Running

Understanding Exercise Induced Asthma

Sports Induced AsthmaHave you found yourself coughing, wheezing or feeling short of breath during or after exercise recently? If so, it may not just be due to being out of shape. It could be caused by Exercise Induced Asthma; also known as Exercise Induced Bronchospasm. Exercise Induced Asthma could be solely triggered by exercise, or due to a variety of other triggers. This, like other forms of asthma, occurs when airways in your lungs constrict and produce extra amounts of mucus, making it hard to breathe.

Symptoms of exercise-induced asthma include:

  • Coughing, wheezing, shortness of breath while exercising
  • Chest pain/tightness
  • Fatigue during exercise
  • Compromised athletic performance

These symptoms can start soon after you begin exercise, and can worsen up to 10-15 minutes after you finish.

Seek immediate medical treatment if your symptoms get worse, since exercise induced asthma can be life threatening in emergency situations:

  • Shortness of breath quickly worsens
  • No improvement even after using a rescue inhaler
  • Shortness of breath continues even after recovery from your workout

There are no clear causes of exercise induced asthma, but factors that can provoke an attack are:

  • Cold air
  • Dry air
  • Air pollution
  • High pollen counts
  • Respiratory infections such as colds
  • Chemicals

No particular exercise is totally forbidden, but those that make you breathe harder can be triggers. These include basketball, running, hockey and soccer versus weightlifting, golfing or moderate walking.

Exercise Asthma risk factors include:

  • Already having asthma
  • Hay fever or other allergies
  • Having a parent or sibling with asthma
  • Smoking or second hand smoke exposure
  • Exposure to chemical triggers such as chlorine in pools
  • Being a child (they tend to be more active than adults)

After being tested and diagnosed by your doctor, they may prescribe two kinds of medicine: Quick Relief and/or Long-Term Control medication.

  • Quick Relief medication is for rapid, short-term symptom relief during an attack. Sometimes a doctor may recommend using it before exercise.
  • Long-Term Control medication is for frequent asthma symptoms that occur even when you are not exercising or when using medicine before workouts does not help. They are taken daily.

If using both, it is suggested not to use the Quick Relief inhaler more than recommended. Get in the habit of recording the number of puffs you take per week. If you find that you need to use it more frequently, talk to your doctor to adjust your Long-Term Control medication.

The good news is that with treatment, you can do intense aerobic activity, along with avoiding causes of attacks by breathing through your nose, wearing a scarf over your nose and mouth, avoiding exercise when the air is polluted or dirty, avoiding exercising near recently mowed lawns, and warming up before exercise and cooling down after.

About Dr. Mason
Dr. Amadeus MasonDr. Mason is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University. He is board certified in Sports Medicine with a special interest in track and field, running injuries and exercise testing. He has been trained in diagnostic musculoskeletal ultrasound, orthopedic stem cell therapy and Platelet Rich Plasma (PRP) therapy. Dr. Mason is Team Physician for USA Track & Field, Tucker High School, and Georgia Tech Track and Field.

Dr. Mason is a member of the American College of Sports Medicine, the American Medical Society for Sports Medicine, the America Road Racing Medical Society, and the USA Track and Field Sports Medicine and Science Committee. He has been invited to be a resident physician at the US Olympic Training Center, a Sports Medicine consultant in his homeland of Jamaica and the Chief Medical Officer at multiple USA Track and Field international competitions. He is an annual speaker at the pre-race expo for PTRR, Publix marathon and Atlanta marathon commenting on a wide variety of topics related to athletics and running injuries.

Dr. Mason is an active member of the Atlanta running community. He attended Princeton University and was Captain of the track team. His other sports interests include soccer, college basketball and football, and the National Hot Rod Association (NHRA). A Decatur resident, he is married with three children.

Related Resources:

Understanding IT Band Syndrome

IT Band Syndrome IT Band Injury

Iliotibial band (IT) syndrome, also referred to as IT band injury or IT band pain, is an injury that affects the outside of the  knee and is caused when irritation or inflammation of the IT band occurs.

