical exam (although genetic testing may be appropriate in families with several affected members). Clinical features include tall stature, long and thin limbs, an arm span substantially greater than height, diminished upper body-to-lower body ratio, and a long, thin face.
Electrophysiologic Abnormalities
Abnormalities of the conduction system may lead to fatal cardiac arrhythmias. Their incidence is likely underreported since autopsy findings may be inconclusive. Approximately 60% of patients present with symptoms related to physical activity or strong emotional response, primarily fainting, seizures, or heart palpitations. One third of previously "healthy" young adults present with sudden death. The mechanism of death is a fatal arrhythmia. The EKG results are abnormal in nearly all affected individuals. Treatment generally involves betablocker medication (sometimes with permanent cardiac pacing or internal defibrillator) and avoidance of intense physical exertion.
Other Causes A number of illicit drugs have also been implicated in sudden death. Cocaine abuse may cause local ischemia and infarction due to clamping down of the blood vessels, whereas inhalant use has resulted in fatal arrhythmias. Additional deaths have also been linked to performance-enhancing agents such as erythropoietin, diet medications and anabolic steroids.
So is pre-screening useful?
Yes Stephen, there is no substitute for a yearly physical exam by your primary physician. And if there is a suspected anomaly, referral to a cardiologist for further investigation is warranted. It is interesting to note that in Italy, where healthcare is universal and everyone gets full pre-screening, the rates of sudden cardiac death are no different than in the USA where not everyone gets pre-screened. This tells us that we, as a scientific community, do not yet have an accurate way to predict this tragic outcome.
What can you do?
Exercising is still far better than stopping. We know that active individuals are far healthier and have a better chance of surviving a cardiac event than our sedentary friends. What you can do to help you and your physician decide how much exercise is good for you is be aware of the following:
* Investigate your family history and be aware of any cases of sudden cardiac death in your family. This is the best predictor. Help your doctor to help you by knowing your history.
* Be aware of your body. Report to your doctor immediately chest pain or abnormal shortness of breath that comes on with exercise or in your training.
* Keep your cholesterol level within a good profile. Don't be afraid of taking a statin pill to lower your cholesterol if recommended by your physician. Keeping those coronaries clean is important.
* Follow your doctor's advice. Once you have a respected doctor, resist doctor searching for the answer you want to hear. We all do this. Realize, it may be the wrong answer.
***
Lewis G. Maharam is the author of the Running Doc's Guide to Healthy Running and medical director of the Rock 'n' Roll Marathon series and the Leukemia & Lymphoma Society's Team in Training program. He is past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
http://articles.nydailynews.com/2011-11-20/news/30423444_1_lewis-g-maharam-marathon-deaths-marathon-medical-directors
DR LEWIS MAHARAM
Monday, November 21, 2011
Dear Running Doc:
Given the two deaths at the Philadelphia marathon this past weekend, please fill me in why young people can have heart attacks. Im really worried I'll be the next one. What can I do? Stephen L. Great Neck, NYC.
Thanks for writing, Stephen. Whenever a runner goes down, we get this same question. My office telephone has been ringing off the hook and I've been getting tons of letters in the wake of the tragedy in Philadelphia in which two runners went down: Their identities haven't been released yet, but a police spokesman said one was a 21-year-old Asian male and the other was a 40-year-old white male.
As I said in my first column for the Daily News, asking the the right questions is the first step in understanding any issue:
What is “sudden cardiac death” and what is its incidence?
Physicians define “sudden death” in young athletes (women as well as men, ages 35 and younger) as a nontraumatic, nonviolent, unexpected death due to cardiac causes within one hour of the onset of symptoms.
One study estimated that the incidence of sudden cardiac death in unscreened men during exercise is 1 in 280,000 per year. In studies of the risk of death in marathons, it's been estimated that one death would occur in 50,000-88,000 marathon finishers.
In a study I published with Dr. Steve Van Camp in 2004, we found that the risk in distances between 10-K and half-marathon was significantly lower: 3.1 deaths per million finishers. There have also been reports of one sudden cardiac death per 4,000-26,000 in active men; 56X greater risk during exercise in sedentary men and only 5X greater risk during exercise in active men.
What is an enlarged heart?
Exercise causes normal blood flow and electrical changes seen on an EKG. During intense aerobic exercise, the oxygen consumption of muscle tissue increases and cardiac output must rise to meet the demands. Over time, aerobic training results in increased left ventricular mass, decreased resting heart rate, increased ventricular stroke volume, and increased cardiac output, among other effects. This is called an “Athlete’s Heart” — it is normal and nothing to worry about.
But there are enlarged heart conditions that can lead to sudden death. Although more than 20 pathologic entities have been identified as causes of sudden death in young athletes, a few lesions are responsible for most of these deaths that are reported:
Hyperpertrophic Cardiomyopathy
Although rare in the general population (0.1% to 0.2% prevalence), this is the most common cause of sudden cardiac death in young athletes It is inherited and 60% of individuals with this have an affected first-degree relative. On autopsy, patients with hypertrophic hearts are found to have a larger-than-normal heart with a distinctively enlarged left ventricle. Hypertrophy of the ventricular septum is often disproportionate to that of the left ventricular free wall, an asymmetry not seen in the “athlete's heart.” In addition to the increased size, the asymmetric thickening of the septum may act as an obstruction to the flow of blood into the aorta during pumping. Microscopic changes include abnormalities of the small arteries and "myocardial disarray," a bizarre arrangement of muscle cells with diffuse interstitial fibrosis.
The hallmark physical examination finding is a murmur that decreases in intensity with the athlete lying down. This contrasts with functional outflow murmurs common in athletes, which increase in intensity with lying down. Approximately 90% of patients with hypertrophic hearts have abnormal EKG results. In many, but not all, cases, this can be diagnosed by echocardiographic findings.
Despite the above information, individuals may present with sudden cardiac death as their first and only symptom of a hypertrophic heart.
Coronary Artery Abnormalities
A variety of inherited coronary artery abnormalities combine to represent the second leading cause of sudden death in young athletes. Only about one third of affected individuals are thought to be symptomatic (experiencing angina, syncope, or shortness of breath with exercise) before sudden death. The mechanism of sudden death in all cases here is thought to be an arrhythmia (abnormal heart rhythm) triggered by heart tissue ischemia or infarction (heart attack). Some cases may be suspected on echocardiography, but a definitive diagnosis is made by coronary angiography, computed tomography, or magnetic resonance imaging.
Myocarditis Acute
myocarditis is an inflammatory condition of infectious origin. Coxsackie B virus causes more than 50% of all cases, but a variety of causes have been implicated. Symptoms are often overshadowed or preceded by symptoms of viral illness such as vomiting, fever, nausea, diarrhea, and muscle aches. However, many individuals are asymptomatic, and again sudden death may be the only presenting sign. The infected myocardium becomes inflamed, creating an unstable site where a potentially terminal arrhythmia may arise. In other cases, involvement of the conduction system may lead to a fatal heart rhythm as well.
Marfan Syndrome
Marfan syndrome is an inherited connective tissue disorder occurring in about 1 in 10,000 people. Affected individuals are at increased risk for sudden death as the result of progressive dilatation of the aortic root, ending in complete dissection or bleeding internally.
The diagnosis of Marfan syndrome is based on a good physical exam (although genetic testing may be appropriate in families with several affected members). Clinical features include tall stature, long and thin limbs, an arm span substantially greater than height, diminished upper body-to-lower body ratio, and a long, thin face.
Electrophysiologic Abnormalities
Abnormalities of the conduction system may lead to fatal cardiac arrhythmias. Their incidence is likely underreported since autopsy findings may be inconclusive. Approximately 60% of patients present with symptoms related to physical activity or strong emotional response, primarily fainting, seizures, or heart palpitations. One third of previously "healthy" young adults present with sudden death. The mechanism of death is a fatal arrhythmia. The EKG results are abnormal in nearly all affected individuals. Treatment generally involves betablocker medication (sometimes with permanent cardiac pacing or internal defibrillator) and avoidance of intense physical exertion.
Other Causes A number of illicit drugs have also been implicated in sudden death. Cocaine abuse may cause local ischemia and infarction due to clamping down of the blood vessels, whereas inhalant use has resulted in fatal arrhythmias. Additional deaths have also been linked to performance-enhancing agents such as erythropoietin, diet medications and anabolic steroids.
So is pre-screening useful?
Yes Stephen, there is no substitute for a yearly physical exam by your primary physician. And if there is a suspected anomaly, referral to a cardiologist for further investigation is warranted. It is interesting to note that in Italy, where healthcare is universal and everyone gets full pre-screening, the rates of sudden cardiac death are no different than in the USA where not everyone gets pre-screened. This tells us that we, as a scientific community, do not yet have an accurate way to predict this tragic outcome.
What can you do?
Exercising is still far better than stopping. We know that active individuals are far healthier and have a better chance of surviving a cardiac event than our sedentary friends. What you can do to help you and your physician decide how much exercise is good for you is be aware of the following:
* Investigate your family history and be aware of any cases of sudden cardiac death in your family. This is the best predictor. Help your doctor to help you by knowing your history.
* Be aware of your body. Report to your doctor immediately chest pain or abnormal shortness of breath that comes on with exercise or in your training.
* Keep your cholesterol level within a good profile. Don't be afraid of taking a statin pill to lower your cholesterol if recommended by your physician. Keeping those coronaries clean is important.
* Follow your doctor's advice. Once you have a respected doctor, resist doctor searching for the answer you want to hear. We all do this. Realize, it may be the wrong answer.
***
Lewis G. Maharam is the author of the Running Doc's Guide to Healthy Running and medical director of the Rock 'n' Roll Marathon series and the Leukemia & Lymphoma Society's Team in Training program. He is past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
http://articles.nydailynews.com/2011-11-20/news/30423444_1_lewis-g-maharam-marathon-deaths-marathon-medical-directors
Know Your Heart Condition and Sports - blog repost from Trisupe's blog
I like this article from a blog by a fellow Malaysian runner / Facebook friend (Trisupe).. This came about after a 22 year old seemingly healthy & fit Singaporean man collapsed and died after crossing the SCMS 2011 Half Marathon @ 1:53. There has been many cases of heart related deaths related to running, cycling and some endurance sports. I still recalled ~2 months ago, 2 deaths were reported at Philadelphia Marathons 2 weeks ago....
********
Know Your Heart Condition And Sports
Another life was lost last weekend during the SCMS 2011 run. A young 22 years old man by the name of Malcolm Sng (RIP) was known to be a fit person that earned the nickname "Man Of Steel" from those that know him. He was one of the fitter ones in his Basic Military Training (BMT), according to those that know him during his National Service days. He ran the 21km race in 1:53 - collapsed upon crossing the line and pronounced dead at 9.30am - an hour after he collapsed. His last run before this was in September 2011.
If all of you remember, there was another death in our country Malaysia during the SCKLM run in 2010 where a 10km participant collapsed with about 2km to go. Runners that saw that rushed to his aid and some even performed CPR on him. Sadly, medical was insufficiently equipped (no AED or defibrillator) and many would remember the inaction by authority that could had used his radio to call for ambulance.
Some would say that Singapore is so perfect - since the organizers was not apprehended on social media unlike what happened in KL. Lets look at the two incident objectively. Both has a young man passing on while running. Both started racing recently (before the incident) and both are at the best of their health, fitness wise. While one received immediate medical attention upon collapsing the end results for both were the same - they could never come back again.
While the investigation is underway for Malcolm, the condition that caused the Malaysian boy to pass on was attributed to under laying heart condition.
In fact, he was not the first one. Remember the other race in Shah Alam where another young man collapsed and died while walking to his car?
Or the national junior badminton player that suffered the same fate after his training just recently?
Closer to home, i lost two friends; one an online friend i never met physically and the other, Kharis or TSB recently - both due to heart condition.
Here are the coincidental cause - cardiovascular or heart failure.
One of the most common cause is abnormal heart rhythm or arrhythmia. Lets look at what this foreign sounding medical terms (as with all medical terms too) is.
Arrhythmia is best described as irregular heartbeat. It has nothing to do with you getting excited when you see someone you love (aka skipping a heartbeat). It can occurs even with someone that has regular heartbeat (50-100bpm), low heartbeat (less than 50) or high heartbeat (more than 100). It can cause by a few factors such as:
1. electrolyte imbalance mostly due to natrium(sodium) - kalium (potassium) imbalance.
2. injury from heart attack or recovery from heart surgery, of which either one would contribute to changes in the heart muscle function/memory
3. Irregular heart rhythm which include other medical condition such as heart flutter, abnormal contraction of artery and/or ventricle.
As you can see, many of us that does the sports (swim and/or bike and/or run) are relatively "fit". Many of us are not aware of under laying condition of our own health, despite getting health screening perhaps only when the job job requires us to. Many a time, we would not be able to recognise the tell-tale sign, but the typical symptoms are:
1. palpitation of the heart (where you feel your heart skipping a beat or suddenly felt like it is drumming away)
2. Pain or tightness in the chest (oh-uh...)
3. Feeling light headed or dizziness
4. short of breath
5. feeling tired even though just doing menial task.
I have experienced up to all five of the above at any one time. Sometimes, we thought we are having low blood pressure or low iron level, but in actual fact, the cause could be more severe. Those that often misses out on their sleep and worked through the night will experience palpitation and feel lightheaded. Reason why rest is crucial for athletes as much as it to train.
So, the next question would be how one could actually strike out all possibilities and actually know what is causing the symptoms above? A comprehensive medical examination that includes ECG or electrocardiogram test, or a stress test (running on treadmill with HR and blood pressure monitored) could be an inexpensive way to prediagnose this condition.
Arrhythmia condition could be treated via drug usage, usually to thin the blood (such as aspirin) to prevent possibility of stroke due to blood clot. If the condition could not be treated by drugs, it will usually requires a lifestyle change.
We human are habitual beings, lifestyle change will be difficult to some and often it requires discipline and life-changing decision. Some of the suggested changes that should be incorporated includes quitting smoking, limits the consumption of alcohol and caffeine (including soft drinks) and perhaps even a diet revamp for a more holistic cardiovascular health including the health of the arteries and lipid (fat) profile. One of the more difficult change would be to limit the activities that causes the condition, especially if it involves the activities we love such as the swimming, cycling and running. The key to this would be a very conscious effort to STOP if we have fainting spell or tightness or pain in the chest. That would be the first indication.
Arrhythmia could lead to more deadly repercussion if not recognised such as heart attack.
Putting all the equations above, i could very generally equate the recent death of some of our fellow friends to possible over training with imbalance diet (electrolyte imbalance - could meant under or over dosing) while pushing very hard to accomplish to obtain a personal best timing possibly with inadequate rest due to anxiety before race days or running up to race day.
I am not a doctor, but my common sense tells me that the sign is always there and it is ourselves that choose to ignore them.
