Bloody Nipples via Red11 Sport

It happens every Spring almost without fail – I’ll be out for a run and I start to feel a bit of discomfort under my shirt and/or between my thighs. If I’m lucky it’ll happen on a short run and the damage will be limited. If I’m unlucky I’ll be 5 miles from home when the discomfort begins, and will have no choice but to suffer through the remainder of the run. The worst of the pain happens in the shower afterward – the combination of soap and hot water conspire to cause agony, and I need bite my tongue to choke back the screams

What’s this problem I speak of? Chafing. It’s something I never have to deal with in winter, but once the warmth returns and I start sweating, so returns the chafe. Chafing is a common problem for runners, and it seems that where chafing is localized varies from person to person. For me, chafing tends to strike in two places: my nipples and my inner thighs (no holding back here!).

Nipple Chafe

Nipple chafe is extremely common for guys in summer. Once our shirts get wet, the rubbing of fabric against bare nipple starts to do its damage. The damage starts as a sting as the skin gets rubbed raw, and can progress to bleeding if allowed to continue. If you’ve ever watched the finish line of a warm-weather marathon you have likely seen men who have attempted to run without protection. Tell-tale red circles over the nipples are a dead giveaway, often with bloody streaks extending down toward the waist line. I’ve been fortunate enough to avoid blood, but I’ve seen others in races who were not so lucky. I can only imagine the pain.

Fortunately, nipple chafe is actually very easy to avoid. I used to apply Body Glide prior to runs where I suspected nipple-chafe might be a problem, but stopped this practice when I realized that it was creating circular stains on my shirts that would not come out in the wash. I know some guys who use products like Nipguards or those little circular bandaids to protect their nipples. I’ve never used Nipguards, but they cost like $10 for 10 sets, and that can get costly. And I’ve found that circular bandaids are a bit too large and can thus stick to chest hair.

I’ve now adopted a far more effective method of protection – I cut up Band-Aids into little squares that are just about the size of my nipples. I prefer the Sport Strip style since they seem to stay put. This method is cheap, and it works very well. I can get 4 sets of nipple squares from one extra-large Band-Aid sport strip, and for a 30-count box that gives me 120 sets for about $3.50. I have not had them fall off on any run I have done so far.

As an added bonus, the Band-Aid trick is great for embarrassing your wife and kids. I’m sure they love it when I run to meet them at the pool in the summer and forget I’m wearing little square bandaids on my nipples when I jump in the water. People must think I’m nuts. But hey, my nipples don’t hurt!

Thigh Chafe

My other problem area is my inner thighs. Not the private areas, but lower down where my shorts rub between my legs with each step. I tend to have a narrow gait width and I think this is why I’m prone to this. Anyway, it only happens when my shorts are really sweaty and the salt in my sweat seems to be the culprit.

I’ve found two ways to combat thigh chafe. The first is to remove the liners from running shorts and substitute compression underwear that extends down the thigh instead. But sometimes even compression underwear can cause chafing.

The other approach is to use regular running shorts and apply some form of protective lubricant to the affected area. I used to use Body Glide, but lately have been having good success using samples of Hike-Goo and Red11 lubricants that were sent to me (Disclosure: both were free samples supplied for review purposes).

Hike-Goo in particular has been be very effective. It comes out of the tube as a sticky paste, but once applied seems to last a long time. It has prevented thigh chafe whenever I have used it. The one drawback is that it’s kind of messy and I feel like I waste a fair amount with each application since it’s easy to apply too much with the applicator mechanism that they use on their tubes. They also make a product called Run-Goo, not sure how that differs or why I was sent the Hike version. No matter, it works well.

Red11 is marketed for nipple protection, but I have not used it for that since I worry about staining shirts (and the band-aid trick works so well). It has also worked well for use on the thighs. On the plus side, since it is an almost solid paste and comes in a tin, it’s easier to take only the amount that you need as compared to the Hike-Goo.

