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Melanie Cole (Host):  Running is such a great form of exercise because not only is it one of the least expensive ways to get physical activity, but it can be done from anywhere.  You see those runners out there, and even I get a little jealous and wishing that I could run, and here to tell us about how to start running and run safely is Dr. Colleen Dupuis.  She’s a board-certified sports medicine physician with Aspirus Houghton Clinic.  Dr. Dupuis, people can start running really any time of their life, but what are some of the most important things you want them to keep in mind before they even start lacing up those running shoes, what do you want them to know?

Colleen Dupuis, DO (Guest):  Before you start lacing up your running shoes, you should probably just check with your primary care provider and make sure that they don’t have any concerns with you starting to run as your form of exercise.  We always want to make sure that you don’t have any underlying conditions that could be exacerbated or that may need to be treated prior to increasing your exercise with running.  The next step is usually to make sure that you know how to start running and starting slow is always important, you know.  Making sure that you start with running a short period of time or doing a run-walk, run-walk interval training is usually a good way to get started with it.

Host:  Well, that’s great advice, and as an exercise physiologist, Dr. Dupuis, I, you know, I work with runners all the time, but I myself have to do the walk-run thing because I just can’t seem to get it going or my breath gets lost.  What do you say to people that start that shuffling and jogging, and they get so out of breath, and they just think that it’s just not going to happen for them?

Dr. Dupuis:  You have to be patient when running.  So, it’s important to remember that it takes a long time to build your cardiovascular strength as well as your muscular strength, and so be patient with yourself and know that you’re still getting a good workout, and you’re getting good exercise and good benefits for your health just by being out there and doing it.  Whether you are running it at a sub five-minute mile, or you are run-walking for 30 minutes, you’re still getting that benefit, and you’re still doing something good for yourself, so be proud of that and be patient with yourself.

Host:  And that’s really great advice.  And now—so before we talk about some of the injuries that we want to prevent in the first place, I’d like to start with shoes because, you know, there’s walking shoes and there’s so much technology with shoes today.  What do you want us to know about shoes, and finding the perfect running shoes?  I even tell people that walk to wear running shoes because they have so much support and cushion.  What do you want us to know about running shoes that you recommend when people want to start?

Dr. Dupuis: So, the most important thing with your running shoes is that they’re comfortable for you.  If you are having any discomfort or pain in them, it’s only going to get worse with the more steps that you put in on it.  Some people need more supportive shoes.  If you tend to be a person who is a little bit more flat-footed, usually making sure that you have a good arch already built into the shoe can be helpful or adding in an arch support can be helpful.  There has been a good push for that barefoot running and using those very low-profile shoes.  I think the first brand to come out with the Vibram one, and depending on your running technique, those can be very helpful for you, but for some people they need that cushion. Their body won’t tolerate being on such a flat shoe, and so it really just depends on the person and their technique of running.  I would say it’s more important that the shoe is comfortable and has some support and that you wear it appropriately meaning you tie your shoelaces snugly, than it is to have a very specific type of shoe that we should all be wearing because we just don’t all have the same feet or the same running style.

Host:  Well, I appreciate you.  I mean I could never wear those flat-feet shoes.  Oh my God.  I’d never walk again, but I appreciate you talking about arch supports because now you can even, without getting fully made orthotics, you can get Spencos and Superfeet and all these ones to insert into your shoes to make them so much more comfortable.  To avoid injuries, what do you want us to know as we begin to run—some of the most common injuries you see, whether it’s chin splints or plantar fasciitis or, I mean, there’s any number of them. What do you want us to know about those?

Dr. Dupuis:  So, I think what gets overlooked the most when it comes to why people get running injuries is the fact that your body needs to have rest days  and cross training days.  It really allows your body to recover and then be able to build more muscle when it has that recovery.  So, it’s important to make sure that when you start out running that you are not running six or seven days a week, but you’re looking for things to do, you know, ways to run maybe three days a week, and have a rest day every other day, or if you feel that the rest isn’t good for you, and you need to get into the swing of things, finding something to replace running on those days, whether it’s using an elliptical, going out for a bike ride, getting in a pool and swimming or doing some weight training.  You’re changing what muscles you use and how you use them, which allows your running muscles to have a recovery and be better able to benefit you as well as be less likely to break down and become injured.  Another thing is to make sure that you’re really going up in your distance and your intensity of running very gradually.  We see a lot of times people will go, well, I felt really good out there running.  So, the next day, they went for a 10-mile run, and after that, I went up again.  Really you don’t need to be increasing your distance by more than about 10% of your weekly mileage each week.  We really try and keep it at that level because then your body can learn to accommodate this increase in steps and pounding on it that you’re doing as you begin to train for either a race or just become more used to running.

