Runners often suffer in more ways than one. There are all manner of potential issues that a runner will face in the course of training or an event, so find out about the most common problems, from cramp to stitches to the dreaded ‘runner’s trots’ and learn how to solve them.
Stomach and bowel problems
Half of all runners have experienced some kind of bowel or stomach problem during training or racing, from stomach cramps to diarrhoea and nausea, the so-called ‘runner’s trots’. Among the many and varied causes are dehydration, sensitivity to a particular food, reduced blood flow to the intestines (due to eating too close to running) and the jolting action of running.
If you can identify what caused your trouble, so much the better – simply avoid the trigger, if you can, when important training runs or races are approaching. If, however, you aren’t sure what’s causing the problem, consider the following strategies:
- Avoid eating too close to a run – allow two to three hours’ break between your last meal and the start of your run. Some runners can only avoid diarrhoea by running on an empty stomach.
- Ensure you are well hydrated at the start of your run.
- See if it helps to run more slowly.
- Consider taking Immodium or the prescription-only Lomotil before important training sessions or races.
While causes of gastrointestinal discomfort are a very individual thing, the following are some of the most common irritants that cause running problems:
Caffeine. This can irritate the gastrointestinal tract (which is why we often need to go to the toilet after drinking coffee or tea).
Sugar. Highly concentrated sugar solutions – such as sports drinks – can cause GI distress in some people. That’s why it’s vital you experiment in training with sports drinks that have different sugar concentrations, to see what works for you.
Fibrous foods. Prior to a race or training run is one of the rare times when you shouldn’t opt for fibrous foods, as they take a long time to digest and absorb a lot of water, making you feel bloated and heavy.
Dairy products. Some people find dairy products hard to digest.
Fruit. The high acid content can cause stomach cramping.
Aspirin and ibuprofen. Non-steroidal anti-inflammatories can cause stomach upsets and even bleeding if taken too often, or when taken on an empty stomach.
Although there can be few runners who aren’t familiar with the pain of a stitch, the science bods still don’t really know what causes it. Some experts believe that the pain is caused by the jolting of the diaphragm and the internal organs connected to it by ligaments, while others argue that if this were the case then cyclists and swimmers wouldn’t suffer from stitches (which they do).
Another theory relates to the outer sheath of the diaphragm muscle becoming fatigued and rubbing on the outside of the abdominal wall. If this is correct, then strengthening the ‘core muscles’ may help. Regardless of the cause, researchers from the University of Newcastle in Australia suggest you avoid big meals prior to running – particularly foods that are high in fat and sugar – and warm up thoroughly. If you do get a stitch, then slowing down or stopping and kneading the painful area is the simplest solution.
Cramp is an involuntary, sharp contraction of muscle that happens either during or immediately after exercise. As in the case of stitches, the cause of cramp is not well understood, but it is often associated with extreme exertion, dehydration and an imbalance of electrolytes. Cramping most often occurs in muscles that span two joints, such as the calf or hamstrings, and may be to do with a malfunction in the muscle contraction process due to fatigue.
It certainly seems to occur most frequently when the body is fatigued, which is probably why 67 per cent of marathon runners have reported experiencing cramps. Research from the University of Cape Town shows that stretching provides almost instant relief from cramp, so try this first. Next, ask yourself whether you have been drinking enough – if you’ve had around 220ml (approx 7.5 fl oz) every 15-20 minutes, you should be fine – and also what you have been drinking. If the answer is water, try switching to a sports drink, to replace your sodium and potassium. If you are regularly afflicted by cramp, ensure you are getting sufficient calcium, too, as this has a major role to play in muscular contraction.
Although it may sound mildly amusing, there’s really nothing funny about jogger’s nipple at all. It most commonly affects men, as they are more likely to be wearing a top against bare skin while running, but women can suffer from jogger’s nipple too, as a result of sports bra friction. The most important thing is to check the fit of the clothing layer closest to your skin. It should be non-abrasive, tight-fitting and sweat-wicking so that it doesn’t rub, move around or allow moisture to linger.
This goes for a sports bra, crop top or running vest. Next, protect vulnerable areas with a lubricant, to create a barrier between clothing and skin. You can use petroleum jelly or a designated anti-chafe product such as Bodyglide. The lubrication strategy works well for other areas that chafe, too – such as the armpits, the bra strap area, the navel and the inner thighs.
