Interruptions to your exercise routine

Jan 27, 2011

Have you had to stop doing the exercise you love? Lenny Bernstein and nutritional biochemist Shawn Talbott will answer your questions on that topic.

I had to stop running (my usual exercise routine) for the past 2.5 months due to shin splints. The thing is I have been running for 11 years and never had a problem with developing shin splints until I changed my sneakers from the basic kind to a stabilizer shoe (I did not increase my distance nor change my running pace) at the recommendation of my local running store and my podiatrist. Do you think that the problem with my shin splints might stem from my change in shoes? What are your thoughts regarding the barefoot running concept?

The people at many running stores are knowledgeable and terrific, and I'm sure you have a good podiatrist. But why did they recommend this change? Have you asked about switching back? It seems to me this is likely a cause of your shin splints after 11 years without pain. Barefoot running is not for everyone, though I have met people with chronic foot and leg pain who swear it has cured them. I would ask about going back to your old running shoes first. And I'd look into orthotics--I wear the custom made ones--to see if they might help.

Previous Misfits column:

Should We Get in Step With Those Who Say Barefoot Is Best?


Hi, this is such a timely article for me. Recently I've learned I have plantar fasciitis, and I cannot walk or jog. At first I was devastated because walking and step aerobic were the primary exercises I was doing. After about a month of pouting and doing mostly yoga I now switched to biking and started a Pilates class. I'm also changing my diet, to reduce the inflammation. But I still feel like a cripple because a long walk through a parking lot will have my feet hurt. I know I'm supposed to take Ibuprofen to reduce the inflammation but I'm scared because I've had stomach ulcer twice in my life - very painful too. So I generally stay away from all the painkillers. Is there anything else I could do to reduce/get rid of inflammation? I'm taking 3,000 ml salmon oil everyday. Anything else I could do? Thank you.

I tried everything for my plantar fasciitis a few years back--stretching, icing, the Strassburg sock, midfoot lifts--and nothing worked. Finally I went to my podiatrist  and he gave me a steroid injection in my heel. (Few things hurt that bad, but it's only for 20 seconds or so).Voila! PF gone. It comes back every year or so and I get another shot. This isn't something you can do too often, but my podiatrist assures me this is safe.

I feel tired and sleepy all the time. I also make up excuses to myself and can feel my appetite growing bigger by the day. How do I get back to my routine, light aerobic in the morning?

It is not normal to be tired all the time, even though we all get sluggish in the winter. Have you had a physical recently to rule out possible medical conditions? I'm sure Shawn, when he overcomes our technical difficulties, can address the role of nutrition. And sometimes people get depressed. But barring all that, I just got fed up with the way I looked and felt and went back into the gym. I resolved not judge myself for doing much less than my normal workouts. Whatever I could do was good.  It was either that or buy much bigger clothes.

I was just getting my New Year's fitness program underway, in anticipation of a ski trip Feb. 3. I was running again, after a layoff during the holidays, strength training, etc. Then I got the flu -- not a bad case, all things considered, but now I can't breathe hard without coughing. I'm back to strength training, and trying to do ski-specific exercises, but how can I build my cardiovascular fitness without hacking my head off? Is it too late for any improvement before my trip? (I'm a 57-year-old woman).

I wonder if you have a case of exercise-induced asthma, which can sometimes follow a respiratory illness. Full disclosure: I'M NOT A DOCTOR!! Have you asked your physician about this?

Because o f heel pains I had to stop my routine long walk. Even after taking rest for 20 days pain has not wholly gone. 10% still remains. Please advice.

What does your doctor say is the cause? What does he/she recommend you do about it? If 20 days is working, I'd see what happens after 30. Then before I started back up again, I'd see my physician and try to figure out a cause and an approach to a remedy. Btw, I'm a big fan of icing, perhaps that would help some.

I am the mother of an active 20 month old girl, and I am simultaneously trying to train for a triathlon. The problem is that I can't plan my training, or even predictably work out at all due to a number of factors: my husband's business travel schedule, which means he's out of town 3 nights a week, my own work schedule, my daughter's bedtime and her unpredictable sleep patterns. On this last one, she is getting in the last of her teeth, and so I don't know whether I will be able to get 6 or 2 hours of sleep on any given night, which of course impacts how well I can work out the next day. Sometimes I am so tired after a rough night I just walk on a treadmill, even though I know I need to get up my energy and do more. I do manage to fit in two long workouts on the weekend (a long swim on a Saturday and a bike/run on a Sunday, for instance) but I should be working out almost every day... shouldn't I? Do you have any recommendations for me?

