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Healthy You

Running Right: How to Stay Off the D.L.

July 18, 2008 11:59 AM with Dr. Stephen Weinberg

Whether you’re marathon bound or the casual runner, you will benefit from this discussion with Dr. Stephen Weinberg, Podiatrist within NorthShore's Orthopaedic Institute. He will be talking about the most common running injuries and how to prevent them.

Kristin (Moderator) - 11:55 AM:
Welcome everyone to today's chat. Dr. Stephen Weinberg will be joining us shortly. Please begin submitting any questions you have.

Dr. Stephen Weinberg (NorthShore) - 12:00 PM:
Hello, my name is Dr. Stephen Weinberg. I have been chief of podiatry service for the Chicago Marathon since 1988. I'm a long distance runner and in a group practice in the Northern Suburbs. One of my specialties is sports medicine. Also, I ran in the infamous 2007 Chicago Marathon. I now welcome your questions.

  Amanda (Evnaston, IL) - 12:00 PM:
I'm just starting out as a runner, are there any special considerations if I've never seriously trained before?
Dr. Stephen Weinberg (NorthShore)
Shoes are going to be your most important piece of equipment and I would rely on a running shoe store for selection of a pair of shoes. As you train, starting out slowly and short distances of walking and running, you may or may not find problems with the shoes. We are all an experiment in one and time brings out the best and worst of us. Should you experience problems initially with the shoes, you can always return them to the store where purchased. This will allow you to find the right type of shoe.

  Angela (Chicago, IL) - 12:03 PM:
I fractured my ankle a few years back and still get pain in it sometimes. How do you think I should modify my running routine?
Dr. Stephen Weinberg (NorthShore)
It depends on what is causing your pain in your ankle. I would suggest for post-traumatic arthritis of the ankle, being seen by a podiatrist or orthopedist who specializes in sports medicine.

  BobRunsSlowly (Chicago, IL) - 12:05 PM:
Is it better if I run on grass or run on concrete / hard road surface?
Dr. Stephen Weinberg (NorthShore)
Good question! Concrete is by far the hardest surface to run on, and creates more impact on the musculoskeletal system; running on asphalt is softer and provides a consistent surface which is not undulating as grass can be. I would suggest asphalt as a surface of choice.

  Nick (Aurora, IL) - 12:06 PM:
Hello Dr. Weinberg: I typically begin my tapering 3 weeks prior to a marathon. Is that an adequate amount of time? And at what point will the training I am doing essentially not improve my actual marathon performance?
Dr. Stephen Weinberg (NorthShore)
For most of the marathon training programs I am acquainted with, two weeks after doing a 20 mile run is sufficient for recovery to run the 26.2 mile event. Certainly, three weeks might be a little longer than necessary.

  Jillian (Mt. Prospect) - 12:07 PM:
When is it more beneficial to walk rather than run?
Dr. Stephen Weinberg (NorthShore)
It's more beneficial to walk than run when you are feeling stale or fatigued and if during a race, especially at aid stations, to drink fluids while walking.

  Danielle (Chicago, IL) - 12:09 PM:
My fiance is training for the marathon and I want to use this as a chance to get in shape and be supportive, but I have some impact issues with my knees - what would you recommend as a program for a relative beginner?
Dr. Stephen Weinberg (NorthShore)
Walking longer and longer distances before even attempting "jog" and "run" would be most advisable. If you have pain in your knees, my suggestion is to see a sports medicine specialist.

  Jonathan (Lake in the Hills, IL) - 12:10 PM:
I’m prone to having sore joints, mostly by my knees. Is running okay for me or should I try something that would put less impact on my knees?
Dr. Stephen Weinberg (NorthShore)
I would suggest finding out the source of your discomfort before making any decisions on the type of exercise you would like to do.

  Monica (Chicago, IL) - 12:10 PM:
How do I avoid getting sick from running in the cold weather during winter?
Dr. Stephen Weinberg (NorthShore)
If you're talking about catching "colds" as a result of training outdoors, layering your clothing is not going to be much of a help because you may be immune suppressed from some systemic condition. I suggest talking to your primary care physician about prevention.

  Katie (Berwyn, IL) - 12:12 PM:
Will running eventually cause arthritis?
Dr. Stephen Weinberg (NorthShore)
Great question, Katie! There have been several studies in the last 30 years in which runners have been followed medically, with x-rays and surveys, and monitoring their distances and paces. And the results have shown that there is no premature progression of arthritic symptoms if the subjects had this when they started running nor was there earlier onset of arthritis when runners were compared to the sedentary population.