If you have ever suffered from IT band syndrome, you know IT band pain is a pain you don’t want to feel again.  The good news is that you can prevent IT band injuries with strengthening and stretching exercises. Pay close attention and follow the information/suggestions here and you may be able to steer clear from the pain of IT band syndrome!

What is the IT Band?

The IT band is the long, strong, thick band of tissue that runs along the outside of the leg.  It starts at the hip area and runs all the way down to just below the knee.  The purpose of the band is to provide stability to the knee during movement.

IT Band Syndrome Causes

An IT band injury is an overuse injury,  primarily caused by inflammation of the IT band.   Tightness in the IT band can cause friction  where the IT band crosses the knee joint.   Causes of IT band syndrome can include:

  • Running up and down hill repeatedly
  • Running on a banked or sloped surface (like an indoor track or edge of a road)
  • Running up and down stairs
  • Weak hip muscles
  • Uneven leg length
  • Excessive foot strike force

IT Band Injury Symptoms

  • Stinging sensation above the knee
  • Swelling or thickening of the tissue where IT band moves over femur
  • Pain may intensify over time and may not occur immediately during activity
  • Pain occurs when foot strikes the ground
  • Pain may occur where the IT band attaches to the tibia

Preventing IT Band Syndrome

  • Warm up and stretch before competing or practicing
  • Recover properly between events/competitions/practices
  • Improve core strength with Pilates type exercises
  • Avoid running on banked surfaces
  • Avoid running the same direction on the track all the time
  • If you have flat fee, where arch supports or orthotics

Check out the exercises in this downloadable document: IT Band Stretching & Strengthening Exercises (PDF). And in this blog post, you’ll find more information on preventing running injuries.

IT Band Syndrome Treatment

  • Rest – most runners don’t want to listen to this advice but rest really will help alleviate the pain
  • Anti-inflammatory medication
  • Ice the painful area
  • Improve flexibility by stretching
  • Physical therapy

We hope you can steer clear of IT band syndrome and keep your legs moving!


Peachtree Road RaceEmory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!


About Dr. Brandon Mines

Brandon Mines, MD

Brandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream and Decatur High School. He is also one of the team physicians for the Atlanta Falcons.  His areas of interest are diagnosis and non-operative management of acute sports injuries, basketball injuries, tennis injuries, golf injuries and joint injections.

Understanding Runners’ Knee aka Patellofemoral Pain Syndrome

Knee PainDo you have pain in the front of your knee behind the kneecap? If so, you may have patellofemoral pain syndrome (PFPS for short), commonly known as “runners’ knee”. Typically runners’ knee is not a product of an injury, but is caused by abnormal leg mechanics including weakness in the quadriceps which result in poor tracking of the kneecap.

You can increase your risk of developing runners’ knee if you have tight hamstrings, or do not warm up enough before an event. Runners often experience patellofemoral pain as they increase their running distance and/or frequency.

Symptoms of Patellofemoral Pain Syndrome:

  • Pain in the knee, usually in the front of the knee, behind the kneecap
  • Pain in the back of the knee or also above or below the kneecap
  • Pain that gets worse after sitting for long periods of time
  • Pain that gets worse after going up or especially down stairs or hills
  • Pain that gets worse when wearing shoes with high heels
  • Pain with jumping, squatting, and lunging
  • “Crunching” or “popping” in the knee
  • Minimal swelling

The good news is that this condition is treatable with improving your overall leg mechanics. You should think about incorporating strength training into your running training so that you strengthen the quadriceps and gluteus muscles. It is also important to stretch the hamstrings and IT band. If you have flat feet or foot pronation (fallen arches) you should consider inserting orthotics in your shoes to support your arches.

