Running Hot

By: Amy Watson ATC,PES
DMC Rehabilitation Institute of Michigan

It’s finally warming up! Running while its hot outside can bring many challenges and frustrations. How do you make the transition to stay safe and comfortable?

To start, it takes about two weeks to acclimate to running in warmer temperatures. Give yourself time to adapt if you have an upcoming event. You may notice increased fatigue, difficulty breathing, and slower times at first. It is much harder on your body to maintain your previous pace with the increasing temps. To start adjusting, you need to slow your runs to a comfortable effort level. As you acclimate, your pace will improve again.

As the summer heat rises, make sure you are staying safe by running earlier or later in the day when it is slightly cooler. Watch the heat index and humidity. Consider your route, and try to make sure you can be in the shade as much as possible.

Clothing makes a difference. Make sure to wear light colors and loose, wicking fabric.  This allows for air to move through the fabric and evaporate faster leaving you cooler. Regular cotton just holds the sweat and gets heavy. Always keep in mind that while you’re running, your body will feel 20 degrees hotter than the actual temperature.

Most important is to stay hydrated!  Everyone is different to what their personal need for fluids are, so make sure to do what is best for you. In general, prepare for your run by hydrating early. Start at least 2 hours before your run by drinking 8-16 oz of water, within 15 min of running you should  drink another 4-8 oz.  Hydrating during your run is also important, consider 3-6 oz every 15-20 minutes. Also realize it is best to begin increasing hydration levels several days prior to long runs or races for optimal performance.

Also to improve hydration, consider electrolytes. Electrolyte’s function are to maintain your body’s fluid balance, nerve and muscle function, and also energy levels. Electrolytes are sodium, potassium, calcium, and magnesium. This can be found in your sports drinks or tablets. Be careful with just salt tablets as they do not have the full electrolyte balance. If you are swollen in hands and feet you may have had too much salt which  can also lead to stomach problems as well. You will know if you need to use or replenish electrolytes if your sweat has left dried salt on your skin, you have cramping issues, or fatigue quickly.

After your run continue to rehydrate. Drink 8-24 oz to replenish fluid and to avoid post workout cramping. You should notice your urine running near clear if you are properly hydrated.  Another good way to replenish electrolytes post-run is with chocolate milk, which contains sodium, potassium, calcium, and most importantly protein. Protein helps with recovery of the muscles as well.

Also try on those super hot runs to drink ice cold or even slushy water before, this can help decrease internal body temperature which can allow you to exercise longer and with more comfort. And nothing beats running through every sprinkler you can find out there to keep cool!

What happens if we don’t follow these tips? Running during extreme temps and not properly hydrating can lead to dehydration which is a serious health risk. Feeling dizzy, lightheaded, nausea, or cramping are the early signs of heat exhaustion. Stop, rest, cool off, and hydrate immediately. If you are getting disorientated, have goosebumps, have red skin, or you stop sweating altogether get medical attention ASAP! This is potential heat stroke and can be deadly.

Don’t take the risks! Keep cool and hydrated to enjoy summer running!

Amy Watson is a certified athletic trainer and an avid runner with many marathons under her belt. To make an appointment with a physician or therapist that specializes in running injuries at the Detroit Medical Center and Rehabilitation Institute of Michigan, call 313-910-9328.

Stretching, The Truth

By: Amy Watson ATC, PES
DMC Rehabilitation Institute of Michigan

I’ll admit it. I’ve walked out the door and just started running. As an athletic trainer, I should know better. And, I will admit that I was much stiffer during and after those runs because of  it. When I take the time to do some warm up stretching, that first 1-2 miles are much easier and more comfortable.

Stretching allows the body to move through its full range of motion (ROM) at the joint. Ideally, for any athlete they need to be able to access their full ROM for optimal performance.

There are many ways you can stretch. Static stretching is considered the old tried and true 30-60  second hold, while feeling the discomfort of the stretch. The joint is passively moved to the end range of motion. Dynamic stretching is using muscle contraction, movement, and momentum through the ROM while not going into the full end ranges.

