Friday, October 12, 2012

DrRic Post Marathon Recovery

    The Chicago Marathon finished last weekend. Good news is I havent had too many walking wounded come in. (Working medical tent at the end, most injured will come in walking well but draped in aluminum and assisted by a volunteer) Finishing is a great accomplishment but at a price. I attribute my finishing the '09 and '10 events with yoga, good nutrition and anti-inflammatory supplement rescue. (...and that was with only a few days of summer pre-race training. Disclaimer! I do not suggest entering into a marathon without proper training/coaching-I just did it my way to prove a point that the practice of clean living allows the body to heal itself insanely fast! If in Chicago, please visit CARAruns.org for proper training I'll tell you about my patient who was unconscious for 2 days later)

    So for pain I suggest adding Turmeric. Love this stuff! Great reproducible studies now out (did a post back in 2008 just suggesting herbal use based on anecdote....now we have data!!!) Janet Funk from UofAz researched the effects of turmeric on arthritis and found it was critical to have the combination of turmeric and black pepper (piperine) for optimal absorption from the gut. So although I have suggested New Chapter in the past, I called the company and asked about their data on absorption and no one gave a straight answer on if their "super critical" prep technique helped the curcumin get into the body. (Sorry for the technical mubojumbo but data is essential to make proper recommendations for my patients-learned that from Andy Weil). There are a few formulations that have the combo together Source Naturals is "ok", but around my area GAIA brand is available at Whole Foods Market and Fruitful Yield. I usually go for high dose at 1 cap 4 times daily for 3-5 days. Magnesium glycinate or oxide is great for muscle spasm (blood tests for proper mag level stinks unless you do an RBC/erythrocyte testing) This one is sensitive as it can cause problems with diarrhea or palpitations if taking too much. Usually 400mg twice a day is good. (caution with thyroid hormone users in that it will mess around with your medicine so dont take together) Make sure you are on Vitamin D3 1000IU twice a day (at the least......and I usually burst high at 4000-5000IU per day) and take it with Omega 3 fish oil. Omega3 I feel is always necessary for balancing omega6 intake for an average American diet. For the 7-10 days following a hard work out, stay aggressively on an anti-inflammatory diet and avoid dairy. (Even if you aren't lactose intolerant, I feel dairy is just to much of a wild card in eliciting a reaction-whether bloating and diarrhea or just slowing healing time). In the first days of crossing the finish line, push Fluid and pee like a race horse. Nothing worse than asking the body to get byproducts of inflammation out from the muscle fiber, through the vascular system and into the liver for breakdown when the vascular space is bone dry. Remember, as a culture, we abuse hydration by ignoring thirst (especially at work), over indulging in caffeine and alcohol (diuretics), and opting for sugary bottled drinks instead of a glass of water (reverse osmosis carbon filtered). So push fluid to the tune of 3 L/daily (13 cups) for men and 2.2 L/daily (9 cups) for women at the least! (8 - 8ounce glasses/daily is oldschool). If it isn't palatable, drop an Airborne fizz tab into the bottle/glass and keep it cool. Cut back at dinner time (6pm) or you will be cursing me as your dream state gets interrupted with a trip to the urinal/toilet.    (There is also the IV therapy option-by coming into the office for a "Meyers Cocktail".   Essentially a whole bunch of vitamins in a bag of fluid we place directly into the vein to bypass an irritated stomach and insure 100% absorption to the areas of inflammation. 

    For muscle stiffness I like manual healing. From massage therapy, to manual therapy by physical therapists to acupuncture/yoga healing. This post marathon time period when I highly suggest investing in a manual healer. Acupuncture can sometimes be reimbursed by HSA or flexbenefit spending accounts (with a prescription), physical therapy is usually covered by medical insurance (with a prescription), chiropractice therapy is usually covered by medical insurance, massage comes out of your wallet. Movement/contraction of muscle helps to get out the lactic acid and keep the stretch receptors from spasming and getting tighter. Moving your own joints when in pain is difficult to do on a regular basis. Get someone to move for you! One way to "self massage", is a technique called Abyangha. Known in yoga circles, the technique is to move "energy" to heal better and apply a thin layer of warm oil to the body. Those who have been to a good massage therapist know the well versed healer will choose oil depending on the mood/nose of the patient/client. In the case of recovering after a tough work out, I would use sesame seed oil, olive oil, apricot kernel oil or lavendar/sandalwood essential oil.  (I prefer PanAway by Young Living for my sorest of sore spots)  Apply the oil warmed from "tips to heart"; start at the finger and toe tips and firmly apply/knead the oil into the skin with long strokes in the direction of "pushing" the lactic acid out of the muscle back to the heart. (actually pushing lymph fluid from out of the extracellular space back into the vascular system to be recirculated by the pump). For the true technique, the oil is left on. My realworld application is to keep the oil on for at least 10 minutes, wrap with a comfortable robe, have a cup of tea then shower off as usual. Not only does this help with sore muscles but great for dry skin winter itch.

    Finally, mornings are usually met with the tightest knees, hamstrings and calves. Like my plantar fascitis sufferers, before you move out of bed, warm up/wiggle the small joints (fingers toes), circle the medium size joints (wrists ankles), flex and extend the big joints (elbows and knees) for 10-20 seconds each, then sit up and take your first steps of the day. Been there, done that and still in pain? Get to a sports medicine specialist ASAP! Running on an injury changes the dynamics of your gait and you will strain or sprain an unrelated body part and have to deal with another injury. See my post on how to pick a healthcare provider. Happy running!

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