Health Topics

Soreness vs. Injury

Everyone can benefit from a deeper understanding of the body’s mechanics to help distinguish muscle injury from soreness.

Cause and Symptoms

Muscle injuries can occur due to overuse of the muscle, an accident or trauma. Being out of shape or doing activities you are not accustomed to may also contribute to pain. Unfortunately, most people don’t go to their primary care physician for all of their muscle injuries. Signs and symptoms include:

• prolonged soreness
• pain, bruising
• heat in a specific area
• deformity

Rehab and Prevention

Rest from the activity that caused the pain is recommended to give your muscles and body time to heal. Ice and over-the-counter medicines can help reduce inflammation and soothe  discomfort. After pain has subsided, focus on improving your mobility with home exercises and physical therapy—helping you build muscle strength and flexibility. With the aid of musculoskeletal ultrasound, a noninvasive procedure, we can find new ways to treat muscle injuries. If pain persists for several weeks, see your doctor. 

Owen Speer, DO

Entry 1 - July 18, 2018

Have you ever wanted to run a marathon? Many cringe at the thought of running any distance, never mind 26.2 miles.  For others, running is both a hobby and a way of life. Completing a marathon is sometimes a lofty fitness goal to check off a bucket list.  Marathons (and sometimes ultra-marathons) are a regular part of their running routine. More than 500,000 people ran a marathon in the United States in 2016.  It’s not a common feat by any means, but marathon running is becoming increasingly popular and is here to stay.

My name is Dr. Owen Speer and I’m a family medicine and primary care sports medicine physician in Hixson, TN. My primary specialty is family medicine. The focus is on primary care of children and adults for wellness, preventive care, chronic medical conditions, and acute illness. I also completed fellowship specialty training in primary care sports medicine. This is added expertise in non-surgical orthopedic care and the care of individuals for sport/exercise related injuries and problems.

I am also a runner myself. I have been running since I was 10 years old, and started competing in middle school cross country. I ran competitive track and cross country in high school and college. I gravitated towards the longer distances pretty early on, and enjoyed working towards running personal best times. I was not a standout athlete, but had dedication to the sport I very much enjoyed. It has been great way to balance the stress of life, enjoy God’s creation, explore new places, push myself beyond the point I think is possible, and be social with other runners. Now, I continue to run regularly on my own and with groups from the Chattanooga Track Club. 

This blog is dedicated to health topics related to running as I train for the Bank of America Chicago Marathon. The race is on October 7, 2018. This will be my 14th marathon, and my first time running Chicago. I am excited for the experience – it’s a flat and fast course - and all of the training that goes into preparing for race day. The more marathons I run, the more I learn. It’s trial and error in training and on race day, that refines that process. A lot of this comes from listening to my body and making adjustments where they are needed. I have yet to start a formal training plan for this race. That will begin about 4 months out from race day.

Getting started
For anyone looking to start being active it is important to know you are healthy before starting an exercise routine. I would recommend a wellness or preventive exam to get started. Meet with your primary care provider, or find one if you don’t already have one. You should ask for a physical exam and discuss your exercise goals with them. This type of visit will include a review of your current medical state and past medical problems. The doctor may order lab tests or run an EKG. Medications may be needed or changed. You may need a stress test or lung function test to assure your cardiovascular or pulmonary systems are in good condition. If you have an acute or chronic injury, you may be referred to a physical therapist to help accelerate healing of a pain that just won’t go away.  You will also likely discuss screening tests and vaccinations that may be needed based on your age and risk factors to keep you healthy in the years ahead.

For those who are already active, whether it’s running or any other form of exercise, the same advice would apply. Regular annual wellness exams keep things on track, even for those who are in the best of shape.

Looking ahead
In the months ahead, I plan to write a couple blog entries per month leading up to the race. Next time, I plan on including some tips on a successful training plan and pitfalls to avoid. 

Happy running!

Entry 2 - July 25, 2018 

Now that you have your sights set on an upcoming race, the next step is to have a training plan. You wouldn’t go into a job interview without preparing first and running a race has the same principle. A plan ensures that you have more success at whatever goal you have in mind. It will help you build strength and speed while minimizing injury – and ensure you meet that goal.

Setting a base
It’s a good idea to have a baseline level of fitness before training for a longer race. If you are a non-runner, this will involve building up from walking to walk-run intervals. A goal time of 30 minutes of exercise is a good place to start. Once you can walk at a brisk pace for this amount of time add in walk-run intervals. You would start your 30 minute session walking and after five minutes of walking, run for one minute. Alternate walking and running this way until you reach 30 minute of exercise. Each week, add one minute of running and take away one minute of walking. Eventually, you will be running a continuous 30 minutes over a six week period.