If you are diagnosed with this condition, you may have to stop running temporarily until the knee pain subsides, but continuing to run will not cause long term damage. You should at least consider adding in cross training with activities such as swimming and cycling which will be easier on the knee with PFPS and maintain your fitness. Make sure to ice your knee after exercise and take anti-inflamatories like ibuprofen. You may also want to try a neoprene sleeve for comfort.  Refer to this Patellofemoral Syndrome document for some exercises you can safely do to strengthen the muscles, increase flexibility and stretch the quadriceps.

If your knee pain has not improved within 4-6 weeks, you should consult your sports medicine physician.


Emory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Peachtree Road RaceEmory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!

About Dr. Jeff Webb

Jeffrey Webb, MDJeff Webb, MD, is an assistant professor of orthopaedics at Emory Orthopaedics & Spine Center. Dr. Webb started practicing at Emory in 2008 after completing a Fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in pediatrics and sports medicine. He is a team physician for the NFL’s Atlanta Falcons, and serves as the primary care sports medicine and concussion specialist for the team. He is also a consulting team physician for several Atlanta area high schools, the Atlanta Dekalb International Olympic Training Center, Emory University, Oglethorpe University, Georgia Perimeter College, and many other club sports.

Dr. Webb sees patients of all ages and abilities with musculoskeletal problems, but specializes in the care of pediatric and adolescent patients. He works hard to get players “back in the game” safely and as quickly as possible. He is currently active in the American Medical Society for Sports Medicine and American Academy of Pediatrics professional societies and has given multiple lectures at national conferences as well as contributed to sports medicine text books. Dr Webb is an avid runner and has completed 16 Peachtree Road Races.

Related Resources

 

Preparing for the AJC Peachtree Road Race: Answers to your Running Questions

Dr. Amadeus MasonLast week I had the opportunity to chat online with over one hundred members of the Atlanta running community to answer their questions about running and how to prevent running injuries to help not only those participating in the AJC Peachtree Road Race, but all runners in our city and state. We had so many questions from the chat that I didn’t get a chance to get to all of them, so I wanted to circle back with the participants that didn’t get answers to their questions. You’ll find my answers below in a Q&A format. If you didn’t get to attend the live chat, or just want a recap, check out the chat transcript (which you can also print), and don’t forget to check out the additional resources and questions and answers below.

For those that are running in the AJC Peachtree Road Race, I wish you a healthy and successful race!

ACL Injuries and Young Female Athletes

Thank you for joining me for the live chat on ACL injuries last week!  We had some excellent questions. One participant asked a key question about young females and ACL injuries and I would like to expand on my response to this important subject.

There are a growing number of  female athletes who are tearing their ACLs.  In fact, young female athletes (under 20 years old) are four to eight times more likely than males to injure their ACL.  Even though extensive research has been done on the reasons why this could happen, we are not exactly sure why females tend to injure their ACL easier. Luckily, if a young woman injures her ACL  we are able to get most athletes back to their previous level of play due to advances in arthroscopic surgery and specialized physical therapy.

Full recovery may take about eight to 10 months but important to note, is in rehabilitation, experienced physical therapists are working with the athlete to help them avoid re-injury.  The physical therapists and athletic trainers are teaching young girls how to jump, how to land, how to contract muscles correctly as well as specific exercises that will help strengthen the knee.  Some of the things we are teaching young female athletes are not instinctual but will greatly help reduce the risk of future injury if implemented correctly when the athlete starts participating in their sport again.

If you have had a ACL injury please make sure to work with your physical therapist to make sure you are working some of these aspects into your recovery.  If you have not had an ACL tear but you are a young female athlete, do some research on how to avoid injuries so you can excel in your sport without injury. One recommended source is the PEP Program which seeks to prevent ACL injuries.

For the full transcript on the chat visit - http://advancingyourhealth.org/orthopedics/past-doctor-chats/acl-injuries-chat/

About Dr. Sam Labib

Dr. Labib is an Emory Sports Medicine orthopaedic surgeon with special interest in problems and procedures of the knee, ankle, and foot. He is the head team physician for the athletic programs at Oglethorpe University, Spelman College, and Georgia Perimeter College. He is also an orthopaedic consultant to the Atlanta Faclcons, Georgia Tech and Emory University.

