It is one week away from the 27th Steamtown Marathon. This column is dedicated to all the runners preparing for the big day. One small piece of advice; start slowly, avoid the first mile adrenaline sprint downhill, and enjoy the journey! Remember, only one Olympic marathon winner (Juan Zabala, Argentina, 1932) was in the lead at the 5 mile mark. Lesson: The last miles matter more than the first!
Today, I hope to address some common questions for the novice marathon runner or for those coming from other locations to run in the race. What should you pack? How should I dress? What supplies will I need?
Elite runners are so experienced that they know exactly what to pack in preparation for the big marathon day. However, those, running in marathon for the first or second time usually have lots of questions. First, what you need and what you can bring will depend on your support team. If you are running alone and will not have family or friends meeting you along the way, then you are limited to a fanny pack and a few supplies. If you have a support team, then they can carry a bag with supplies, meet you along the course and you can have a sense of security.
Remember; do not do anything different on race day. Try out special clothing, water with supplements and snacks on a practice run. Also, experiment with your best pre-race meal. You will be getting up at 5-6:00am to catch the bus from Scranton to Forest City. You may want to pack breakfast to eat in the high school gym such as; bagel, peanut butter, jelly, banana and coffee or Gatorade. Moving your bowels before the race is a must.
Dress: Columbus Day Weekend in NEPA could bring 30 to 40 degree temperatures when you catch the bus in Scranton and at the 8:00 am race starting time in Forest City.
Clothing:
Accessories:
If you don’t mind the little pack on your butt, a fanny pack can be valuable. In it, you will want supplies such as: small bandages, small roll of medical tape, ibuprofen, antacid tablets, small tube of lubricant, favorite running snack, and extra shoe laces. One might also consider packing a little money, credit card, ID, emergency contact numbers and medical insurance cards. A cell phone is optional.
your supply bag. In the bag, you might consider all of the above fanny pack items and: A change of clothes such as: extra running shoes, socks, shorts, shirt, water proof wind breaker, according to the weather, especially if rain is predicted. Towels, ace bandages, gauze pads and wrap, antibiotic cream, mole skin, sunscreen, petroleum jelly, safety pins, extra water and favorite sport drink, favorite sport snacks, extra ibuprofen, antacid, anti diarrhea medicine, chemical ice pack, mobile phone, money, credit cards, ID, medical insurance cards.
For those with allergic reactions, remember to pack: epinephrine, antihistamine, and other important medications.
Map and directions to the bus or starting line, course map, race number, and get your timing chip.
Enjoy! Enjoy! Smell the roses, take in the fall foliage and chat with a fellow racer. Savor the moment enjoy the day…you are doing something very special!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
During a recent “lunch-and-learn” meeting at our office, several younger staff members were discussing the use of supplements to compliment their fitness routines. One such staff member, Lily Smith, a physical therapy student aid at our clinic from the University of Scranton, is also a serious weight training and fitness enthusiast and shared her experience with creatine supplements with the hope of educating others, especially those preparing to “get fit” in 2024!
A National Health Interview survey found the creatine use among adolescents and young adults to be 34%. It is also very popular in the military with 27% average usage. While athletes and exercise enthusiasts use protein shakes and creatine supplements with hopes to improve size, strength and performance, it appears that most users do not have a full understanding of the risks and benefits. In view of this, today address the use of creatine in strength training and make recommendations based on the literature.
As long as I can remember, young athletes would take or do anything that they believed would improve their speed, strength, agility and athletic edge in order to succeed in sports. Running with weights wrapped around the ankles, drinking raw eggs and whole milk, and consuming copious amounts of beef, pork, and chicken were not unusual. Today, it may not be much different. However, the products do not come from our kitchen cabinet and tremendous misinformation is associated with it. Creatine is one example that was purported to enhance performance as early as the 1970’s but only gained popularity in the 1990’s. 40% of all college athletes and 50% of professional athletes admit to using creatine at some point, despite a lack of scientific evidence to support its effectiveness or safety.