As for the frequency of your running, start out at two to three days per week. Add one day of running every two weeks to get up to your desired goal. Anywhere from four to six days per week is ideal. This allows you to have at least one day off per week to recover and add some other types of exercise or stretching into your routine. These off days from running could include stretching, swimming, cycling, yoga, weightlifting, or other activities.

Your goal for running should be 30 continuous minutes three days a week. Once you can do this for two to four weeks you should be set to start formal running training program. (You may want to work up to a mix of walking and running, not continuous running. This is fine and can be your goal to start training for a longer race. Some people can achieve more alternating these than continuous running.)

Marathon training plans
There are a variety of training plans out there and I suggest you research these and find one that fits your abilities, schedule, and goals. Some are available for free and others involve paying for a customized plan with coaching along the way.

There are three major components to any training plan: Easy runs, workouts, and long runs. These should be mixed in each week with running at a variety of easy, medium, and hard paces. You will get used to these more as you practice them.

I have my plan set and am about one fourth of the way into it. After you train for a few races you will learn which workout works well for you, how much rest you need between runs, and how often you can run based on your schedule and running goals.

Resources for training plans

• Marathon Training Information
  
• Various Training Plans
  
• Hal Higdon Training Programs
  
• The Run SMART Project – Dr. Jack Daniels’ Training Plans
  

Entry 3 - August 20, 2018

Running in the summer goes along with the summer heat and humidity. It’s nearly impossible to avoid in Tennessee. Luckily, there are a few ways to be smart about summer training and get your workouts in without having too much trouble. Here are a few tips about how to stay safe in the summer heat.

Heat illness
It is important to be able to recognize heat illness. This is a condition where you feel sick due to heat exposure. Symptoms may include dizziness, headache, nausea, vomiting, muscle cramps, and weakness. You may end up cutting your run short as a result.

How to avoid it
Consider the time of day you plan to run. Avoid being outside in the sun and heat during peak hours, 10 AM – 4 PM. Early morning runs will be the coolest. Evening runs will be warm, but without the added heat of the sun.

Stay in the shade as much as possible on your run. Tree-lined streets and parks are good choices. Trails can be the coolest because of the tree cover, but might be more humid with less of a breeze.

Gradually increase your time in the heat and humidity over several weeks to acclimatize your body. You may encounter a heat wave during the summer where the weather is warmer than usual. Be careful not to push too hard during these days if this is a big change.

Stay well hydrated – drink plenty of fluids. Water will do just fine for runs and workouts less than 1 hour. Sports drinks can be used if the run will be longer than 1 hour. Drinking 4-6 oz. every 15-20 minutes is a good amount for most people to help during the summer heat.

You can calculate your sweat rate to see how much water you need to drink during and after a workout. Weight yourself before and after a 30-minute run (preferable naked, and dry off with a towel) without drinking any fluids to calculate the difference. One gallon of water weighs about 8.3 pounds. Multiply the difference by 2 and divide by 8.3 pounds per gallon. Then multiply by 128 to get the number of ounces. Make sure you drink this amount of fluid per hour during and within 2 hours after a run to replace the fluid lost.

If you begin feeling bad from the heat, what should you do?

Entry 4 - September 10, 2018 

As the race gets closer, my training has been ramping up. My speed work is getting faster and long runs getting longer. My weekly mileage has gradually increased over the past 6 weeks, with Saturday long runs up to 20 miles.

This was the case up until about a month ago. My left knee started bothering me after running trails. This was a new pain for me. I don’t remember injuring it during the run, but 12 hard miles on undulating hills with steep ups and downs did something to set it off.

I took a few days to rest and restart slow running, but it still didn’t feel quite right. I then took four days off, had a massage, and tried to stretch my low legs (calves, hamstrings, quads). I also iced a few times a day during those days off. I don’t normally stretch and know my leg muscles tend to stay tight – a perfect setup for an overuse injury.

I moved and stretched my knee, felt around for the sore areas, and self-diagnosed myself with a popliteus strain. This is a small muscle behind the knee that can be injured by knee hyperextension or overuse, especially with downhill running.

It’s not easy to be injured, especially when you are training for a race.

