The New Jersey Marathon is very interested in helping you to be ready to race with us and in providing as much information and help to you as we can!
This blog is an example of that commitment to helping you as you train and plan for race day.
Our Race Director posts his weekly updates here in order to help you think through and plan for the entire weekend experience with us. From planning for: the Expo and Race Packet Pick-up, your arrival time prior to the start of your race, the fluids and food you will find on the course, the post race Festival, and many other parts of your time with us, he is the person with the answers.
On the other hand, if something physical is bothering you during your training, this is the place to turn for advice. Weather you are seeing signs of wear on your body (it could be a blister, a dull ache, an occasional twinge) or perhaps dealing with a more serious pain or injury, we are here to help you sort through the many questions about what it could mean to your training and racing, what to do right after your injury, when to seek in-person medical help, and much more.
Please leave a comment on this post for Joe (our RD) or Christine (our PT) and they will get back to you as time permits. We hope that you will understand that as we get closer to race day, these people will be increasingly consumed with that work, and their responses will likely be slower than normal.
In addition to having a full time PT practice to manage, Christine is also a member of our Race Committee and is in charge of the exciting, free, speaker and exercise series during the expo days, as well as the therapists who will be providing the free messages, etc. in our Recovery Tent in the Finish Area on race day. Please note: Christine will not provide an online diagnosis of your issue, but she will attempt to help you to think about the issue in the best possible way in order to help you find a suitable resolution, as quickly as possible. She is NOT soliciting for your business. She is an athlete and knows what it’s like to train and work through pain and injuries.
We hope that you will benefit from their knowledge and advise. All you have to do is ask your question, by commenting on this or any other of their posts on this site.
Best wishes,
The New Jersey Marathon Race Committee
The Novo Nordisk New Jersey Marathon & Half Marathon Blog 
Christine I was hoping you could help me out with my right hamstring issue. I tweaked it a little over a month ago but was able to run by keeping the pace down and the incline up on the treadmill. As soon as I tried to speed up I would feel it more and more.
I was able to do a 18 miler March 22. This was my last long run.
Last week all was going well until Sunday night when I was 7 miles into my 15 miler when my hammy tweaked on me again. Here’s the weird part, I’m able to do Insanity (part of my training) in the mornings and it doesn’t really bother me, it’s when I run.
I’m no stranger to Marathons (4 NYC’s) but this being my 5th I really wanted to do Jersey. I’ve averaged 35 miles per week and long runs of 15 miles on 2/11, 2/15, 2/22, 18 miles on 3/2, 3/22 and 20 miler on 3/15. I’m concerned about getting the last two long runs in before my taper.
This week I’m on the bike instead of my runs and it’s slowly getting better but I’m concerned that when I attempt my long run of 18 this Friday I will only tweak it again. Should I take off running until next weeks 20 mile tune up? As long as it doesn’t hurt during Insanity can I still continue those workouts? Any other advice?
Let me start by saying that the best recommendations I can make would be after an in person examination (or having your preferred health care provider take a look at you), but here you go:
It sounds like you have a hamstring strain, but there are a bunch of factors that contribute to your symptoms. The intensity or grade of the strain is dependent on a few factors: the type of muscle or connective tissue involved, the amount of tissue involved, as well as other structures that could contribute (low back tightness, calf tightness, history of low back or nerve issues).
Other factors that affect your symptoms include: fatigue as you run longer, stride length as you speed up, and mechanics of the activities during your “Insanity Work out.” Whatever it is that had changed in your mechanics during your Sunday night run was enough to put strain on the recovering tissue. (Not to mention the unknown variable eating right and giving yourself the building blocks to recover during runs, and to fuel yourself while running.)
While you are biking, and during your Insanity work out, there is a different degree of stretch and demand on your hamstring. So if the strain is mild, you wouldn’t experience the same physical discomfort/ degree of tweak. While doing these activities, you are strengthening the hamstring in a shortened position because it is not stretching at the hip and knee joints fully. When you go to run, the mechanics are different, and you experience muscle fiber demand/strain in a different way.
Various health care providers are going to do their exams to get to your diagnosis, but as far as treatment: tissue work is a must. You have to get the strained fibers to heal with a proper length tension relationship to avoid recurrent strain when running. Other modalities (heat, ice, electrical stimulation, kinesio taping, strengthening hip stabilizing muscles, stretching tight/imbalanced muscles) are all components that will help you get on track faster.
Evaluating how you respond to running your shorter distances, and based on the above assessment information, you will have the best answer on how soon to get those long runs in. You may also want to try water jogging or an elliptical machine mixed in with your cross training so that you don’t tighten your hamstrings up on the bike.
Hope this helps. Feel free to contact me with any other questions.
