Wednesday, January 16, 2013

Runners,Doctors and Medicine

I should begin by saying that I spent close to 36 years in the healthcare field. During this time I was employed in many different capacities within the areas of medicine and psychiatry.It would be a huge understatement to say that things have changed over the decades.
What follows,in no particular order, is some advice  I would give to runners in regards to their health,medicine and seeking medical treatment. Forgive me if some of what you are about to read is already familiar to you.
To begin,prevention is always the key,meaning,you want to do all you can to avoid going to the doctor or taking medication. Obviously, I am not discouraging physicals and diagnostic tests,they are a part of assessing your health and wellness.What I'm referring to here is reducing or eliminating risk factors that could eventually lead to you  needing medical treatment.Things like poor diet,overeating,smoking,and excessive alcohol consumption over the years will take a toll on everyone.I recently heard a health practioner say that up to the age of 40 the body can tolerate many abuses inflicted upon it but after that age it will start to break down.I would also add that for athletes who train hard,compete and have been doing so for years,you have to be very careful to give adequate time to rest and recover.You must not over race.Years ago when I was into the ultra scene,I would read about these runners who would emerge out of nowhere and run some incredible races,many within a relatively short period of time.You'd read how this athlete did a 24 hour race one weekend and a month later was in the top ten at the Leadville 100. Then within a couple of years after, you'd never hear from them again except to read that they were struggling with some type of chronic injury,blood disorder or muscle wasting.The body can tolerate tremendous amounts of abuse for only so long.
Concerning doctors:I can't tell you the number of runners I've known who've gone to a doctor for an issue that was obviously related to overuse.For example,the runner who wanted to increase his mileage but did it too quickly and started to develop knee problems. What is a physician going to do for him in this case? He's going to tell him what any runner should know,rest,ice in the beginning,motrin as needed,assess your training and make the necessary adjustments.
And while we're on the subject of doctors,are there any of you out there who still go to one who thinks running is basically bad for you or that doing more that 12 miles a week is folly? If you are, why? Decades ago it was commonplace for docs to warn the masses that running would ruin your joints,cartilage,etc. With that said,here's what I look for in a physician:
1.Does he listen to my concerns and at least act concerned?
2.Does he respect the fact that I try to take control of my health by exercising, taking vitamins and eating a certain way?
3.Does he take the time to explain why he is ordering certain tests?
4.Does he explain how he has come to a certain diagnosis?
5.Does he address ways of preventing problems?
6.Does he recommend follow-up care and interventions?
Now to the subject of medicine.
I have found that in my years as medication nurse that there is an action and a reaction to all meds.It is always the desire that the effects of taking a med resolve the problem while the reaction(side effect) to it is minimal.For instance,lets look at the seemingly innocuous drug motrin(Ibuprofen).Runners like myself popped them as if they were vitamins in order to deal with muscle and joint pain.Motrin works.The problem with it is when taken long term it causes stomach problems,is not good for the kidneys,and perhaps worst of all,causes an increase in blood pressure and can contribute to heart problems.So am I advocating never taking motrin? No,but I am advocating looking for other ways first to relieve the problem.I recall that after very long runs or races I would soak in a tub of cold water.My muscle soreness was never a problem after I did this.Thinking along these lines goes for other drugs too.Cholesterol drugs,blood pressure drugs,drugs for adult onset diabetes;if you make certain lifestyle changes your need for medication for these disorders and others are greatly reduced.
The key in medical treatment and medication should be,look to eliminate the cause of the problem,don't just treat the symptom.Taking control of your health requires a desire to think,study,and a willingness to monitor and assess yourself and your training.Who knows how you feel physically better than yourself? Take control,be in control!


  1. Thanks Dave for this information. I avoid the medical profession when possible, however, I have an excellent Doctor who is also a runner. Smart fellow who shares my philosphy of prevention and using medication as last resort.

  2. You are very fortunate to have such a Doc--they are the exception not the rule these days. A few years back I found a similar type of physician to yours.On the occasion when I do need to see him it takes an hour and a half to get to his office.People have asked me why I see someone who is so far away? I tell them I'd travel further if needed to see someone who teaches prevention,promotes health,doesn't prescribe unnecessary tests and meds and actually listens and cares about what you have to say. As a sidenote,and I hold to no political party at all,when nationalized healthcare kicks in next year the necessity of maintaining personal health will be taken to a whole other level.