... about endurance training

Hit the ground running and eradicate 'no pain, no gain'

By Julia Cyboran

At 45, Barrie's Bay sales rep Marcel Petersen decided to take up running. He had a few buddies who were into the sport and he figured it was about time to lose the spare tire. Never one to do things by halves, Mr Petersen wasn't just thinking of morning jogs with the boys. He had a far loftier goal in mind -- he planned to run the Toronto Marathon in October. But there's one little catch: he hadn't been physically active since his university days.

Toronto GP Dr Steve Blitzer advises patients looking to turn over a new fitness leaf to be patient. "I always tell people that you'd be amazed at how it can creep up on you and what your body can do," he says. Dr Blitzer speaks from experience -- the 47-year-old is himself a marathon runner and triathlete. "I probably trained for about seven months, an average of seven to eight hours a week for my first marathon."

There are many programs available to people looking to start training for marathons or any other endurance sport like cycling, duathlons and triathlons, enthuses Dr Blitzer the runner. But speaking as an MD, he cautions that patients should seek advice before jumping into any sort of training regime. "It's a good idea to talk to a physician," he says, "because they can fine tune any health problems and make some healthy suggestions."

As marathon season approaches, you may have a lot of patients like Mr Petersen dashing through your office -- hopefully before the hamstring injury. Here are some tips that you can share with your patients on how to avoid common injuries and how to keep on the path to long-distance glory.

Tips for a healthy start -- and finish
•In the beginning First of all, establish what your patient's fitness goals are -- a half marathon, a full marathon, a triathlon? And how long do they believe it will take to reach that goal? Find what works for the patient. "You can't cookie cut people. Whenever I'm talking to patients about exercise, I first think about what they like," says Dr Howard Winston, a sports medicine specialist and assistant professor at the University of Toronto. "You have to sit down with the patient and set realistic schedules and goals."

•Getting intense It's a good idea to steer your patient toward a moderate training level in the beginning. "For the individual who's just getting started, you want them to get used to the concept of exercise," says Dr Winston. "A safe guideline is to increase distance by 10% each week."

•Insult to injury The most common injuries to plague endurance trainers are muscle strain, joint pain, shin splints and lower back and hamstring injuries. Dr Winston says the four key ways patients can avoid those overuse injuries are by: 1) building up muscle strength through resistance or weight training, 2) building up endurance slowly, 3) stretching to increase flexibility, and 4) doing aerobic exercises to improve cardiovascular health so that more oxygen gets to the muscles. Dr Blitzer adds that you should talk to your patients about a solid cross-training routine. "It's important to always exercise the opposite muscle," he says.

•If the shoe fits Shoes with a good fit and proper support are key for preventing hyperpronation of the foot and to avoid any tendon and joint injuries.

•Eat, drink, run Dr Winston puts a strong emphasis on hydration and a proper diet. "Patients need to know that if they're not hydrating themselves properly, they're leaving themselves very vulnerable to injury," he explains. "I'm not a big fan of the fad diet. Your patients need the proper caloric intake. They need to know that the less they feed their body, the more susceptible they are to injury."

Dr Blitzer strikes another blow to fad diets, saying that patients have to face the fact that they need to consume a balance of carbs and proteins. "It's actually important to replenish muscle glycogen," he says.