Boston Marathon Training Update - Week 14

Okay, folks, it’s getting to be that time. Last week was my last high mileage week and since the marathon to end all marathons (at least for me) is less than four weeks away, I really don’t have any more time to fool around. So I’m just going to give it to you straight. Do you want the good news first or the bad news? The good news is I got all my scheduled miles in this week, all 54 miles of them. Wahoo! The bad….well, you’re just going to have to read ‘til the end to find out!

Week #14 (3/23-3/29)

What I Planned:

Marathon Paced Run: 14 miles at 6:52 pace

Recovery Run: 6 miles at easy pace

Tempo Run: 9 total miles with 6 miles at 6:22 pace

Weekend Long Run: 21 miles at long run pace

Recovery Run: 4 miles at easy pace

Total week 14 distance planned: 54 miles

What I Ran:

Tues – Marathon Paced Run: 13.1 miles at 6:49 pace

Tues – Cooldown Jog: 1.6 miles at 7:23 pace

Wed – Recovery Run: 7.7 miles at 7:00 pace

Thu – Treadmill Tempo Run: 9.1 miles with 6 miles at 6:19 pace

Sat – Weekend Long Run: 21.2 miles at 7:37 pace

Sun – Recovery Run: 3.0 miles at 7:11 pace

Total week 14 distance: 55.7 miles; avg pace – 7:10 min/mi

How I Ran:

Well, if you remember from where we left off last (If you don’t, I can’t blame you, I had to look back a few times myself because even though it was only a week ago, it seems so very long ago in retrospect), I had just come back from an injury-plaqued week to run a PR in a 15K race almost unintentionally. Although I was not bothered at all that day by my tight right hammy, it was still fresh on my mind as I set on Tuesday for my marathon-paced long workout Unfortunately, I made 2 mistakes that day that destroyed my run. The first was that I had a late greasy lunch and headed out almost immediately after. The second was that because I was so anxious to test out my hammy and set a good pace early on, I ran way too fast in the first downhill mile. My breathing became labored, I developed stomach cramps and it became a physical struggle just to get through the workout. Eventually, I ended up at 1:29:41 (avg 6:49 pace) for 13.1 miles, which is a far cry from the 1:28:13 (avg 6:43 pace) I had done for the same distance 12 days prior. I was somewhat disappointed by this result but sought solace in the fact that my right hammy strain was really a non-factor throughout.

After a late night recovery run the next day necessitated by another patient emergency at 4pm (Why do these always seem to happen in late afternoons?) where I found myself at one point racing a raccoon down Harlem Hill, it was again time for another hard speedy Thursday workout. If you notice, this was my third straight run in as many days, which is something I really don’t advocate but because this was high mileage week, I really had no choice. My right knee felt a bit gimpy over the past couple of days (perhaps from overcompensating for that pulled hamstring) so I was a bit relieved to see that it was actually raining all day, meaning my tempo run would be done on the treadmill instead. of on the road. Although the human hamster wheel totally chewed me up and spat me out that night, grossing out all the unsuspecting ladies doing their pretend light cardio on the machines next to me, I still hit my paces dead on and successfully completed the workout.

The 21 miler on Saturday was really a combination of two runs for me. Because I wanted to prevent further injury and run a bit slower that day, I decided to at least start the run with my running group, the NY Flyers. Unfortunately, less than a half mile into the run, when I dropped back to take a quick bathroom break, I prompted lost everyone and couldn’t find them again. Luckily, because the group leader had handed out pre-printed directions just in case of that exact scenario, I was able to find my own way and eventually found them again up in the depths of Inwood, about 8 miles into the run. For the next four miles, I ran with different people within the group, all running paces that were much slower than mine. I sacrificed a lot of speed during this stretch for the social aspect of running which I like. Unfortunately, this was also my last long run before Boston, so I really didn’t want to run so slowly for the full duration. So after I caught up a bit with everyone and made plans with several to meet up for brunch after the run, I sped up and found my own way back to the park. By the time I got back to the Boathouse in Central Park, I had done 12.2 miles with the group at 8:05 average pace and 8.9 miles on my own at 7:00 average pace. I was extremely sore after the run but was glad just to have finished strong.