Other Chafe-Prone Areas

Personally, the only other area I have had chafing issues is (on rare occasions) under the waistline of my shorts. I’m not sure why it happens when it does (I only experience it a few times each summer), and I almost never notice it while running – I know it has happened when I’m in the shower and water hits the chafed spots. Lubricant typically helps here as well, and I always lube my waistline before long races. (As an aside, if you ever have the opportunity to crew an ultra, you will see runners applying lube all over the place!). I used to lubricate my toes as well, but now that I tend to only wear shoes that allow toe wiggle on longer runs this has ceased to be an issue.

I’m sure there are other areas that are problem spots for other people, and I’m sure women have stories to tell that might differ slightly from those of men. If you have any advice that is not covered here, feel free to leave a comment!

Most of the runners in the group will acknowledge that their fitness has improved since that chilly first run in early April. Running is still not easy, but it’s easier than it was a month ago. However, one of the comments that we’ve heard a few times recently goes something along the lines of “I’m feeling fitter, but I still can’t say that I’m enjoying running.” Or more simply “When does running become fun?”

My first response is that running will become more fun as your fitness continues to improve and your body gets stronger. One of the biggest things that new runners have to deal with is the fact that running can hurt. It challenges the body in a lot of new ways, and until you adapt it may not be fun. Patience is critical, as is a gradual approach. A lot of people take up running but don’t stick with it – I suspect that in most cases this is because they try to do too much, too soon. They try to run too far or too fast, and their body simply isn’t ready for that. Running starts to hurt, it’s not fun, and they quit. So the first part of the answer is to give yourself time – running will become more fun when your runs are less of a struggle, and this comes with increased strength and fitness. It doesn’t happen overnight.

Let’s assume that you have taken a gradual approach, and you’re at a point where you feel like running has gotten easier. But you’re still not enjoying it. When does running become fun?

I’ve thought a lot about this question over the past few weeks. At lunch today my wife and I had a long conversation about it. Our answers were quite different. I thought I’d share my own story here.

What Makes Running Fun For Me

I’ve run off and on for most of my life. I actually vividly remember having to run the 1-mile test on a cinder track back in 7th grade. I was a bit overweight, and I was ashamed at how poorly I did relative to my classmates. That was my initial spur to run. I made it my goal to do better the following year. I honestly don’t remember if I ran a lot, but I know that I lost weight and improved my time in 8th grade.

I played soccer in high school and was quite fit, but I never really loved running. It was more often just a form of “conditioning,” or worse, a punishment served by our coaches. Running was not fun.

I continued to run off and on through college and graduate school, but it was always done in a effort to get my weight down. Whenever I needed to lose a few pounds, I’d start running. It was never really something I did for enjoyment. And it often hurt. Running was not fun.

Things changed in May of 2007. It was again a time when I had put on some extra weight – quite a lot of extra weight, actually, it was the most I’d weighed in my life (that’s me from May 2007 in the photo to the left). It was time to start running again.

The difference between 2007 and all previous running attempts was that I had a goal. My wife and I had signed up for a race that July – it was a four mile race, and I had never run more than three miles in a single run before. It seemed like a monumental challenge.

I’m a very competitive person, but moreso with myself than with other people. I’d never run in a race before, and the fact that I had to perform lit a fire in me. I started running with a purpose, and every run became a new challenge. As my runs started to exceed 3 miles I got a rush from each new single-run distance PR. I started timing myself on my training runs and looking for improvement on my regular routes (which I’d measure with my car odometer – no GPS watch back then for me). Running became a game – what can this fat, out of shape body accomplish? Each run may have been a struggle, but watching my fitness go up and my body weight go down was fun.

Running that first race was an even bigger turning point for me. I now had a formal time attached to a race distance. And I wanted to beat it the following year. I was hooked on races, and hooked on beating myself. I was hooked on leaving that fat, sedentary guy that I had been when I started running in the dust. I was running away from my old self. And it was fun.

It didn’t take long for my runs to get longer, and my racing goals progressed as well. First a half-marathon, then a full marathon, then a BQ, then Boston itself. I faced and met each of those challenges. It was exhilarating – running became fun for me when I realized what my body was capable of if I kept pushing it. And it’s still fun for that reason today. There’s always a new challenge to face, and old PR to beat. There’s always room to improve on what I have done before. This is what drives me – pushing myself and testing my limits are what make running fun.