This supplement is a natural substance that turns into creatine phosphate in the body. Creatine phosphate helps produce adenosine triphosphate (ATP), which provides energy for muscles to contract. While the body produces some creatine, it can also be found in foods rich in protein such as meat and fish. Manufacturers claim that creatine use will improve strength, increase lean muscle mass and aide in the recovery from exercise induced fatigue.
While creatine is popular among young people due in part to its availability, very little research has been done in people under 18 years of age. Even in the few studies conducted on adults, the results regarding efficacy are mixed. Some studies show that creatine may improve strength performance due to the recovery cycle of ATP. In theory, the use of creatine is purported to allow one to recover more quickly from exercise. For example, shortly after lifting heavy weights to failure, a quick recovery might allow the weight lifter to lift an additional set of repetitions to increase the duration of intensive training. Therefore, based on this theory, one must work out to complete failure during training to benefit from creatine. However, it is important to remember, there is no evidence that this purported benefit is realized in performance improvement in weight training or endurance sports.
Furthermore, no studies support the notion that it improves performance in endurance sports. Also, research does show that not all users are affected by creatine the same way. Most users fail to find any benefit at all. More concerning to this author is the fact that there are no guidelines for safety or disclosure of side-effects from long term use. Make no mistake, based on the research and current wisdom, CREATINE IS AN UNPROVEN TREATMENT SUPPLEMENT!
If one decides that creatine is a product they would like to use, despite the lack of evidence for its effectiveness, there are recommendations that one should follow for proper use. But there is no consistently established dose. Some studies have found 25 grams daily for 14 days as a “kickstart” dose or “loading” phase followed by 4-5 grams (or 0.1 g/kg of bodyweight) daily for 18 months with few side effects such as: muscle cramps, dehydration, upset stomach, water retention/bloating with weight gain. It is important to remember when establishing a dosage that many weight training supplements already contain creatine and in high doses excess creatine is excreted by the kidneys. It is also recommended that creatine users “wean off” the product when they decide to discontinue use.
Remember, an average adult in the United States receives 1 to 2 grams of creatine each day from a normal, well-balanced diet. Creatine is naturally found in meat, poultry and fish and theoretically, one could increase their creatine intake through dietary changes. Some manufacturers recommend 10 to 30 grams per day with a maintenance dose of 2 to 5 grams per day for athletic performance. Creatine is available in many forms; tablets, capsules and powder. It should be kept in a cool, dry place out of direct sunlight.
Creatine use is not recommended if you are pregnant, breast feeding, have kidney disease or bipolar disorder. There are many reported side effects associated with creatine use such as; water retention, nausea, diarrhea, cramping, muscle pain and high blood pressure. It is recommended that users consume large quantities of water when taking creatine to prevent dehydration. It may be very dangerous to use creatine when dehydration or weight loss is associated with an activity such as wrestling or summer sessions during football.
Furthermore, some studies show that large amounts of carbohydrates may increase the effects of creatine and caffeine may decrease the effects. Users are warned that using creatine with stimulants such as caffeine and guarana (a Brazilian plant extract similar to caffeine found in energy drinks) can lead to serious cardiac problems. The effects of creatine supplements on the many organ systems of the body are unknown. High doses may cause kidney damage. Although no cases have been reported in the literature, it is not known how it may interact with other supplements, over-the-counter medications and prescription drugs.
In conclusion, despite the lack of scientific evidence that creatine is more effective than proper nutrition and effective weight training, it remains a popular, easily available supplement purported to improve strength, endurance and performance in athletes. While relatively safe if taken as directed, it is always wise to consult your physician, especially if you have a history or risk of kidney problems. And, by the way, Lily did not feel that creatine supplements made any significant difference, positively or negatively. She no longer uses it due to the expense, inconvenience and lack of scientific evidence to support its efficacy.
