Fitness Marathon Preparation Questions and Answers By Sports Medicine, May 15, 2015 New and even experienced runners can have questions when preparing for a distance race. While so much of training is finding out what works for you, three of our UPMC Sports Medicine experts, Ron DeAngelo, CSCS, ATC, LAT; Kathleen Nachazel, ATC; and Brittany Patterson, PT, DPT, SCS, have advice on how to approach two common running hurdles: motivation and injury. Q: I am having a lot of pain in my knees from my distance runs. Are there are specific stretches I can do to prevent any injuries and to help with the pain? Brittany: Location and onset of pain can help determine cause. If the pain is limiting you and not just felt with running (stairs, sitting for a long time, etc), we recommend seeing a clinician. We have physicians who specialize in the treatment of runners. We also have physical therapists that can see patients for 30 days without needing a script from a physician. If the pain is not limiting, the key stretches to complete for runners include hamstring, hip flexor/quadriceps, and IT band. If you have a foam roller, that can help with all three but particularly your IT band. For hamstrings: Lie on your back, keep one leg straight on the ground, raise the other leg straight up in the air with a strap; be sure to keep the raised leg straight. In this position, you can also pull the leg gently across your body to stretch your IT band. For hip flexor/quad: Lie on your stomach and a strap/towel around your ankle; place a rolled up towel under your thigh; keep your hips and chest square against the floor and gently pull the strap to bend your knee; the towel puts your hip into a little extension to stretch your hip flexors and the bend of your knee will focus on your quadriceps. When you stretch, it should be a comfortable, tolerable stretch. You don’t want to stretch into pain. It’s recommended to hold the stretches for approximately 30 seconds at a time and perform three times. Allow yourself to ease into the stretches. This allows for a better stretch and more tolerance for the stretching routine. People often get discouraged if they want to see immediate gains in flexibility. Slow and gradual is the way to go. Q: I started training for the UPMC Health Plan Half Marathon at the beginning of January. Some days I have no problem completing my long runs and other days I still struggle to hit four miles. What am I doing wrong? How can I ensure I’m having a good run every time? Ron: There can be many reasons why a runner might be having this problem. Some things to consider: Are you getting adequate sleep? 8 to 10 hours a night is recommended. How are your stress levels? Stress, especially at work, can wear you down. How are you fueling your body? Nutrition before, during, and after run are all important. In addition to enough total calories per day, a high performance body needs high performance fuel. Are you adequate hydrated? Dehydration can be cumulative; if you don’t hydrate well on a daily basis by the end of the week you could be starting your long run on a half tank of water. Do you have adequate recovery time in between runs? You have to listen to your body. Some days you have it and some days you don’t. Are you overtraining? Monitor your resting heart rate first thing in the morning. If it starts to become elevated you are either stressed, sick, or overtraining. Are you running with proper biomechanics? Poor biomechanics or running efficiency create more labored runs which require more energy. The longer the run the sooner poor mechanics kick in. Q: My biggest hurdle is; how do I motivate myself? This half marathon is going to come whether I train or not. I know that. How do I get the energy to run and the motivation to train again? Kathleen: One of the most common questions we see from runners, especially in the middle months of their training is how do I stay motivated. During training we suggest: Train with a group or a friend. Run at the same time every day so it becomes part of your daily routine. Set specific training goals the night before and stick to them. Setting specific goals allows your workout to be more focused and more productive. Make training on the treadmill fun. Listen to music. Compete against the person on the treadmill next to you. Have a backup plan. There are days when due to your schedule or other obstacles you may not be able to complete your planned work out. It is ok to miss a day of training, but have a plan for when you are going to make up the missed workout, and you may want to make it a little harder than the one you missed. Remind yourself why you’re training. You’re not running a marathon because you HAVE to, you’re doing it because you WANT to. Have a little sign that says “I am finishing the marathon on (date) in (goal time).” There are even countdown apps available for your phone to help you remember you’re training. What questions do you have in preparation for race day?