The Runner's Survival Guide

There are many physical challenges on the run. Here's how to keep them to a minimum


Posted: 16 May 2005
by Martha Schindler

Sometimes, running is the simplest of activities. One foot follows the other, taking you from point A to point B by the shortest, most straightforward route. But other times, it can be fraught with discomforts ranging from the mildly annoying to the downright dangerous. Here’s our list of the more common pitfalls, and ways to avoid them once and for all.

Lightheadedness

Every runner wants feet as light as feathers, but what if you're getting that ethereal sensation at the other end of your body? Dizziness is often a sign of dehydration or oncoming heat illness, according to sports doctor David Jenkinson. "Even slight dehydration immediately impacts performance," he explains. "It is a danger even in the colder winter months."
Dizziness can also be caused by a shortfall in nutrients, especially carbohydrates. Ironically, feeling dizzy can even be a sign that you’re over-hydrated. "This isn't nearly as common as dehydration," says Dr Lewis Maharam, medical director of the New York City Marathon, "but it can strike a novice who grabs three or four cups of water at every drinks station during a long race, or who chugs too much water on a long training run."
Now what? If you're far from home when dizziness strikes, make a phone call that’ll get you a lift home. At this point, you're probably so dehydrated, or otherwise off kilter, that it'll take an hour or two until you're feeling normal again. If you're still feeling dizzy when you get home, or if the feeling becomes more extreme, call your doctor.
Never again! Drink appropriately, which means 150-350ml of fluid – preferably a carbohydrate drink – for every 15-20 minutes of running. To do this, take your favourite drink on the run, or stash it along your route. And sniff out all the available water along the way – and use it.

Side Stitches

Of course, it's just a tiny cramp in a minuscule muscle. But when you get a stitch, it's easy to imagine being torn asunder like some medieval saint. Stitches strike all runners, from the elite to the novice, but are most common among new runners or those who are pushing themselves to run further or faster than usual. They often occur when food or drink in your stomach pulls down on the ligaments that attach your stomach to your diaphragm. This causes your diaphragm, which controls your breathing, to go into spasm.
Now what? When a stitch strikes, concentrate on expanding your diaphragm on every exhalation, then pull your abdomen and chest in on every inhalation. After four full breaths, visualise the cramp and try to direct your breath to it, as if you were massaging it away. If this doesn’t work after a minute or so, slow to a walk (or stop) and raise your arms over your head for several seconds. This should help the muscle to relax.
Never again! Ease into any increases in speed and/or distance. Also, don't run within two hours of eating a main meal or a large drink. Or at least consume small amounts of fluid frequently rather than gulping a large drink.

Twisted Ankles

Turning your ankle halfway through a run has to be right up there with a tax audit on the list of life's more annoying setbacks. Never mind that it hurts; spraining an ankle also ruins your training, and sometimes your day. If it’s bad enough, it can keep you away from running for two weeks or more.
A twisted ankle can run the gamut from mild to severe, says orthopaedic surgeon Nicholas DeNubile. "If you turn it with enough force, you'll stretch or tear ligaments, which produces dramatic, and almost immediate, swelling." Women are slightly more prone to ankle twists than men because of the sharper angle between their hips and feet, but almost any runner can turn an ankle. You can do it by stepping on an uneven surface, or just by not watching where you're going.
Now what? First, assess the situation: did you slightly roll your ankle, or did you slam it over and really do some damage? "If it's very sore and swelling quickly, you're done for the day," says Jenkinson. Call a taxi. If you must walk home, be sure to do so gingerly – with both shoes on. "I'm always amazed at how many people take off their shoe to check the damage, then never put it back on," Jenkinson continues. "Wearing your shoe will help keep the swelling down, and should keep you from taking another bad step."
Never again! If twisted ankles are a problem, find a podiatrist who can evaluate your gait and possibly fit you with stabilising orthotics. Add strengthening exercises to your routine. Try rubber resistance tubing or wobble boards, which are designed to build balance and strengthen the muscles in your lower leg.