I often race with a heart rate monitor (HRM) so i could monitor my own condition if i am pushing myself too hard or within my own limits. I even stopped running once when i felt immense tightness on my chest just after 2km of running at an easy pace. It is never nice to just "drop dead" - life is too short to let it end that way.
Stay conscious, stay informed and stay alive. There will always be another race for another day.
http://www.tristupe.com/2011/12/know-your-heart-condition-and-sports.html
********
Know Your Heart Condition And Sports
Another life was lost last weekend during the SCMS 2011 run. A young 22 years old man by the name of Malcolm Sng (RIP) was known to be a fit person that earned the nickname "Man Of Steel" from those that know him. He was one of the fitter ones in his Basic Military Training (BMT), according to those that know him during his National Service days. He ran the 21km race in 1:53 - collapsed upon crossing the line and pronounced dead at 9.30am - an hour after he collapsed. His last run before this was in September 2011.
If all of you remember, there was another death in our country Malaysia during the SCKLM run in 2010 where a 10km participant collapsed with about 2km to go. Runners that saw that rushed to his aid and some even performed CPR on him. Sadly, medical was insufficiently equipped (no AED or defibrillator) and many would remember the inaction by authority that could had used his radio to call for ambulance.
Some would say that Singapore is so perfect - since the organizers was not apprehended on social media unlike what happened in KL. Lets look at the two incident objectively. Both has a young man passing on while running. Both started racing recently (before the incident) and both are at the best of their health, fitness wise. While one received immediate medical attention upon collapsing the end results for both were the same - they could never come back again.
While the investigation is underway for Malcolm, the condition that caused the Malaysian boy to pass on was attributed to under laying heart condition.
In fact, he was not the first one. Remember the other race in Shah Alam where another young man collapsed and died while walking to his car?
Or the national junior badminton player that suffered the same fate after his training just recently?
Closer to home, i lost two friends; one an online friend i never met physically and the other, Kharis or TSB recently - both due to heart condition.
Here are the coincidental cause - cardiovascular or heart failure.
One of the most common cause is abnormal heart rhythm or arrhythmia. Lets look at what this foreign sounding medical terms (as with all medical terms too) is.
Arrhythmia is best described as irregular heartbeat. It has nothing to do with you getting excited when you see someone you love (aka skipping a heartbeat). It can occurs even with someone that has regular heartbeat (50-100bpm), low heartbeat (less than 50) or high heartbeat (more than 100). It can cause by a few factors such as:
1. electrolyte imbalance mostly due to natrium(sodium) - kalium (potassium) imbalance.
2. injury from heart attack or recovery from heart surgery, of which either one would contribute to changes in the heart muscle function/memory
3. Irregular heart rhythm which include other medical condition such as heart flutter, abnormal contraction of artery and/or ventricle.
As you can see, many of us that does the sports (swim and/or bike and/or run) are relatively "fit". Many of us are not aware of under laying condition of our own health, despite getting health screening perhaps only when the job job requires us to. Many a time, we would not be able to recognise the tell-tale sign, but the typical symptoms are:
1. palpitation of the heart (where you feel your heart skipping a beat or suddenly felt like it is drumming away)
2. Pain or tightness in the chest (oh-uh...)
3. Feeling light headed or dizziness
4. short of breath
5. feeling tired even though just doing menial task.
I have experienced up to all five of the above at any one time. Sometimes, we thought we are having low blood pressure or low iron level, but in actual fact, the cause could be more severe. Those that often misses out on their sleep and worked through the night will experience palpitation and feel lightheaded. Reason why rest is crucial for athletes as much as it to train.
So, the next question would be how one could actually strike out all possibilities and actually know what is causing the symptoms above? A comprehensive medical examination that includes ECG or electrocardiogram test, or a stress test (running on treadmill with HR and blood pressure monitored) could be an inexpensive way to prediagnose this condition.
Arrhythmia condition could be treated via drug usage, usually to thin the blood (such as aspirin) to prevent possibility of stroke due to blood clot. If the condition could not be treated by drugs, it will usually requires a lifestyle change.
We human are habitual beings, lifestyle change will be difficult to some and often it requires discipline and life-changing decision. Some of the suggested changes that should be incorporated includes quitting smoking, limits the consumption of alcohol and caffeine (including soft drinks) and perhaps even a diet revamp for a more holistic cardiovascular health including the health of the arteries and lipid (fat) profile. One of the more difficult change would be to limit the activities that causes the condition, especially if it involves the activities we love such as the swimming, cycling and running. The key to this would be a very conscious effort to STOP if we have fainting spell or tightness or pain in the chest. That would be the first indication.
Arrhythmia could lead to more deadly repercussion if not recognised such as heart attack.
Putting all the equations above, i could very generally equate the recent death of some of our fellow friends to possible over training with imbalance diet (electrolyte imbalance - could meant under or over dosing) while pushing very hard to accomplish to obtain a personal best timing possibly with inadequate rest due to anxiety before race days or running up to race day.
I am not a doctor, but my common sense tells me that the sign is always there and it is ourselves that choose to ignore them.
I often race with a heart rate monitor (HRM) so i could monitor my own condition if i am pushing myself too hard or within my own limits. I even stopped running once when i felt immense tightness on my chest just after 2km of running at an easy pace. It is never nice to just "drop dead" - life is too short to let it end that way.
Stay conscious, stay informed and stay alive. There will always be another race for another day.
http://www.tristupe.com/2011/12/know-your-heart-condition-and-sports.html
Time to Rest ?
Pay attention to 10 body indicators to gauge when to run and when to back off.
By Jayme Otto
Image by Saverio Truglia
From the June 2011 issue of Runner's World
After disappointing performances in a couple of key tune-up races last fall, a depleted Ryan Hall made the hard decision to withdraw from the Chicago Marathon. Too many grinding 15-mile tempo runs at a five-minute-per-mile pace at 7,000 feet with too little rest afterward had finally caught up with him. "I love to push my body," he says. "Recovery is the hardest part of training for me."
Problem is, if you don't take time for proper R&R, your body won't adapt to the stress of your training—you won't get stronger or faster, explains Stacy Sims, Ph.D., at the Stanford Prevention-Research Center, School of Medicine. Neglect recovery for too long, and you will start to lose strength and speed. You'll sink into the black hole known as overtraining.
First, your sleep patterns and energy levels will feel the effects. Eventually, your immune system crashes, and you lose your appetite. It's like burning out your engine. And you don't have to be logging 100-mile weeks to suffer. Recreational runners can overtrain, too. "With deadlines, chores, bills, kids, and lack of sleep, it's more challenging to recover properly from your runs," says Sims.
So in preparation for the 2011 Boston Marathon, Hall used an online recovery-tracking program called Restwise, which looks at simple biological markers input by the athlete first thing each morning, calculates a daily recovery score from 1 to 100, then trends it over time. (Rest-wise subscriptions start at $119 for six months; go to restwise.com.)
Pay attention to the following 10 markers. If three or more of these indicators raise a red flag, you should consider a few easy sessions or off days so you can return to running strong (see box, right). Says Hall, "Now I'm learning to love to rest."
1 BODY MASS: You lost weight from yesterday
A two percent drop in weight from one day to the next indicates a body-fluid fluctuation. Most likely, you didn't hydrate enough during or after your last workout. Dehydration negatively impacts both physical and mental performance, and could compromise the quality of your next workout.
2 RESTING HEART RATE: Your resting heart rate is elevated
Take your pulse each morning before you get out of bed to find what's normal for you. An elevated resting heart rate is one sign of stress. It means your nervous system prepared for fight or flight by releasing hormones that sped up your heart to move more oxygen to the muscles and brain. Your body won't know the difference between physical and psychological stress. A hard run and a hard day at work both require extra recovery.
3 SLEEP: You didn't sleep well or enough
A pattern of consistently good sleep will give you a boost of growth hormones, which are great for rebuilding muscle fibers. Several nights in a row of bad sleep will decrease reaction time along with immune, motor, and cognitive functions—not a good combination for a workout.
4 HYDRATION: Your pee is dark yellow
This can be an indicator of dehydration, barring the consumption of vitamins, supplements, or certain foods the evening before. The darker the color, the more you're struggling to retain fluids, because there's not enough to go around. You need H2O to operate (and recover).
5 ENERGY LEVEL: You're run down
If your energy level is low, there's something amiss. The key is honesty. Athletes can block out signs of fatigue to push through it, thinking it will make them stronger. It won't always work that way.
6 MOOD STATE: You're cranky
When your body is overwhelmed by training (or other stressors), it produces hormones like cortisol that can cause irritability or anxiety. Stress also halts chemicals like dopamine, a neurotransmitter in the brain that has a big bummer effect on mood when depleted. Crankiness probably means not enough recovery.
7 WELLNESS: You're sick
Any illness, or even a woman's menstrual cycle, will increase your need for energy to refuel your immune system, which is having to work overtime. This means fewer resources available for recovering from training.
8 PAIN: You're sore or nursing an injury
Whether you're sore from overworked muscles or an injury, your body needs more energy to put toward repair, lengthening total recovery time.
9 PERFORMANCE: Your workout went poorly
This is a subjective measure of workout quality, not quantity nor intensity. If you felt great on yesterday's run, you'd evaluate that as good. If you felt sluggish on that same run, you'd count it as poor. Trending workout quality—multiple poors in a row—is one of the easiest ways to identify the need for more recovery.
10 OXYGEN SATURATION: Your oxygen level has dipped
The amount of oxygen in the hemoglobin of the red blood cells can be measured by placing your fingertip in a portable pulse oximeter, a gadget available online for about $40. The higher the percentage, the better: Above 95 percent is the norm at sea level or for an athlete who is fully acclimated to a given altitude. This is a new area in recovery science, requiring more research, but there may be a link between low oxygen saturation and the need for more recovery.
Count Your Red Flags
The restwise algorithm assigns more weight to some markers (e.g., performance) than others (e.g., mood), along with other factors to generate a precise recovery score. But you can get a sense for your ballpark recovery quality by tallying the red flags (left) you average per day in a week.
0-1 GREEN LIGHT
You are clear to train hard.
2-4 CAUTION
You can go ahead with a hard workout if your training plan calls for it, but cut it short if it feels too hard. Better yet, take an easy day, or a day off.
5-6 WARNING
You're entering the danger zone, which could be intentional according to your periodization or peaking protocol. If not, back off.
7-10 DANGER
You require mandatory time off, ranging from a day to a week, depending on the severity of your fatigue and what you've seen over the previous few days and weeks. You may need to visit your doctor.
FEEL Better: Too much rest has its own problems: Your performance stalls. On your recovery days, do something active; go for a bike ride, walk, or do yoga.
MUSCLES NEED 48 HOURS TO RECOVER AFTER AN INTENSE RUN. DURING THIS TIME, CELLS ARE REPROGRAMMED TO BE STRONGER.
http://www.runnersworld.com/article/0,7120,s6-238-267--13950-2-1-2,00.html
By Jayme Otto
Image by Saverio Truglia
From the June 2011 issue of Runner's World
After disappointing performances in a couple of key tune-up races last fall, a depleted Ryan Hall made the hard decision to withdraw from the Chicago Marathon. Too many grinding 15-mile tempo runs at a five-minute-per-mile pace at 7,000 feet with too little rest afterward had finally caught up with him. "I love to push my body," he says. "Recovery is the hardest part of training for me."
Problem is, if you don't take time for proper R&R, your body won't adapt to the stress of your training—you won't get stronger or faster, explains Stacy Sims, Ph.D., at the Stanford Prevention-Research Center, School of Medicine. Neglect recovery for too long, and you will start to lose strength and speed. You'll sink into the black hole known as overtraining.
First, your sleep patterns and energy levels will feel the effects. Eventually, your immune system crashes, and you lose your appetite. It's like burning out your engine. And you don't have to be logging 100-mile weeks to suffer. Recreational runners can overtrain, too. "With deadlines, chores, bills, kids, and lack of sleep, it's more challenging to recover properly from your runs," says Sims.
So in preparation for the 2011 Boston Marathon, Hall used an online recovery-tracking program called Restwise, which looks at simple biological markers input by the athlete first thing each morning, calculates a daily recovery score from 1 to 100, then trends it over time. (Rest-wise subscriptions start at $119 for six months; go to restwise.com.)
Pay attention to the following 10 markers. If three or more of these indicators raise a red flag, you should consider a few easy sessions or off days so you can return to running strong (see box, right). Says Hall, "Now I'm learning to love to rest."
1 BODY MASS: You lost weight from yesterday
A two percent drop in weight from one day to the next indicates a body-fluid fluctuation. Most likely, you didn't hydrate enough during or after your last workout. Dehydration negatively impacts both physical and mental performance, and could compromise the quality of your next workout.
2 RESTING HEART RATE: Your resting heart rate is elevated
Take your pulse each morning before you get out of bed to find what's normal for you. An elevated resting heart rate is one sign of stress. It means your nervous system prepared for fight or flight by releasing hormones that sped up your heart to move more oxygen to the muscles and brain. Your body won't know the difference between physical and psychological stress. A hard run and a hard day at work both require extra recovery.
3 SLEEP: You didn't sleep well or enough
A pattern of consistently good sleep will give you a boost of growth hormones, which are great for rebuilding muscle fibers. Several nights in a row of bad sleep will decrease reaction time along with immune, motor, and cognitive functions—not a good combination for a workout.
4 HYDRATION: Your pee is dark yellow
This can be an indicator of dehydration, barring the consumption of vitamins, supplements, or certain foods the evening before. The darker the color, the more you're struggling to retain fluids, because there's not enough to go around. You need H2O to operate (and recover).
5 ENERGY LEVEL: You're run down
If your energy level is low, there's something amiss. The key is honesty. Athletes can block out signs of fatigue to push through it, thinking it will make them stronger. It won't always work that way.
6 MOOD STATE: You're cranky
When your body is overwhelmed by training (or other stressors), it produces hormones like cortisol that can cause irritability or anxiety. Stress also halts chemicals like dopamine, a neurotransmitter in the brain that has a big bummer effect on mood when depleted. Crankiness probably means not enough recovery.
7 WELLNESS: You're sick
Any illness, or even a woman's menstrual cycle, will increase your need for energy to refuel your immune system, which is having to work overtime. This means fewer resources available for recovering from training.
8 PAIN: You're sore or nursing an injury
Whether you're sore from overworked muscles or an injury, your body needs more energy to put toward repair, lengthening total recovery time.
9 PERFORMANCE: Your workout went poorly
This is a subjective measure of workout quality, not quantity nor intensity. If you felt great on yesterday's run, you'd evaluate that as good. If you felt sluggish on that same run, you'd count it as poor. Trending workout quality—multiple poors in a row—is one of the easiest ways to identify the need for more recovery.