He has lectured both nationally and internationally at many orthopedic meetings. His research has been published in several journals, including JBJS, Arthroscopy, Foot and Ankle International and the American Journal of Orthopedics as well as numerous video presentations and book chapters. Dr Labib is Board Certified in orthopedic surgery with additional subspecialty certification in Sports Medicine Surgery.

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How to Prevent Plantar Fasciitis – a Common Running Injury

Plantar Fasciitis

It is almost spring time and many runners will be ramping up their running mileage in preparation for spring and summer running races! Take a couple of minutes to read this blog post to learn about ways to prevent a painful and irritating condition called plantar fasciitis.

Plantar fasciitis is a common running related injury and is often caused by excessive running, wearing the wrong type of shoe while running, wearing shoes that are too old and worn out while running, or building up running mileage too quickly. Plantar fasciitis involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.

Takeaways from Running Injury Live Chat

Dr. Amadeus MasonOn Tuesday, Dr. Amadeus Mason of Emory Sports Medicine, held a live chat that answered your questions about preventing running injuries. Dr. Mason provided some great answers to some very interesting questions; from how to prevent running injuries to the ideal length of time one should consider when training for a 5k and other long distance races.  Dr. Mason also provided participants with resources on things like: knee pain and strengthening and IT Band Syndrome.

The following is a recap of the live chat, or you can check out the transcript from Dr. Mason’s Preventing Running Injuries chat.

Q. Is it better to stretch before a run? After a run? Or Both?

A. For runners stretching for flexibility, it’s better to stretch after their run, because muscles are looser and more receptive to the stretch at that time. Dr. Mason also noted that while stretching before a run doesn’t hurt, runners should keep in mind that it’s best to spend at least ¼ of the time you spend running on stretching. As an example, Dr. Mason suggests if a runner trains for an hour, it’s best to stretch for at least 15 minutes.

Q. How does a runner prevent shin splints from reoccurring and preventing the pain’s longevity?

A. Runners experiencing recurrent shin splints, or moderate to severe pain in the shin that lasts for a long period of time, should see a specialist. Make sure not to train too much, too quickly, that’s one of the most common causes of shin splints, according to Dr. Mason. If shin splints occur, it’s recommended that a runner modifies their training regimen to accommodate for pain relief. Females, who experience shin splints on a fairly regular or recurrent basis, should contact their Physician.  Continuous shin pain is a possible indication that there’s some sort of hormonal imbalance or insufficient caloric intake from a female runner’s diet.

For more information on preventing running injuries, check out Dr. Mason’s chat transcript. You can also download the resources he shared in the chat by using the links below.

Related Resources

10 Tips for a Healthy Peachtree Road Race Run

Peachtree Road RaceRunning is great exercise for your health and your mind. Follow the tips below to ensure that you are in top form on race day. Have a safe and fun Peachtree Road Race!

  1. Hydrate yourself frequently before, during and after running in order to loosen muscles.
  2. Warm up and/or stretch before the race to loosen tight muscles.
  3. Run slower in hot weather in order to avoid heat stroke, heat cramps or heat exhaustion.
  4. Use hand lotion on feet and areas of chafing to prevent skin damage and blisters.
  5. Don’t forget to use sunscreen to protect against sunburn.
  6. Wear sunglasses to reduce glare and avoid tripping.
  7. When your energy is gone, imagine someone running in front of you and pulling you forward.
  8. Get your rest! Sleep one extra minute each night for every mile you run. For example, if you run 30 miles a week, sleep 30 additional minutes each night.
  9. Change soggy, sweaty socks soon after the run and stuff shoes with newspaper to avoid moisture buildup.
  10. Pay attention to your body! If you experience pain during or after the race and it does not go away, something may be wrong. Schedule an appointment with an Emory Sports Medicine physician.