The real damage from everything didn’t hit me until the day after, when I woke up Sunday with deep searing pain in my left lower calf. Ah yes, I nodded to myself. It was the reappearance of an old friend whose personality I’ve come to know well. After palpating and confirming that yes, it was indeed the old familiar Achilles’ tendonitis rearing it’s ugly head, I got up, limped around and went about my chores for the morning. I figured a little movement would ease the tension and satisfy the cry for attention, but by the time the early afternoon came and my calf still hadn’t resolved its differences with the Achilles, I wondered if even a slow recovery run would prove beneficial. So I waited and waited. Yes, I should go, it’d help. No, I shouldn’t, it’d wouldn’t help. Yes, I should because I’m 2 miles short of my goal. No, I shouldn’t because I have a speed workout planned for tomorrow. I was locked in a mental tug-of-war for several long hours. Eventually, by the late afternoon, while perusing around some running blogs, I saw this, and the decision was made for me.

Honestly, if you even remotely identify yourself as a runner, can you watch this and NOT run? Even if it’s not Kara Goucher, who I’ve met, and is from Queens just like I am, and who ran NYCM ’08 just like I did, and who will be running in BM ’09 just like I will, and who loves to run and compete just like I do (oh yeah, and do I have to mention she’s super cute!)…even if it wasn’t her or you're not a fan, can someone watch this and not believe in the run? Nope, not me. So I did three slow ones close by, up and back down the East River Drive. Despite it being windy and cold, my Achilles held up okay. I didn’t push it at all and slipped it into a bucket of ice the moment I got back. It is still quite sore this morning so I’m probably going to have to take another couple of days off. It’s alright though because it’s taper time! Wahoo! I’m so excited that I’ve made it this far! Now I have every reason to pig out, run just a little and get ready for the biggest and longest block party in the Northeast! Yeah, can you tell I’m bubbling right now! I can hardly wait.

Oh, and by the way, don’t worry about my Achilles. I’m not. It’s an old friend so I know its temperaments well. It will heal itself in due time. Everything will be fine by Boston time. Have a great week everyone!

Running: Physiologically SpeakingThe Marathon and Hormones Edition

At times during the day, when I’m busy attending to patient affairs and practicing clinical medicine, I sometimes feel as if I’m Clark Kent, because hidden behind my long white coat and the stethoscope that adorns my shoulders like a Christmas ornament is a speed-crazed super runner that is unknown to anyone within the confines of the hospital. This suits me just fine because contrary to what someone might think, when I’m at work, I generally do not like to think about running because not only does it distract attention away from the patient at hand, but also because no one could or would understand my passion for it anyway. So as a general rule, running and clinical medicine don’t mix, at least for me.

But like they teach all the students in medical school, patients don’t read textbooks and there are exceptions to every rule. True to form, every once in a while, especially when I’m at the peak of marathon training, some running thoughts inexplicably force their way into my head even as I’m seeing patients and dealing with issues that have nothing to do with running. Below is a sampling of the random thoughts that flowed through my head this week as I was working. Some of it will be beneficial to you all, some not very much so. Read ‘em at your own risk.

Weighing In

Some kid came in early last week for evaluation of poor weight gain. He was a scrawny looking prebuscent kid who’s only abnormality I found after performing all the necessary tests, was having O.C.D. parents. As I was explaining to both mom and dad that their boy didn’t have malaria or parasites living within him, the boy said something that completely surprised me. “I’m okay. I’m not weak, or sick, or anything. I work out everyday. I can probably bench-press the doctor if I wanted to.” It would have been funny if it wasn’t so blatantly obvious. After some mild chuckling and further assurance that everything was indeed fine, I shooed the whole family out of my office and went to weigh myself. Sure enough, another 3 pounds lost since the beginning of the month. All together that makes 10 since the beginning of January! No wonder the kid picked up on it. I was turning into a stick figure faster than Haile Gebrselassie running a marathon!

Okay, I know for most of the population, this would be a cause for celebration, but for me, this is anything but since I’m already underweight for my size as it is. Unlike most everyone who have problems losing weight, I find it extremely difficult to keep the pounds that I have. Marathon training I’ve found is the worse for me since I tend to eat less even as I’m running more. Friends and patients have asked me how I lose weight so easily and I reply by asking them how they gain weight so easily (No I don't, but I so want to!). Last month, I was in contact with a nutritionist in my department who advocated many small meals for me throughout the day instead of the three large ones I’ve habitually consumed. It worked for a while, until I couldn’t find time anymore to have my seven meals and so now, instead of the three big meals that I started out with, I’m having only about three small snacks a day. So not good.