10 OXYGEN SATURATION: Your oxygen level has dipped
The amount of oxygen in the hemoglobin of the red blood cells can be measured by placing your fingertip in a portable pulse oximeter, a gadget available online for about $40. The higher the percentage, the better: Above 95 percent is the norm at sea level or for an athlete who is fully acclimated to a given altitude. This is a new area in recovery science, requiring more research, but there may be a link between low oxygen saturation and the need for more recovery.
Count Your Red Flags
The restwise algorithm assigns more weight to some markers (e.g., performance) than others (e.g., mood), along with other factors to generate a precise recovery score. But you can get a sense for your ballpark recovery quality by tallying the red flags (left) you average per day in a week.
0-1 GREEN LIGHT
You are clear to train hard.
2-4 CAUTION
You can go ahead with a hard workout if your training plan calls for it, but cut it short if it feels too hard. Better yet, take an easy day, or a day off.
5-6 WARNING
You're entering the danger zone, which could be intentional according to your periodization or peaking protocol. If not, back off.
7-10 DANGER
You require mandatory time off, ranging from a day to a week, depending on the severity of your fatigue and what you've seen over the previous few days and weeks. You may need to visit your doctor.
FEEL Better: Too much rest has its own problems: Your performance stalls. On your recovery days, do something active; go for a bike ride, walk, or do yoga.
MUSCLES NEED 48 HOURS TO RECOVER AFTER AN INTENSE RUN. DURING THIS TIME, CELLS ARE REPROGRAMMED TO BE STRONGER.
http://www.runnersworld.com/article/0,7120,s6-238-267--13950-2-1-2,00.html
Sunday, November 27, 2011
SCKLM 2012
24 June 2012.. Tickets booked (via AA). Gonna make my 'maiden' full at SCKLM ! Registration starts 31st January 2012
Sunday, November 20, 2011
My race of a lifetime !!
PBIM 2011 marks the 2nd anniversary of me taking up running seriously, at least participating in races at least.. and this must be the mother of all races to me, a race of a lifetime.. I did my first ever full marathon (that is 42.195k) on 20/11/2011 (20112011 – easy to remember ) – and that is called an FMV (Full Marathon Virgin :) Well technically I did the olden days Penang Bridge Run which started from USM (don’t think it was a full though which I remember came in at 5:50, just before the 6 hour cut off mark… and that was 1995, 16 years ago !!!)
I set up my 16 weeks training regime way back in early July by checking out web sites and learning from others but mainly comes from Chris’s Brooks marathon 16-weeks training plan. Well, interruptions along the way, including many travels, holidays, unexpected rain and especially being out sick in the last 4 weeks of training pretty much allowed me to do 60% if the targeted plans. Anyhow, 1 LSD of 26k, a few 21k runs and some shorter runs/speed works/tempos, I was ready to go ! I felt jittery as the day drew near, not knowing what to expect – like whether I will collapse half-way, whether I can last the distance or take the shuttle back (which means DNF, that will be WTF !), whether I will hit the wall too early etc etc.. But many thanks to the FMV Facebook page, I learned a lot from the preparation, what to anticipate and how to prepare. That helped to calm the nerves a bit. Saturday (the eve of the run) was a busy day. Meeting up fellow runners from out of state and it’s a rare opportunity to have many of them in together.. Saturday early morning, sent Jadyn to her wushu class, then met up Sabri for a short while to pass him the race kit collected earlier, then went to Vistana to pick up Karim for a breakfast @ the Transfer Road Roti Canai (the first carbo load) before heading towards Queensbay Mall to pick up some ORS (Oral Rehydration Salt) – a tip I learned from the FMV. Never tried that but no harm.. I didn’t want to get cramp and limp to finishing line ! After sending Jadyn to her art class, I picked up Hizam and Anna at the airport in the late afternoon and sent them to the hotel before meeting up Ray shortly for a quick 2nd carbo load @ Old Town.. After that, it’s time to head home and catch some precious sleep. Slept at 8.15pm, and woke up at 11pm.. and the moment of truth has arrived..
The race started at 2am as the bridge was closed at 1am. Thank God the rain stopped at around 10pm+ and cleared the air for a refreshing night. I went thru the checklist of items to be brought along – bib, race pouch, 5 GU gel (kiasu, 1 for each km + 1 backup), 3 ORS and some Yoko2 lotions, and decided to pick my Brooks Ravenna 2 for the race. I guess I am still getting myself familiar with the new Brooks Glycerin 9. That will be for future races – and boy how right I was ! The ‘old’ faithful Ravenna 2 worked its magic ! Picked up Karim again on my way to Queensbay Mall at around 12 midnight. The whole Vistana was painted yellow with bus-loads of DiGi runners all dressed in their yellow vests. I think DiGi booked the whole Vistana for their runners !! As expected, the starting point was already filled with an air of carnival-like atmosphere except that this time, I would be there to kick-off the full marathon versus watching the full marathoners flew-off last year (I was doing half the 2 previous years). Saw some familiar faces, especially the i-Run runners making their usual ‘battle cry’. After 5 toilets breaks, yes.. 5 ! I must drank gallons of water, ORS, honey, Nutrimeal the few hours prior to that ! LOL.
After some cultural shows and the arrival of CM LGE (who got his usual loud applauses), the race was flagged-off .. and it started at 12.54am – 6 minutes earlier !
1-10k : The first 10k was ran at 5:48”/k and 5:46”/k pace respectively (5k split) which included a 3-4mins toilet break under the tree, opposite Seagate ! The first 7km or so was a quick race as everyone tried to go out fast before hitting the bridge ramp. Saw some runners that I know.. fellow Facebook runners – Uncle Oliver, an unbelievable fit and regular marathoners at his age.. Tee HH, Cheng Liang, and Bee Hong.. Did a shout-out to Tee and he must have been shocked.. As I approached the Half-marathon U-turn point, I was determined not to let any half marathon runners over-take me (who started 1 hr later than us) but alas, as I was running on the middle of the lane, a group of 6 Kenyans galloped past me so fast that I felt like a strong wind whizzed past me, trust me !
11-20k : As I just recovered from my knee pain (still remember painful race @ PJ Half Marathon), I tried to conserve some energy and do some slow jogs and brisk walking in between to give my knees some rest for the long haul. There were no pain on both knees but I did that just in case anyway. Had my 1st gel at 12th k. There were many photographers near the mid-span snapping away and the drummers surely lifted the spirits somewhat. I made a terrible mistake though with my Garmin 305 watch. I must have fiddled with it so much (checking the time and the pace etc) that I accidentally stopped it without realizing it. It stopped at 11.99k and by the time I realized it, it was nearly a km down the stretch. Of course at that time, I didn’t realize the gap was so huge as a counter-check with the clock showed I was only a min or 2 off – but not knowing the race was started 6 mins earlier !! At around 19-20th point, we had to make a loop at the Seberang Jaya toll plaza to make a U-turn back to the returning stretch. I did 6:27 and 6:41 for the 11-20th split.
21-30k : I had my 1st ORS at the 21st k, taping it at 2:17. I was quietly confident I could meet my target of 5 hrs and was thinking of even 4:45. But alas.. my 22nd – 25th km was a struggle. The pace slowed and once I merged into the half-marathon U-turn point, the crowd became significantly larger. Since this is the last batch of the half runners, many were walking and even stopping by the side and take pictures. I think I was ‘influenced’ by them and started to walk. So much for being mentally tough !! Took my 3rd gel at around 25th km. Right at the mid-span, I had some giddiness and had to stop for a couple minutes. I felt my stomach churning and I suspect it’s due to my calories burning faster than the food I loaded earlier ! Thank God a bun stall appeared immediately and how grateful I was ! Grabbed a bun and I started to jog and eat at the same time. I did 7:05 and 8:00 for this 21-30th and it’s clear I lose most of the time here !!
31-42km : Exiting the bridge at around 3:45, I got my 2nd wind and started running. The line got thinner as we approached eGate where the half runners make a U-turn back. I hit the 33th km at 3:51.. which meant I used up 1:34 for this 12k !! The last stretch was dark and lonely with many runners hitting the wall and doing stretching by the roadside. I found my 3rd wind and kept running + jogging. The cheering volunteers surely helped to lift the spirits. This is the last stretch where runners will run towards MacCallum Street and make a U-turn back to Queensbay Mall. That is the time you could see who’s in front and who’s not. I saw Jin Xiang, a fellow colleague who eventually did <4:30, Hoe Hock who was doing his FMV ! and then Karim who eventually did 4:41.. Got my 4th gel at around 34th km from Powerbar. Up until then, my knees were holding up and my cramps were kept to a minimal. The first aiders along the stretch did a pretty good job in massaging my calves and hips. As I made a U-turn, my spirit was lifted again as the huge group of volunteers gave a loud cheer and I managed to give some of them High-5s.. I knew I was on the home stretch towards Queensbay Mall.. But the most amazing thing must be at the ~37th km when I saw Mohan, with his whistles, running towards MaCCalum Street and encouraged the runners. By then, he has finished the race and made a turn towards the 30+km to cheer up the runners.. How contagious that was ! I gave him a huge Hi-5 and I started to ‘speed’ towards the finishing line. Around 4km from the finishing line, I saw Karen Loh ran past me together with a runner wearing the K-Swiss vest. I tried to keep pace, but too bad, I had to make numerous stops and jogs. I think my fuel had been totally consumed ! I was determined to beat the 5 hrs target, at least get a sub-5.. I told myself !! That motivated me to keep running and jogging.. At that time, I was 6mins behind my Garmin watch and I was oblivious to that. Well, I thought I could hit 4:50 ! But as soon as I saw the 5 hrs pacer ran past me 1km before the finishing line, I knew I was behind the time ! Increasing my pace, I kicked-start and ran towards Queensbay Mall. The finishing line must hv felt like 10k away and never ending ! I hit the tape at 4:58 (43k distance based on Karim’s watch).. of course at that time, I thought I did 4:52 ! My last 30th – 42k was @ 7:12, &;15 and 6:37 for the last 2k ! Well, I guessed I managed to ‘Finish Strong’ !
I was glad I managed to end the race in one piece.. Relieved that my knees held strong, my cramps were kept to a minimum (ORS sure did help a lot !!) and my heartbeat were ok ! I nailed my first full marathon and a virgin no more !! My chip time results from the PBIM web site as below. Now time for some sleep and relax before resuming my raining for a half marathon at SCMS on Dec 4th !!
Name : GOH THUAN LIN
Status : Active Collect
Method : Queensbay Mall (12th & 13th Nov 2011)
Category : Full Marathon Men Open
Bib No : A00014
Event Results
21KM CheckPoint : 2:17:25.45
33KM CheckPoint : 3:51:01.36
ChipTime : 4:58:22.91 GunTime : 4:58:54.58
Ranking : 242/1190
How do I feel about the organization of the race ?
- Overall, I think it was fairly organized with plentiful of water and electrolyte drinks at every 4km. There were many complains about water running out at water stations especially for the last few batches of runners. So I hope the organizers can take heed of this and imporve next year.
- As for the finishing line, it was a clear mess. When I approached the finishing line, all the categories were cramped into the one-side small lane in front of Queensbay Mall. The volunteer keep saying full marathon take middle lane but they were standing at the middle lane and blocked me ! Pretty annoyed especially after you have been running for 5hrs and can't wait to end the race. The officials shud hv been standing after the line, not in front of it !
- The 42k finisher tee was dsitributed freely at the finishing point and so many complaints of 21k/10k runners taking the 42k finisher tee, causing sizes to run out etc. That could have been avoided had the organizer place more emphasis on full marathon finishing area. After all, it's not the number of runners that count, it's the # of full marathoners that make it a worthwhile race !
- The queue to get drinks and bananas etc were another chaos with no clear signage. I ended up walking back to my car and take my own food & drinks supply.
- Hopefully Allianz can improve the organization of the race (2009 & 2010 were pretty well-organized though 2008 was another disaster all together) for the coming year(s), if they are going to be the anchor sponsor again !
I set up my 16 weeks training regime way back in early July by checking out web sites and learning from others but mainly comes from Chris’s Brooks marathon 16-weeks training plan. Well, interruptions along the way, including many travels, holidays, unexpected rain and especially being out sick in the last 4 weeks of training pretty much allowed me to do 60% if the targeted plans. Anyhow, 1 LSD of 26k, a few 21k runs and some shorter runs/speed works/tempos, I was ready to go ! I felt jittery as the day drew near, not knowing what to expect – like whether I will collapse half-way, whether I can last the distance or take the shuttle back (which means DNF, that will be WTF !), whether I will hit the wall too early etc etc.. But many thanks to the FMV Facebook page, I learned a lot from the preparation, what to anticipate and how to prepare. That helped to calm the nerves a bit. Saturday (the eve of the run) was a busy day. Meeting up fellow runners from out of state and it’s a rare opportunity to have many of them in together.. Saturday early morning, sent Jadyn to her wushu class, then met up Sabri for a short while to pass him the race kit collected earlier, then went to Vistana to pick up Karim for a breakfast @ the Transfer Road Roti Canai (the first carbo load) before heading towards Queensbay Mall to pick up some ORS (Oral Rehydration Salt) – a tip I learned from the FMV. Never tried that but no harm.. I didn’t want to get cramp and limp to finishing line ! After sending Jadyn to her art class, I picked up Hizam and Anna at the airport in the late afternoon and sent them to the hotel before meeting up Ray shortly for a quick 2nd carbo load @ Old Town.. After that, it’s time to head home and catch some precious sleep. Slept at 8.15pm, and woke up at 11pm.. and the moment of truth has arrived..
The race started at 2am as the bridge was closed at 1am. Thank God the rain stopped at around 10pm+ and cleared the air for a refreshing night. I went thru the checklist of items to be brought along – bib, race pouch, 5 GU gel (kiasu, 1 for each km + 1 backup), 3 ORS and some Yoko2 lotions, and decided to pick my Brooks Ravenna 2 for the race. I guess I am still getting myself familiar with the new Brooks Glycerin 9. That will be for future races – and boy how right I was ! The ‘old’ faithful Ravenna 2 worked its magic ! Picked up Karim again on my way to Queensbay Mall at around 12 midnight. The whole Vistana was painted yellow with bus-loads of DiGi runners all dressed in their yellow vests. I think DiGi booked the whole Vistana for their runners !! As expected, the starting point was already filled with an air of carnival-like atmosphere except that this time, I would be there to kick-off the full marathon versus watching the full marathoners flew-off last year (I was doing half the 2 previous years). Saw some familiar faces, especially the i-Run runners making their usual ‘battle cry’. After 5 toilets breaks, yes.. 5 ! I must drank gallons of water, ORS, honey, Nutrimeal the few hours prior to that ! LOL.
After some cultural shows and the arrival of CM LGE (who got his usual loud applauses), the race was flagged-off .. and it started at 12.54am – 6 minutes earlier !
