On Ganglion Cysts….

We runners continually get odd injuries and one of them is a Ganglion Cyst.  According to my friend and runner personal trainer podiatrist Nicole Hayward: ”

What Is a Ganglion Cyst?

A ganglion cyst is a sac filled with a jellylike fluid that originates from a tendon sheath or joint capsule. The word “ganglion” means “knot” and is used to describe the knot-like mass or lump that forms below the surface of the skin.

Ganglion cysts are among the most common benign soft-tissue masses. Although they most often occur on the wrist, they also frequently develop on the foot – usually on the top, but elsewhere as well. Ganglion cysts vary in size, may get smaller and larger, and may even disappear completely, only to return later.

Causes
Although the exact cause of ganglion cysts is unknown, they may arise from trauma – whether a single event or repetitive micro-trauma.

Symptoms
A ganglion cyst is associated with one or more of the following symptoms:

  • A noticeable lump – often this is the only symptom experienced
  • Tingling or burning, if the cyst is touching a nerve
  • Dull pain or ache – which may indicate the cyst is pressing against a tendon or joint
  • Difficulty wearing shoes due to irritation between the lump and the shoe

Diagnosis
To diagnose a ganglion cyst, the foot and ankle surgeon will perform a thorough examination of the foot. The lump will be visually apparent and, when pressed in a certain way, it should move freely underneath the skin. Sometimes the surgeon will shine a light through the cyst or remove a small amount of fluid from the cyst for evaluation. Your doctor may take an x-ray, and in some cases additional imaging studies may be ordered.

Non-Surgical Treatment
There are various options for treating a ganglion cyst on the foot:

  • Monitoring, but no treatment. If the cyst causes no pain and does not interfere with walking, the surgeon may decide it is best to carefully watch the cyst over a period of time.
  • Shoe modifications. Wearing shoes that do not rub the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.
  • Aspiration and injection. This technique involves draining the fluid and then injecting a steroid medication into the mass. More than one session may be needed. Although this approach is successful in some cases, in many others the cyst returns.

When is Surgery Needed?
When other treatment options fail or are not appropriate, the cyst may need to be surgically removed. While the recurrence rate associated with surgery is much lower than that experienced with aspiration and injection therapy, there are nevertheless cases in which the ganglion cyst returns.”

 

Thanks Nicole!!!!    Happy Running Everyone.   Please like my running coaching page:  Click Here

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Where Have You Been?

You are questioning yourself…..  Those doubts…. I was injured and how can I come back?  I gained weight – how can I come back?  I was faster when I was 23 yrs old – how can I come back?  I am getting old – can I continue this?

Running is for FUN

We have to take stock sometimes that running is for FUN – the pressure we put on ourselves for PRs and records and statistics is meaningless if running has become a job to you.  Has it?

Everyone Has a Story

Your story may have been weight loss or disease or whatever inspired you in the 1st place.  Reach back to that place and get your inspiration back.  You did it before and you can do it again.  What is stopping you?

Just do it – this is your chance to get back what you had before.  You may not be what you were, but who cares….you are better than the original and that’s where you need to aspire to be.

Happy Running

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Shin Splints -Why the Pain?

I turn again to my running physical therapist friend Jessica Garcia here in Paramus, NJ for answers to those nagging shin splints!   Here you go:

“Anytime we get lower leg pain we are quick to say that we have shin splints but is that actually true or have we just grown accustomed to saying that because it’s what we have heard.  Shin splints has become the go to term for any lower leg pain that we get below the knee, either on the outside front part of the leg or the inside of the leg. Shin splints are the bane of many athletes, runners, tennis players, dancers and military recruits. They are much more common among beginning runners who build their mileage too quickly but can also affect seasoned runners who abruptly change their workout regimen. Shin splints can be summed up in 4 words….. Too Much, Too Soon.

Shin splints, (most commonly known as medial tibial stress syndrome), were always considered a soft tissue injury but with new information it is now thought that the cause of shin splints may actually be repeated stress to the bone. With running the tibia (bigger shin bone) bends backward slightly on impact with the ground, putting compressive forces on the inner side of the bone. The body responds to this but this process can take several weeks to months during which time the bone is even more vulnerable. Shin problems are more common in less experienced runners because the bone has not yet adapted. Did a light just go on?

Be careful, shin pain doesn’t always mean you have shin splints. It can be a sign of another problem, 2 conditions in particular, with potentially greater ramifications. The first of these is Compartment Syndrome– a swelling of muscles within a closed compartment which creates pressure. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.  Symptoms include leg pain, unusual nerve sensations and eventually muscle weakness. Compartment syndrome can be either acute or chronic. Acute compartment syndrome is a medical emergency.

