Things runners never say #1 hematuria

It turns out a lot of runners experience it at some point. Blood in your urine. It can certainly give you a fright and send you running to your GP. While it actually should (because there may be several reasons for passing blood through the urinary tract which are not exercise-related), there is no need to panic if you're not experiencing pain and the red hue does not persist a few hours after you have stopped exercising.

Apparently, there are as many as three (!) reasons for passing blood through your urinary tract (a.k.a. Hematuria) that are induced by running itself. Gross? Good news is, it could be worse :) Welcome to the world of endurance running!

1. Footstrike hemolysis / mechanical muscular trauma
   The reason for blood in your urine may actually lie in your...feet. The foot strikes, repeated several times over a few hours, especially on hard surfaces, cause damage to red blood cells in the feet and releases haemoglobin into the bloodstream, whose excess is then lost to the urine. This type of hematuria is actually called haemoglobinuria.
2. Microscopic lesions in the interior wall of the urinary bladder as a result of bladder-jostling on the run
   We all know that if you are a runner, you are prone to injury sooner or later...but we often associated 'running injuries' only with the musculo-skeletal system. But would you think you can actually injure an internal organ while running? Well, now you do! The impact of your foot strikes, especially if you are running on hard surfaces without sufficient padding, can cause trauma to the delicate walls of the urinary bladder, causing tiny capillaries inside to bleed and tint your urine. If hematuria has happened to you after a long run before, do not urinate later than 30 minutes before exercise. The little urine in your bladder may prevent the bladder walls from making contact and alleviate the symptoms.
3. Increased permeability of the glomeruli
   Strenuous exercise has a serious impact on the renal function. It is estimated that the renal blood flow may drop to 25% of its resting value. This changes the permeability of the glomeruli. The increased glomerular permeability allows the red blood cells to pass to the urine, thus colouring it before normal filtering capacity is restored.

All in all, passing blood into your urine after strenuous exercise (especially a marathon or half-marathon) has several physiological causes and is not as serious as it may seem. However, if it has happened to you for the first time, you are experiencing pain or the blood remains in your urine several hours after you have stopped exercising, it is important to consult your physician, as it may also be a symptom of an infection, kidney stones or a tumor.

Read more: http://www.ncbi.nlm.nih.gov/pubmed/6567229

http://www.time-to-run.com/doctor/bloodyurine.htm

http://link.springer.com/article/10.1007/s004210050480#page-1

How to deal with *Runger... *

When I typed 'runger' into goolgle I got surprisingly (or even disapplointingly) few hits. Even more disappointingly, when I pressed 'images', I got pictures of those gorgeous, skinny, leggy actresses, without warning and any real reason.

But runger is a real phenomenon and it is a very logical consequence of how a day (especially Sunday, the staple long-run day) in the life of an endurance runner/ athlete looks like.

Say you're going on a long Sunday run. Say a 20-miler. You get up at nine and have some light breakfast rich in carbs. Preferably complex, whole carbs with different GIs like porridge topped with some fresh and dried frui with a dash of almond milk / natural greek yoghurt. But you know how it is – some of us just don't feel hungry early in the morning and will just grab a banana and chew it absent-mindedly over the Sunday morning catch-up with the news.

Then you duly wait for the meal to settle in your stomach and set out at – say, 10:30 or 11.00. For a *really slow* endurance, ekhm, jogger like me, the finishing line of a 20 miler is almost 4 hours away from now.

Let's say I didn't forget and take a gel or two. At best, I am going to consume 200 kcal between breakfast (9 a.m.) and the time I come back from my long run (2 p.m. - let's be optimistic!). In that time, I – at approx. 115 Ibs – will have burned about 2000 kcal.

I come back home and the first thing I can think about is shower. Then bed. Never the fridge (yet; but it will hit home in 2-3 hours, and it will hit hard); I forget about post-run, pre-shower 4:2 carbs:protein snack of course.

So...now it's 4:30 p.m.; I have not eaten in more than 7 hours and have burned more than my daily calory intake. The slight feeling of nausea has subsided, I have had a snack and the a dinner and then...the hell breaks loose. I spend the rest of the evening on trips to the fridge. The weight loss miracle for me does not happen. (I actually put on half stone in the run up to my first marathon);

So, what to do to avoid this scenario? (And runger can last the next day too!)