1-10k : The first 10k was ran at 5:48”/k and 5:46”/k pace respectively (5k split) which included a 3-4mins toilet break under the tree, opposite Seagate ! The first 7km or so was a quick race as everyone tried to go out fast before hitting the bridge ramp. Saw some runners that I know.. fellow Facebook runners – Uncle Oliver, an unbelievable fit and regular marathoners at his age.. Tee HH, Cheng Liang, and Bee Hong.. Did a shout-out to Tee and he must have been shocked.. As I approached the Half-marathon U-turn point, I was determined not to let any half marathon runners over-take me (who started 1 hr later than us) but alas, as I was running on the middle of the lane, a group of 6 Kenyans galloped past me so fast that I felt like a strong wind whizzed past me, trust me !
11-20k : As I just recovered from my knee pain (still remember painful race @ PJ Half Marathon), I tried to conserve some energy and do some slow jogs and brisk walking in between to give my knees some rest for the long haul. There were no pain on both knees but I did that just in case anyway. Had my 1st gel at 12th k. There were many photographers near the mid-span snapping away and the drummers surely lifted the spirits somewhat. I made a terrible mistake though with my Garmin 305 watch. I must have fiddled with it so much (checking the time and the pace etc) that I accidentally stopped it without realizing it. It stopped at 11.99k and by the time I realized it, it was nearly a km down the stretch. Of course at that time, I didn’t realize the gap was so huge as a counter-check with the clock showed I was only a min or 2 off – but not knowing the race was started 6 mins earlier !! At around 19-20th point, we had to make a loop at the Seberang Jaya toll plaza to make a U-turn back to the returning stretch. I did 6:27 and 6:41 for the 11-20th split.
21-30k : I had my 1st ORS at the 21st k, taping it at 2:17. I was quietly confident I could meet my target of 5 hrs and was thinking of even 4:45. But alas.. my 22nd – 25th km was a struggle. The pace slowed and once I merged into the half-marathon U-turn point, the crowd became significantly larger. Since this is the last batch of the half runners, many were walking and even stopping by the side and take pictures. I think I was ‘influenced’ by them and started to walk. So much for being mentally tough !! Took my 3rd gel at around 25th km. Right at the mid-span, I had some giddiness and had to stop for a couple minutes. I felt my stomach churning and I suspect it’s due to my calories burning faster than the food I loaded earlier ! Thank God a bun stall appeared immediately and how grateful I was ! Grabbed a bun and I started to jog and eat at the same time. I did 7:05 and 8:00 for this 21-30th and it’s clear I lose most of the time here !!
31-42km : Exiting the bridge at around 3:45, I got my 2nd wind and started running. The line got thinner as we approached eGate where the half runners make a U-turn back. I hit the 33th km at 3:51.. which meant I used up 1:34 for this 12k !! The last stretch was dark and lonely with many runners hitting the wall and doing stretching by the roadside. I found my 3rd wind and kept running + jogging. The cheering volunteers surely helped to lift the spirits. This is the last stretch where runners will run towards MacCallum Street and make a U-turn back to Queensbay Mall. That is the time you could see who’s in front and who’s not. I saw Jin Xiang, a fellow colleague who eventually did <4:30, Hoe Hock who was doing his FMV ! and then Karim who eventually did 4:41.. Got my 4th gel at around 34th km from Powerbar. Up until then, my knees were holding up and my cramps were kept to a minimal. The first aiders along the stretch did a pretty good job in massaging my calves and hips. As I made a U-turn, my spirit was lifted again as the huge group of volunteers gave a loud cheer and I managed to give some of them High-5s.. I knew I was on the home stretch towards Queensbay Mall.. But the most amazing thing must be at the ~37th km when I saw Mohan, with his whistles, running towards MaCCalum Street and encouraged the runners. By then, he has finished the race and made a turn towards the 30+km to cheer up the runners.. How contagious that was ! I gave him a huge Hi-5 and I started to ‘speed’ towards the finishing line. Around 4km from the finishing line, I saw Karen Loh ran past me together with a runner wearing the K-Swiss vest. I tried to keep pace, but too bad, I had to make numerous stops and jogs. I think my fuel had been totally consumed ! I was determined to beat the 5 hrs target, at least get a sub-5.. I told myself !! That motivated me to keep running and jogging.. At that time, I was 6mins behind my Garmin watch and I was oblivious to that. Well, I thought I could hit 4:50 ! But as soon as I saw the 5 hrs pacer ran past me 1km before the finishing line, I knew I was behind the time ! Increasing my pace, I kicked-start and ran towards Queensbay Mall. The finishing line must hv felt like 10k away and never ending ! I hit the tape at 4:58 (43k distance based on Karim’s watch).. of course at that time, I thought I did 4:52 ! My last 30th – 42k was @ 7:12, &;15 and 6:37 for the last 2k ! Well, I guessed I managed to ‘Finish Strong’ !
I was glad I managed to end the race in one piece.. Relieved that my knees held strong, my cramps were kept to a minimum (ORS sure did help a lot !!) and my heartbeat were ok ! I nailed my first full marathon and a virgin no more !! My chip time results from the PBIM web site as below. Now time for some sleep and relax before resuming my raining for a half marathon at SCMS on Dec 4th !!
Name : GOH THUAN LIN
Status : Active Collect
Method : Queensbay Mall (12th & 13th Nov 2011)
Category : Full Marathon Men Open
Bib No : A00014
Event Results
21KM CheckPoint : 2:17:25.45
33KM CheckPoint : 3:51:01.36
ChipTime : 4:58:22.91 GunTime : 4:58:54.58
Ranking : 242/1190
How do I feel about the organization of the race ?
- Overall, I think it was fairly organized with plentiful of water and electrolyte drinks at every 4km. There were many complains about water running out at water stations especially for the last few batches of runners. So I hope the organizers can take heed of this and imporve next year.
- As for the finishing line, it was a clear mess. When I approached the finishing line, all the categories were cramped into the one-side small lane in front of Queensbay Mall. The volunteer keep saying full marathon take middle lane but they were standing at the middle lane and blocked me ! Pretty annoyed especially after you have been running for 5hrs and can't wait to end the race. The officials shud hv been standing after the line, not in front of it !
- The 42k finisher tee was dsitributed freely at the finishing point and so many complaints of 21k/10k runners taking the 42k finisher tee, causing sizes to run out etc. That could have been avoided had the organizer place more emphasis on full marathon finishing area. After all, it's not the number of runners that count, it's the # of full marathoners that make it a worthwhile race !
- The queue to get drinks and bananas etc were another chaos with no clear signage. I ended up walking back to my car and take my own food & drinks supply.
- Hopefully Allianz can improve the organization of the race (2009 & 2010 were pretty well-organized though 2008 was another disaster all together) for the coming year(s), if they are going to be the anchor sponsor again !
My FMV vest. A virgin no more.. Wohooo !!
The Starting & Finishing Point 
Met Hizam who was running the 10k together with Anna 
Me having cold dip for my sore feet after the race 
This is what my Garmin clocked, minus the 6mins miscalculation due to unexpected stoppage at 11.99th k !! lesson learned ! 
Finisher medal 
Me @ Finishing Line, photo courtesy of MJ Jamal !! 
This gotta be my best bib foe the year !! :-)
The Starting & Finishing Point 
Met Hizam who was running the 10k together with Anna 
Me having cold dip for my sore feet after the race 
This is what my Garmin clocked, minus the 6mins miscalculation due to unexpected stoppage at 11.99th k !! lesson learned ! 
Finisher medal 
Me @ Finishing Line, photo courtesy of MJ Jamal !! 
This gotta be my best bib foe the year !! :-)
Friday, November 18, 2011
Jittery sinks in... I must Finish Strong !!
Slightly over 24 hrs before the biggest run of my life.. I am truly an FMV = Full Marathon Virgin ! Jittery has set in. Worried about the weather, the body condition, whether I will hit the wall too early, enough gel to last me etc. I guess that's normal.. and this will be a good test for me to endure and exercise mind-over-body again !!
So, wish me luck. Any timing will do.. Just wanna start steady & finish strong.. and end up with a great race !
So, wish me luck. Any timing will do.. Just wanna start steady & finish strong.. and end up with a great race !
Sunday, November 13, 2011
Rock to Rock Run - they really rock !!!
Did my first ever Rock to Rock Run on November 13th (Sunday), and well well well.. they do rock ! It wa sa short 4k (measured on my Garmin as 4k vs published 3.8k) run from Hard Rock Hotel to Tropical Spice Garden, make U-turn at the big tree right opposute the Tree Monkey Restaurant, and back to Hard Rock Hotel.. Pretty much an ascending run from hotel to Spice Garden and mostly descending run on the way back.
I did my run in 18:40mins, with a pace of 4:40mins/km.. Enjoyed the run, and think I did well. In fact, I just had a 10k run the evenng on Saturday at Botanical Garden ! I guess that must be me trying to catch up the lost time - I only did 3 runs in the last 3 weeks, including the "disasterous" 21k @ PJ Half and a couple of short runs ! So much for my early tapering towards PBIM.. LOL !!
and for once, I became a semi-photographer myself.. Had some great shots, especially the whacky dressing the runners came in with.. I went with Chris, good that he's off the clutches and walk with a slight limp but definitely in a much better shape !!
I did my run in 18:40mins, with a pace of 4:40mins/km.. Enjoyed the run, and think I did well. In fact, I just had a 10k run the evenng on Saturday at Botanical Garden ! I guess that must be me trying to catch up the lost time - I only did 3 runs in the last 3 weeks, including the "disasterous" 21k @ PJ Half and a couple of short runs ! So much for my early tapering towards PBIM.. LOL !!
and for once, I became a semi-photographer myself.. Had some great shots, especially the whacky dressing the runners came in with.. I went with Chris, good that he's off the clutches and walk with a slight limp but definitely in a much better shape !!
The stage for the performance and post-run awards
Me and Chris 
The winners for the runs and best dressed 
Very creative dressing in deed ! 
Mostly i-Run and Forward runners 
Monday, November 7, 2011
Geoffrey Mutai Wins New York Marathon With Course Record
Geoffrey Mutai breaking the tape in the record time of 2:05:06. More Photos »
By LIZ ROBBINS
Published: November 6, 2011
The footsteps keep getting faster, pounding like a drumbeat on the city streets. From Boston to London to Chicago this year, Kenya’s marathon men have smashed course records in frenzied fashion, and they drilled the world record in Berlin.
Would New York, the final and hilliest of all the major marathons, allow a similarly blistering pace?
Geoffrey Mutai of Kenya, the self-coached 30-year-old who shocked the running world to start the season in Boston, made the question rhetorical on Sunday. On a glistening, windless day that seemed made for marathoning, Mutai flew over five New York bridges, surging in the final six miles to shatter a decade-old course record by more than two and a half minutes.
Mutai captured the 2011 New York City Marathon in 2 hours 5 minutes 6 seconds — and the stampede did not stop when he broke the tape. His countryman Emmanuel Mutai, 27 and no relation, finished second in 2:06:28. Tsegaye Kebede, 24, of Ethiopia finished third in 2:07:14.
The official margin of victory, 1:22.31, was the largest in the race since 1992.
The three men each earned a $70,000 bonus for breaking the course record (2:07:43, set by Tesfaye Jifar of Ethiopia in 2001). Emmanuel Mutai collected an additional $500,000 for winning the World Marathon Majors with his strong performances over the last two years. Geoffrey Mutai won a total of $200,000 for his victory and the record run on a day in which an event-record 47,438 competitors started.
“Although I won, the race was not easy,” Geoffrey Mutai said. “I was not expected to win at that time.”
But he was favored, given his history. About seven months ago, he obliterated the hilly Boston Marathon course record in a world-best time of 2:03:02. It was an eye-popping mark in a roaring tailwind that was, however, ultimately not sanctioned as a record because of the course’s elevation loss and because Boston’s start and finish were separated by more than 50 percent of the race distance.
Running a marathon faster than anyone in history (Patrick Makau of Kenya set the world record, 2:03:38, with the aid of pacesetters in Berlin in September) yet being told that his race was not worthy of a record deflated and elated Mutai. Those dual emotions, he said, motivated him through his training runs in the remote trails of the Rift Valley in western Kenya.
By winning in Boston and in New York — on hilly courses where pacesetters are not permitted — Mutai allowed that he might have erased any doubts about his talents.
“I am happy now because even although it was not recognized, I’m happy to be at that level,” he said.
Meb Keflezighi of the United States, the Olympic silver medalist in 2004 and the winner in New York in 2009, marveled at Mutai’s race.
“To run that fast is pretty incredible,” he said.
On Sunday, Keflezighi stayed with the leaders through 19 miles, then started to feel his stomach churning. He stopped in Mile 22 to vomit but still finished in 2:09:13, his fastest marathon. In this swift field, it was good for sixth place.
Keflezighi said he was thrilled to finish the race healthy, because he plans to compete in the United States Olympic marathon trials Jan. 14 in Houston, hoping to make his third Olympic team.
New York was an unofficial Olympic trials for the Kenyans. Officials from the country’s federation traveled to New York to make a decision, ostensibly on a final runner, as Makau, as the world-record holder, and Abel Kirui, the world champion, seemed to be guaranteed to make the team.
But are Geoffrey Mutai’s accomplishments in the enigmatic world of Kenyan athletics enough to put him on the Olympic team?
“If they select me, I’ll be there,” he said after the race.
With patience and grace, Mutai ran in front of a tightly packed group for the first 16 miles. The pack thinned from 11 to 10, and by the time the men hit First Avenue, there were seven, including last year’s winner, Gebre Gebremariam of Ethiopia.
But crossing the Willis Avenue Bridge at Mile 20, Mutai broke away on Alexander Avenue in the Bronx. He charged off the Madison Avenue Bridge into Harlem, and from there, he attacked the incline of Fifth Avenue and entered Central Park with a 55-second lead.
“We all worked together — and then it was time to push it,” he said. “For me, I was trying to run my own race.”
For 10 years, Mutai has been his own coach. In 2004, he made a painful decision when he was not winning enough to afford treatment for a leg injury. He went to work cutting trees for Kenya Power, the nation’s utility company.
In the last two years, his own power has been sizzling. He said he wondered if he could break the world record on a flatter course.
“I have that in my mind, if it was another course, maybe I can do it,” he said.
As for the role of pacesetters in aiding world records, he said bluntly, “I don’t think if those people can come here and run here, if they can break the world record here.”
Mary Wittenberg, the chief executive of the New York Road Runners, which oversees the race, said she believed someone would one day run 2:04 in New York.
“I think to take two-plus minutes off that record says a lot more about Geoffrey Mutai than it says about our course,” she said.
A world record has not been set in New York in three decades: the American Alberto Salazar ran the race in 2:08:13 in 1981. But that era is long gone. Now there is a brave, blistering crop of runners who are threatening to run under two hours.
“The record is still going down and down,” Emmanuel Mutai said. “I see maybe it would not take too much more time, maybe after three years or one year, the record will be broken again. Even if it is not me, the other generation is coming.”