The second, one that evokes fear just at the mere mention, is a Stress Fracture-an incomplete crack in the bone. The pain of shin splints is a generalized ache that may be worse in the morning because the soft tissue has tightened up overnight. They are at their most painful when forcibly lifting the foot at the ankle or flexing the foot. By contrast the pain from a stress fracture becomes focused on a smaller area of the bone and is sharp or burning in nature. The pain may be noticed more during the run eventually hurting while walking or even when you’re not putting any weight on it at all. They may feel better in the morning because the bone has rested overnight. If you suspect you have a stress fracture you should get it checked.

There can be a number of factors that cause shin splints, those related to the body and those related to training errors.  When shin splints strike it is best to stop running completely or decrease your training, depending on the extent and duration of pain. The initial focus is on decreasing the inflammation and once that is achieved it turns to reducing the relative amount of stress on the tibia. This can be accomplished by increasing flexibility and strength, reducing impact, wearing the correct footwear, cross training and,  once returning to running, avoiding hills and hard surfaces, avoiding running the same direction on a track, gradually increasing mileage, gradually increasing intensity and increasing stride frequency.

Most runners don’t want to interrupt their training unless absolutely necessary but the decision is not a clear cut one. In an attempt to help patients make this complicated decision I use this simple spectrum:  Red zone(stop): localized tenderness, sharp burning pain, pain with hopping, pain with walking, Yellow zone (caution): Tight aching pain when running; goes away when you stop, hopping isn’t painful, Green zone (go): Completely pain free while running. In most cases shin splints are often not serious however, call your health care provider if: you have pain even with rest, icing, and pain relievers after several weeks, you are not sure whether your pain is caused by shin splints, the swelling in your lower leg is getting worse or your shin is red and feels hot to the touch. So while in many instances you could run, the question becomes…. should you run?  If there is any hesitation when answering this question err on the side of caution. If you think having to rest because of a mild injury is difficult, you don’t even want to think about what it would be like with a full blown one.”

Thanks, Jessica!   Happy Running……

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2016 – A Year In Review – Your Running

If you had to summarize your running year in one word, what would it be? Mine would be “Almost”.  I ran my 3rd best Manchester Classic, finished in 2nd or 3rd in a race three times, could not get under 40 minutes for the 10K and ran my 2nd-best 1/2 marathon.  Although I did run my lifetime PR in the 20K and my fastest 5K since 2010, it all felt a little hollow for me. So what was it for you?

In order to have a good goal for next year, you need to assess the current year.  What kind of year was it for you? Once you can figure that out, then you can see what went right and what went wrong.  Examples:

  1.  Injuries
  2. Exhaustion
  3. Overtraining
  4. Boredom
  5. Races finished too slow/fast
  6. DNFs
  7. Not enough time to train and race

The plan you come up with for next year could involve many steps.  Think of what you need to get to your goal.  Is it a coach?  Is it a new running group or a different place to start running?  Is it a different time of day to run?  Whatever it is, change something up – changes in running keep you fresh and motivated.

What is your goal for 2017?

Think About It

Plan It

Execute It !

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Miles Are Not Important – II

Yes – the number of miles you run per year is not important. You did read this correctly.  The number of miles you run per week, month and year are not important.  It is the quality of the miles that is more important. Yes – you can’t only run speed or run only 200 miles a year, but the threshold varies per person, but it is usually not as much as you think.

From 2005-2013 I averaged 1400-1670 miles per year with only 3 or 4 months under 100 miles and massive streaks of 30+ mile weeks.  In 2014, I tore my meniscus and had to take almost 2 months off from running.  Those months were the best thing that happened to me.  As an aging runner (33+ years, 35,000 miles and 46+ yrs. old) I had to assess what I had been doing.

In late 2014, I changed my running strategy.  In addition to using the Isagenix nutritional program, I started hitting the gym 2-3 times a week for intense low-impact boot camps that emphasized core, stability, agility, balance and strength in an injury-free way.  I also lowered my mileage by almost 35% and ran 3-4x a week instead of my customary 6x a week.

The results have been staggering – all these times occurred since 2015:

5K – 18:24 -> fastest since 2010
4M – 25:26 -> fastest since 2001
10K – 39:31 -> fastest since 2008

10M – 1:06:36 -> PR
20K – 1:23:39-> fastest ever lifetime (PR – Personal Record)
13.1 – 1:30:05-> fastest ever lifetime  (PR)                                                                  4.72 – 29:22 -> fastest since 2009 (Manchester Classic-CT)

26.2 – 3:24 -> fastest at Boston; 6th-fastest ever                                                     26.2 – 3:21 ->  3rd fastest ever

And I’m going to finish this year with just over 1170 miles (after last year finishing with 1025 miles – least since 1998) with maybe 5 30+ mile weeks and one or two 100+ mile months.

So this is how I am going to train going forward – less miles, more speedwork and tempo runs and more strength training.  Father time always wins, but you don’t have to give up without a fight.