Christine M. Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
http://www.wilsoncenter.com
I got a blister on my toe during the week and am looking for the best way to treat it and prep it for long runs. Any recommendations? Thanks for your help!
The key to dealing with blisters is not getting them. However there are ways that you can manage them so that you can continue with your training. The longer you can keep skin over the blistered area, the better, so it is not recommended to remove the skin from a raw blister site.
If the blister is small enough, you can try using mole skin to protect the area and relieve friction:
1. Cut a piece of moleskin that is large enough to cover the blister and yet leave a decent border around the irritated area.
2. Fold the moleskin in half so that you can cut a hole that will expose the blistered area.
3. Place the moleskin on your toe so that the remaining border will protect the edges of the blister from sustaining more pressure.
Another alternative is to pop the blister by following the following steps, but then keeping the area clean is a must:
1. Wash and clean your hands and feet.
2. Prep the area with rubbing alcohol.
3. Sterilize a needle with rubbing alcohol.
4. Carefully puncture the side of the blister in several spots so that you can drain the blister with a clean tissue, gauze, etc.
5. Apply antibiotic ointment and cover the area with a band-aid, etc.
6. Once the blister is dried out (after 2-3 days) you can use a piece of moleskin to cover the area.
In the future, the key to avoiding blisters includes reducing friction and pressure points of the foot and toes, using appropriate footwear, and maintaining proper hydration.
To reduce friction:
You can try foot powders, glide products, and vaseline. A double sock (I use Wright Socks and have never had a problem since switching to them) is really helpful.
Proper foot wear:
Make sure that your sneaker accommodates for the swelling of your feet as you get up into your longer distances. I will never forget the first time I trained for a marathon and once my mileage got over 10-14 miles with some regularity, my feet did some crazy things. My toes seemed to spread out, my feet swelled a bit… I even got some numbness between my second and third toes (Morton’s Neuroma). And all of that was addressed by switching brands of shoes. A good running store can help you with the proper fit.
Proper Hydration:
Avoid the swelling in your feet mentioned above by monitoring your hydration. Drinking fluids during your run isn’t necessarily enough. Fluid levels in your body need to be in balance (or homeostasis) throughout the day. If you over-hydrate and take in excess sodium, fluid retention causes your toes to swell. Swollen toes can rub on each other, and swollen feet can rub on the shoe. If you underhydrate and lose too much sodium from sweating, fluid tends to accumulate in your feet because you actually retain fluid in extremities. As you train, it is important to modify your hydration not only during your run, but during the day. One of our previous blogs has talked about nutrition and hydration (https://njmarathon.wordpress.com/2013/03/13/fueling-your-body-during-training/)
Good luck with your training, and be sure to check back if you have any other questions.
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
ChristineScaranoDPT@WilsonCenter.Com
I ran my first 20 miler two weeks ago, and it went fine. This past Saturday i was supposed to run 12, but really was struggling, ended up doing 11. Not during the run, but afterwards, and more so yesterday I had terrible arch pain in my left foot. My heel did not hurt but upon stretching, realized my calf and Achilles were tight. i spent the day in compression pants, foam rolling my legs, concentrating mostly on my left middle an outer calf. Today I feel much better but my arch is tight. What do you recommend for my runs this week? I’m planning on doing my second 20 on Sunday’s “hot chocolate run.”
I need to preface this post by saying that the best recommendations would come from a functional examination by your favorite clinical provider. Speaking from a physical therapist’s perspective, I would want to take into account you, and your medical/ training history… not just the symptoms at your ankle.
First thing, I would recommend is to invest in having some professional manual therapy work done (sports massage therapy, etc.) Often pain or tightness at the foot or calf means that area is a victim of a tissue imbalance somewhere else. By addressing connective tissue and muscle tissue, you can alleviate a lot of your symptoms.
You could also try a “Night Splint” or Dorsiflexion Splint brace. It’s not the most comfortable thing, but it helps to stretch your calf and plantar fascia while you sleep. There are a lot of brands and some are more comfortable than others. You may find them in your local running specialty store http://www.amazon.com/dp/B001B5JVIA/ref=asc_df_B001B5JVIA2456335?tag=thefind0265348-
20&creative=395261&creativeASIN=B001B5JVIA&lin
kCode=asna
All the other things you are doing will help. So will icing your foot after your run, or trying an ice bath for your lower leg.
If your symptoms are not constant, and do not bother you with your daily activities, just keep an eye on them. If you have been following a good training schedule, your body has and will continue to adapt to the stress of running for longer distances or longer periods of time. What is your mileage like leading up to this Sunday? If the symptoms do not get worse during your weekly training, and you are keeping up with these other maintenance tips, you may surprise yourself with this next 20 miler. Again, the best way to see if you would need to alter the distance for this long run is to have a physical exam and a qualified person look at your running mechanics.