There is a lot of controversy out there in the timing and type of stretching to perform prior to activity to achieve this optimal ROM for athletic performance. There are a few studies that do show an increase in ROM after static stretching but a decrease in torque and force which was seen in decreased jump performance and sprint speed. This decrease is still seen at a minimum of 10 minutes after the stretch in these studies. The effect of the ROM gain did not last long either. Most of these studies used a calf stretch to the point of irritation. After the 10 minutes, performance ability did return. That being said, other studies found that static stretching followed by sport specific drills did not decrease jumping or sprint times.

Dynamic stretching studies found that some small ROM gains were made, and  no significant negative effects were observed in performance tests.

So, the truth seems to lie somewhere in the middle. We do need good ROM for performance. It does not seem to be ideal prior to activity to stretch statically. Therefore, stretching at another time of day would be preferred to work on that ROM. Dynamic stretching would be the  warm-up of choice.  Again these dynamic stretches are done using movement and can be more sport specific. They help increase heart rate, body temp, and increase elasticity in muscles. This helps increase flexibility, while decreasing risk of injury and improving sport readiness and performance. That is also most likely why the study showing that static stretch followed by sport specific drills did not show the impairments of static stretching alone.

Again, dynamic stretching uses movement. Multidirectional leg swings, inchworms, scorpions, iron cross, and even lunges are a few of many stretches that would be considered dynamic stretching.  Use as much motion as you can without excessive tension.

Get started with a few good minutes of stretching and then head out for a great run!

Amy Watson is a certified athletic trainer and an avid runner with many marathons under her belt. To make an appointment with a physician or therapist that specializes in running injuries at the Detroit Medical Center and Rehabilitation Institute of Michigan, call 313-910-9328.

Are You Struggling To Breathe When You Run?

By: Amy Watson ATC,PES
      DMC Rehabilitation Institute of Michigan

Have you ever experienced tightness in your chest at the beginning of your run or when you are running really hard?  Had a cough after you stopped running?  Do you feel like you are struggling with fatigue in your training or having a hard time getting better?  You potentially are struggling with exercise induced asthma, which is also known as exercise induced bronchoconstriction. Running is considered a high risk activity for this condition, as well as swimming, biking, and hiking.

Exercise induced bronchoconstriction (EIB) is not the same as asthma. Asthma is the chronic inflammation of the airways that causes narrowing and decreased airflow. EIB is the narrowing of the airways triggered by exercise.  A person could technically suffer from both conditions.

EIB symptoms typically are at the beginning of the workout and/or shortly after finishing.  Some symptoms can last greater than 24 hours. EIB Symptoms include:

  • Shortness of breath
  • Chest tightness
  • Wheezing
  • Coughing
  • Upset stomach
  • Sore throat
  • Inability to improve
  • Decreased endurance

Symptoms are typically triggered by high or low temps, dry air, humidity, and environmental factors like pollen and air pollution. Having other allergies, like seasonal allergies, can add to the irritation factors. A Finnish study tested 103 runners and found 52% had evidence of EIB and of those 58% also had other allergies as well.

If you are experiencing any of theses symptoms see your primary doctor or an allergy and asthma specialist.  They will take a history and perform spirometry and other testing to help make a diagnosis. Ignoring symptoms over time can potentially  lead to permanent decrease in lung function because of constant irritations. It is very important to be diagnosed to avoid this. If you are diagnosed with EIB you will most likely be placed on a bronchodilator inhaler which you use 15-30 minutes prior to exercise.  You may also need other medication depending on your specific diagnosis.

You can still keep running with a diagnosis of EIB! Keep that inhaler close and don’t forget to use it. Schedule your run around extreme temps or the time of day where there are lower conditions of allergens and air pollution. If it is really cold, cover your mouth to help warm the air on its way in. Breathe through your nose until you are feeling better. A minimum of a five minute warm-up prior to activity has also been shown to help. Start with a slow run with intermittent fast paces for at least 30 seconds. If your ever feeling dizzy or faint  while running make sure you stop, relax, and use the inhaler as needed.  Severe wheezing, coughing, or difficulty breathing that is not improving after using your inhaler is a medical emergency.

I personally deal with many of these symptoms and did have testing done. As long as I use my inhaler and keep my allergies in control, I have minimal issues. Get yourself checked, so you can get back to running and breathing easier!