I’m hoping to get back to eating more regularly and eating healthy and gaining back my 10 pounds after the marathon. Ideally I want to gain 20, but that’s as likely as me running a 2:30 marathon so yeah, maybe in the next lifetime. I’m saying after the marathon too not because I think I want to keep my weight down to maintain top efficiency for the big race (as some friends have suggested), but rather it is because I think it’ll take me not running for an extended period to gain the weight back. It is not funny how many times I’ve wished that some of the obese kids I see in clinic everyday could just lend me an extra twenty pounds or so…

A Cure For Childhood Obesity

Speaking of obesity, Mr. Petes at Runner Write wrote an interesting article last week on how to solve the traffic problems in big cities like New York. He proposes the elimination of roads for cars and the construction of running routes to encourage people to run to work everyday. Not only so, but instead of parking lots, there’d be showers and lockers for each employee to change and clean up after their run.

I thought this was a brilliant idea, but thought it could be further extended down to children commuting to school. Instead of school buses picking up kids everyday, we can have coaches lead walking and running groups to school every morning. Given the lack of physical education and playground time in schools these days (most of the kids I see on average report only 2 gym sessions in school per week), they need all the exercise they can get. Traveling to school on one’s two feet (like they do in other parts of the world) would be a pivotal start. I’m sure the rates of childhood obesity would plummet if we could somehow implement that strategy.

Menstruation and Marathons

I don’t know if many of you know, but as part of my job description, I help young women deal with their menstrual problems on a daily basis. Whether it is a problem of frequency, irregularity or pain, I’m often the one that’s called upon to perform the detective work necessary to determine if there’s a hormonal basis for the abnormality. Most of the time, within the first fifteen minutes of the interview, I can tell that the issue is psychological or social and not hormonal. Yet I still find myself listening to the stories, hoping to nail down the root cause of the concern. In a perverse sort of way, I find the menstrual cycle very intellectually stimulating, similar in many respects to a marathon training cycle. The interplay of the rise and fall of different hormones at different times within the menstrual cycle parallels the synchronous nature in which different types of runs complement each other in a marathon training program. Not only so, but just as emotional stress can create havoc in a woman’s inherent cycle, so too can physical or psychological stress interfere with the success of marathon training.

Exercise May Be Dangerous During Pregnancy

I don’t want people to freak out over this because it is only one paper, and it’s from Europe no less. (Apologies to Xenia and whoever reads this from across the pond) According to this study (pages 12-13 here), exercise, even as little as 30 minutes per day, can dramatically increase the risk of pre-eclampsia during pregnancy. Really? Now I’ve already spoken to several colleagues about this, and they seem to think that this study only applies to a selective population that is already at high risk but still I am at least a little worried. More confirmatory studies are on the way.

I guess if this were proven true, it’d be just one more excuse to be lazy...considering you are pregnant of course. So from now on, if I hear that a female runner all of a sudden loses motivation and is sitting on the couch all day eating Doritos, rumors are going to start to fly. Just sayin’.

Hormone Doctor or Performance Enhancement Guru

Almost on a weekly basis, one of my patients, or their parents will ask if stopping some medication that I’ve prescribed for them previously will interfere with their athletic performance. Most of the time, I’m somewhat perplexed by the question because enhancing performance on the court or the ball field or track was never discussed as a potential positive side effect when starting the medication in the first place. And then it hit me late last week, as I was working at the office while ordering the Boston Marathon jacket online. Because I’m a hormone doctor, practically every medication I prescribe can be considered performance-enhancing. Seriously. Almost every single one. A partial list of common medications I write for include testosterone, estrogen, androstenedione, insulin, growth hormone, and IGF-1, and every single one has been banned by the I.O.C. and M.L.B. I wrote a tongue-in-cheek essay on this when the Mitchell report came out a couple years back, but I seriously hadn’t realize how prevalent my involvement in this arena was, or could be. So in essence I could be called a performance enhancing guru and be responsible for a whole generation of dopers out there. This is somewhat of a frightening proposition.