But right now, Emmanuel and Geoffrey, especially, are not looking back.
http://www.nytimes.com/2011/11/07/sports/geoffrey-mutai-wins-new-york-marathon-with-course-record.html?pagewanted=2
By LIZ ROBBINS
Published: November 6, 2011
The footsteps keep getting faster, pounding like a drumbeat on the city streets. From Boston to London to Chicago this year, Kenya’s marathon men have smashed course records in frenzied fashion, and they drilled the world record in Berlin.
Would New York, the final and hilliest of all the major marathons, allow a similarly blistering pace?
Geoffrey Mutai of Kenya, the self-coached 30-year-old who shocked the running world to start the season in Boston, made the question rhetorical on Sunday. On a glistening, windless day that seemed made for marathoning, Mutai flew over five New York bridges, surging in the final six miles to shatter a decade-old course record by more than two and a half minutes.
Mutai captured the 2011 New York City Marathon in 2 hours 5 minutes 6 seconds — and the stampede did not stop when he broke the tape. His countryman Emmanuel Mutai, 27 and no relation, finished second in 2:06:28. Tsegaye Kebede, 24, of Ethiopia finished third in 2:07:14.
The official margin of victory, 1:22.31, was the largest in the race since 1992.
The three men each earned a $70,000 bonus for breaking the course record (2:07:43, set by Tesfaye Jifar of Ethiopia in 2001). Emmanuel Mutai collected an additional $500,000 for winning the World Marathon Majors with his strong performances over the last two years. Geoffrey Mutai won a total of $200,000 for his victory and the record run on a day in which an event-record 47,438 competitors started.
“Although I won, the race was not easy,” Geoffrey Mutai said. “I was not expected to win at that time.”
But he was favored, given his history. About seven months ago, he obliterated the hilly Boston Marathon course record in a world-best time of 2:03:02. It was an eye-popping mark in a roaring tailwind that was, however, ultimately not sanctioned as a record because of the course’s elevation loss and because Boston’s start and finish were separated by more than 50 percent of the race distance.
Running a marathon faster than anyone in history (Patrick Makau of Kenya set the world record, 2:03:38, with the aid of pacesetters in Berlin in September) yet being told that his race was not worthy of a record deflated and elated Mutai. Those dual emotions, he said, motivated him through his training runs in the remote trails of the Rift Valley in western Kenya.
By winning in Boston and in New York — on hilly courses where pacesetters are not permitted — Mutai allowed that he might have erased any doubts about his talents.
“I am happy now because even although it was not recognized, I’m happy to be at that level,” he said.
Meb Keflezighi of the United States, the Olympic silver medalist in 2004 and the winner in New York in 2009, marveled at Mutai’s race.
“To run that fast is pretty incredible,” he said.
On Sunday, Keflezighi stayed with the leaders through 19 miles, then started to feel his stomach churning. He stopped in Mile 22 to vomit but still finished in 2:09:13, his fastest marathon. In this swift field, it was good for sixth place.
Keflezighi said he was thrilled to finish the race healthy, because he plans to compete in the United States Olympic marathon trials Jan. 14 in Houston, hoping to make his third Olympic team.
New York was an unofficial Olympic trials for the Kenyans. Officials from the country’s federation traveled to New York to make a decision, ostensibly on a final runner, as Makau, as the world-record holder, and Abel Kirui, the world champion, seemed to be guaranteed to make the team.
But are Geoffrey Mutai’s accomplishments in the enigmatic world of Kenyan athletics enough to put him on the Olympic team?
“If they select me, I’ll be there,” he said after the race.
With patience and grace, Mutai ran in front of a tightly packed group for the first 16 miles. The pack thinned from 11 to 10, and by the time the men hit First Avenue, there were seven, including last year’s winner, Gebre Gebremariam of Ethiopia.
But crossing the Willis Avenue Bridge at Mile 20, Mutai broke away on Alexander Avenue in the Bronx. He charged off the Madison Avenue Bridge into Harlem, and from there, he attacked the incline of Fifth Avenue and entered Central Park with a 55-second lead.
“We all worked together — and then it was time to push it,” he said. “For me, I was trying to run my own race.”
For 10 years, Mutai has been his own coach. In 2004, he made a painful decision when he was not winning enough to afford treatment for a leg injury. He went to work cutting trees for Kenya Power, the nation’s utility company.
In the last two years, his own power has been sizzling. He said he wondered if he could break the world record on a flatter course.
“I have that in my mind, if it was another course, maybe I can do it,” he said.
As for the role of pacesetters in aiding world records, he said bluntly, “I don’t think if those people can come here and run here, if they can break the world record here.”
Mary Wittenberg, the chief executive of the New York Road Runners, which oversees the race, said she believed someone would one day run 2:04 in New York.
“I think to take two-plus minutes off that record says a lot more about Geoffrey Mutai than it says about our course,” she said.
A world record has not been set in New York in three decades: the American Alberto Salazar ran the race in 2:08:13 in 1981. But that era is long gone. Now there is a brave, blistering crop of runners who are threatening to run under two hours.
“The record is still going down and down,” Emmanuel Mutai said. “I see maybe it would not take too much more time, maybe after three years or one year, the record will be broken again. Even if it is not me, the other generation is coming.”
But right now, Emmanuel and Geoffrey, especially, are not looking back.
http://www.nytimes.com/2011/11/07/sports/geoffrey-mutai-wins-new-york-marathon-with-course-record.html?pagewanted=2
Monday, October 31, 2011
PJ Half Marathon (Oct 30, 2011) - a tough race indeed !!
PJ Half-Marathon... This must be one of the toughest race I hv ever run.. I have not been feeling well during the Deepavali Melaka home trip, and to top it off, I had a 'great' time enjoying the ikan bakar, nasi lemak, satay goreng etc at Umbai ! and I have been feverish during the trip up to KL. I decided to run since I am already at KL and also I have been short of training the last 1 week+ due to the incessant evening rain. So I popped 2 panadol and there I went !
The parking @ Stadium Petaling Jaya (used to be called Stadium Kelana Jaya) was easy and there were many policemen and volunteers helping out. The race started at 6.30am but by 7am, the sun is already up.. The race is along the highway side roads, more like motorcycle paths.. The first couple of km was OK except that at times, you need to run in between runners as at certain stretch, it's only 2.5 person's width !
The first 5km was OK and i did that in 5:12 pace.. in between 5-10km, there were some ascending run along the highway and I was keeping to the 5:39 split. trouble started when I was at 12/13th km when my knee problem started (the usual suspect - runners knee / patella pain). The pain was bearable and I continue running though I had to make a few stops/walks in between. However, once I made the U-turn at Subang Skypark, the pain became unbearable. I could not even walk properly ! So in between 14th-18thkm, I literally walked and limped. Even when I tried to do a slow jog, the excrutiating pain came right back.
Well, the direct sunlight and the exceptionally hot morning did not help. Imagine you have to walk and limped all the way along highway back to finishing point while facing the sunlight ! I nearly gave up at the point and wait for an ambulance to pick me back. But I guess I am made of better quality and decided to hold on. At the last 1.5km, I decided to jog slightly to the finishing line. The last 400-500km was really refreshing. As we close into the stadium, there are people who came and cheer us and the entrance into the stadium was very carnival-like with many photographers shooting the runners.
After some ice-pack at the medical tent, I was up and away. All in all, 20.76km, so not exactly 21.1km.. Took me 2:13:31, not exactly a respectable time but to think that I limped and walked for 4-5km, it is a consoldation that I still get my medal as the top 200 finisher in Men's Veteran category ! I finished #175 out of the field of 337 runners in Men's Veteran.
I must say while the route was not exactly great but it was a pretty much flat route and the drinks/sponging were well spreaded out every 4km. Pretty well organized event. Thumbs up to the organizers !
Pace:
1st 5km split - 5:12 mins/km
2nd 5km split - 5:39 mins/km
3rd 5km split - 6:25 mins/km
4th 5km split - 8:20 mins/km
5th split - 7:07 mins.km
Average pace : 6:26 min/km
So, that was my 7th Half-Marathon since Nov 2009 and my 9th 21k+ road race since Nov 2009
The parking @ Stadium Petaling Jaya (used to be called Stadium Kelana Jaya) was easy and there were many policemen and volunteers helping out. The race started at 6.30am but by 7am, the sun is already up.. The race is along the highway side roads, more like motorcycle paths.. The first couple of km was OK except that at times, you need to run in between runners as at certain stretch, it's only 2.5 person's width !
The first 5km was OK and i did that in 5:12 pace.. in between 5-10km, there were some ascending run along the highway and I was keeping to the 5:39 split. trouble started when I was at 12/13th km when my knee problem started (the usual suspect - runners knee / patella pain). The pain was bearable and I continue running though I had to make a few stops/walks in between. However, once I made the U-turn at Subang Skypark, the pain became unbearable. I could not even walk properly ! So in between 14th-18thkm, I literally walked and limped. Even when I tried to do a slow jog, the excrutiating pain came right back.
Well, the direct sunlight and the exceptionally hot morning did not help. Imagine you have to walk and limped all the way along highway back to finishing point while facing the sunlight ! I nearly gave up at the point and wait for an ambulance to pick me back. But I guess I am made of better quality and decided to hold on. At the last 1.5km, I decided to jog slightly to the finishing line. The last 400-500km was really refreshing. As we close into the stadium, there are people who came and cheer us and the entrance into the stadium was very carnival-like with many photographers shooting the runners.
After some ice-pack at the medical tent, I was up and away. All in all, 20.76km, so not exactly 21.1km.. Took me 2:13:31, not exactly a respectable time but to think that I limped and walked for 4-5km, it is a consoldation that I still get my medal as the top 200 finisher in Men's Veteran category ! I finished #175 out of the field of 337 runners in Men's Veteran.
I must say while the route was not exactly great but it was a pretty much flat route and the drinks/sponging were well spreaded out every 4km. Pretty well organized event. Thumbs up to the organizers !
Pace:
1st 5km split - 5:12 mins/km
2nd 5km split - 5:39 mins/km
3rd 5km split - 6:25 mins/km
4th 5km split - 8:20 mins/km
5th split - 7:07 mins.km
Average pace : 6:26 min/km
So, that was my 7th Half-Marathon since Nov 2009 and my 9th 21k+ road race since Nov 2009
My new running shoes - Brooks Glycerin 9 :-)
Pampered myself with a new pair of Brooks Glycerin 9 on Oct 18th.. Planned to use them at PJ Halk Marathon and PBIM !!
Reviews @ Brooks web site
(http://www.brooksrunning.com/Brooks-Glycerin-9-Mens-Running-Shoe/110097,default,pd.html)
The Glycerin® 9 will make your feet even happier. With Brooks® DNA now running the full length of the midsole, this shoe continues to raise the bar and set the standard for out-of-this-world comfort. We've upped the stakes even further with the introduction of Omega flex grooves that enhance flexibility and improve gait efficiency - for the smoothest, most comfortable run possible. Talk about happy feet!
Surface : Road/Track
Pronation : None/Normal
Build : Small, Medium, Large
Arch : Medium, High
Category: Neutral
Weight: 12.1 oz
Platform: Universal
Construction: Strobel
Launch Date: June 1, 2011
Reviews @ Brooks web site
(http://www.brooksrunning.com/Brooks-Glycerin-9-Mens-Running-Shoe/110097,default,pd.html)
The Glycerin® 9 will make your feet even happier. With Brooks® DNA now running the full length of the midsole, this shoe continues to raise the bar and set the standard for out-of-this-world comfort. We've upped the stakes even further with the introduction of Omega flex grooves that enhance flexibility and improve gait efficiency - for the smoothest, most comfortable run possible. Talk about happy feet!
Surface : Road/Track
Pronation : None/Normal
Build : Small, Medium, Large
Arch : Medium, High
Category: Neutral
Weight: 12.1 oz
Platform: Universal
Construction: Strobel
Launch Date: June 1, 2011
Monday, October 17, 2011
KWYP City Run 2011
Participated in my 2nd KWYP City Run held on Oct 16th (Sunday). This was supposed to be 10k run but my Garmin showed only 8.09k ! A nice route though, pretty flat race.. Exiting Komtar into Carnavon St, then into Malay St, into Beach St, thru Farquhar St, City Bayview, Citibank, turn into Jln Larut, then into Burmah Road before turning into the Salvation Army, before moving into the home stretch of MaCalister Road all the way to Penang Road and back into Komtar.
Did a decent time, taking into consideration of my still a bit sore knee at that time.
Date : Oct 16th (Sunday)
Time : 41:06 mins
Distance : 8.09km (no PB !)
Pace : 5:05mins/km with a split of 5:06 (1st 5k) and 5:03 (last 3.09k)
Did a decent time, taking into consideration of my still a bit sore knee at that time.
Date : Oct 16th (Sunday)
Time : 41:06 mins
Distance : 8.09km (no PB !)
Pace : 5:05mins/km with a split of 5:06 (1st 5k) and 5:03 (last 3.09k)
The starting and finishing point @ Komtar
The majestic Komtar view at the finishing point, and the certificate - no medal !!
Longest LSD.. and knee pain !!
I was attempting to do 30km run in preparation for my PBIM 42k.. Ended with 26k, and running out of a proper route and not forgetting my knee pain ! Did the usual Youth Park-Straits Quay-Tj Bungah Hotel loop, then followed by Gurney Drive-clock tower loop.. That was about 22k until youth Park back, so I decided to run a few loops at Botanical Gardens as the sun was getting hotter and running under the hot sun, even though it's 9+am, is not in my plan !
Knee pain ? OK now.. Guess I stressed it too much thru hard running.. I am changing my running form - more gliding vs pounding, more knee bent when landing and shorter strides to reduce the stress. Hope this will work better !
So, my longest LSD to date:
Time : 2:49:17
Distance : 26.08km
Pace : 6:29min/km
Will attempt my 30km this coming weekend !
Knee pain ? OK now.. Guess I stressed it too much thru hard running.. I am changing my running form - more gliding vs pounding, more knee bent when landing and shorter strides to reduce the stress. Hope this will work better !
So, my longest LSD to date:
Time : 2:49:17
Distance : 26.08km
Pace : 6:29min/km
Will attempt my 30km this coming weekend !
Wednesday, October 12, 2011
2012 calendar draft
Drating out my 2012 calendar... I guess I am excited about 2012 runs :P
- Mar x - Malakoff 26k Penang (26k)
- Apr 29 - Bidor Half-Marathon (21k)
- Jun 10 - Laguna Phuket International Marathon (42k) - TH2600 (That's RM260 !!)
- Jun 24 - SCKLM (42k)
- Oct x - Adidas KOTR (16.8k)
- Nov 25 - PBIM (42k)
- Dec 2 - SCMS (21k)
- Mar x - Malakoff 26k Penang (26k)
- Apr 29 - Bidor Half-Marathon (21k)
- Jun 10 - Laguna Phuket International Marathon (42k) - TH2600 (That's RM260 !!)
