To heel, or not to heel...

I started running almost 40,000 miles ago (actually, I should hit 40k sometime late 2010). Fortunately, I was once in "the industry" and received dozens (if not hundreds) of pairs of shoes either free or close to it. While I don't know how many pairs I've worn, I can recall every brand and model in which I've logged miles.

As my body adapted, my ideal shoe type changed. In the earliest days (before I learned about running biomechanics and before I discovered some great running shops), I wore cheap, poorly cushioned and non-stability shoes. I actually ran a half marathon in Guadalajara in Nike crosstrainers. Needless to say, I blistered badly and could barely walk for a week.

Soon after that, a local running shop fitted me in a moderate stability shoe. I logged a couple thousand miles over the next 2-3 years in shoes like the Asics GT 2001, Nike Structure Triax and Brooks Adrenaline. With all of those miles, my body adapted (the daily stretching and strength training helped, too). Soon, I was running in neutral trainers like the Adidas SL96, Brooks Cheetah, Adidas Ozweego and Saucony Jazz.

A couple of years ago, I took up barefoot running 1-3 times per month. Thanks to the adaptations in my gait, my current trainers of choice are cross country flats. Yep, went from no stability to moderate stability to no stability/no cushioning. Funny thing is, my body feels better now with these basic shoes than it ever did with "cushioned" shoes.

You could spend hours online reading about the benefits of barefoot running or minimalistic running. For a more brief and basic read, check out this article by podiatrist William Rossi.

If you're interested in shedding a few ounces from your feet, please do it gradually. Take your time in the journey towards minimalism or barefoot running. I took around 30,000 miles to make the change that maybe could have been accomplished in half the time. Still, that would have been 15,000 miles, or 5-6 years of running.

Now, get out there and run!

Run, don't trot

None of us was born a runner. At some point, all runners experience that moment of being a runner. With running comes a universe of great side effects: increased endurance, lower body weight, stronger bones, decreased joint problems, etc. With running also comes a host of problems: sprain/strain injuries, chafing, sunburns, over-training, etc.

For the most part, we were all aware of the typical problems that runners endure (chafing being a possible exception to that list). One issue with which MANY runners contend is gastro-intestinal related. Sure, we all have to use the restroom before a race, but some people really struggle with what has become known as runner’s trots.

Patients don’t typically seek out my services to help them with this. Gastro-intestinal problems are not very often discussed by patients with any health care provider. It’s believed that is why colon cancer is so deadly---the stigma associated with the bowels is so strong that patients would rather ignore gravely serious problems than have to discuss them with a healthcare provider. Often, patients come to me with an aching achilles or a sore low back. At some point during the course of treatment, he or she will mention having the symptoms runner’s trots.

There’s no set group of symptoms that defines runner’s trots. Typically, it’s defined as cramping, flatulence, diarrhea and/or nausea during or immediately following a run. If you google the problem enough, you’re sure to find countless recommendations on how to deal with this, including not eating or drinking before or during a run, using Immodium before every run, increasing water intake, decreasing water intake, eliminating wheat from your diet, and many, many others.

My advice is this: first, talk to your healthcare provider so he/she can help to determine that nothing more serious is occurring. And second, change your eating and running routines until you find one that works for you. I have a friend who cannot run before 8 a.m. without suffering diarrhea during a run, and another one that must run after 3 p.m. for the same reason. Some patients have found eliminating caffeine was the key, while others found no change. As similar as we all are, we are also very unique (see, your mom was right!). Don’t be discouraged if you have not yet found the solution. It’s probably out there, waiting for you to discover it.

The next step you might take is to research irritable bowel syndrome. The symptoms of IBS are essentially the symptoms of runner’s trots. Some of the dietary restrictions of IBS are on the extreme end of the spectrum (good-bye pepperoni pizza and Guinness), but they may be the solution to an uncomfortable problem.

If all else fails, live with it. Find an area where you like to run that has numerous restrooms. Maybe over time your body will adapt and the problem will lessen. If it doesn’t at least you can still run.