Shortness of Breath

Wheezing and feeling short of breath are classic symptoms of asthma and its cousin, exercise-induced asthma (EIA), which affect over a million Britons. Asthma and EIA are more common among athletes than the general public. (One in four of the athletes at the 1998 Winter Olympics and one in six at the 1996 Summer Games had some form of asthma.) EIA is characterised by spasms in the airways in response to physical exertion, often occurring only in specific conditions (such as cold weather or polluted environments). Asthma involves bronchospasms plus chronic inflammation in the lungs. But wheezing is not the sole domain of asthmatics. Anyone can feel short of oxygen if the conditions are bad enough. When it’s really hot, or when the air quality is really bad, even top runners will have a hard time.
Now what? If you're gasping your way through your run, slow down and cut it short. Whether it's asthma, humidity or plain old pollution that is interfering with your breathing, the result is the same: less oxygen is being delivered to your muscles. And that translates into greater exertion (and longer recovery times) for the same run.
Never again! Pay close attention to the weather reports, especially air quality, and ease back on both the duration and the intensity of your runs on problem days. Also, be sure to bring your inhaler on every run, and start slowly. Many runners find that a 10-minute easy warm-up before every run keeps them from getting attacks.

Stomach Queasiness

There's nothing like the sensation of fighting with your food long after you've eaten it – for example, while trying to finish a race or training run. Some runners have more sensitive stomachs than others, and running has a funny way of turning those little sensitivities into full-blown crises – and always when you’re miles away from home.
Now what? Depending on your tolerance for public vomiting, you might want to take the shortest route to relief (and take comfort in the fact that you’re neither the first runner nor the last to lose their lunch). A less dramatic option is to take a breather and walk for a while. Even sit on a bench or on the ground for a minute if that helps. Pregnant women have been known to nibble on crackers to quell morning sickness, and some runners keep an energy bar on hand for the same reason – a little bit of food can help when nausea strikes.
Never again! Know your stomach's idiosyncrasies – and obey them. If you're travelling overseas, stick to familiar foods where possible. Don't skip the pre-run food entirely. Eat at least a few bites of a bagel, banana or energy bar before heading out. If you have a bigger meal, eat it at least an hour before you start your run (experiment to find your own personal cut-off time).

Blisters

While the medical and sports communities wrestle with the age-old question 'to pop it or not to pop it?', runners have a more pressing concern: what do you do when a blister appears in the middle of a run? Blisters form when the skin is exposed to repetitive friction, which causes the top layers to separate. Then the fluid arrives at the site as the body attempts to protect the area from any more damage.
Now what? As soon as you feel a blister, take a break and apply a good anti-blister patch (eg Compeed). These are made with gel, and are specifically designed to absorb the friction that would otherwise be inflicted on your skin. Once you get home, wash the area and keep it dry to encourage speedy healing. If you pop it (and we're not saying you should), be sure to use a sterile needle, make a tiny hole at the edge of the blister and leave the top skin in place.
Never again! Make sure that your shoes and socks fit properly. Blisters aren’t part and parcel of an active life. They're evidence that your feet and your footwear are mismatched. Always wear clean, well-fitting running socks made from a wicking, synthetic fabric. You can add an extra layer of protection by wearing two thin pairs of socks, or trying a single double-layer model.

Chafing

Right up there with blisters are those insanely painful little patches of raw skin that appear after a few miles of running (and rubbing). Lots of men get abraded nipples; women tend to chafe along the bra line, under the arms or between the thighs (when running shorts hike up).
Now what? Slap on some good, old-fashioned petroleum jelly or any other ointment that lubricates the area (even lip balm will work in a pinch). Then re-apply every hour or so.
Never again! Be sure you’re running in soft, broken-in clothing without any irritating seams. If traditional running shorts tend to ride up on you, try tights or bicycle-style shorts. Coat problem spots with lubricant before you leave home.