On the flip side, I wonder if people are getting suspicious of me running such great times recently. After all, I might not be so “clean” either. As I’m writing this, I’m wondering how long it would take for the Boston Marathon race officials to e-mail or call and ask me for a urine sample. If they don’t, and I end up running a sub-3 in three weeks, I wonder if I can voluntarily drop trough right at the finish line and ask the race officials to take my pee and run some tests. I’m sure they’d appreciate the honesty.

That’s all from me today folks. Can you tell I’ve got marathon fever up in the head? Hope you all are enjoying your weekend. I’ll be back later to recap the week of marathon training, which will the last for me before the taper. Wahoo!

Moving On: Pacetats and Pacing

Alrighty then. Now that everyone has gotten a chance to speak their mind on the mileage controversy, I think it’s about time we bury the hatchet and move on. But before I do, let me set the record straight. Although I was perturbed and rather perplexed by the harsh criticism, it was NEVER my intention to desecrate or otherwise ridicule the character of the critic. Nor was it my intent to assemble the minions to launch a verbal assault against the perpetrator. I highly respect everyone’s opinion, even those that do not agree with my own. However, I also believe that when the basis of ones hard work for the last several months comes under heavy scrutiny, I am similarly obliged to offer an objective defense using my own past training as evidence. Otherwise, if I continued forward in silence, it would appear as if I am acquiescing to the label of my marathon training as “soft” which I vehemently do not agree with. (As a matter of fact, even in further defining the term, the lesson learned in a sub 2:30 marathon was used – which is really not anywhere close to what MY marathon goals are. Therefore, the question of mileage for a sub 3:00 marathon is not the same as for a 2:30 marathon. So, in my opinion, to use that derogatory term to describe my training when it’s already been shown to be able to carry me to a 3:02 marathon is really not justified.) Furthermore, as I’m the acting running coach for more than a few friends and bloggers, how can I perform my duties honestly in helping them train for their own half-marathons and marathons with a custom plan I designed for them if I don’t even believe enough in my own training philosophy to offer a suitable defense when it is under attack. As such, I was more or less forced to build a strong case for myself not using slander or ridicule but using objective verifiable training data from marathons past. I truly hope I have done that. If anyone took offense from my arguments on my own behalf, then I am the one who’s truly sorry because I thought I handled the situation as tactfully as I could and took my time to select my words carefully.

I guess we can all agree to disagree and continue on with our individual methods for training for races the way we like.

Whew, now that’s over…I have other burning issues to discuss as it relates to the Boston Marathon, or just marathoning in general…

My new bloggy friend carpeviam made a recent discovery and sent me a link in the comments of the last post. It was for pacetat. It seems like they now offer temporary tattoos with pace tables for each mile of the marathon on them. How cool is that? Although I’ve never been one to use predefined set paces to carry me through a marathon (mostly because I often do not run marathons with a singular goal in mind), I’m tempted to use a pace bracelet on this go round just to keep myself on my goal pace. Are there people out there who swear by them? How have your experiences been running with and without a pace bracelet? The way I look at it, sometimes it can be a godsend when other times it can be a crutch.

Secondarily, even if I were to run strictly according to pace, what is considered good pacing strategy for a deceptive hilly course like Boston? I’m thinking strictly an even pace throughout is probably not the way to go since most of the hillier portions are towards the end. Still, I’m nervous that if I work too hard building up bank time for the hills, I’ll just burn myself out. As a guide, I’ve downloaded Greg Maclin’s amazing worksheet (as listed in RWOL forum here) and have been playing around with different numbers. I’ve also been looking with interest at normalized paces of the elites from the 2008 version of the race (as described in this thread) in trying to decide how I should tackle the course myself. Any helpful insights or knowledgeable insider info would be much appreciated.

Or if you don’t have experience in such matters, you can tell me how I totally just jinxed myself in ignoring all inhibitions for spending $90 on one of these.

So what if I’m planning to wear it in front of the kids at the hospital instead of my white coat for the entire month of April? I think I’m entitled. Besides, I’m sure the kids won’t mind…even if the administration or my colleagues might think differently. But then again, they've never qualified to run The Boston Marathon now have they?