A blister is a build-up of fluid between the upper and lower layers of the skin, caused by friction between your foot and your shoes or socks. Blisters are hardly life-threatening, but they can cause untold misery to runners who are prone to them. If you are one such runner, avoid cotton or seamed socks and ensure your shoes fit perfectly. If you get a blister, protect it from further friction with a blister plaster, moleskin or even surgical tape.
You only need to pop it if it feels painful. If you do opt to pop, then use a sterilised needle heated in a flame, and pop it in two places, close to the unblistered skin, to drain the fluid. Dab on antiseptic lotion and then cover with a blister plaster for at least 48 hours before leaving bare. Always have a stash of blister plasters handy. Look for those that create a ‘second skin’ between the blister and your footwear, such as Compeed or Hydra-Gel, which help to cushion the skin. These are also breathable and waterproof so will prevent your blister from festering or getting sore.
It is the unmentionable problem, yet urinary incontinence affects as many as 50% of all women, particularly after pregnancy – and it can really hamper your running. Urinary incontinence is usually caused by pelvic floor weakness. The muscles on the pelvic floor form a figure of eight shape around the vagina and anus – the main muscle is called the pubococcygeous – and support the contents of the pelvis and abdomen, as well as controlling the emptying of the bladder and bowels and the contraction of the vagina.
When these muscles become weakened through misuse, disease or damage, then anything from a cough or sneeze to a knee lift on the spot can cause urinary leakage.
The first course of action is to do pelvic floor exercises, and lots of them. Providing they are done correctly, these exercises are 90 per cent effective in stopping urinary incontinence. Often, when women say such exercises don’t work, it is because they have done far too few of them to make a difference, or have done them incorrectly.
How to do pelvic floor exercises
Sit, stand or lie with your legs slightly apart and with your buttocks, abdominals and thighs relaxed. Now pull ‘up and in’ as if you were trying to stop yourself having a wee (don’t actually do this more than once, though, or you may cause a urinary tract infection). Breathing normally, continue to pull up and in through the vagina and the anus. The most common mistakes are to pull in the tummy or clench the buttocks. Make sure you are doing neither. Mix both fast and slower contractions for best results and do these exercises as often as you can. It is consistency that is the key to success.
As well as strengthening the pelvic floor, there are other things you can do to alleviate the problem:
- Always visit the toilet last thing before you leave the house.
- Make it a habit to always go and urinate when your body tells you to. Don’t ‘hold on’ unless it’s absolutely necessary.
- Don’t be tempted to avoid drinking fluid to reduce your chances of an incontinent episode. A small number of people get symptoms of urinary tract infection when they are dehydrated – including burning, stinging and abnormal frequency of urination. If you do have a UTI, it will not cause you problems if you are well hydrated, but as soon as you become a little dehydrated, the UTI will flare up. The above symptoms may also occur due to the concentration of your urine, so it is essential in all cases to maintain normal hydration by drinking fluids.
- Keep caffeine (in coffee, tea and caffeinated fizzy drinks) and alcohol to a minimum if you have a problem – all of these are diuretics and can cause dehydration.
Black toenails, often worn like a badge of honour among runners, are the result of bruising and blood blisters under the nail. These are normally caused by your toes repeatedly hitting the front of your shoe because the shoe is too tight or has an insufficient toe box, or because the end of the toes are rubbing against a sock seam, or because the toenails are simply too long. Running downhill, which causes the feet to ‘jam’ into the toe box, can also be a contributing factor.
If a black toenail just looks ugly and doesn’t hurt, leave it alone. It will either grow out or, more likely, fall off. If, however, there is a soreness and pressure behind the nail, then you may need to have the blood blister drained by a podiatrist or doctor. Some runners use foam toe protectors (rather like a soft thimble that goes over the toe) to protect from bruising but the most important thing is to address the fit of your shoes. And if you do end up nail-less just before sandal season, you can get a nail salon to apply an acrylic false nail while your real one grows back!
A sweat rash under your arms, under or between the breasts or in the groin area is an unpleasant but surprisingly common running affliction. Minimise the risk by always showering immediately after running, wearing fresh gear and by using petroleum jelly to prevent chafing. Tea tree oil is a natural anti-fungal agent and many shower and body products contain it. If you do get a rash, treat it with an anti-fungal lotion or cream – preferably one combined with hydrocortisone to reduce redness and itching.