RUNNERS – LISTEN TO YOUR BODY!

njuries often have a prodromal period. That means a part (or parts) of your body will send you signals that things aren't quite right. Your sore foot, Achilles, hamstrings, or shins may not necessarily become quickly evident at first. You may notice it in the morning when you arise or at the beginning of your run, but it fades and disappears as you continue. Granted there is a distinction between ‘good pains’ and ‘bad pains’. For instance, delayed onset muscle soreness is a good type of pain that is proportional to the intensity of training. The deep muscle pain appears within a day or two of your longer runs and wanes with light exercise and anti-inflammatories. Bad types of pain present differently. They are almost always there whether running or not and should not be run through. This type of pain may be accompanied by certain visual changes such as swelling, redness, or painful lumps, auditory changes such as pops, grinding or snapping, or sudden weakness of the ankle or foot. These acute signals may need the evaluation of the sports physician. Heed the warning signals carefully as a failure to do so may cause benign problems to develop into a frank injury, ultimately ruining your ability to enjoy healthy workouts and race. Attempts to push the envelope too far in an effort to prepare for an event often results in injury that can ruin the entire racing season. I have seen too many runners suffering from torn fascia, tendons, and fractures because of exuberant training techniques. Some of this is maybe self-inflicted by the athletes themselves, their enthusiastic coaches, or parents relying too much on the Internet for information and treatment. Too many injuries are sustained by runners trying to cram in more miles and speed-work right before a race. Unlike a final exam, you can’t cram for a race or event. Your body is not conditioned to withstand a sudden increase in volume or intensity without breaking down. Follow the time tested10% rule by increasing your total running mileage by 10% a week. This will allow your bones, muscles, and joints to adapt safely.

Warm-up by walking at least 1/4 mile before stretching. Attend early signals (prodromes) by adjusting your speed and mileage accordingly. Alter your running form, as in the case of a sore Achilles

By Dr. Michael M. Cohen, DPM, FACFAS

Ior hamstring by shortening your stride, staying away from inclines and hills, and learning to roll over the ankle rather than emphasizing the push-off. Try to land in the middle of the foot rather than running on your toes. Check to make sure your running gear is appropriate for you. Your running shoe should be appropriate for the distance, and type of foot you have. Running shoes should be discarded after 400 miles of running or walking, especially in Florida where the EVA (the white stuff in the outsole of the running shoe) collapses quickly in the summer heat. EVA is constructed from blown rubber which provides cushioning during the run. After a run, the air cells in the rubber collapse and require 24-48 hours to re-expand. So, consider purchasing two pairs of the same shoe and alternate daily to allow for maximum shock absorption. Try to stay away from flats (light flexible racing shoes) during the prodrome period or when recovering from an injury. Make sure to ice after running and use anti-inflammatories judiciously, you do not want to mask important signals.

When feeling the prodrome skip a day or two of running, or better yet alternate every other day with cross-training instead. You’ll find that sports-specific cross-training will improve your running technique. This may include stretching your calves and hamstrings, aqua-jogging, and strength training. Do your best to avoid running back-to-back ‘hard’ days, especially if you are over forty. Rest is an extremely important part of training; it’s virtually impossible to improve without a proper recovery. When resuming your runs after injury or a period of convalescence make sure to return cautiously. Be patient, don't let feelings of guilt send you back to the war zone before you've recovered. Remember that training and recovery are Siamese twins who cannot exist without each other.

▸ Dr. Michael Cohen is a former triathlete and marathon runner who achieved a personal marathon record of 2:37 at age 21, 2:50 at age 39, and at 50 was a Top 3 age group finisher in both the ING Miami and Disney Half Marathons. In 1997 he placed third place overall in the Florida Gatorade duathlon series. He is a Board-Certified Foot and Ankle Surgeon and Diplomate of the American Board of Foot and Ankle Surgery. He is a Fellow of the American Board of Foot and Ankle Surgeons and Board Certified and Diplomat of the American Board of Podiatric Medicine. He practices with the Foot, Ankle and Leg Specialists of South Florida specializing in lower leg injuries and reconstructive surgery of the foot and ankle. The South Florida Institute of Sports Medicine in Weston is located at 1600 Town Center Blvd., Suite C, (954) 3895900 and in Pembroke Pines at 17842 NW 2nd Street, (954) 430-9901. The practice website is www.SOUTHFLORIDASPORTSMEDICINE.org.