1. Take enough gels/ gums/ Gatorade to re-fuel on the run. It will do three tricks:
   - prevent you from 'hitting the wall' (bonking) when your carb tank runs empty;
   - it can actually make you go faster! A recent study (http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2008.164285/full) found that the cyclists who washed their mouths with glucose solution on the bike had faster times and lower perceived fatigue levels. All thanks to the stimulation of the reward system in the brain...
   - the sugar oozing in your blood will help you stave off hunger; and if you actually feel nauseous after endurance training, it may be because of your depleted blood sugar levels
2. DO EAT A POST-RUN SNACK. Just do it. Do it. Really. Prepare some plant-based chocolate milk & banana smoothie beforehand – boil a little water, add a heaped table spoon of cocoa, a few stevia leaves to sweeten it up without loading on sugar, and a two pinches of salt (that's actually important! And it will be tasty too, don't worry); pour two glasses of natural unsweetened almond/ soymilk (before buying, check the ingredients first) and leave to cool; mix in a blended banana (gives 1-2 servings).
3. Take shower and have a proper dinner. This should include a good source of protein (e.g. chicken breast) and complex carbs with lots of fibre (I personally opt for more low-IG sources of carbohydrates, e.g. steamed veggies – green beans, collard greens, spinach – than high-IG foods like rice/ pasta, which spike my blood sugar levels and make me feel drowsy when it drops);
4. Don't shun fat – healthy fats (e.g. salmon) make you feel fuller for longer – unlike carbs, which are digested quickly and which can cause you to feel hungry soon after your blood sugar level drops
5. Snack healthy – if you have to, prepare a bowl of crunchy veggies (julienned carrots, cucumbers and celery sticks) with some spicy hummus – the capsaicin in chillies ratchets up your metabolism and will make you simply...eat leass.
6. Sip on 'sports' water – people often confuse thirst with hunger and overeat when they should be hydrating; but be careful about drinking too much of plain water! This can cause hyponatremia (water poisoning) – a common condition among endurance athletes caused by the loss of minerals with sweat; hence, prepare your own 'sports' drink: mix two pints of still mineral water with 2-3 pinches of salt, a hint (teaspoon is enough) of honey and lemon slices for a low-calorie, 100% natural 'sports' drink; you can go creative with fruit and make different flavours – I personally love my water with lime and blackberries.
   Hope this helps...Do you have any other life hacks for fighting 'runger'? Please share your tips, I'm curious!

More useful tips can be found here:

http://dailyburn.com/life/health/control-your-hunger-distance-running/

http://www.bengreenfieldfitness.com/2013/07/what-to-eat-before-during-and-after-your-workouts-races/

Am I a runner? #Netty

The Spenborough Athletics Club was taken by storm (of discontent) by the running community on Facebook and Twitter last Sunday, as Netty Edwards, one of the participants in the Spen's annual 20-mile road race, was pulled off by a marshal only 1.5 miles in for 'running too slow'. At 12 minute mile pace, Netty was actually doing fine for a 20-miler...or wasn't she?

Come to think about it, I am no better than Netty. At 5:2'23'' my marathon time qualifies me to be pulled off track for running too slow. And I'm a 25-year old, and at at 5'4" I'm a healthy weight of approx. 115 Ibs...(so much about me as a matter of introduction :) ) So I really look up to girls like Netty who need to go an extra mile to compete at that pace!

Hold on a sec, so why am I going that slow? And why the heck am I taking part in races, if I'll obviously land at the bottom of the K20 list?

Well, there's more to running (and even racing!) than just results.

Dear marshals of #Spen20, some of us run for fun! Some of us run to test themselves. Some of us run to face their inner demons.

Chasing a PB is not something I'm interested in. I don't mind closing the list (or even the race, although that hasn't happened yet), as long as I can enjoy the atmosphere and meet like-minded people. Racing is fun, going to a distant location and packing in those 13.1 or 23.6 miles is certainly worth it. It shows me that, yes, #thisgirlcan.

I was a very outdoorsy kid (football, swimming, skiing, ice-skating, hockey...you name it) but I neglected sports a bit (well, a lot) at college and took a real beating at Uni and my first job. Before I knew it, I began crumbling under pressure. I hadn't a clue sports plays such an important role in maintaining not only physical, but also mental health. Until one day...I just got out for a run. At first maybe with the intention of shaping up a bit, but then my attitude to running gradually changed – it became a substitute therapy for the pressure I couldn't quite cope with that well earlier.

And as my mileage increased, I began to cope better and better. I learnt to let things go and – when I was stressed - take it out on the asphalt rather than myself. 

Four years after I first started running regularly, I decided to take part in my first marathon. At that time I had no idea what a 'good' marathon pace was. No idea, in fact, about running whatsoever.

But as I started taking more interest, I realised there was a lot of pressure in that too...pressure I wasn't happy to invite into my world now that I had successfully made running my pressure-coping strategy!

I began to question whether – at an average pace of 10 to 12 minute mile - I am a runner at all. But after a few failed attempts at 'starting to train properly' I stumbled (pun intended) upon a really good article (http://www.cracked.com/blog/5-ways-youre-sabotaging-your-own-life-without-knowing-it/) and finally asked myself whether I really wanted to compete with other runners and whether results were really so important to me. And the answer to both was a clear and straightforward 'no'.

I have finished my marathon within an unimpressive time of five hours and two halves at equally unimpressive 2:26'. I still run regularly, whenever I need, at a pace I find comfortable. And running is still something that helps me cope with stress without stressing me out.

So - to all that doubt in themselves - if you run, you are a runner! 

Support Netty with a few warm words...or follow the story @ ...#Netty at #Spen20