Trying to train for a triathlon when you're "time-crunched" can be a real problem - but you can actually get a LOT of benefits from doing shorter - high intensity workouts - like interval training. I travel a lot for work, but even a 30min workout on the treadmill - alternating fast/slow intervals can give you many of the same endurance benefits as a longer/slower (and more time consuming) workout. Check out Chris Carmichael's series of "time crunched" books for cyclists and triathletes for some workout ideas.

Because the body is so efficient, doesn't it become more efficient at exercises we do frequently? Isn't more effective to mix up the regimen and make working out less of routine?

Correct - you always want to keep the body "guessing" to some extent so that you continue to improve. This involves varying both the training "load" (duration/intensity) but also the training "mode" (running versus lifting versus aerobics class). Even if you're focused on one sport (like training for a marathon), you can make greater gains and help to prevent injury if you are "mixing things up" from time to time (it's also good for keeping yourself mentall fresh).

Mr. Bernstein, When you were training for the marathon last year, how did you handle the effects of the blizzards on your training schedule? Did you switch to treadmill running? Make up for the days lost by increasing your workout on the days where you could run outside? I am at my best when training on the roads or track but the snow has been making it difficult and I could use any advice. Thanks

I did move indoors to the treadmill during Snowmageddon, Snowpocalypse and their after-effects. I hated it. I have a built-in treadmill limit of about 5 miles or so. But last February I was doing 7-8 miles a few times a week. It was hot, it was dry, it was boring--even with my iPod and the TV on. I made it a little more interesting by doing intervals and by raising and lowering the treadmill to simulate hills. But please, we run because of the freedom and joy we feel, even when we're layered up in the winter.


A Dreamer's Run: Can professional training improve a middle-age runner's marathon time?

For 8-9 months,after a groin pull (4 of 5 adductors?) I couldn't play tennis or walk fast. I've had a number of painful cramps/charlie horses? in that area-usually in summer. Recently diagnosed with very low Vitamin B-12 and high uric acid. Any connections?

If you've been diagnosed with low B12, then your doctor will probably recommend a course of vitamin B12 injections to help bring your levels back up to normal - this will probably be followed by a daily supplement of B12 to maintain your levels. Low B12 can be associated with nerve damage, depression, and general fatigue, but not typically with muscle cramps. For cramps, you'll want to look at your electrolyte intake (sodium, potassium, etc) and perhaps consider taking a sports drink like Gatorade along for your tennis and walking workouts.

I usually run 5-6 times a week for about 5 miles per run. I'm in my late 20s and have been doing this for approx. 3 years with almost no injuries. But lately, I do have a persistent pain in my pelvic/inner hip area, and three doctors haven't been able to find the cause. It does not hurt when I run, but everyone's guess is that running aggravates it. I've been asked to consider drastically reducing my running routine, and I have tried cross training (bike, elliptical, swimming). But I can't find another cardio activity that gives me the same satisfaction as running does. Non runners do not understand this. Any tips for things I can do to feel good and stay active when I can't run? I also have trouble adjusting my diet when I am not burning 600+ calories per day. Any tips for coping with that? Thanks

Sounds like you and I have the same problem, or something similar. As I said in the column, I've been doing the stationary bike a bit--hate it!!--and the experts I talked to recommended running in the pool (I don't have easy access). Best I can tell you is that you've got to do SOMETHING, anything to keep up your fitness and mental health and keep down your weight. And if they ever figure out what is causing your problem, let me know because I'll ask my doctor about it.

When someone stops lifting weights after doing it frequently, what happens to their muscles? I know that they atrophy, but I was wondering to what extent, how fast does this happen, is it reversible, what are some ways to prevent this without going to the gym as much? Thanks

This is one of the major problems with being forced to take some time "off" from your workouts - it takes so long to "build" ourselves - whether to get stronger with lifting or to build endurance with running - but they "go away" SO fast. Muscles start to atrophy within a few days of being sidelined - which makes it extremely important to "come back slowly" when you're able to resume workouts again. There are some good studies showing that we can "maintain" our levels of fitness with short high-intensity workouts - so that can help when you're pressed for time, but still is a problem if you're injured and can't exercise.

Need some exercise [suggestions] that [involve] not using the knees.

Any kind of upper body weightlifting would work for you. If you're looking for a cardiovascular workout, you could use any kind of hand-cranked bike. And I don't know if swimming would hurt your knees, but it's a terrific total body workout.