Related Running Resources:

Still looking for more tips? Check out the transcripts from a few of our recent MD chats on running using the links below:

Runners’ Chat with Dr. Mason Part I

Runners’ Chat with Dr. Mason Part II

More Running Questions Answered

More Runners’ Chat Questions Answered

Dr. Amadeus MasonOn Wednesday, I held a live chat on the topic of running to help those preparing for the Peachtree Road Race and to educate runners of all skill levels on injury prevention, nutrition, and technique. It was my first so-called “live chat,” so I really didn’t know what to expect. The questions that I received in yesterday’s chat were fantastic. Not only do I feel like I got to help the 50+ people who joined me in the chatroom, but I myself was able to learn something in the process. Typically when I chat with people who have questions for me, they are my patients, in a one-on-one setting. This really gives me the time to feel them out and learn about them as individuals. Wednesday, I was charged with a new and equally inspiring and fulfilling task– to educate a group, without being able to see them in person or learn about them before we talked. It was an extremely eye opening experience.

I want to thank those who joined me Wednesday for a wonderful chat. It was so successful, in fact, that I didn’t get a chance to answer each and every question. For those who were in the room, I promised to follow up with a blog to answer all questions that were unaddressed, and I have done so below. At the bottom of this blog post, you will also find the documents I mentioned in the chat for your further reference. As an added bonus, to make sure everyone gets a chance to discuss the topic of running and all of its facets with me, we will be holding the next live chat on running on June 15th. PART II CHAT TRANSCRIPT

Larry: I ran a marathon with IT band issues.  What can I do to prevent it in the future?
Dr. Mason: Larry, to prevent IT band problems, you should strive to work on increased flexibility. I’d advise that you watch the rate at which you increase your mileage/distance and start training early enough to allow for a slow and steady progress with sufficient recovery times between training sessions.

Shirley: Dr. Mason, Why does my back hurt periodically when I am tired while running?  Should I bend over to stretch?  I am a beginner.
Dr. Mason: I can’t speak to your specific medical circumstances without seeing you in-person, but generally speaking, oftentimes people experience back pain while running due to hamstring tightness. For these patients, I advise that they avoid the typical stretch that involves bending over, and instead focus on extension type exercises.

M. White: How do I know when it is time for new running shoes?  This will be my first time running longer than a 5k.
Dr. Mason: My recommended guidelines for footwear are if you run more than 20 – 25 miles a week you should change you shoes every 3 – 4months ( ~300 miles); if you run less than 20 miles a week can change shoes twice a year.

Sylvia: Hi. Dr. Mason. Is there any particular type of shoe that you would recommend as best for protecting against injuries; Knees, ankles, shin splints, etc.?
Dr. Mason: Studies have shown that shoe comfort is a more important factor in preventing injury than the actual type of shoe.  I would recommend you get evaluated at your local running store to determine what class of running should would be best for you. After doing that, go ahead and pick the most comfortable one in that class.

Judy: I’m used to walking about 3 miles about 3 times a week.  I am signed for the Peachtree.  Obviously I will be walking it.  I have 6 weeks to step up my training.  How would you suggest I proceed to get to 6 miles in time for the race?  Thanks.
Dr. Mason: Good question, Judy. I’d recommend adding about ½ mile to your distance each week.

Steve: Dr. Mason, I have a chronic hamstring issue.  What can I do to help the issue?  What type of Dr. or therapist should I seek out for help?
Dr. Mason: I would recommend you see a physician with sports medicine training.

M. White: I have been training for a 5k (took 30min) – which I ran a couple of weekends ago.  To train for the Peachtree what should I do?  Increase distance or time?
Dr. Mason: My answer here depends on whether you want to run the Peachtree for time or just for fun.  Since this race is twice the distance of a 5k,  I would start out increasing your distance (1/2 mile a week. Once you get to 5 miles then you can start increasing your pace.

Mac: What are some good lower-fat proteins for vegetarian novice runners?
Dr. Mason: As a vegetarian you should be concerned about getting in GOOD fats as opposed to LOW fat.  To that end eating things like beans, nuts and/or soy would be good choices.