Here are some keys to overcoming injury while training:

• Be patient – Rest, ice, and stretching can go a long way. Back off from high levels of running. Taking days off might be just what your body needs. Be sure to have a positive outlook going forward.
  
• Cross training – Use your time away from your training plan to strengthen other muscle groups. Consider biking, swimming, aqua jogging, yoga, weight training to keep your heart pumping and muscles working as you give your injury time to heal.
  
• Seek an expert opinion – For most injuries, if you are not able to get back to easy running in 2 weeks, it is time to be evaluated by a professional. You may need help from a team of experts to get back, including your primary care doctor, sports medicine specialist, or physical therapist.

Keep a positive outlook going forward. Some injuries can take you away from training for weeks or months, but most don’t take quite that long. You will likely be able to get back on track towards your racing goals.

Entry 5 - September 27, 2018

Race Day Plan
The Chicago Marathon on October 7, 2018 is fast approaching. Here are a few important elements you will want to make sure are a part of your final few weeks. After all, having a great race day requires a great plan!

Rest is Key
The first step in your plan is rest. Make sure you get enough sleep. Seven hours or more is usually adequate for most adults. Getting less than that amount can add up to excessive fatigue – and this can lead to over use of caffeine and energy drinks to stay awake during the day. I wake up early for my runs and workouts, and these can suffer with minimal sleep. If you have fallen into a pattern of not sleeping as much as you need, work hard to make this happen the days leading up to the race.

Reduce Your Miles
Next, taper down on mileage. Your hard workouts and long miles should be behind you at this point. Tapering helps avoid injury and enhances recovery towards the end of a training plan. A gradual reduction in weekly miles translates to running the same number of days per week, but cutting back your distance 20-30% each week as race day approaches. Keep your workouts shorter, but just as fast, during the taper. The taper can start 2-4 weeks out from race day.

Nutrition Matters!
Lastly, nutrition plays a big role. Concentrate on healthy meals and snacks with a mix of protein, healthy fats, vegetables, and carbohydrates. Carb loading for race day starts at least a week prior to race day. You should increase the percentage of carbohydrates in your diet significantly to build up stores in your liver and muscles. This is the fuel you will need to make it all 26.2 miles.

On your Mark, Get Set, Go
In general, keep things predictable and stick closely to what has worked for the past several months. This applies to your meals, shoes, running routes, and daily routine. The hard work is done. It is time to enjoy what you have been working towards!

Post-Race Wrap-Up
My last entry will be after the race. I will let you know how things went and what to expect after a race is over.

Entry 6 - February 2019 

What an experience! What a race!

This was the 41st year of the annual Chicago Marathon. The race organizers have been refining the details over the past 4 decades to make this an unforgettable event for both runners and spectators. All of their hard work was easy to see all throughout the weekend.

One of the best decisions I made in planning for this was my hotel location. By recommendation from runner friends who have run this race in the past, I chose to stay in a hotel near the center of the city. This put me less than a mile from the start of the race.

This made getting lined up with 44,000 other runners about as easy as it could be. There were huge crowds of people, both spectator and racers. There were specific instructions about when to head to the start based on how close you were to the front of the starting line. There were several security checkpoints to get runners into this area. It was crowded and harried, and yet impressive how well it all worked.

After an introduction of the elite runners and the national anthem, the race began. The first few miles were slow going, as a sea of thousands of runners alongside me got started on their 26.2 mile journey. The course winded through city streets with tall skyscrapers on either side of the block and across bridges over the Chicago River.

It took about 4 miles to break free from the dense crowds of runners and get settled into to my race pace. This meant starting out slower than planned by 20 seconds per mile. I took some time to enjoy the experience and look around a little more than I normally would. The crowds also prevented me from going out too fast, something so easy to do on race day.

The course is flat. The course is fast. It was easy for me to settle in with a pack of runners moving at my pace. Cheering spectators and a variety of bands lined the streets along the entire course, giving a supportive boost of energy to all runners.

I stayed true to my nutrition plan: taking an energy gel 15 minutes before the race and every 30 minutes with water. I drank electrolyte sports drink every 2-3 miles as well to maintain hydration. This provided good fuel to get me through to the end. I felt good the entire race – perhaps too good. All of the race-pace training had paid off. I was a little uncomfortable for the last 4 miles, but I was able to keep the momentum going.

I highly recommend this race for either a seasoned marathoner or a first time marathon runner. The flat course and energy from spectators helped out so much. I might even go back again in the future for another chance to experience this great running event!