While it’s cool to hear about 25+ year streaks of not taking a day off or 3,000+ mile years, I’m sticking to what I have learned.  I want to be running when I’m in my 80’s.  So if my body reacts positively to less miles, then I will go there.  That is exactly the way I treat the runners I coach, with a balance….

Happy New Year to everyone!!!

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On Plantar Fasciitis….

When I don’t know about a subject other than suffering the injury, I turn to a professional for some clarity – here is my PT friend Jessica Garcia on plantar fasciitis:

“As runners, more than likely every one of us has had a pain in our heel or foot at one time or another and our first thoughts have been, what is it and can I still run , and probably not in that order. Typically we will try to ignore it hoping that it goes away and if it doesn’t we will look to our fellow runners or the internet for answers. Somewhere in this process we are bound to come across the term plantar fasciitis and wonder if that’s what the problem is and if so how do we fix it. So let’s take the mystery out of this thing they call plantar fasciitis.

The plantar fascia is the thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. It is made of collagen, a rigid protein that’s not very stretchy. Plantar fasciitis is the inflammation or tiny tearing of the plantar fascia.

Tell-tale signs of plantar fasciitis include sharp pain in the heel when getting out of bed in the morning due to being in a contracted position overnight. Other symptoms include a dull ache along the arch or bottom of the foot which can be sharp, as well as a tight and painful sensation at the base of the heel.  The pain gets worse when you climb stairs, stand on your toes, stand/sit for long periods of time and at the beginning of exercise. The pain gets better or goes away as the foot limbers up but returns when exercise is completed.

The causes of plantar fasciitis can be broken down into two categories: intrinsic factors, those related to the body itself, and extrinsic factors, those “outside” the body. Intrinsic factors are decreased core strength (stable core reduces stress on spine and stops pain transference to foot), decreased flexibility of calf, hamstrings and hip flexors, and biomechanical issues including flat, high-arched feet  and increased foot pronation. Extrinsic factors can primarily be thought of as training errors: improper/worn shoes, sudden increases in training mileage or elevation; beginning speedwork; running on hard surfaces or simply overtraining.

The tricky thing about plantar fasciitis is that many people can continue to run with symptoms—the condition has to be pretty severe to make a stubborn runner with a high pain threshold stop training. Having said this, there are times when it’s better not to push through the pain. Using a red (stop), yellow (caution), green (go) spectrum the following can be used to help answer the burning question of to run or not to run:  Red: Ongoing, arch pain & tenderness that doesn’t fade even once you’ve warmed up, Yellow: Pain when you step out of bed, get up after prolonged sitting or during the first few minutes of a run, Green: Pain free all day including first steps in morning, walking barefoot on hard surfaces without an issue. Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it’s present. If pain persists it’s a good idea to see a professional. Conservative treatment significantly decreases symptoms in about 95 percent of sufferers within six weeks however fixing the problem relies on determining the responsible process.

The bottom line is that plantar fasciitis is an overuse injury. Overuse injuries are the great equalizer, taking out the elite and weekend warrior alike. Most runners experience their share of injury, and although many of these conditions can be nagging, few are more so than plantar fasciitis.”

  • Jessica Garcia is a PT in Paramus, NJ and has her own practice – Ultimate Motion

 

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Seize the Day

“Carpe diem. Seize the day, boys. Make your lives extraordinary” – that is a line from the movie Dead Poets Society as spoken by Robin Williams.  That is what today’s post is about. You can apply it to anything and running falls under the ‘anything’ category.

I lost a good true friend this week suddenly.  She was not a runner – not an athlete – in many ways she was the opposite.  However she was full of life, always making people laugh – she had an infectious laugh….and was kind and caring.  Hanging out with her was always fun – you never knew what to expect.  There was always a moment that might catch you off guard …. but you would laugh 10 minutes later or 10 years later.  She was only 46 when she died….that is too young for anyone to die.   And I am struggling with the fact that I lost 2 friends just this year from heart attacks at the same age as I am now – 46.

Life is too short to not make every day count.  yea, you may be tired and cranky, you may not want to go to that next gathering with friends, but you don’t know when your last day will be.   So, whatever it is, just do it – get it done.  We don’t have all the time in the world to do everything, so get out there….

To connect this to running – go run with some friends, even if it is a 22 minute drive to get there; get up for that daily renewal – that exercise that gets you going.  What do you have to lose:  try your hardest – every single time;  leave it all on the track or on the race course.  You can’t regret what happened in the past – just get them in the next race.  There are inspirational stories of people who run with only 1 leg, or with a disease, etc.  If you are reasonably healthy and stay careful, there is no reason, no excuse, to not get out there and run, or bike, or love, or care…..

This has been a tragic week….we all have to remember the good times with people who passed.  But for the people still alive, we can make new memories with them all the time – we have to just make the effort….

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