Host:  So, if we do start to feel injuries; if we do start to feel pain in our heel or in our chin or in our toes, whatever, give us some home treatments that you would recommend?  Do you like ice?  Do you like bracing?  Do you like heat?  What do you want us to do?

Dr. Dupuis:  For most injuries, if it hurts right after a run, putting some ice on it will help with the pain, and it can decrease some of the inflammation.  If you are able to take anti-inflammatories, sometimes that can also assist in the recovery.  If you need it for that time, you know, you should check with your doctor before taking anti-inflammatory medication such as ibuprofen or naproxen.

Host:  So, that leads very well into my next question, and it’s the age-old million-dollar question, do you recommend people stretch before they go running, during running, after running or both?  I mean, do they need to be a little warmed up before they just start doing that quadriceps stretch and pulling that foot up and, you know, stretching their hamstring?  What do you want them to do?

Dr. Dupuis:  I recommend that people stretch after running.  If you have the time and are able to, and you can do a light warmup and stretch before your running workout, then I do recommend that as well.  So, I recommend definitely after because your muscles are warm and ready to be stretched when you’re done with your workout, and that will help them from tightening up, and it’ll help you better prepare for your next workout.  We know that stretching in general can be very helpful in decreasing your risk of injuries, so if you can warm up for five minutes, get those muscles warmed before you stretch, and then do it before your workout also, then I would add that in, too.

Host:  And nutrition.  You know, obviously, if you’re an experienced runner, and you run races or marathons, you know.  Some people can do that, and not all of us can, but we still need to think about good nutrition if we’re going to exercise at that intensity, and at that level different than just walking or, you know, taking a leisurely walk.  What do you want us to know about nutrition?  Are there some supplements you would prefer people try and use if they’re going to run or do we eat a little bit before a run, chocolate milk after?  What do you want us to do nutritionally?

Dr. Dupuis:  Nutrition has importance for your general health, which allows you to better be able to participate in running as well as recover from running.  So, most importantly, eat a healthy well-rounded diet, make sure that you’re getting plenty of those good vegetables, protein, and drinking plenty of water to stay well-hydrated, especially as you increase your activity.  There’s a couple of nutrients that we tend to see put people at risk for injuries with running.  We know that if people are low in vitamin D and calcium, they’re a little bit more likely to end up with a stress fracture.  So, if you aren’t getting a good amount of calcium in your diet, and you are very good about your sun protection and live in a colder, cloudier area such as where I am at currently, then I would recommend that you add in some vitamin D supplementation.  We also see a lot of runners end up becoming anemic, and so having some extra iron in your diet can help prevent that and give you a little boost in there.  Generally, iron supplementation can be hard on people’s intestines, so just making sure that you’re getting enough iron in your diet with some leafy greens or some meat for protein can be really helpful to keep that iron level up.
 
Host:  This is all really great advice for people that really want to up their exercise a little and take on running which not everybody can do, but everybody can certainly try and we can all start to try and run, and I highly recommend it.  So, give us your best advice, Dr. Dupuis, to start a plan, to begin running, get those shoes going, do our good warmup and our stretches and be nutritionally sound, give us your best advice for starting—that day—today.  

Dr. Dupuis:  I would say, first, make sure that you’re healthy enough, and you’re ready to start.  Occasionally, we’ll have people who need to start with some physical therapy or start with a home exercise program to make sure that they have the right strength in their muscles and the right flexibility to be able to run without becoming injured.  Like we were talking about before, it’s really important that when you do start running, that you’re really patient with yourself and know that it’s good just to be out there, whether it’s mostly walking with a little running or mostly running with a little walking.  Whatever your body can do at this time, be patient and grateful for that.  I also recommend that you make sure that you’re comfortable in your shoes and your clothing when you’re out there; that you’re prepared for if you’re running outside versus on a treadmill that you’re prepared for the elements and that you’re staying well hydrated before and after, and enjoy it.  Make sure that it’s something you give yourself some small goals that you can reach weekly as well as some big goals that you might be able to reach over a couple of months, and enjoy every minute that you’re out there appreciating what your body can do.

Host:  Amazing, and what a great way to end the segment and really great advice.  Thank you so much, Dr. Dupuis for coming on, and sharing your expertise for those of us that want to start running.  Thank you again and thank you so much for listening to this episode of Aspirus Health Talk.  You can head on over to our website at aspirus.org for more information and to get connected with one of our providers.  If you found this podcast as helpful as I did, please share on your social media.  Share with friends and family.  Get a running buddy because you can start running with somebody, and that’ll help keep you motivated and be sure not to miss all the other interesting podcasts in the Aspirus library.  Until next time, I’m Melanie Cole.