Now, my competitive nature plays a big role in why running is fun for me. Not everyone shares that competitive fire – for example, my wife loves to run, but she hates to compete. And I’d be remiss if I were to say that competition is the only thing that makes running fun. So I thought I’d list a few more of the things that make running fun:

1. The Community. The running community is incredibly supportive and full of great people. I’ve made great friends both locally and quite literally around the world as a result of becoming a runner. One of the things I love about coaching beginner 5K groups is that after a few weeks the group becomes a community. It’s a group of people who share similar reservations and are facing similar challenges. Pace groups develop organically and new friends are made. It’s incredibly fun.

2. Exploration. Yesterday morning I ran 14 miles along a route that I had not done before. It was a beautiful day, and the time passed quickly. I love exploring new places on foot, and running is a great way to do that.

3. The Reward. Running can be hard, especially for beginners. You may ache, your lungs may burn. But you will almost always feel better after a run. It’s hard to beat the sense of well-being and accomplishment gained from a tough workout. You’ll also feel less guilty about the occasional indulgence in a favorite food or drink if running is part of your regular routine. I tell my 5K group that I run so I can eat what I want, and that’s not far from the truth!

4. The Release. My wife would tell you that this is what makes running fun for her – the release from the stresses of the daily grind. Fresh air, bright sun, and a bit of sweat can go a long way to reducing your stress-load. It can be hard for a new runner to recognize this since those early runs can each be a monumental struggle, but once your body is adapted, an easy run is one of the best ways to clear your head after a long day.

I’m going to finish up here, but I’d love to hear your answers to this question – what makes running fun for you?

I’m far from a nutritional expert, so my co-coach Erin Girzone will be doing the bulk of the presentation. I’m going to talk a bit on fueling and hydrating for workouts and races. To accompany this, I put together an outline containing thoughts on these topics gleaned from my own experience as a runner. It’s not intended to be a scientific examination of fueling and hydration strategies, but rather a list of practical tips that I have learned mostly through personal experience. I thought I’d share the outline here for the benefit of any who might be interested.

You can also download this outline as a Word document (right click and save here).

Nutrition and Hydration Tips for Beginning Runners

1. Pre- and Post-Workout Fueling

• Fueling prior to workouts
  • Go by personal preference, consider workout intensity/duration.
    • With experience, you will come to learn when fueling is necessary, and when you don’t have to worry about it.
    • We’re all a bit different, get to know your own body and let it guide you.
  • For shorter workouts, fueling is not as critical.
    • Some people like to have some food prior to a workout, others find that eating prior to a workout can upset the stomach.
  • For longer, harder workouts it makes sense to have some fuel in the body.
    • Again, you will learn with time when fueling helps and when you don’t need to worry about it.
      • I typically only make a conscious effort to fuel before races and for long runs over about 15 miles.
  • There is some evidence that training in a fasted state improves the ability of the body to burn fat while exercising, but improving fat burning capability probably has more impact in longer races than a 5K

• Fueling after workouts
  • It’s generally good to eat and drink something after a workout.
  • A mix of carbs and protein is best after a hard workout, but don’t overdo it.
  • You can wipe out the calorie burn from a shorter workout with a single bottle of Gatorade or Power Bar – think before you drink!
    • Calorie burn for running depends on body weight, below is a table with some estimates for running and walking:
      

      	Calories/Mile
      Weight (lbs)	Running	Walking
      125	90	71
      150	108	86
      175	126	100
      200	144	114
      225	162	128
      250	180	143
      275	198	157
      300	216	171

2. Race Day Fueling and Hydration

• Avoid eating anything unusual the day before or the morning of a race.
  • Foods that don’t agree with you can cause bowel issues, especially since running tends to stir up/jostle the intestines.
  • Practice makes perfect – practice what you plan to eat/drink on race day beforehand to be certain that it agrees with you.
• Avoid eating within an hour before a race.
  • I usually aim for a meal or snack about 2 hours prior to a race.
  • Again, this helps avoid digestive issues which can ruin a race.
• Hydrate, but don’t overdo it.
  • I usually stop drinking about an hour before race.
    • Maybe have a few sips just before the race starts to top off.
  • Drinking too much pre-race might require a bathroom break during the race.
    • All races will have bathroom access or porta-potties, but lines can get long.