- Jun 24 - SCKLM (42k)
- Oct x - Adidas KOTR (16.8k)
- Nov 25 - PBIM (42k)
- Dec 2 - SCMS (21k)
Tuesday, October 11, 2011
2012 - a new season !!
There you go.. 3 months before the end of 2011 and 2012 is about to begin soon !!
Kicking off the year is the Jan 1st Newton Run@KL.. Will skip this for sure.. I will be celebrating my new year at home !!
Then closely followed by the Multi Purpose Insurans Run to be held at Padang Merbok, Jalan Parlimen. They only ahve 6k and 12k.. Looks like I will skip this too !
Kicking off the year is the Jan 1st Newton Run@KL.. Will skip this for sure.. I will be celebrating my new year at home !!
Saturday, October 8, 2011
The Big 7 Body Breakdowns (Injuries)... from Runner's World
From the web : http://www.runnersworld.com/article/0,7120,s6-241-285--13841-1-1X2X3X4X5X6X7-8,00.html
The Big 7 Body Breakdowns
How to avoid (and recover from) the most common running injuries.
By Christie Aschwanden
From the March 2011 issue of Runner's World
In an ideal runner's world, every step of every mile would be 100 percent pain-free. No aches, no twinges, no lingering soreness from yesterday's workout. The reality is that many runners constantly deal with a slight (or not so slight) disturbance—a tender foot, a tight hamstring, a whiny knee. While these nagging issues often aren't serious enough to require a time-out, they are annoying, especially when they don't let you fully enjoy your time on the roads.
Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries—call it the red zone, which includes stress fractures that require time off. The other end, where you're in top form, is the green zone. Mild, transient aches that bug you one day and disappear the next sit closer to the green end. Unfortunately, many runners get stuck in the middle—the not-quite-injured but not-quite-healthy yellow zone.
Whether you land in the red, linger in the yellow, or return to the green end of the spectrum depends largely on how you react when that first stab of pain hits, says Richard J. Price, M.D., a sports physician at Rocky Mountain Orthopedic Associates in Grand Junction, Colorado. "Often it comes down to whether you take a little time off now or a lot of time off later," he says. You can reduce your risk of ending up in the red zone if at the first sign of an issue, you back off your mileage, reduce the intensity of your runs, start a treatment program, and develop a proactive long-term injury-prevention strategy, such as strength training, stretching, and regular foam-rolling. "Physical therapy is like homework," Dr. Price says. "None of us likes having to do it, but if you don't do it, the issue will come back."
According to Price and a team of doctors and physical therapists consulted in the following pages, there are seven injury hotspots that most frequently plague runners. If you don't get a handle on them, these issues can trap you in that nefarious yellow zone, or worse, turn into an acute injury that forces you to take a layoff. Here's how you can keep annoying pains in check so you can move into—and, with hope, stay in—the green zone.
1 Runner's Knee
Patellofemoral pain syndrome (PFPS), or "runner's knee," is the irritation of the cartilage on the underside of the patella (kneecap). About 40 percent of running injuries are knee injuries. And 13 percent of runners suffered knee pain in the past year, according to 4,500 respondents to a runnersworld.com poll. PFPS typically flares up during or after long runs, after extended periods of sitting, or while descending hills and stairs.
WHO'S AT RISK?
Anyone with biomechanical factors that put extra load on the knee is vulnerable to PFPS, says Bryan Heiderscheit, Ph.D., P.T., director of the University of Wisconsin Runners' Clinic. Risk factors include overpronation (excessive inward foot rolling) and weak quads, hips, or glutes.
CAN YOU RUN THROUGH IT?
Yes, but taking extra rest days and reducing your mileage is necessary. Run every other day and only as far as you can go without pain. Some runners find that uphill running is less painful, so Heiderscheit recommends simulating hills on a treadmill. Uphill running has the added value of working your glutes. Strong gluteal muscles help control hip and thigh movement, preventing the knees from turning inward. Avoid running downhill, which can exacerbate pain. Bicycling may speed your recovery by strengthening the quads. Elliptical training and swimming are other knee-friendly activities.
REHAB IT
Strengthen weak hip and glute muscles with lateral side steps, says Charlie Merrill, M.S.P.T., a physical therapist at ALTA Physical Therapy in Boulder, Colorado. Place a loop of resistance band just above your ankles or your knees. Separate your feet and bend your knees, lowering down into a slightly crouched position. While staying in this position, walk sideways 10 to 15 steps, keeping your feet straight and your upper body still. Then reverse directions. Keep your feet separated to maintain band tension. When this becomes easy, try doing this on your toes with your heels off the ground. If there's a problem in the way your kneecap tracks, athletic tape may reduce pain (Merrill demonstrates knee taping at runnersworld.com/kneetape). Postrun icing also provides relief in the early stages of this injury. Heat works best once the injury is healing and no longer in an acute stage.
PREVENT A RELAPSE
Heiderscheit recommends shortening your stride length and landing with the knee slightly bent, which can take up to 30 percent load off the joint. Count the number of steps you take per minute and increase by five to 10 percent per minute. Keep your knee tracking correctly by strengthening your knee's support muscles like quads and glutes with exercises like lateral side steps and squats. It's also important to stretch your hip flexors.
ELITE TREATMENT
Marathon silver medalist Meb Keflezighi was building up for the 2010 Boston Marathon last year when he slipped on ice and tweaked his knee. He took two weeks off, ran only every other day for the next two weeks, and then decided not to run a half-marathon in March. The strategy worked: He was the second American at Boston in April, running a 2:09.
Knee Check: How to Proceed
STOP!
Pain on the inside or outside of the knee immediately upon waking, which doesn't go away as the day progresses.
WITH CAUTION
Twinges early in run, dissipate, come back after run. Bothersome after prolonged sitting.
GO RUN!
Completely pain-free even after sitting through a two-hour movie or after going on a hilly long run.
2 Achilles Tendinitis
The Achilles tendon connects the two major calf muscles to the back of the heel. Under too much stress, the tendon tightens and becomes irritated (tendinitis). It makes up 11 percent of all running injuries; eight percent of runnersworld.com poll respondents dealt with it this past year.
WHO'S AT RISK?
Runners who dramatically increase training (especially hills and speedwork) and have tight, weak calves are vulnerable.
CAN YOU RUN THROUGH IT?
"If you have any pain during or after running, stop," says Amol Saxena, D.P.M., a sports podiatrist in Palo Alto, California.
"This is not an injury to run through." If you catch a minor strain early, a few days off might be sufficient healing time. If you keep running as usual, you could develop a serious case that may take six months to go away.
REHAB IT
Five times a day, apply ice. Strengthen the calves with eccentric heel drops: Stand with the balls of your feet on a step. Rise up on both feet. Once up, take your stronger foot off the step. Lower down on your injured foot, dropping your heel below the step. Rise back up, return your other foot to the step. Do 20 reps. Pool-run, use an elliptical machine, and swim, but avoid cycling unless it's not painful.
PREVENT A RELAPSE
Strong calves protect your Achilles from flare-ups, Dr. Price says, so do heel drops daily. Avoid aggressive calf stretching and wearing flip-flops and high heels, all of which can irritate the Achilles.
ELITE TREATMENT
Shannon Rowbury, 1500-meter bronze medalist (2009 World Championships), wears compression socks for hard workouts to relieve Achilles tightness. "It's made a huge difference," she says.
Ankle Alert: How to Proceed
STOP!
Severe pain and swelling above your heel, even when not running. Standing up on your toes causes pain.
WITH CAUTION
Dull pain around your heel at the end of your run that lingers afterward but goes away when iced.
GO RUN!
No pain when you pinch the tendon, starting at the heel and working your way up toward your calf.
3 Hamstring Issues
The muscles that run down the back of our thighs bend our knees, extend our legs, drive us up hills, and power finish-line kicks. So when our hamstrings are too tight or weak to perform well, we notice it. Seven percent of poll respondents say their hamstrings have bugged them this past year.
WHO'S AT RISK?
Hamstring issues usually arise because these muscles are weak—often from being too long or too short. Counterintuitive as it might seem, very flexible people are prone to hamstring problems because their overly stretched-out muscles are more vulnerable to damage. On the flip side, people who can barely touch their toes or who sit for long periods of time are also at risk. Tight, short muscles are under greater tension. Another factor is muscle imbalance: Many runners' quadriceps overpower their hamstrings, which sets them up for injury.
CAN YOU RUN THROUGH IT?
If the pain comes on suddenly and strong and the area bruises, you may have a true pull and you'll need extended rest—months—before you can run again. If it's a less severe, chronic overuse injury, you can usually run, but it'll take some time before you're back in the green zone. "Hamstring issues stink," Price says. "It takes a long time to heal them." Running a slow, easy pace is usually less bothersome than attempting intervals or hill repeats. Bicycling, pool running, and swimming are good alternative activities.
REHAB IT
Strengthen your hamstrings with one-legged hamstring curls (raise the bar with both legs, then slowly lower it one leg at a time) and one-legged deadlifts. Use a foam roller to alleviate tightness before and after a run, Merrill says. In chronic cases, active release technique (ART) and deep-tissue massage may be necessary.
PREVENT A RELAPSE
Stay strong with bridges: Lie on your back with your feet on a chair or exercise ball. Raise your hips, then lift one leg into the air. Slowly lower your hips back down to the floor, using the supporting leg. Return that leg to the ball. Repeat with the other leg. Also, compression tights (see "Home Remedies," below) during or after running can aid blood flow.
ELITE TREATMENT
When U.S. champion miler David Torrence felt his hamstring tighten up, he took the next day off and went to his chiropractor. "My pelvis was misaligned, causing my hamstring to do extra work," he says. "I took it easy for a few days, iced the hamstring four times throughout the day, and was improved within a week."
Hamstring Signs: How to Proceed
STOP!
Sharp, sudden, strong pain and possibly even a snap or pop sound while running. The area is bruised.
WITH CAUTION
Chronic achiness and tightness that forces you to slow your pace and shorten your stride.
GO RUN!
Pain-free while climbing hills and doing speedwork, even after long periods of sitting.
4 Plantar Fasciitis
It's not shocking that about 15 percent of all running injuries strike the foot—with each step, our feet absorb a force several times our body weight. Plantar fasciitis, small tears or inflammation of the tendons and ligaments that run from your heel to your toes, is usually the top foot complaint among runners—10 percent of runnersworld.com poll respondents struggled with it this past year. The pain, which typically feels like a dull ache or bruise along your arch or on the bottom of your heel, is usually worse first thing in the morning.
WHO'S AT RISK?
Runners with very high or very low arches are vulnerable, Saxena says, because both foot types cause the plantar fascia to be stretched away from the heel bone. Other causes are extreme pronation (foot rolls inward excessively) or supination (foot rolls outward excessively) and increasing your mileage too quickly. Long periods of standing, especially on hard floors without supportive footwear, may exacerbate the problem. Tight hip flexors, weak core muscles, and a history of lower back pain can also contribute. "Back issues and core weakness can lead to subtle changes in your stride that you'll feel in the feet," Merrill says.
CAN YOU RUN THROUGH IT?
Plantar fasciitis is one of the most notoriously nagging injuries, and running through it, while possible, can delay healing. Recovery time can range from three months to a year, but six months is fairly typical, Saxena says. In chronic cases, a complete break from running is usually best. Pool running and swimming keep pressure off your feet. Cycling or using an elliptical can help you maintain fitness, but only if you can do those activities without pain. Wearing a Strassburg Sock (see "Home Remedies," below) while you relax keeps your arch from tightening up.
REHAB IT
Roll your foot over a frozen water bottle for five minutes at a time, five times a day, Saxena says. To stretch your plantar fascia, sit with one leg crossed over the other so that your right ankle rests on your left knee. Grab the end of your right foot at the toes and gently pull back. Because calf tightness can be a factor, Merrill also recommends using a foam roller to loosen them up. He also stresses the importance of doing core work (planks, back extensions). "When I see someone who has had plantar pain for years, they're almost always missing core strength," Merrill says. "Sometimes all they need is some core work and their heel gets better. A stable core reduces stress on the spine and stops pain transference to the foot."
PREVENT A RELAPSE
Make sure your shoes fit your foot type by getting an analysis at a running shoe store or from a podiatrist or physical therapist, says Saxena. A custom orthotic may even help. Stretch and massage the plantar fascia several times a day. In the morning, hang your feet over the edge of the bed and roll your ankles. Do core work at least twice a week.
ELITE TREATMENT
Magdalena Lewy Boulet, a 2:26 marathoner, struggled with plantar fasciitis in 2007 that became so severe she contemplated ending her career. "I got on a rehab routine that included active-isolated stretching, and it cured me," she says. "Now it's part of my maintenance routine. I do it for about 15 minutes twice a day."
Foot Wary: How to Proceed
STOP!
Ongoing, ever-present arch pain and tenderness that doesn't seem to fade even once you've warmed up on a run.
WITH CAUTION
Pain when you step out of bed, get up after sitting for a long time, or during the first few minutes of a run.
GO RUN!
Pain-free all day, including your first steps in the morning. Walking barefoot on hard surfaces isn't an issue.
5 Shinsplints
"Shinsplints" refers to medial tibial stress syndrome, an achy pain that results when small tears occur in the muscles around your tibia (shin bone). This makes up about 15 percent of running injuries; 10 percent of runnersworld.com respondents poll had shinsplints in the past year.
WHO'S AT RISK?
Shinsplints are common among new runners and those returning after an extended layoff. They're a sign that you've done too much, too quickly, Dr. Price says. Shinsplints strike runners wearing the wrong shoe or a pair with too many miles, and those with high arches or flat feet.
CAN YOU RUN THROUGH IT?
When the first twinges of pain strike, back off your running to a comfortable level for a few days to a week, then slowly up your mileage using the 10 percent rule (no more than 10 percent increase per week). Bike, pool run, and swim.
REHAB IT
Rest, ice, and ibuprofen can ease the pain. Though conventional wisdom has preached calf stretching as a way to rehabilitate shinsplints, there's little evidence that helps, Price says. Taping the shin with Kinesio Tex tape can relieve pain and speed healing. (See how at runnersworld.com/shintape.) Wearing an air cast ankle brace throughout the day—even while running—can speed recovery. These braces stabilize the ankle so the shin muscles don't have to work so hard to support your leg, Saxena says.
PREVENT A RELAPSE
The easiest and best way to avoid shinsplints is to increase mileage gradually. Saxena also says to make sure you are in an appropriate shoe. Beginners, especially, can benefit from the professional help at a specialty running shop. If you have high arches, you may need a cushioned shoe. Or if you have flat feet, a rigid shoe might be the solution, he says.
ELITE TREATMENT
Once or twice a month, miler David Torrence jumps in a game of pickup basketball or soccer. "The lateral movement uses your muscles differently than running in one direction," he says. "It's helped me manage my shinsplints."
Shin Signs: How to Proceed
STOP!