Amy Watson is a certified athletic trainer and an avid runner with many marathons under her belt. To make an appointment with a physician or therapist that specializes in running injuries at the Detroit Medical Center and Rehabilitation Institute of Michigan, call 313-910-9328.


Adding Miles to your Running Routine Safely

By: Amy Watson ATC/PES
DMC Rehabilitation Institute of Michigan

If you are just starting to run you’ve noticed it’s no walk in the park.  Running is hard work, especially in the beginning.  Getting that first mile to be remotely comfortable takes a while, and being able to not have to stop and walk is rough.

So, how do you add on more miles? How do you get to that 5k race?  Well, number one, it’s a lot of work and determination. Next it’s a game plan. Consider  a program for Couch to 5k which is usually about 10-12  weeks of training.

Adding on distance might be small goals at first.  Be competitive with yourself.  As you are getting tired try to make it to that stop sign at the end of the block before you walk.  Next time, make it past that sign.  Wearing a watch helps too.  Set a time you have to make before stopping. Some runners consistently use a run/walk program.  Start with run 3 min/walk 1min. Work up to 5:1.  It also allows for more speed with the ability to recover.  Using a GPS watch is also very helpful.  You can see your distance, time, and pace which shows you exactly what’s going on and what you need to do.

I always tell people that when starting to run, it’s the first 3 miles that are the hardest.  It does take quite awhile to make that comfortable.  Once 3 miles are finally comfortable, adding on miles goes much smoother.

Again, consistency is key. You should be running 3-4 days per week. One of those days in the week should be a longer run.  Try to spread them out a little so that there is some rest and recovery days in between.  As you move on past those 3 miles, add 1-2 on per week onto the long run days.  After a few weeks make some of your mid week miles increase as well.  Keep adding on toward your goal distance.

Remember each run can be different.  The time of day, how busy you’ve been, how much or what you have eaten that day, and the temperature all can affect your run.  It takes a little trial and error to find out what gives you your best run.  Once you find what works for you, stay consistent. That will start to set you up for success. Unfortunately, some days for no known reason, running is just hard. That day will happen, so don’t let it deter you. When starting a running program make sure it’s at your pace. Don’t worry about what anyone else is doing.  You know your body, and as you get to know it better, you’ll know when you can push harder.  Too much too soon can lead to injuries and disappointment which decreases the desire and enjoyment. Running should be fun!  You are going to have sore muscles, feel tight, and probably achy too.  That means you’re doing something right.  This will decrease the more consistent you are.  Sharp pain however, is different. If it lasts more than 5 days without decreasing and you aren’t able to be active, then get it checked out.

Amy Watson is a certified athletic trainer and an avid runner with many marathons under her belt. To make an appointment with a physician or therapist that specializes in running injuries at the Detroit Medical Center and Rehabilitation Institute of Michigan, call 313-910-9328.

A Special Message From CEO Joe Mullany Regarding the Flint Water Crisis

Mullany JosephFORdistribution.jpg The history of the Detroit Medical Center is built on improving the quality of life of every person who comes through our doors and elevating the communities we touch, in both good and bad times. Leading this professional and compassionate team is a source of great pride for me.

As experts in disaster management, our extensive organization, communication and resource coordination is the engine to drive a successful management effort. To that end, our Children’s Hospital of Michigan and the Lead Clinic in collaboration with the Michigan Poison Control Center stand ready to assist where needed. In addition, many DMC employees have directly and indirectly reached out to me seeking ways to help the City of Flint and the surrounding community. Although the DMC is connecting with Michigan and Flint officials, and our healthcare partners throughout mid-Michigan, there remains a desire and commitment to go further.

I challenged our leadership team to ensure additional support from the DMC system must complement federal, state and local efforts already underway. While global outreach has resulted in thousands of bottled water donations, we have determined our teams’ greatest impact will be through financial contributions to support services necessary for the health and well-being of Flint residents now and in the future. In support of this challenge, we have partnered with the DMC Foundation, a supporting organization of the Community Foundation for Southeast Michigan to provide a means by which our caring DMC employees may collectively make a difference in the lives of children and families affected by the Flint Water Crisis.