  David (Lakeview, Chicago) - 12:14 PM:
I used to be a regular marathon runner (4 total) but it has been a while and a few pounds. I also travel frequently and find it hard to maintain a normal training schedule. What would you recommend I do for a training so as not to hurt myself.
Dr. Stephen Weinberg (NorthShore)
To stay fit and healthy, I would suggest and others have suggested, running no more than 20 miles a week at a long slow, easy pace.

  Kim (Highland Park, IL) - 12:15 PM:
Is running on a treadmill a good substitute for "real" running?
Dr. Stephen Weinberg (NorthShore)
There are differences in the biomechanics of the body when running over land or on treadmill, especially if the treadmill is motorized rather than self propelled. A lot of my patients have a tendency to turn up the treadmill and the inclination of it, too high, too soon and end up with injuries. While running over land, you can adjust your pace immediately to how you feel and you should stay comfortable.

  Dan (Chicago, IL) - 12:16 PM:
I love running with my dog, but I feel like the stop and go pace can be harmful... is this true?
Dr. Stephen Weinberg (NorthShore)
It depends on whether you're running for leisure or training for a marathon. I would leave the training program for yourself and walk or jog with your dog at another time.

  Luke (Highland Park, IL) - 12:17 PM:
When on a marathon training plan, do you recommend additional supplements aside from eating a healthy diet and staying well hydrated?
Dr. Stephen Weinberg (NorthShore)
No! I would stay on your regular diet, hopefully it's healthy, and as far as liquid supplements, drink what you feel comfortable with.

  Caroline (Naperville) - 12:18 PM:
When I run, I frequently get shin splints. I usually wait until the pain subsides to continue my run; however, the pain keeps on coming back. What are some things that I can do to avoid getting shin splints?
Dr. Stephen Weinberg (NorthShore)
Shin splints can be caused by one of three muscle groups in the legs. My first suggestion is to slow your pace to see if you feel better. Second suggestion is to check the age of your shoes because you may need more support if they have "bottomed out." Third suggestion is possibly if you're having calf pain is some gentle stretching, especially after you run.

  Robb (Elgin, IL) - 12:20 PM:
Is there anything I can do stretch-wise to make sure that hill training doesn't cause any long term problems?
Dr. Stephen Weinberg (NorthShore)
The most frequent problem with hill running for aerobic training is the downhill stress on the knees. My suggestion is to run up and jog down.

  Robert (Chicago, IL) - 12:21 PM:
Same question as Kim, except about elliptical machines: Is exercising on an elliptical machine a good substitute for "real" running? Is this better for preventing injuries?
Dr. Stephen Weinberg (NorthShore)
There's an old adage, if you're going to run you've got to run. Using an eliptical machine is one of the subsitute exercises I use when a patient is injured especially in their feet, because you do not go through the same range of motion when "really running." Is it better to use the eliptical to prevent injuries, the answer is "yes."

  Greg (Downers Grove, IL) - 12:23 PM:
Will I improve by just going out and doing some steady running with the odd fast hard run?
Dr. Stephen Weinberg (NorthShore)
Yes, studies have shown on college students that were observed from freshman to senior year, who were runners, that they "self-optimize" with their stride and mechanics, and with their aerobic capacity just by merely running regularly.

  Pam (Gurnee, IL) - 12:24 PM:
What benefits can you see for runners who cross train to other sports like swimming or even yoga?
Dr. Stephen Weinberg (NorthShore)
The benefits are that you spend less time running and using other muscle groups in your body, and that's how the triathlon came into being; because runners were getting injured so much.

  Danielle (Chicago, IL) - 12:25 PM:
What kind of strength training should I do when I can't run or to supplement my running?
Dr. Stephen Weinberg (NorthShore)
If you've been running for many years and become injured, the one principle that you have to bear in mind is that running strengthens all of your posterior muscles such as your buttocks, thighs, calves, etc... while the muscles on the front of your legs like your quads and anterior muscles of the shin are relatively weaker. So you want to stretch your posterior muscles and strengthen your anterior muscles.

  Jane (Urbana, IL) - 12:27 PM:
How often do I need to replace my running shoes?
Dr. Stephen Weinberg (NorthShore)
There are many factors involved here; how much you weigh, how much you run, and how fast you run and the quality of the materials that are manufactured in your shoes. Sometimes, the foam outer soles don't last long, meaning 3-4 months. My rule of thumb is if you start to have symptoms, and you've been doing fine for steady state of running, take a look at your shoes first and then get a new pair. But definitely don't go longer than 8-10 months.

  Howie (Chicago, IL) - 12:28 PM:
How do you get past running as exercise to running as an enjoyable activity?
Dr. Stephen Weinberg (NorthShore)
It depends on why you're running. Most studies have shown that when you start, if you can get through the first 3 months of taking it easy, without injuries, you will stick with it and enjoy it.