Tenderness down the leg, especially if you hop on it. If walking (not just running) hurts, it could be a fracture.
WITH CAUTION
Tight, aching pain when running, but the pain goes away when you stop. Hopping isn't painful.
GO RUN!
Completely pain-free while running—even long after you stop applying ice and taping your shins.
6 Iliotibial Band Syndrome (ITBS)
The iliotibial (IT) band lies along the outside of the thigh from the hip to the knee. When you run, your knee flexes and extends, which causes the IT band to rub on the side of the femur. This can cause irritation if you take up your mileage too quickly, especially if you're doing a lot of track work or downhill running. ITBS makes up 12 percent of all running injuries; 14 percent of poll respondents experienced this in the past year.
WHO'S AT RISK?
Runners who develop ITBS may overpronate, have a leg-length discrepancy, or suffer from weak hip abductor and gluteal muscles. "If your hip motion is not well controlled, then your IT band gets stretched with your running stride, and that can irritate it," Heiderscheit says.
CAN YOU RUN THROUGH IT?
ITBS is known as a stubborn, nagging injury. Take a rest day or two and back off your mileage for a week, and you could avoid a full-blown flare-up, Dr. Price says. If you ignore the first symptoms and continue training at your usual mileage and intensity, you can exacerbate it.
REHAB IT
Strengthen the hip abductors with lateral side steps, side leg lifts, and one-legged squats. Use a foam roller before and after you run: Rest the outside of your thigh on top of the roller, and roll your IT band from your knee to your hip. Hiking and bicycling can aggravate ITBS. Instead, swim, pool-run, and use an elliptical trainer.
PREVENT A RELAPSE
Continue exercises and foam-rolling. Change directions every few laps while on a track, and limit how often you do hilly routes, Heiderscheit says. IT band issues often get better if you can learn to shorten your stride so that your weight centers on the front of the heel or the midfoot as you land. "A five to 10 percent difference in your stride length can make a huge difference," Heiderscheit says.
ELITE TREATMENT
Two-time Olympian (5000 meters) Bolota Asmerom, of Oakland, California, dealt with ITBS when he took up his training to 70 miles a week in 1999. "I got relief through massage, strength, and flexibility work," he says. "I've stayed injury-free since then because I take care of every ache with massage and ice. I also try to avoid doing too much track running."
Thigh Anxiety: How to Proceed
STOP!
Pain on the outside of the knee that radiates up and down your leg when just walking down a hill or stairs.
WITH CAUTION
Twinges on the outside of the knee appear 10 minutes into a run, but disappear during a walk break.
GO RUN!
Outer knee and thigh are completely pain-free even after running a hilly route or circling a track.
7 Stress Fracture
Unlike an acute fracture that happens as the result of a slip or fall, stress fractures develop as a result of cumulative strain on the bone. Runners most often have stress fractures in their tibias (shin), metatarsals (feet), or calcaneus (heels). They are one of the most serious of all running injuries; almost six percent of poll respondents had one in the past year.
WHO'S AT RISK?
Runners who overtrain. Bones need downtime to rebuild after a workout. If you increase the duration, intensity, or frequency of your running too soon, your bones can't repair themselves fast enough to keep up. Stress fractures are more common in women than men, usually due to nutritional deficits, low estrogen levels, and inadequate calorie intake. Luckily, weight-bearing exercise like running is protective, which means experience is on your side. "The longer you've been running, the lower your risk is," Dr. Price says.
CAN YOU RUN THROUGH IT?
In a word: no. Expect to take eight to 16 weeks off from running. The amount of rest you'll need depends on the severity of the fracture and its location. Weight-bearing bones like those in the foot heal slower than those in the shin, for example. And if you ran through the pain for a while before you realized you had a fracture, your recovery could take longer, Merrill says. Avoid all impact exercise. Instead, pool-run and swim.
REHAB IT
Listen—well—to your body. "Once you can walk without any pain, you can try a bit of jogging," Dr. Price says. "But you have to back off if there is lingering pain. It's crucial that you build your mileage slowly—start with just a few minutes."
PREVENT A RELAPSE
Improve bone density with weight training, and make sure you're getting enough calories and nutrients. Contrary to popular belief, running surfaces don't seem to make a difference. "It makes sense that running on soft surfaces like grass would be better than roads, but studies have not borne that out," Dr. Price says.
ELITE TREATMENT
Some people with stress fractures can maintain fitness with pool running. "When Deena Kastor suffered a broken bone in her foot during the 2008 Olympic Marathon, she had to take six weeks off," Dr. Price says. "Daily pool running kept her strong." After making a recovery, she ran a 2:28 Chicago Marathon in 2009.
Bone Scan: How to Proceed
STOP!
Pain builds up as you run. But it doesn't just hurt when you run; just being on your feet is uncomfortable.
WITH CAUTION
Sorry, no middle ground here. With this injury, you are either in the red or in the green zone.
GO RUN!
Pain-free throughout a run and no lingering pain afterward, even when you've been on your feet all day.
Home Remedies
Tools to help you stay injury-free
THE PROBLEM: Foot, shin, ankle pain
THE FIX: Zoot Active Compression socks $60 These snug-fitting socks improve circulation, reduce swelling, and keep muscles and tendons warm. zootsports.com
THE PROBLEM: Achy hamstrings and knees during a run
THE FIX: Saucony AMP PRO2 Training Tight $110 Sturdy fabric may support major leg muscles in an effort to delay muscle fatigue. saucony.com
THE PROBLEM: Hamstring weakness, knee pain
THE FIX: Thera-band $4 and up
These stretchy bands enable you to do resistance training and physical therapy at home. optp.com
THE PROBLEM: Achilles tendinitis, calf soreness, shinsplints
THE FIX: 2XU's Compression Calf Guards $55
Footless sleeves support the shins, calves, and Achilles. It's an alternative to taping for shinsplints. 2xu.com
THE PROBLEM: Plantar fasciitis
THE FIX: The Strassburg Sock $40
These socks keep your arches in a stretched position so that irritated plantar fascia can heal optimally while you rest. thesock.com
THE PROBLEM: Sore hamstrings and knees after a run
THE FIX: Zoot Recovery Compress RX $150
These tights are similar to training versions, but with more compression to ease postexercise soreness. They feel sort of like a massage—a soothing pressure on your sore muscles. zootsports.com
THE PROBLEM: Tight iliotibial bands, hamstrings, calves
THE FIX: PB Elite Molded Foam Rollers $6 to $20
A weekly professional sports massage is great, if you can afford it. But with a foam roller, you can get many of the same benefits from self-massage at home. performbetter.com
Brain Drain
The big 5 mental breakdowns
MENTAL BREAKDOWN #1: Seeking perfection
If you aim to make every workout perfect, you end up spending valuable time and energy recovering from the inevitable disappointment. Learn to view a few off days as part of the training process, or a lousy run or race as a learning experience, says Stan Beecham, Psy.D., a sports psychologist in Roswell, Georgia.
MENTAL BREAKDOWN #2: Caring too much
Some runners never feel good about themselves, no matter how well they run. "I remind athletes that running is something they do, not who they are," he says. Once you untie yourself from your performance, you release mental energy that can be directed to running.
MENTAL BREAKDOWN #3: Stressing out
Is the weather too cold? Too hot? Are the lines at the porta-potties too long? Don't stress over things you can't control. "Your performance is based on your training, not on external items," he says.
MENTAL BREAKDOWN #4: Poor goal setting
Performing at your highest level requires risk-taking and pushing yourself outside your comfort level. "A lot of runners underestimate themselves," Beecham says. "They say: 'I can cut five minutes from my time.' I say: 'How about 10 minutes?'" Don't go crazy, but push yourself.
MENTAL BREAKDOWN #5: Not focusing
If you approach a race as a run or with a let's-see-what-happens attitude, you risk not meeting your goal. "You have to engage mentally," Beecham says. Set small goals, such as staying with the runner in front of you. Try it, he says, and you'll likely find the race goes by faster than expected. Your time just might be faster, too.
—MICHELLE HAMILTON
The Big 7 Body Breakdowns
How to avoid (and recover from) the most common running injuries.
By Christie Aschwanden
From the March 2011 issue of Runner's World
In an ideal runner's world, every step of every mile would be 100 percent pain-free. No aches, no twinges, no lingering soreness from yesterday's workout. The reality is that many runners constantly deal with a slight (or not so slight) disturbance—a tender foot, a tight hamstring, a whiny knee. While these nagging issues often aren't serious enough to require a time-out, they are annoying, especially when they don't let you fully enjoy your time on the roads.
Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries—call it the red zone, which includes stress fractures that require time off. The other end, where you're in top form, is the green zone. Mild, transient aches that bug you one day and disappear the next sit closer to the green end. Unfortunately, many runners get stuck in the middle—the not-quite-injured but not-quite-healthy yellow zone.
Whether you land in the red, linger in the yellow, or return to the green end of the spectrum depends largely on how you react when that first stab of pain hits, says Richard J. Price, M.D., a sports physician at Rocky Mountain Orthopedic Associates in Grand Junction, Colorado. "Often it comes down to whether you take a little time off now or a lot of time off later," he says. You can reduce your risk of ending up in the red zone if at the first sign of an issue, you back off your mileage, reduce the intensity of your runs, start a treatment program, and develop a proactive long-term injury-prevention strategy, such as strength training, stretching, and regular foam-rolling. "Physical therapy is like homework," Dr. Price says. "None of us likes having to do it, but if you don't do it, the issue will come back."
According to Price and a team of doctors and physical therapists consulted in the following pages, there are seven injury hotspots that most frequently plague runners. If you don't get a handle on them, these issues can trap you in that nefarious yellow zone, or worse, turn into an acute injury that forces you to take a layoff. Here's how you can keep annoying pains in check so you can move into—and, with hope, stay in—the green zone.
1 Runner's Knee
Patellofemoral pain syndrome (PFPS), or "runner's knee," is the irritation of the cartilage on the underside of the patella (kneecap). About 40 percent of running injuries are knee injuries. And 13 percent of runners suffered knee pain in the past year, according to 4,500 respondents to a runnersworld.com poll. PFPS typically flares up during or after long runs, after extended periods of sitting, or while descending hills and stairs.
WHO'S AT RISK?
Anyone with biomechanical factors that put extra load on the knee is vulnerable to PFPS, says Bryan Heiderscheit, Ph.D., P.T., director of the University of Wisconsin Runners' Clinic. Risk factors include overpronation (excessive inward foot rolling) and weak quads, hips, or glutes.
CAN YOU RUN THROUGH IT?
Yes, but taking extra rest days and reducing your mileage is necessary. Run every other day and only as far as you can go without pain. Some runners find that uphill running is less painful, so Heiderscheit recommends simulating hills on a treadmill. Uphill running has the added value of working your glutes. Strong gluteal muscles help control hip and thigh movement, preventing the knees from turning inward. Avoid running downhill, which can exacerbate pain. Bicycling may speed your recovery by strengthening the quads. Elliptical training and swimming are other knee-friendly activities.
REHAB IT
Strengthen weak hip and glute muscles with lateral side steps, says Charlie Merrill, M.S.P.T., a physical therapist at ALTA Physical Therapy in Boulder, Colorado. Place a loop of resistance band just above your ankles or your knees. Separate your feet and bend your knees, lowering down into a slightly crouched position. While staying in this position, walk sideways 10 to 15 steps, keeping your feet straight and your upper body still. Then reverse directions. Keep your feet separated to maintain band tension. When this becomes easy, try doing this on your toes with your heels off the ground. If there's a problem in the way your kneecap tracks, athletic tape may reduce pain (Merrill demonstrates knee taping at runnersworld.com/kneetape). Postrun icing also provides relief in the early stages of this injury. Heat works best once the injury is healing and no longer in an acute stage.
PREVENT A RELAPSE
Heiderscheit recommends shortening your stride length and landing with the knee slightly bent, which can take up to 30 percent load off the joint. Count the number of steps you take per minute and increase by five to 10 percent per minute. Keep your knee tracking correctly by strengthening your knee's support muscles like quads and glutes with exercises like lateral side steps and squats. It's also important to stretch your hip flexors.
ELITE TREATMENT
Marathon silver medalist Meb Keflezighi was building up for the 2010 Boston Marathon last year when he slipped on ice and tweaked his knee. He took two weeks off, ran only every other day for the next two weeks, and then decided not to run a half-marathon in March. The strategy worked: He was the second American at Boston in April, running a 2:09.
Knee Check: How to Proceed
STOP!
Pain on the inside or outside of the knee immediately upon waking, which doesn't go away as the day progresses.
WITH CAUTION
Twinges early in run, dissipate, come back after run. Bothersome after prolonged sitting.
GO RUN!
Completely pain-free even after sitting through a two-hour movie or after going on a hilly long run.
2 Achilles Tendinitis
The Achilles tendon connects the two major calf muscles to the back of the heel. Under too much stress, the tendon tightens and becomes irritated (tendinitis). It makes up 11 percent of all running injuries; eight percent of runnersworld.com poll respondents dealt with it this past year.
WHO'S AT RISK?
Runners who dramatically increase training (especially hills and speedwork) and have tight, weak calves are vulnerable.
CAN YOU RUN THROUGH IT?
"If you have any pain during or after running, stop," says Amol Saxena, D.P.M., a sports podiatrist in Palo Alto, California.
"This is not an injury to run through." If you catch a minor strain early, a few days off might be sufficient healing time. If you keep running as usual, you could develop a serious case that may take six months to go away.
REHAB IT
Five times a day, apply ice. Strengthen the calves with eccentric heel drops: Stand with the balls of your feet on a step. Rise up on both feet. Once up, take your stronger foot off the step. Lower down on your injured foot, dropping your heel below the step. Rise back up, return your other foot to the step. Do 20 reps. Pool-run, use an elliptical machine, and swim, but avoid cycling unless it's not painful.
PREVENT A RELAPSE
Strong calves protect your Achilles from flare-ups, Dr. Price says, so do heel drops daily. Avoid aggressive calf stretching and wearing flip-flops and high heels, all of which can irritate the Achilles.
ELITE TREATMENT
Shannon Rowbury, 1500-meter bronze medalist (2009 World Championships), wears compression socks for hard workouts to relieve Achilles tightness. "It's made a huge difference," she says.
Ankle Alert: How to Proceed
STOP!
Severe pain and swelling above your heel, even when not running. Standing up on your toes causes pain.
WITH CAUTION
Dull pain around your heel at the end of your run that lingers afterward but goes away when iced.
GO RUN!
No pain when you pinch the tendon, starting at the heel and working your way up toward your calf.
3 Hamstring Issues
The muscles that run down the back of our thighs bend our knees, extend our legs, drive us up hills, and power finish-line kicks. So when our hamstrings are too tight or weak to perform well, we notice it. Seven percent of poll respondents say their hamstrings have bugged them this past year.
WHO'S AT RISK?