Sources: University of New England; Medicine & Science in Sports & Exercise; NIH and Lily Smith, PT student, University of Scranton, Student PT aide, Mackarey Physicla Therapy
.Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
According to The Council for Responsible Nutrition, 77 percent of adults in the United States take dietary supplements. These supplements are available in many forms of pills, capsules, powders, gel tabs, extracts, or liquids. Vitamins and minerals are common supplements and, of these, multivitamins are the most widely consumed. The scientific literature does not support the value or need for supplements, especially for healthy individuals consuming a well-balanced diet. For those with medical problems affecting nutritional absorption, supplements may have merit. However, these over-the-counter products are not regulated by the FDA and for some, may be harmful. Some supplements can interact with your medications. Therefore, before taking any supplements be sure to talk with your medical doctor to be sure it is safe for you. Keep in mind, just because you use herbs for cooking, not all herbs are the same and some can be harmful.
St. John’s Wort is a popular supplement in the USA. It is often used for depression, anxiety and sleep disorders. However, it is not without its side-effects and dangers. Some side effects include: headaches, nausea, dizziness, dry mouth and vulnerability to sunburn. Also, this supplement can be very harmful when taken with some drugs and treatments. Some include; heart medications, antidepressants, birth control pills and chemotherapy treatments
Kava is purported to help with anxiety and insomnia. However, it also may cause liver damage such as hepatitis and should not be taken by those with liver or kidney problems. Kava should not be mixed with alcohol or other drugs that cause drowsiness.
Some believe that Ginkgo can improve memory, circulation, prevent altitude sickness and other scientifically unsupported claims. However, this supplement can thin your blood and cause bleeding. This is especially dangerous if you take blood-thinning medications.
Users claim that oil from this plant can be rubbed into the skin to provide healing from bruising, swelling, and pain. Others take the supplement to help with constipation. However, side effects from Arnica include; high blood pressure, shortness of breath, fast heartbeat and liver damage. In rare cases it has been associated with coma or death.
Ginger is often used to ease nausea associated with motion sickness and chemotherapy. It is also used for joint pain from arthritis. But, as with other supplements, it is not without its problems and can impact; blood clotting, heart rhythms, blood pressure, and blood sugar. Those on blood thinners or have diabetes should be aware.
Goldenseal has a long history as a favorite among Native Americans. Presently, it is used for constipation, colds, eye infections, and cancer. But Goldenseal can affect heart rhythm, blood clotting and lower blood pressure; therefore, if you take blood pressure medication or have clotting issues ask your doctor before taking this supplement.
Aloe, often in the form of a lotion from the plant, has been used on burns or wounds to promote healing and lessen pain. However, when taken by mouth it has been associated with abnormal heart rhythm, kidney problems.
Ephedra has been used for thousands of years in China and India to treat coughs, headaches, and cold symptoms. In contemporary society it has been used for weight loss and to boost energy. But, studies have shown it may increase blood pressure and heart rate and increase the risk of heart problems and stroke. While the FDA has banned ephedra as a supplement, it is still found in some herbal teas.
This supplement is often associated with slowing down the aging process, managing diabetes and improving sexual performance. But, it is also associated with lowering blood sugar (a potential problem for those with diabetes), and thinning blood (a potential problem for those taking blood thinners).
Black cohosh is used to ease menopause symptoms such as hot flashes and night sweats. However, it should not be used by women with liver problems or breast cancer.
This popular supplement is used for high blood pressure and cold symptoms. Some studies support its use to lower cholesterol. While safe for most, garlic can thin your blood and those taking blood thinners must be cautious and seek medical advice.
This supplement has been used for coughs, sore throat, bronchitis, infection, and stomach ulcers. However, licorice root can raise blood pressure and affect heart rhythms so be sure to consult with your physician.
Users believe this supplement has value for allergies, dandruff, bladder stones, and urinary tract infections. But it can also cause fluid retention and should be avoided by those with heart or kidney problems or if taking diuretics.
Feverfew is most commonly used for migraine prevention. It is also used for arthritis joint pain and allergies. But, it is associated with blood clotting and can be problematic for those with heart disease or blood disorders.
In conclusion, while supplements may not be valuable or necessary for healthy individuals, others may find merit. However, these products are NOT regulated by the FDA and may be harmful. Some supplements can interact with your medications. Therefore, before taking any supplements be sure to talk with your medical doctor to be sure it is safe for you.
SOURCES: National Institutes of Health; WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment.
Read all of Dr. Mackarey's articles at: www.mackareyphysicaltherapy.com/forum
If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