3. Nutritional Approaches for the 5K vs. Longer Distance Races

• Fueling is not necessary during a 5K.
  • Your body has more than enough fuel stored to get you through 3.1 miles of running.
• Drinking during a 5K is also typically unnecessary, but not a problem if you feel you need it.
  • Not really necessary unless it’s a hot day and you did not pre-hydrate; also likely depends on how long it takes you to finish a 5K.
• Fueling becomes more important as you go beyond 13.1 miles.
  • Body starts to run low on glycogen (stored carbs) around ~18-20 miles, which is why marathons are so challenging and you need a fueling plan for that distance.
  • Managing pace is also critical in longer races so you don’t burn through your glycogen stores too quickly.
    • You burn through your carb stores faster at faster paces.

4. General Hydration Advice

• Drink to Thirst
  • Overdoing hydration can be just as bad (or worse) than underhydration.
    • Drinking too much can lead to hyponatremia, a dangerous condition in which sodium concentration in blood drops too low.
      • I learned this the hard way in the 2011 Boston Marathon – a case of mild hyponatremia landed me in the medical tent at the end of the race.
  • Let your body tell you when to drink, it’s smarter than any general rule of thumb.
    • If you’re thirsty, drink.
    • Water works.
      • I typically only use sugar sports drinks at water stops in a marathon, rarely ever in training.
• Summer vs. Winter – hydration approaches vary.
  • In winter, you can get away with hydrating less.
    • I rarely carry water with me in winter unless I’m planning to run for longer than about an hour and a half.
  • In summer, be more careful about water intake.
    • Having water on hand on a hot day also can help to cool you down if you pour it over your head.
    • Cramps – popular notion is that cramps result from dehydration or electrolyte imbalance, reality is that fatigue plays a bigger role here.

If you have any tips you’d like to add, please leave a comment!

One of the first questions we got last year, and one that I anticipate getting tonight, is what to do about running shoes?

I make running shoe recommendations almost every day either to clients in the clinic, or via email/Facebook/Twitter to readers of this blog. I can usually come up with some good options for an experienced runner – they’ve got some running footwear history to work off of, and I can ask lots of questions about their injury history and what they do and do not like about their current shoe(s). Making a shoe recommendation is a lot harder for a new runner, so I typically refrain from making specific suggestions, and instead go through some general advice. I thought I’d share some tips here.

10 Tips For Choosing a First Running Shoe

1. Go to a running specialty store. It’s very difficult for anyone to tell you exactly which shoe is best for you if you don’t have a lot of history with running or running footwear. As such, I recommend going to a local running store with experienced and knowledgeable staff who can help you out. And by local running store I mean a running specialty store, not a shoe shop in the mall or a big box sporting goods store. You want to work with people who know runners and who know running shoes.

2. Try a variety of shoes. There are tons of options out there for running shoes, and they span the gamut from shoes with no cushion at all to monstrously cushioned shoes that look like Frankenstein boots. I recommend trying a range of shoes from lighter, more flexible models to more heavily cushioned models. Try shoes from different brands. A good store will let you take shoes for a short run on a treadmill or around the block (better) – take advantage of this! The shoe you want is the one that feels most comfortable when you are running in it, not the one that feels best while you are standing still.

3. Get the right size for your feet. Last year we had a woman in our group whose toes looked like they were going to burst out of the front of her shoes. After a few weeks we took her aside and suggested she get fitted for a pair in a larger size, and it made a world of difference for her level of comfort. Similarly, I recently discovered that for years my wife has been wearing shoes that are too small for her – she has now moved up a half to a full size in all of her running shoes. Don’t be vain about your shoe size, and don’t be afraid to size up in a running shoe if it’s warranted! I generally recommend aiming for about a thumb’s width of space between your longest toe and the tip of the shoe. Let the store you go to fit you, don’t just ask for the size you always wear in your work or casual shoes. Your feet will thank you!