Hamstring issues usually arise because these muscles are weak—often from being too long or too short. Counterintuitive as it might seem, very flexible people are prone to hamstring problems because their overly stretched-out muscles are more vulnerable to damage. On the flip side, people who can barely touch their toes or who sit for long periods of time are also at risk. Tight, short muscles are under greater tension. Another factor is muscle imbalance: Many runners' quadriceps overpower their hamstrings, which sets them up for injury.
CAN YOU RUN THROUGH IT?
If the pain comes on suddenly and strong and the area bruises, you may have a true pull and you'll need extended rest—months—before you can run again. If it's a less severe, chronic overuse injury, you can usually run, but it'll take some time before you're back in the green zone. "Hamstring issues stink," Price says. "It takes a long time to heal them." Running a slow, easy pace is usually less bothersome than attempting intervals or hill repeats. Bicycling, pool running, and swimming are good alternative activities.
REHAB IT
Strengthen your hamstrings with one-legged hamstring curls (raise the bar with both legs, then slowly lower it one leg at a time) and one-legged deadlifts. Use a foam roller to alleviate tightness before and after a run, Merrill says. In chronic cases, active release technique (ART) and deep-tissue massage may be necessary.
PREVENT A RELAPSE
Stay strong with bridges: Lie on your back with your feet on a chair or exercise ball. Raise your hips, then lift one leg into the air. Slowly lower your hips back down to the floor, using the supporting leg. Return that leg to the ball. Repeat with the other leg. Also, compression tights (see "Home Remedies," below) during or after running can aid blood flow.
ELITE TREATMENT
When U.S. champion miler David Torrence felt his hamstring tighten up, he took the next day off and went to his chiropractor. "My pelvis was misaligned, causing my hamstring to do extra work," he says. "I took it easy for a few days, iced the hamstring four times throughout the day, and was improved within a week."
Hamstring Signs: How to Proceed
STOP!
Sharp, sudden, strong pain and possibly even a snap or pop sound while running. The area is bruised.
WITH CAUTION
Chronic achiness and tightness that forces you to slow your pace and shorten your stride.
GO RUN!
Pain-free while climbing hills and doing speedwork, even after long periods of sitting.
4 Plantar Fasciitis
It's not shocking that about 15 percent of all running injuries strike the foot—with each step, our feet absorb a force several times our body weight. Plantar fasciitis, small tears or inflammation of the tendons and ligaments that run from your heel to your toes, is usually the top foot complaint among runners—10 percent of runnersworld.com poll respondents struggled with it this past year. The pain, which typically feels like a dull ache or bruise along your arch or on the bottom of your heel, is usually worse first thing in the morning.
WHO'S AT RISK?
Runners with very high or very low arches are vulnerable, Saxena says, because both foot types cause the plantar fascia to be stretched away from the heel bone. Other causes are extreme pronation (foot rolls inward excessively) or supination (foot rolls outward excessively) and increasing your mileage too quickly. Long periods of standing, especially on hard floors without supportive footwear, may exacerbate the problem. Tight hip flexors, weak core muscles, and a history of lower back pain can also contribute. "Back issues and core weakness can lead to subtle changes in your stride that you'll feel in the feet," Merrill says.
CAN YOU RUN THROUGH IT?
Plantar fasciitis is one of the most notoriously nagging injuries, and running through it, while possible, can delay healing. Recovery time can range from three months to a year, but six months is fairly typical, Saxena says. In chronic cases, a complete break from running is usually best. Pool running and swimming keep pressure off your feet. Cycling or using an elliptical can help you maintain fitness, but only if you can do those activities without pain. Wearing a Strassburg Sock (see "Home Remedies," below) while you relax keeps your arch from tightening up.
REHAB IT
Roll your foot over a frozen water bottle for five minutes at a time, five times a day, Saxena says. To stretch your plantar fascia, sit with one leg crossed over the other so that your right ankle rests on your left knee. Grab the end of your right foot at the toes and gently pull back. Because calf tightness can be a factor, Merrill also recommends using a foam roller to loosen them up. He also stresses the importance of doing core work (planks, back extensions). "When I see someone who has had plantar pain for years, they're almost always missing core strength," Merrill says. "Sometimes all they need is some core work and their heel gets better. A stable core reduces stress on the spine and stops pain transference to the foot."
PREVENT A RELAPSE
Make sure your shoes fit your foot type by getting an analysis at a running shoe store or from a podiatrist or physical therapist, says Saxena. A custom orthotic may even help. Stretch and massage the plantar fascia several times a day. In the morning, hang your feet over the edge of the bed and roll your ankles. Do core work at least twice a week.
ELITE TREATMENT
Magdalena Lewy Boulet, a 2:26 marathoner, struggled with plantar fasciitis in 2007 that became so severe she contemplated ending her career. "I got on a rehab routine that included active-isolated stretching, and it cured me," she says. "Now it's part of my maintenance routine. I do it for about 15 minutes twice a day."
Foot Wary: How to Proceed
STOP!
Ongoing, ever-present arch pain and tenderness that doesn't seem to fade even once you've warmed up on a run.
WITH CAUTION
Pain when you step out of bed, get up after sitting for a long time, or during the first few minutes of a run.
GO RUN!
Pain-free all day, including your first steps in the morning. Walking barefoot on hard surfaces isn't an issue.
5 Shinsplints
"Shinsplints" refers to medial tibial stress syndrome, an achy pain that results when small tears occur in the muscles around your tibia (shin bone). This makes up about 15 percent of running injuries; 10 percent of runnersworld.com respondents poll had shinsplints in the past year.
WHO'S AT RISK?
Shinsplints are common among new runners and those returning after an extended layoff. They're a sign that you've done too much, too quickly, Dr. Price says. Shinsplints strike runners wearing the wrong shoe or a pair with too many miles, and those with high arches or flat feet.
CAN YOU RUN THROUGH IT?
When the first twinges of pain strike, back off your running to a comfortable level for a few days to a week, then slowly up your mileage using the 10 percent rule (no more than 10 percent increase per week). Bike, pool run, and swim.
REHAB IT
Rest, ice, and ibuprofen can ease the pain. Though conventional wisdom has preached calf stretching as a way to rehabilitate shinsplints, there's little evidence that helps, Price says. Taping the shin with Kinesio Tex tape can relieve pain and speed healing. (See how at runnersworld.com/shintape.) Wearing an air cast ankle brace throughout the day—even while running—can speed recovery. These braces stabilize the ankle so the shin muscles don't have to work so hard to support your leg, Saxena says.
PREVENT A RELAPSE
The easiest and best way to avoid shinsplints is to increase mileage gradually. Saxena also says to make sure you are in an appropriate shoe. Beginners, especially, can benefit from the professional help at a specialty running shop. If you have high arches, you may need a cushioned shoe. Or if you have flat feet, a rigid shoe might be the solution, he says.
ELITE TREATMENT
Once or twice a month, miler David Torrence jumps in a game of pickup basketball or soccer. "The lateral movement uses your muscles differently than running in one direction," he says. "It's helped me manage my shinsplints."
Shin Signs: How to Proceed
STOP!
Tenderness down the leg, especially if you hop on it. If walking (not just running) hurts, it could be a fracture.
WITH CAUTION
Tight, aching pain when running, but the pain goes away when you stop. Hopping isn't painful.
GO RUN!
Completely pain-free while running—even long after you stop applying ice and taping your shins.
6 Iliotibial Band Syndrome (ITBS)
The iliotibial (IT) band lies along the outside of the thigh from the hip to the knee. When you run, your knee flexes and extends, which causes the IT band to rub on the side of the femur. This can cause irritation if you take up your mileage too quickly, especially if you're doing a lot of track work or downhill running. ITBS makes up 12 percent of all running injuries; 14 percent of poll respondents experienced this in the past year.
WHO'S AT RISK?
Runners who develop ITBS may overpronate, have a leg-length discrepancy, or suffer from weak hip abductor and gluteal muscles. "If your hip motion is not well controlled, then your IT band gets stretched with your running stride, and that can irritate it," Heiderscheit says.
CAN YOU RUN THROUGH IT?
ITBS is known as a stubborn, nagging injury. Take a rest day or two and back off your mileage for a week, and you could avoid a full-blown flare-up, Dr. Price says. If you ignore the first symptoms and continue training at your usual mileage and intensity, you can exacerbate it.
REHAB IT
Strengthen the hip abductors with lateral side steps, side leg lifts, and one-legged squats. Use a foam roller before and after you run: Rest the outside of your thigh on top of the roller, and roll your IT band from your knee to your hip. Hiking and bicycling can aggravate ITBS. Instead, swim, pool-run, and use an elliptical trainer.
PREVENT A RELAPSE
Continue exercises and foam-rolling. Change directions every few laps while on a track, and limit how often you do hilly routes, Heiderscheit says. IT band issues often get better if you can learn to shorten your stride so that your weight centers on the front of the heel or the midfoot as you land. "A five to 10 percent difference in your stride length can make a huge difference," Heiderscheit says.
ELITE TREATMENT
Two-time Olympian (5000 meters) Bolota Asmerom, of Oakland, California, dealt with ITBS when he took up his training to 70 miles a week in 1999. "I got relief through massage, strength, and flexibility work," he says. "I've stayed injury-free since then because I take care of every ache with massage and ice. I also try to avoid doing too much track running."
Thigh Anxiety: How to Proceed
STOP!
Pain on the outside of the knee that radiates up and down your leg when just walking down a hill or stairs.
WITH CAUTION
Twinges on the outside of the knee appear 10 minutes into a run, but disappear during a walk break.
GO RUN!
Outer knee and thigh are completely pain-free even after running a hilly route or circling a track.
7 Stress Fracture
Unlike an acute fracture that happens as the result of a slip or fall, stress fractures develop as a result of cumulative strain on the bone. Runners most often have stress fractures in their tibias (shin), metatarsals (feet), or calcaneus (heels). They are one of the most serious of all running injuries; almost six percent of poll respondents had one in the past year.
WHO'S AT RISK?
Runners who overtrain. Bones need downtime to rebuild after a workout. If you increase the duration, intensity, or frequency of your running too soon, your bones can't repair themselves fast enough to keep up. Stress fractures are more common in women than men, usually due to nutritional deficits, low estrogen levels, and inadequate calorie intake. Luckily, weight-bearing exercise like running is protective, which means experience is on your side. "The longer you've been running, the lower your risk is," Dr. Price says.
CAN YOU RUN THROUGH IT?
In a word: no. Expect to take eight to 16 weeks off from running. The amount of rest you'll need depends on the severity of the fracture and its location. Weight-bearing bones like those in the foot heal slower than those in the shin, for example. And if you ran through the pain for a while before you realized you had a fracture, your recovery could take longer, Merrill says. Avoid all impact exercise. Instead, pool-run and swim.
REHAB IT
Listen—well—to your body. "Once you can walk without any pain, you can try a bit of jogging," Dr. Price says. "But you have to back off if there is lingering pain. It's crucial that you build your mileage slowly—start with just a few minutes."
PREVENT A RELAPSE
Improve bone density with weight training, and make sure you're getting enough calories and nutrients. Contrary to popular belief, running surfaces don't seem to make a difference. "It makes sense that running on soft surfaces like grass would be better than roads, but studies have not borne that out," Dr. Price says.
ELITE TREATMENT
Some people with stress fractures can maintain fitness with pool running. "When Deena Kastor suffered a broken bone in her foot during the 2008 Olympic Marathon, she had to take six weeks off," Dr. Price says. "Daily pool running kept her strong." After making a recovery, she ran a 2:28 Chicago Marathon in 2009.
Bone Scan: How to Proceed
STOP!
Pain builds up as you run. But it doesn't just hurt when you run; just being on your feet is uncomfortable.
WITH CAUTION
Sorry, no middle ground here. With this injury, you are either in the red or in the green zone.
GO RUN!
Pain-free throughout a run and no lingering pain afterward, even when you've been on your feet all day.
Home Remedies
Tools to help you stay injury-free
THE PROBLEM: Foot, shin, ankle pain
THE FIX: Zoot Active Compression socks $60 These snug-fitting socks improve circulation, reduce swelling, and keep muscles and tendons warm. zootsports.com
THE PROBLEM: Achy hamstrings and knees during a run
THE FIX: Saucony AMP PRO2 Training Tight $110 Sturdy fabric may support major leg muscles in an effort to delay muscle fatigue. saucony.com
THE PROBLEM: Hamstring weakness, knee pain
THE FIX: Thera-band $4 and up
These stretchy bands enable you to do resistance training and physical therapy at home. optp.com
THE PROBLEM: Achilles tendinitis, calf soreness, shinsplints
THE FIX: 2XU's Compression Calf Guards $55
Footless sleeves support the shins, calves, and Achilles. It's an alternative to taping for shinsplints. 2xu.com
THE PROBLEM: Plantar fasciitis
THE FIX: The Strassburg Sock $40
These socks keep your arches in a stretched position so that irritated plantar fascia can heal optimally while you rest. thesock.com
THE PROBLEM: Sore hamstrings and knees after a run
THE FIX: Zoot Recovery Compress RX $150
These tights are similar to training versions, but with more compression to ease postexercise soreness. They feel sort of like a massage—a soothing pressure on your sore muscles. zootsports.com
THE PROBLEM: Tight iliotibial bands, hamstrings, calves
THE FIX: PB Elite Molded Foam Rollers $6 to $20
A weekly professional sports massage is great, if you can afford it. But with a foam roller, you can get many of the same benefits from self-massage at home. performbetter.com
Brain Drain
The big 5 mental breakdowns
MENTAL BREAKDOWN #1: Seeking perfection
If you aim to make every workout perfect, you end up spending valuable time and energy recovering from the inevitable disappointment. Learn to view a few off days as part of the training process, or a lousy run or race as a learning experience, says Stan Beecham, Psy.D., a sports psychologist in Roswell, Georgia.
MENTAL BREAKDOWN #2: Caring too much
Some runners never feel good about themselves, no matter how well they run. "I remind athletes that running is something they do, not who they are," he says. Once you untie yourself from your performance, you release mental energy that can be directed to running.
MENTAL BREAKDOWN #3: Stressing out
Is the weather too cold? Too hot? Are the lines at the porta-potties too long? Don't stress over things you can't control. "Your performance is based on your training, not on external items," he says.
MENTAL BREAKDOWN #4: Poor goal setting
Performing at your highest level requires risk-taking and pushing yourself outside your comfort level. "A lot of runners underestimate themselves," Beecham says. "They say: 'I can cut five minutes from my time.' I say: 'How about 10 minutes?'" Don't go crazy, but push yourself.
MENTAL BREAKDOWN #5: Not focusing
If you approach a race as a run or with a let's-see-what-happens attitude, you risk not meeting your goal. "You have to engage mentally," Beecham says. Set small goals, such as staying with the runner in front of you. Try it, he says, and you'll likely find the race goes by faster than expected. Your time just might be faster, too.
—MICHELLE HAMILTON
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