  Clive (Chicago, IL) - 12:29 PM:
Is there a best way to roll your foot on each step while running or just whatever feels natural?
Dr. Stephen Weinberg (NorthShore)
Whatever feels natural. Don't try and emulate other peoples' gates.

  Simon (Hyde Park) - 12:30 PM:
I have a dull pain in my calf after I finish a run. Is this normal? Does this just indicate that there is inflammation or could it be a ruptured muscle?
Dr. Stephen Weinberg (NorthShore)
If this dull pain is a persistent pain over several weeks, it is not normal and should be evaluated by a professional.

  Benjamin (Matteson, IL) - 12:31 PM:
I tore my ACL on a bad landing in Tae Kwan Do and recently had knee surgery. I used to run almost every day, but I couldn't before and now that I've had my surgery I want to go back to running. How should I go about doing so?
Dr. Stephen Weinberg (NorthShore)
I would talk to your orthopedist who did the surgery and hope that he's an active practitioner and can cater to your psychological as well as your physical needs.

  Meghan (Chicago, IL) - 12:31 PM:
I like to run but I've never been very good at staying motivated. What do you do to stay motivated after the first half-hour of a run?
Dr. Stephen Weinberg (NorthShore)
My suggestion is to keep a log. Nothing elaborate, just a description of your mileage, time, how you felt and how many times a week. I look at this as a savings deposit book that you can go back to look at the exercise you're doing to stay fit and healthy. The other thing I would look at is your perception of yourself, your body image, and if staying lean and healthy looking is your desire, that's what I would use as motivation.

  Kent (chicago) - 12:33 PM:
I've had shin splints for almost three years and they've kept me running. I really want to get back into it and am trying to strengthen my calf muscles. Will this help at getting the shin splints to go away?
Dr. Stephen Weinberg (NorthShore)
In most cases, your calf muscles are strong because your walking and if you were running before then they should be up to the task. Your shin splints can be caused by many factors and I would suggest a trip to a sports medicine professional. It would be well worth your doing if you want to run pain-free.

  Nick (Aurora, IL) - 12:35 PM:
Is it best to consume only a sports drink during long runs or should I have a bottle of water as well?
Dr. Stephen Weinberg (NorthShore)
You should drink the fluid that you feel comfortable with. You don't necessarily need to drink electrolyte replacement for all long runs, depending on the environment. Water works fine in most cases.

  Sam (Evanston, IL) - 12:36 PM:
Are black or discolored toenails the result of the wrong shoes or simply the result of intense training?
Dr. Stephen Weinberg (NorthShore)
It may not be either. It could be fungal involvment of the nails that just happens. Long runs can induce bleeding under the toe nails, especially the Great toe. But this will usually disappear with months of growth of the nail.

  Bruce (Lincoln Park) - 12:37 PM:
Besides starting with walking or a slow jog, what other warm-up exercises should I do before running for an extended period of time?
Dr. Stephen Weinberg (NorthShore)
I would suggest walking for the first 10-15 minutes of your run and then break into a jog and pick up your pace as you feel comfortable. This utilizes all the muscles at a less intense level and increases circulation of the muscles and makes them more flexible. If you're talking about stretching, it is not.

  Lana (Chicago, IL) - 12:38 PM:
What is your opinion on running on sand? I have heard this can be very good exercise and prevent injuries caused by running on hard surfaces.
Dr. Stephen Weinberg (NorthShore)
Categorically I will state that most patients that run on soft sand and not wet packed sand, end up with severe cases of plantar fasciitis from not enough support of the surface.

  Mary (Highland Park) - 12:39 PM:
I am a little overweight and I recently started walking to get back into shape, but after maybe a mile my ankles start to hurt & swell. Should I be concerned about this?
Dr. Stephen Weinberg (NorthShore)
Yes, you're ankles are probably hurting because you don't have enough support in your shoes. Although you're walking, I would suggest a pair of good running shoes for support and this means a heavier weight pair rather than lighter which will not provide as much support.

  Wayne (Alsip, IL) - 12:40 PM:
How long does the body usually take to adjust to a running routine?
Dr. Stephen Weinberg (NorthShore)
It depends on how much of a stress or demand you're putting on your body while running. That is, distance, pace, and frequency during the week. Running every other day can be a solution in that it gives you a day of recovery before the next bout of running.