I have developed a pinched nerve in my neck. I stopped going to the gym about 2 months ago, but I have kept up with my walking and some yoga poses which alleviate the pain in my neck. I have also been going to the chiropractor, have had a couple of deep tissue neck and shoulder massages and have seen the acupuncturist several times. It's improving - i.e. the pain is not constant and when it's there it is less acute. When can I start going back to the gym?

That one is up to you and your treatment providers. It wouldn't be responsible for me to offer a suggestion on that, especially with the various methods you're trying.

Hi, Your article is so true. You don't realize how much gets taken away from you when you can't exercise. I am 36 and a runner and I had to spend last year undergoing treatment for breast cancer. Often I was too sick or weak to workout. Once I started feeling better, I craved sweets but thought it was emotional eating. I went back to running as soon as I could and it felt great. I actually started crying when I took those first steps jogging because it marked a time of feeling back in control. However, since I let myself have all of those sweets during treatment, it's hard to break the sugar habit. Any suggestions?

Congratulations on getting back to exercise after your treatments - it is often said that "exercise is medicine" because it can help with so many physical and psychological ailments. A great deal of "emotional" eating is driven by changes in stress hormones such as cortisol (more stress = more cortisol = more sugar cravings) - but sugar cravings can also be caused by flucuations in blood sugar levels. A few efefctive ways to break the sugar habit are:

1. make sure you're getting as much sleep as you can. For example, if you only get 6 hours of sleep, you'll have about 50% more sugar cravings than if you got 8 hours of sleep (due to cortisol and blood sugar flucuations).

2. make sure that you're always combining protein and fat with any carbohydrates that you eat. Example = put peanut butter (fat/protein) on a slice of bread (carb) - the protein/fat will slow the absorption of the sugar/carb and help to maintain blood sugar levels longer.

3. make sure that the carbs you are eating come mostly from "whole" sources - such as fresh fruits/veggies and whole grain breads. These will also help to maintain blood sugar levels and reduce sugar cravings.

[...] I'm training for a half-marathon in March and ran 6 miles ago a few weeks ago and really screwed up my shin--it was either a shin splint or strain on the calf muscle. The part that hurt was the front/side of the shin/calf vs back of the calf. I decreased the miles and hope to try 6 again this weekend and add a mile each week. Could the cold weather have anything to do with it? I don't run during the winter but I made sure to stretch before and after the run like I do normally during the summer. My shoes are fine and everything else was the same except for the difference in temperature. Is there anything else I can do to prevent this from happening again? And if it does happen again, what can I do to treat it? Thank you for taking my question and I hope this becomes a regular, weekly chat!

You'll hate this answer because I honestly don't know whether the cold has anything to do with your pain. It does sound likes shin splints though. And for those you need to ice, rest and stretch until the pain goes away. Don't start back up while you're still hurting. And please see a physician, preferably someone familiar with runner's issues.

I broke the tibia in my right leg in five places, but with no displacement, in a rock climbing accident on Aug 2. of last year. I am a near 46 year old male, 5'8", 155 lbs, in reasonably good health. I did not have surgery; I was in a non-weight bearing cast for six weeks and non-weight-bearing, on crutches, for another six weeks. I took calcium (+D) supplements faithfully and began swimming as my rehab exercise of sorts, but have had no physical therapy (my ortho doc does not believe in it) and I am not scheduled for any more orthopedic consults. Yet I am still experiencing pain, have seemed to develop some co-incidental patella tracking issues, and feel really stark limitations to my function. I can do some elliptical cross-trainer work, but swimming is still the exercise I find myself doing--I cannot jog and am afraid to try. Is there some rehab and nutritional advice you can offer, besides be patient? :-)

On the nutrition side of things, make sure that your calcium/D supplement brings you up to the recommended levels (including what you consumer in your diet):

Calcium = 1,000-1,500mg/day

Magnesium = 400-800mg/day

Vitamin D = 1,000-2,000IU/day

Zinc (15mg), Copper (2mg), and Vitamin C (100-300mg)

These nutrients are all needed for proper bone healing/growth - but the pain/tracking issues may take longer to fully resolve and may even take soem physical therapy to get you back to running.

My active lifestyle was derailed for a year or more with severe post concussion syndrome after a car wreck. Anytime my heart rate went above 120, I felt terrible and would be sick for days afterward. Honestly, I was terrified I would gain a lot of weight and never get back on track. But restlessness led to me taking walks almost every day, and guess what, I'm still in pretty good shape and feel great. The benefits of simply walking was a real eye opener, and I can't stress enough what a difference it made for me, mentally and physically.