Dawn: When I ran the Peachtree last year, I found it difficult to actually drink water at the hydration stations (did more of a swish-and-spit).  I am concerned about dehydration during the race.  Should I increase my fluids before the race?
Dr. Mason: Yes, in a 10K there is LESS risk/concern for dehydration that in half or full marathons, but you should be starting your hydration process now.  I recommend increasing you fluid intake (electrolyte/water) weeks before you run and incorporating “water stops” in to your training.  You know you are well hydrated when you have to use the bathroom 30 min after fluid intake (when you’re not running).

1st Timer: Are there any weight training exercises you recommend?
Dr. Mason: In order to answer this question in detail, I would need more information from you.  What I can say is that weight /strength training should be a part of any running program. This type of training should primarily (but not solely) focus on lower body strength and be accompanied by a good flexibility program.

Jacqui: How frequently should you increase pace or distance?
Dr. Mason: I normally recommend increasing distance then pace. But, as we mentioned in the chat, it really depends on the goals you’re looking to achieve. If you are looking to run a long distance race, you’ll probably want to focus on increasing distance, more often than pace, and doing so every 2 weeks should work well. Just remember to never increase both distance and pace at the same time.

Shalewa: What about energy enhancers like sports beans or 5 hour energy drink?  Are those bad for you?
Dr. Mason: Most “energy enhancers” are just caffeine or a caffeine derivatives and I would stay away from them as they greatly increase dehydration risk.  Good nutrition that balance carbohydrates, proteins and good fats should give you the energy you need for a 10K.  With marathons, ultra marathons, and triathlons in-competition metabolic supplements (which are very different from the energy enhancers) are often provided and can be helpful.  You’ll want to be careful and make sure that you are using them throughout your training so your body has time to adjust.

Jennifer: Hi, Dr. Mason.  I am an active person who is new to running.  After my training runs I am experiencing some discomfort/tightness in my upper and outer knees.  What can I do to help prevent this?
Dr. Mason: If these symptoms are not preventing you from doing the type/intensity of run that you want, then I would recommend working on the flexibility and strength of you quads and hamstrings.  If you are having to modify your training runs then you should see a Sports Medicine Physician.

Thanks again to those who joined me in Wednesday’s chat. I hope to see you all in Part II on June 15th! Below are the documents I referenced in the chat, please feel free to download them and keep them for reference. If you missed Part I of the chat, you can check out the chat transcript. You can also sign up to attend Part II of the chat, which is taking place on June 15th at 12pm.

Related PDF Downloads:

 

 

Are You a Runner Looking to Prepare for the Peachtree Road Race?

Peachtree Road RaceDr. Amadeus MasonThe Peachtree Road Race is right around the corner! Whether you’re a beginning runner and wondering how to get started, or a seasoned pro and have been running for years, there always new things to learn about training, nutrition, attire, and even injury prevention. As a runner, training for peak performance is key.

No matter what running category you fall into, you can join me on Wednesday, May 18 from 12 – 1:00 p.m. for an interactive online Q & A web chat TRANSCRIPT on healthy running. Much of what we cover will be dependent upon your questions, but the chat will span a wide array of running related topics and I will be available to answer questions and discuss them, including how to best prepare for Peachtree Road Race success!

If you are interested in learning more about running benefits, prevention, and tips, register for the live chat now. Spread the word about our online runner’s chat to your fellow runners, friends and neighbors. I’ll see you on the 18th!

RUNNERS CHAT TRANSCRIPT

 

About Dr. Mason
Dr. R. Amadeus Mason is a board-certified physician at Emory Sports Medicine with a special interest in track and field, running injuries and exercise testing. He is the team physician for USA Track and Field and the Nike/National Scholastic Sports Foundation Track and Field and Cross Country meets, Tucker High School, and Georgia Tech Track and Field. Dr. Mason is an active member of the Atlanta running community.