

All the important stuff the female triathlete needs to know!
By Marianne McGinnis
from Prevention, posted on Active.com
Dr. Lisa Cannada, a runner and orthopedic surgeon, offers advice on knee, foot and ankle pain.
As a new runner, I'm not sure when to run through the pain and when to stop and see a doctor. How can I tell the difference between muscle soreness and an injury?
Just because you feel uncomfortable tightness or some minor pain while running doesn't necessarily indicate you have an injury. You could simply be doing something different--running on a new type of surface or terrain, for example--that works your muscles in a new way. If you only feel pain while you are running, and it goes away within two weeks, it's most likely a strain or soreness.
But there are times when it's crucial to see a doctor, as you could have a variety of more serious conditions. Here are four easy ways to know when you should schedule an appointment:
My knees hurt when I run. What can be causing this and what can I do about it? It seems every female runner I know suffers from knee pain.
The No. 1 cause of knee pain for female runners is anatomy. Most women have a larger Q-angle--the angle between the pelvis and the knee--than men. This increased angle can cause a wide variety of problems, from placing stress on the knee to causing foot pronation (an inward roll of the foot).
The easiest way to minimize knee pain caused by your Q-angle is to strengthen the quadriceps muscles. By strengthening the quads through weight exercises such as leg extensions, you can reduce the stress being placed on the knees.
I recommend strength training three times a week to see improvements. Also, building up your quads is vital if you do a lot of hill running. Running downhill is one of the easiest ways to hurt your knees if you don't have the strength in your quads to support them.
Overuse is another major cause of knee pain. Never increase your mileage by more than 10 percent per day or week, no matter how good you feel. Other common causes of knee pain include being a "weekend warrior" and attempting too much without ample training, bad running form or something as simple as tasks around the house that involve squatting or lifting small children.
After my last marathon, I developed a severe case of iliotibial (IT) band syndrome and spent three months in physical therapy. I'd like to run another marathon, but don't want this to happen again. What can I do about it?
I get so many visits from patients with this problem. IT band syndrome is inflammation in the tendon that runs from the hip to just below the knee. Highly painful around the knee for many runners, the problem most commonly occurs during marathon training.
It happens for a variety reasons, including running constantly on the same angle--like the same side of a slightly canted street during all of your runs. But the biggest cause is increasing your mileage too quickly. Remember the 10 percent rule!
Adding activities like swimming and using an elliptical machine can help keep your endurance up without aggravating the condition. If the pain lasts longer than two weeks, see a doctor. Physical therapy may be recommended.
To prevent this condition, you need to stretch the IT band regularly--not just after you run but at least five days a week. Adding cross-training into your regular schedule can also help. If you don't take preventative action and you let IT band syndrome become severe, you may end up sidelined from running again.
Many people in my running club have problems with plantar fasciitis. What causes this and what can be done to prevent it?
This is the worst! Plantar fasciitis, which can cause a burning or stabbing sensation in the heel, is most common in people with flat feet. Anatomy and wearing the wrong shoes for your foot type are common causes.
Here's a simple way to know if you have an inflammation of the plantar fascia tissue: if the pain is at its worst when you first get up in the morning. Because these tissues in your feet contract as you sleep, the pain can be significant until your feet limber up, and then it will reduce in intensity.
If you have this type of pain for more than two weeks, go see your doctor. They can provide you with an easy cure: a night splint, which stretches the tissues as you sleep.
After a long run, do ice baths help reduce muscle soreness and inflammation? If so, how soon should you take one for it to be effective?
You don't need to take an ice bath unless you are in the top five percent of elite runners, who build up a lot of lactic acid in their muscles. (Most of us never have that much lactic acid in our bodies.) I feel stretching and taking an anti-inflammatory are much better at reducing soreness and inflammation for the average runner. If you are training for a marathon, regular massages can help reduce muscle soreness.
I commonly counsel athletes who skip breakfast, grab only a light lunch, train on fumes, gorge at dinner and snack on "junk" until bedtime. They not only rob their bodies of the nutrients needed for health, but also lack energy for high-quality workouts.
A satisfying breakfast tends to invest in better health than does a grab-anything-in-sight dinner. Sarah, a collegiate athlete, learned that fueling her body's engine at the start of her day helps her feel more energetic and also able to choose better quality lunch and dinner foods.
That is, when she has granola, banana and juice in the morning, as well as a sandwich and yogurt for lunch, she stops devouring brownies after dinner.
Excuses to skip breakfast are abundant: "No time," "I'm not hungry in the morning" and "I don't like breakfast foods." Weight-conscious athletes pipe up, "My diet starts at breakfast."
These excuses are just that, excuses; they sabotage your sports performance.
Here's a look at the benefits of eating breakfast. I hope to convince you that breakfast is the most important meal of your sports diet.
Breakfast for Dieters
If you want to lose weight, you should start your diet at dinner, not at breakfast! For example, do not eat a meager bowl of Special K for your "diet breakfast." You'll get too hungry later in the day and crave sweets.
A bigger breakfast (cereal + toast + peanut butter) can prevent afternoon or evening cookie-binges. An adequate (500 to 700 calorie) breakfast provides enough energy for you to enjoy your exercise, as opposed to dragging yourself through an afternoon workout that feels like punishment.