So if your symptoms get worse, make sure to check in with the appropriate health care provider.
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
http://www.WilsonCenter.com
I was out running my long run this weekend and felt a twinge where my butt meets my thigh. It was dull, so I didn’t think too much of it but I did cut my run a little bit short to be safe. Now I find it is fine most of the time, but sometimes when I walk a feel the twinge. I would say it is mild to moderate, not stabbing. I consulted Marty and he said to rest it for another day and do an easy five tomorrow. I’m just getting worried because I’m going to do my 20 this weekend. Any tips? Any idea what I might have done?
I know this first line may be getting a little redundant, but each person needs to know: the following recommendation is not diagnosis, and it is important for you to follow up with your preferred health care provider to address your symptoms. A full history and examination is important to rule out the conditions that may mimic your true diagnosis
There are several conditions that can rear there ugly heads and give you pain in your butt. One of the more common is referred to as Piriformis Syndrome. (And I can’t help but mention that this is not my favorite term, as there are structures other than the piriformis muscle that contribute to the symptoms.) This condition refers to a pattern of referred pain to the sacroilliac region (where your spine meets your hip to the gluteal fold). Symptoms can be caused by muscle spasm, poor hip/spine alignment, or nerve irritation. The pain can be managed in the short term by stretching, deep tissue work, anti-inflamatory medications, and icing after activity. To get at the root of the symptoms, you need to address imbalances of strength and flexibility. This will allow your running mechanics to be more efficient over time, and the repetitive stress of the activity won’t irritate the tissues to the same degree.
If the symptoms persist, or the pain seems to travel down the leg, you may be dealing with a more serious condition. Nerve root irritation or vertebral disc injury/ irritation are two other conditions that refer pain to this area and further down the leg (following the course of the sciatic nerve and it’s branches).
As far as recommendations of how to modify your training: if you are not giving your body enough time to heal, you will likely experience an increase in symptom intensity and/or frequency. It is worth it to invest the time and money to get to someone who can listen to the description of your symptoms, assess the muscle spasm, look at your posture, and make appropriate recommendations of how to get rid of your pain. Running through the pain will likely result in more time on the couch than on the road.
I hope this helps. And good luck with your training!!!
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
http://www.WilsonCenter.com
Hey Christine,
Everything was going wonderfully in my training, when the day after Easter, I was hustling to catch a train back to NYC and I tripped on the curb, fulling with all my weight and the weight of my belongings, on my knees on the pavement. The blow was more on my left knee than my right. Because I was nervous it was a sensitive time in my training — my 20 week — I ran a 12, a 2 and then a 19. All the while, both knees were feeling a little better. Last week, I rested during the week and swam, and I ran 12 over the weekend. My right knee is fine now, my left one still is present. It hurts a little right on the tip of my patella and is annoying, but I have full range of motion and it’s definitely getting (very slowly) better or at the least not worse. I’ve been icing and taking motrin. I’m nervous both about running on it if its anything other than a bone bruise, and about taking it TOO easy during my taper…
Thank you!
-Acacia O’Connor
Brooklyn, NY
Examination by your favorite trained professional is the only way to know what is going on for sure, but here are some observations:
1. The only way to know if there is no fracture would be to have X ray films taken. That being said, if the pain is more intermittent than constant, a fracture is less likely. Also, the most common way to let a fracture of the patella heal would be rest (in this scenario).
2.It is probable that as your symptoms resolve, with running, there is irritation to the patellar tendon. The repetitive stress from running too much could be causing a tendonitis. If motrin and icing are managing the pain/ infmamation and it is not getting worse, that is a good sign. Should your symptoms persist, I would recommend going to an orthopedist, physical therapist, etc. Other conservative measures (kinesio taping, of the shelf knee brace) may be helpful, but I would recommend seeing someone rather than just trying this on your own.
3. Regarding your taper, at this point you most likely have done enough mileage for your body to accommodate to the stress of doing the full marathon. I’ll never forget my first marathon because at week 13 of a 16 week program, I strained my hamstring DURING my one and only 20 mile run. Needless to say my taper started immediately. Not the best situation, but my training prior to that had was enough that even with 2+ weeks of elliptical, swimming, tissue work, proper nutrition, etc. I finished my marathon.
It would be more beneficial to get checked out, and modify your training to non-impact and shorter distances. By letting your knee recover, keeping your cardio up, keeping your mental state in check with some shorter runs, overall you may be in a better place to do the marathon. If you get checked out, and are cleared to do running, than you can be a bit more aggressive with your running, but keep in mind… This is your tapering phase. You will finish, and you don’t want to irritate your knee by causing too much repetitive stress if it needs to heal.