  Joan (Chicago, IL) - 12:42 PM:
There are many products on the market that claim to provide a better stretch, such as "the Pro Stretch" or calf massagers. Do you recommend anything like this, or should one just stretch on their own?
Dr. Stephen Weinberg (NorthShore)
I am familiar with the Pro Stretch device and I have had patients who have ended up with pain in their big toe joint following the use of this for stretching their calf muscles and fascia, because of overdoing it. My suggestion is to do the regular "wall push up" for your calf muscles and forget about the Pro Stretch.

  Amber (Evanston, IL) - 12:45 PM:
Do you recommend reflexology as part of training for a marathon?
Dr. Stephen Weinberg (NorthShore)
Categorically, no.

  Milo (Batavia, IL) - 12:45 PM:
Do you believe there are true medical benefits to receiving massages during training or after a race?
Dr. Stephen Weinberg (NorthShore)
Definitely. Massaging and kneading the tissues definitely has a salutory effect on the body especially after a race.

Kristin (Moderator) - 12:46 PM:
Thank you everyone for these great questions. We only have 15 minutes left, so please submit any last questions you have now. Thank you.

  Lana (Chicago, IL) - 12:46 PM:
I am not familiar with 'plantar fasciitis' - what is it and how can I recognize if I am getting it?
Dr. Stephen Weinberg (NorthShore)
The classical symptoms of plantar fasciitis are pain in the heal area, upon arising from either sleeping or sitting for a period of time. It will get better as you walk but then can become more intense later in the day.

  Reginald (Lisle, IL) - 12:48 PM:
Do you recommend I replace my running shoe's insoles with a gel one?
Dr. Stephen Weinberg (NorthShore)
It depends on how old the shoe is; with brand new shoes, you should not need to do this and as the shoe is aging sometimes removing the sock liner and replacing it with a gel, may replace some of the cushioning affect but that is only limited. Get a new pair of shoes.

  Maria (Waukegan) - 12:49 PM:
I have a lot of callous on my feet. How can I get rid of them?
Dr. Stephen Weinberg (NorthShore)
It depends on what is causing the callus formation. I would suggest seeing a sports medicine podiatrist.

  Dante (Lombard, IL) - 12:50 PM:
Do you recommend I see a chiropractor to deal with lower back and leg pain that comes from running?
Dr. Stephen Weinberg (NorthShore)
Yes that's an option.

  Danielle (Chicago, IL) - 12:51 PM:
After a run, I switch out of my sneakers to flip flops. Should I use a sturdier shoe when I am in training?
Dr. Stephen Weinberg (NorthShore)
You don't need to wear a sturdier shoe unless you're injured and still training and then you should be in a sturdy shoe as much as possible. Flip flops, although they don't provide much support, they are not totally detrimental to your foot health.

  Karla (Ravenswood, Chicago) - 12:52 PM:
How can I prevent a pulled hamstring?
Dr. Stephen Weinberg (NorthShore)
Range of motion exercises taught to you by a physicial therapist is usually the best type of exercise that can be done. Running too fast is often the cause of getting hamstring spasms and cramps.

  Gary (Waukegan) - 12:53 PM:
Does running increase my chances of getting athlete's foot?
Dr. Stephen Weinberg (NorthShore)

  Jen (Downers Grove) - 12:54 PM:
If I am preparing for a race, how many times a week should I be running?
Dr. Stephen Weinberg (NorthShore)
It depends on the length of the race but for shorter races, 4-5 times a week is adequate. If you're talking about the marathon, I would suggest no less than 5 days a week with alternating hard, easy days.

  Meghan (Chicago, IL) - 12:55 PM:
is it a good idea to run with a group if you're just starting out?
Dr. Stephen Weinberg (NorthShore)
Yes, the social aspect of running is a good motivator. However, if you end up injured, you should really run on your own so that you can moderate your pace or stop and rest.

  Andie (Chicago Heights, IL) - 12:58 PM:
Are stress fractures more commonly found in individuals that run everyday?
Dr. Stephen Weinberg (NorthShore)
No, but, no matter what type of exercise you're doing, you should have recovery periods built into your schedule. Bones do not immediately strengthen when you increase the demand on them. They actually weaken during the first 3 weeks of increased stress and then start to strengthen in the fourth week. So every fourth week you should have a recovery week. This does not mean not to run.

Kristin (Moderator) - 12:59 PM:
Thank you everyone for all the great questions. If you would like more information about running injuries, please visit our website.

Dr. Stephen Weinberg (NorthShore) - 1:01 PM:
Thank you for joining me today. I encourage you to watch Runners Ultimate Network tomorrow, July 19, at 1:30 pm. I am interviewed on the show for the top 5 most common running injuries. It appears on Comcast Sports Network.

This chat has ended.

Thank you very much for your participation.