If you are trying to lose weight, you should target at least 500 to 700 calories for breakfast; this should leave you feeling adequately fed. [So NC has it about the same, if eat 2000 calories a day - L]
To prove the benefits of eating such a big breakfast, try this experiment:
1. Using food labels to calculate calories, boost your standard breakfast to at least 500 calories. For example, add to your english muffin (150 calories): 1 tablespoon peanut butter (100 cal.), 8 oz. orange juice (100 cal.) and a yogurt (150 cal). Total: 500 calories.
2. Observe what happens to your day's food intake when you eat a full breakfast vs. a skimpy "diet breakfast." The 500+ calorie breakfast allows you to successfully eat less at night and create the calorie deficit needed to lose weight.
Remember: Your job as a dieter is to fuel by day and lose weight by night. Successful dieters lose weight while they are sleeping; they wake up ready for another nice breakfast that fuels them for another high-energy day.
Breakfast for the Morning Exerciser
If you exercise first thing in the morning, you may not want a big pre-exercise breakfast; too much food can feel heavy and uncomfortable. However, you can likely tolerate half a breakfast, such as half a bagel, a slice of toast, or a banana before your workout.
Just 100 to 300 calories can put a little carbohydrate into your system, boost your blood sugar so that you are running on fuel, not fumes, and enhance your performance.
You'll likely discover this small pre-exercise meal adds endurance and enthusiasm to your workout. In a research study, athletes who ate breakfast were able to exercise for 137 minutes as compared to only 109 minutes when they skipped this pre-exercise fuel.
After his morning workout, Jim, a banker, felt rushed and was more concerned about getting to work on time than eating breakfast. Using the excuse "No time," he overlooked the importance of refueling his muscles.
I reminded him: Muscles are most receptive to replacing depleted glycogen stores within the first two hours after the workout, regardless of whether or not the athlete feels hungry. I encouraged Jim to be responsible! Just as he chose to make time for exercise, he could also choose to make time for breakfast.
One simple post-exercise breakfast is fluids. Liquid breakfasts take minimal time to prepare and very little time to drink, yet they can supply the calories, water, carbohydrates, protein, vitamins and minerals you need all in a travel mug. (You can always get coffee at the office.)
Because Jim felt thirsty after his morning workout, he found he could easily drink 16 ounces of juice or lowfat milk. Sometimes, he'd make a refreshing fruit smoothie with milk, banana and berries.
Later on mid-morning, when his appetite returned, Jim enjoyed the rest of his breakfast: (instant) oatmeal, multi-grain bagel with peanut butter, yogurt with granola, a banana or any other carbohydrate-rich foods that conveniently fit into his schedule.
This nutritious "second breakfast" refueled his muscles, abated hunger and curbed his lunchtime cookie cravings.
Breakfast for the Noon-time, Afternoon and Evening Exerciser
A hearty breakfast is important for people who exercise later in the day. It not only tames hunger but also provides the fuel needed for hard workouts.
Research has shown that athletes who ate breakfast, then four hours later enjoyed an energy bar five minutes before a noontime workout were able to exercise 20% harder at the end of the hourlong exercise test compared to when they ate no breakfast and no pre-exercise snack. (They worked 10 percent harder with only the snack.)
Breakfast works! Breakfast + a pre-exercise snack works even better!
What's for Breakfast?
From my perspective as a sports nutritionist, one of the simplest breakfasts of champions is a wholesome cereal with lowfat milk, banana and orange juice. This provides not only carbohydrates to fuel the muscles, but also protein (from the milk) to build strong muscles, and numerous other vitamins and minerals such as calcium, potassium, vitamin C, iron (if you choose enriched breakfast cereals) and fiber (if you choose bran cereals).
Equally important is the fact that cereal is quick and easy, requires no cooking, no preparation, no refrigeration. You can keep cereal at the office, bring milk to work and eat breakfast at the office. Breakfast is a good investment in a productive morning.
The Bottom Line
Breakfast works wonders for improving the quality of your diet. That is, eating breakfast results in less "junk food" later in the day. Breakfast also enhances weight control, sports performance, daily energy levels and future health.
Breakfast is indeed the meal of champions. Make it a habit no excuses!
Sample Grab-and-go Sports Breakfasts
Sausalito, CA. LUNA Sport, makers of luxurious cycling clothing for women, has created a program that provides local influencers with LUNA Sport product. In 2010 the LUNA Sport Luminary™ program will outfit 50 influential women around the United States and Canada with a full complement of LUNA Sport clothing and accessories.
The Luminary program is inspired by the efforts of the women working in non-competitive roles in cycling and fitness -women who work as hard as Olympians, but purchase clothing, bikes and equipment to conduct their businesses. The Luminary program aims to provide these strong leaders with access to performance cycling product sufficient for all of their workouts and group events.
"The Luminaries will assist in providing Luna Sport with relevant product feedback - while also spreading the LUNA Sport message to targeted audiences around the U.S. and Canada," said Marla Streb, former LUNA pro and Luminary program manager.
LUNA Sport is accepting resumes for the Luminary Program at http://www.lunasportgear.com/contacts. Applicants will complete the field titled "Your Message," with a brief overview (100 words or less) of their Luminary qualifications. LUNA Sport will review the brief and contact prospective members by 12/1/10.
· The LUNA Sport Luminary™ program will outfit 50 influential women with a full-complement of LUNA Sport clothing and accessories for the 2011 cycling and fitness seasons
· LUNA Sport Luminaries are women working in non-competitive roles in cycling and fitness
· Qualified women can apply online at online by going to http://www.lunasportgear.com/contacts