I hope this helps and would love to hear how you do. Look for me in the Rejuvenation Station/ Recovery area (that goes for any of the runners I’ve responded to). Good luck.
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitoner
http://www.WilsonCenter.com
Good luck to all the athletes!!!! I will be at the Health Expo on May 3-4 and at the Rejuvenation Station/ Massage Area at the finish on Race day. Enjoy the Experience!!! You have earned it!
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
CMScarano@msn.com
Hi Christine,
I have had some calf issues going back to last summer and fall. I get some tightness, and if I don’t shut down, it just gets worse. If I do not rest for several weeks, it just keeps flaring up. I am doing the half marathon and I was very careful all winter and spring. I reached the point where I did 10-13 miles several times without any problems. I thought that this issue was a thing of the past. My last long run was on April 14th with the training group. On Saturday, I went out for a 4 mile run and when I finished, I felt that familiar discomfort. I rested for two days and felt fine. I went out last night and the pain returned 1/2 mile into my run. I immediately walked home and did ice and elevated. Obviously, I will not do anything more before the race. Do you have any suggestions at this late date? Based on my experience with this condition, I don’t think I can run with that pain for 13 miles, but I feel like I have to try. Can I load up on Tylenol or Aleve before the race? I’ve killed myself for this, so I don’t want to just shut down, but not finishing would feel worse. Any suggestions would be appreciated. I’m devastated!
Thanks,
Jimmy
I apologize for the late response, but as you can imagine, things are really ramping up as we draw closer to race weekend. Please know that this post does not constitute a diagnosis or specific medical treatment. The only way to definitively know what is going on is to see your preferred medical provider and get a physical exam.
As part of assessing your symptoms, I would want to know if you have any history of low back issues or vascular issues. Irritation of certain nerves or discs in the low back can refer pain to the calf. Compromised arteries or veins in the calf could also result in localized muscle pain.
I would also want to know if you use orthotics, or if your sneakers had too much mileage in them. Proper foot wear is a must with distance running.
If your symptoms are due to a localized recurrent calf strain, getting sports massage therapy could help as long as it is not too aggressive this close to the race. Icing and elevating the leg is also important to do. However, if you are only doing passive things to help with the healing (ice, elevation, anti-inflamatories) you are not necessarily doing enough to re-organize the injured tissue.
During the NJ Marathon Health Expo, there will be two presentations and demonstrations of Kinesio Taping. This is a well researched and valuable tool, and I can attest to that as these techniques are invaluable to my practice as a physical therapist. If you can time it right, stop by and we’ll see if we can do a screening to see if it might help with your symptoms.
Lastly, I wouldn’t necessarily do “nothing” before the race maybe try biking, water jogging, or a standing elliptical, just to keep the wheels greased and the blood flowing.
I hope you have a great race, and definitely swing by the Rejuvenation Station/ Recovery area after you finish, and let me know how things went!
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
CMScarano@msn.com
Christine,
Thank you very much for your time and response during this busy period. I have no back problems or any vascular issues. I have never been injured in my life. I think that I’ve been pacing too fast as I’ve gotten closer to the race. I ran 13.3 miles on 4/14 with a personal best time, so once I felt that I’ve had this, I focused on speed and I’ve been running much faster over the last 3 weeks. No orthotics and shoes are not an issue. In fact, after years of Nike, I spent the big bucks on New Balance 2002 and running has never felt so good. They are in great shape.
I have to try something, so it will be a priority to stop by the health expo tomorrow. Is it possible to get a massage there? Is it possible to get an appointment anywhere? I have also come to realize that I should keep active through Sunday. Thank you so much!
Jimmy
P.S. Do you have any thoughts on loading up on Aleve or Tylenol before the race????
Thanks!
Glad you found the information helpful. It does sound like you have answered your own question, and by modifying your pace (hydrating and fueling appropriately during the race especially with the expected weather temps), you can do this.
I believe Chris Sorti D.C. may do chair massages, but you would benefit from more specific attention to the lower legs and back. If you email me (and if you are from the monmouth county area), I can give you some recommendations for massage therapists. I hope the timing of your packet pick up allows you to catch one of the the Kinesio Tape Demonstrations.
As for “loading up on Aleve or Tylenol.” these medications do not have the same blood thinning effects of aspirin (when taken in isolation from other blood thinners), and may help with addressing aches and pain from your run. Again, not offering medical advice, but speaking anecdotally, taking these over the counter medications in recommended doses, can take the edge off.
Good Luck!!!
Christine Scarano PT, DPT, CKTP
Doctor of Physical Therapy
Certified Kinesio Taping Practitioner
Cmscarano@msn.com