Our gifts will be provided to the Flint Child Health & Development Fund at the Community Foundation of Greater Flint. This fund was established by Dr. Mona Hanna-Attisha, a former Chief Resident at Children’s Hospital of Michigan, who has been at the forefront of the Flint water issue. Our financial support coupled with the previously offered Children’s Hospital of Michigan medical expertise, will ensure that our collective contribution is impactful.

Those wishing to join us in our efforts can do so by making an online donation directly to the Flint Child Health and Development Fund at

Another proud moment for DMC, as Children’s Hospital – Troy opens today

The new Children’s Hospital of Michigan-Troy officially opened today, bringing pediatric experts closer to the children and families of Oakland County. The three-story, 63,000 square-foot iconic structure offers a 24/7 pediatric emergency room, outpatient surgery and multiple pediatric medical and surgical specialties for children, including cancer and infusion therapy, cardiology, neurology, orthopedics, urology, imaging and lab services.

Dominating the landscape at 350 W. Big Beaver Road, this facility, with its vibrant colors and design that includes fun, child-inspired spaces and artwork, and advanced treatment rooms, sends a clear message that this is a special place for children to feel better.

“Having a sick, injured or chronically-ill child is not easy for the child or parents, and may often mean frequent visits for emergency care, outpatient surgery and consultations with pediatric specialists,” said Larry Gold, CEO of the Children’s Hospital of Michigan. “To have Children’s Hospital of Michigan services like these located closer to home for many of the patients we serve will help make the lives of many families just a bit easier.”

Off season for runners: What you need to know

By: Amy Watson AT, ATC, PES
DMC Rehabilitation Institute of Michigan

“Off season,” it’s not a bad word. I promise it isn’t. It’s definitely dreaded, hated, and really misunderstood by most runners though. But it’s a good thing, and will actually help improve your running!   Perhaps we can refer to it as recovery time, fun time, refocusing time, or even goal making time! Hopefully that makes you feel a little better.

Off season or recovery time, whatever you’d like to call it, is a necessary part of your training period. Most  training cycles use four phases to build you up for your goal race. You begin with building strength and endurance in phase one. This is followed by increasing speed and fine tuning in phase two. Then onto the third phase which is taper and competition time. Then of course it’s all followed up by recovery as phase four. Athletes of almost all sports use this method.

The real reason you need the off season time is to let your body actually recover. This is when your body can heal itself, repair itself, rebuild, and make some gains. This phase actually helps you improve your performance!  Not giving your body the rest it needs can lead to overtraining.  Overtraining can set you backwards, and that can make it difficult to achieve your goals.

How do you know when it’s time to take a break? Typically after your goal race it’s time to take a few weeks to recover. This time frame may vary per runner. A few signs may also let you know it’s time to rest:

  • Sleeping pattern changes
  • Decreased energy level
  • Poor immunity
  • Decreased appetite
  • Increased resting heart rate
  • Dehydration issues
  • Decreased interest or moodiness
  • Increased pains and injuries

If you are beginning to experience more than a few of these, it may be time to take a rest. Again, this is to help  improve your performance.  Even at the peak of your training, this may indicate a need for a day off.

It’s really not as bad as it sounds. Being “Off,” isn’t actually being fully off.  Most runners will decrease their mileage 25-50%. So, calm down, you DO still get to run. It’s also a perfect time to hit the gym and build up some strength again because you maybe didn’t have the time while training. It’s time to increase flexibility, mobility, and core strength.  Cross train by biking or swimming to keep the need for cardio going. Focus on cleaning up the diet as well. This is also definitely the time to care for your injuries.  See a physician or a physical therapist to help your body get back on track.

So really, this “off season” is a good thing. Training cycles can get to be like a job. Everyone loves a little vacation from their job. Use it to refocus and rejuvenate that love of running. Make that new race schedule and get excited about new goals!  Enjoy your time off!

Amy Watson is a certified athletic trainer and an avid runner with many marathons under her belt. To make an appointment with a physician or therapist that specializes in running injuries at the Detroit Medical Center and Rehabilitation Institute of Michigan, call 313-910-9328.