Bathroom (or Lack Thereof) Woes

Faecal incontinence, while it can be a medical condition in its own right, most often strikes runners who are experiencing diarrhoea (which, in turn, can be caused by a reaction to certain foods). Then there's urinary incontinence, in which a small amount of urine leaks, often during times of exertion. This is a problem for thousands of Britons – mostly women; usually those who have had children.
Now what? Find the facilities (or a secluded shrub, if need be) as soon as possible. And don't worry about appearances. "I can't tell you how many times I've gone into a fast-food restaurant, made a beeline for the bathroom, then walked out again without buying a thing," says marathon runner Jim Spivey. "I used to feel awkward, but not any more. People understand. And it’s much better than the alternative." If you've had to go au naturel, or if you've had incontinence of either type, it's very important to clean the area as soon as possible. Both types of leakage will irritate your skin. (Think nappy rash.)
Never again! "Be sure to use the bathroom before you leave home," says Dr Cathy Fieseler. "Learn every toilet on your route, and run under the assumption that you'll have to make at least one pit stop." If urinary incontinence is a frequent problem, talk to your doctor about remedies as well as exercises that you can do. If diarrhoea is your downfall, take a close look at your diet – and don’t overlook anything, even if you never have a problem on non-running days. For example, some people have trouble digesting milk, but only when their bodies are under stress, such as during a run.

Tweaks and Twinges

Let's face it, running can produce all sorts of aches and pains. Most are normal by-products of muscle strengthening and endurance building, but others are signs of damage to muscles, bones or connective tissue.
Now what? "If you're running and you feel a slight pain or twinge, give yourself another minute or two to see if it goes away," suggests Jenkinson. If it doesn't, stop and try to stretch it out. If that still doesn't work, call it a day. "Running will often involve some discomfort. The key is to recognise when discomfort turns into pain, and react accordingly. And if something is hurting so much that it’s affecting your stride, stop," says Maharam. "Otherwise, you can actually damage something else on top of the original injury."
Never again! Know your body and pay attention to little problems before they become chronic. If you've been having twinges (or are recovering from an injury), run in a loop or cloverleaf pattern so that you're never too far from home, and stop if the pain worsens.

Bailing Out

You've set out to do your weekly long run, and you're about a quarter of the way into it when you suddenly feel the urge to stop. Right where you are.
Now what? Assess the situation, says Jenkinson. "Are you truly, physically too tired to go on? If so, then stop. There are certainly times when it's smarter to quit." If things aren’t quite so bad, walk for a few minutes, drink some energy drink or eat a gel and start moving again. Then take regular walking breaks the rest of the way.
Never again! The key to avoiding these situations is to plan ahead. Be sure to eat and drink properly before heading out, and start conservatively. Keep the pace down until well into the run. As time goes on, you’ll learn what you can and can’t do as a runner. That confidence also lets you make the commitment to finish every run, without any problems. This helps eliminate all those mental battles along the way, which can be mentally exhausting all by themselves.

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Discuss this article

I recently moved to BErmuda and am having difficulty climatising to running in the heat and humidity out here.

Any ideas on how long it should take before I'm back to normal (whatever that is) or any tips on how to ease myself back up to the standard I was running in the cooler conditions of England?
Posted: 22/08/2005 at 17:54

Bermuda!!

If you are asking for sympathy - forget it


Posted: 23/08/2005 at 09:05

There is a chap called Dubai Dave who posts on here, I read something by him about runners adjusting to the heat there a bit ago, if you can track that down.
Posted: 23/08/2005 at 13:51

Hi Matt,

I know how you feel about running in Bermuda I was there in 1988 for four years. It does get easier you just have be a bit more realistic in your goals. Running in England is totally different, as you've found out. Stick at it.

Posted: 02/01/2006 at 01:22


K9
Hello MC3! I'm over in Perth, Australia on holiday and wondering the same thing. I was advised to train early mornings before it gets hot, and temperature-wise it feels lovely. I also take water even for shorter runs and am trying to drink a lot more during the course of the day. However early morning is a really bad time for me and I never seem to perform as well - in the UK and certainly not here either .I think it must get easier with time though. There are also lots of air-conditioned gyms for speed work and the like I guess - don't know if the facilities are similar where you are.
Posted: 02/01/2006 at 08:15

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