4. Pay attention to shoe width. We all know that shoes come in different lengths, but width matters as well. You can buy some shoes in widths, but be aware also that shoe width can vary from brand to brand, and even among models within a brand. You should aim for a shoe that fits snug but comfortably through the heel and midfoot, and that does not squeeze your foot excessively in the forefoot (forefoot width probably varies the most among shoes). My width test is whether a shoe pushes my big toe excessively inward into the second toe – if it does, then it’s too narrow (or I need a larger size). Another good test is the toe wiggle – if you can comfortable wiggle your toes up and down and spread your big toe out a bit to the side, you should be good to go.

5. Things to think about when you take a shoe for a test drive. As mentioned above, your best bet when looking for a shoe is to take a few models out for short runs. Think about things like how firm the sole is (some people like softer, some like firmer), how flexible the shoe is, if you feel any abrasion/rubbing inside the shoe or at the back of the heel (which could be a trigger for a blister down the road). The ideal shoe is one that you barely notice – if it’s comfortable and it disappears on your feet, then it’s likely a good match for you.

6. Expensive does not necessarily mean better. Shoes are getting more expensive every day, and there are some models out there priced at upwards of $200. Recognize that more expensive does not necessarily mean better, and if you feel like you are being pressured to buy the most expensive shoe on the wall then you may not be in the best store. Most of my favorite shoes are priced at about $110 or lower, and there are some excellent shoes that can be purchased for much less. No need to break the bank on your first running shoe.

7. Arch height and pronation – don’t fall for scare tactics. For a long time arch height and pronation were considered to be among the most important factors in matching a runner to a shoe. Some stores still use this method, and many footwear brand webpages do as well. A store in my town still has one of those fancy machines that scans your arches and spits out shoe recommendations (neutral, stability, motion control) based on the result. The problem with this approach is that there was never any strong scientific evidence to support it, and over the past few years we have learned that it doesn’t work very well. Arch height and pronation can be part of the fitting process, but they should not be the foundation, and if you are told you need a certain shoe to control your pronation, be wary. Pronation is a completely normal movement, and sometimes letting the foot move the way it wants to move is better than trying to control it (there are times when pronation control may be of some benefit, but I generally only consider it if there is an injury that might be linked to excessive pronation). Once again, let comfort be your guide, how a shoe feels on the run is more important than the pronation “category” you are supposedly assigned to.

8. Consider waiting before buying a new shoe. Most of the runners that came to our group last year owned a running shoe already that they used casually. Rather than rushing out to get a new shoe before you start, consider doing a few runs in the shoe you have so you can get a sense of what you do and don’t like about it. This is valuable information for anyone who helps fit you in a new shoe. The more evidence we have to work with, the easier it is to make a shoe recommendation. In fact, tonight I’ll likely suggest this to the group – do a few runs in the shoe you have, let me know what you like/don’t like, then I can make some suggestions and send you to our local running store.

9. Be wary of high-priced insoles. Some stores will try to sell you premium insoles/inserts with your shoes. There may be times when some type of off-the-shelf insole is warranted, but I recommend holding off until you have a good reason to buy an insert, or a medical professional recommends that you get one for a specific pathology. Some stores make good money off selling insoles, but they are not necessarily something that you need in order to be able to run.

10. Recognize that finding the right shoe may be a journey. We had runners last year who went through 2-3 different pairs of shoes before finding a good match. The reality is that it’s hard to know what will be the best match for you until you get some miles under your belt. Sometimes the shoe you like on day one starts to feel off as you get stronger and faster. Your body is going to change a lot as you start to run – you will build muscle, strengthen bones, ligaments, and tendons, and maybe even shed a few pounds. These changes are great, and they are what most people who start running are looking for. But, these changes can make matching the right shoe to you challenging, and you should be prepared to adapt your footwear to your changing body if it’s warranted. As you progress, there may even be some benefit to rotating several pairs of shoes. It may cost a bit of money, but you can have fun with it, and lightly worn shoes can always be sold on Ebay or donated to a good cause (and some stores will take returns of lightly worn shoes for store credit).

If you have any tips you’d add to this list, feel free to leave a comment!