I've interviewed people who believe that if everyone in this country simply walked 30-60 minutes a day, we could bring down health care costs by billions and billions of dollars. I'm not sure it's the total answer--as we age we also need to keep up our strength, balance and flexibility--but there is no doubt that walking is very, very good for you. The CDC wants you to get 225 minutes of exercise a week and a good, brisk walk qualifies. Good for you!


The many benefits of walking

I was out hiking pre-storm, went maybe 4 miles up and down thru the Massanutten. By the time I was back to the car, the sides of my thighs were howling! Not quads, but along the sides. I could hardly walk, and had a good laugh in between tears trying to go up the steps at my house. Motrin, a hot shower and a good night's sleep helped a lot. What muscles might they be, and what can I do to avoid this the next time? Oh, and I'm 58 female, in fairly good shape otherwise. Thanks

Ouch! Along the "sides" of your thighs (but not quads) mkes me think about your IT band (IT = Ilio-Tibial). The IT band is a strong fibrous tissue that runs along the outside of your thigh - from the hip down to the outside of your knee - and it is notorious for causing pain and stiffness when we "over use" our quads - as in running or up/downhill hiking. Sometimes the pain is localized to just outside the knee, while other times it can involve tightness in the entire length of IT band. The best treatment for a tight IT band is just what you did - rest, ice, oral anti-inflammatory (like Motrin) - and a slow build up to the hike next time (with periodic rest/stretch breaks).

I have a chronic knee condition and I am in pain most of the day when I am exercising regularly, but it stops hurting when I am sedentary. This makes it tough for me to motivate myself.

Are there other exercises that don't cause knee pain that you would be interested in doing? For example, walking on the road or a treadmill may be painful, but walking in a pool might be OK (and would provide much of the same "aerobic" or cardio benefits without the pounding).

Swimming is mostly an upper-body exercise, so it would "save" your knees, but it is also an exercise that takes some learning of technique to get right - but it's also perhaps the "most cardio" of all of the endurance exercises and an amazing workout.

Hi, I have some wrist and hand pain probably from repetitive stress/computer use. I have had it evaluated and it is not clinically "bad" enough to do anything surgically about. I ice it, do hand exercises as well as try to limit my computer use. I am wondering if this pain will ever go away (this has been an issue for years). It limits my yoga practice, which I love, since bending my wrist is painful. I adapt my poses, but that hasn't helped much. I would really like to be able to do something to rid myself of this pain. Thanks for answering my question.

What do the docs say is the cause? Is it carpal tunnel syndrome, which sometimes has to be addressed surgically if it's bad enough? Or is it tendonitis, for which you usually have to rest, ice and take anti-inflammatory drugs? Is there any way you can stop or reduce your computer use for a while? Are you using a wrist rest (I do and it helps a lot)? Are the arms of your chair at the same level as your keyboard, supporting your elbows, so you don't have to bend your wrists as you type? Is your keyboard laid flat on the desk  (ie not elevated at the top)? These are all little tricks they taught us 20 years ago or so as journalists were coming down with RSI in droves. Now you don't hear about it nearly as much.

I have really been getting into HiiT step aerobic routines lately, which helps me as a time crunched new mother get at least 30 minutes in 3 days a week. But how does 30 minutes of HiiT compare to 50 minutes stead state? Does one burn more calories? Is one better for your heart and respiratory strength? Better to alternate between the two? 30 minutes can fit perfectly into nap time; 50 minutes can't always do that. Thanks.

Good for you! HiiT (high intensity interval training) is a great way to go when you're time-crunched. IN terms of calorie expenditure, you'll burn about DOUBLE the calories with 30min of HiiT compared to 30min of steady state. The HiiT will also provide more cardio/lung benefits and very new research suggests that HiiT (such as 1-minute intervals) can provide many of the same endurance benefits as the standard "long steady" workouts (that take so much more time).

Are their additional coping methods if the injury is more serious? Involving surgury, a month off of work, crutches, and months of physical therapy befoe getting back to normal? Staying home all day is super boring and definately depression-inducing.

That's rough. Is there something you always wanted to do and never had the time? Some kind of longterm project you can do? I sympathize with  your situation though I haven't encountered it myself.

In This Chat
Lenny Bernstein
NFL editor / MisFits columnist
Shawn Talbott, Ph.D.
Shawn Talbott, Ph.D. is a nutritional biochemist and author
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