Running tips from a doctor who runs

Host Amber Smith: Upstate Medical University in Syracuse, New York invites you to be "The Informed Patient" with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith. Dr. Emily Albert was one of almost 2,000 runners who competed in the Syracuse Workforce Run this year, and she placed third in the women's race. Dr. Albert is an assistant professor of medicine at Upstate, and she agreed to talk with me about running. Welcome to "The Informed Patient" Dr. Albert.

Emily Albert, MD: Thank you very much for inviting me.

Host Amber Smith: The Workforce Run is a 5K, which is 3.1 miles. And you finished in 21 minutes, 25 seconds, which means your pace was just under a seven minute mile. How did you do it?

Emily Albert, MD: So I didn't really train specifically for that particular 5K. I have been a runner for most of my life, probably since I was like 12 or 13. More recently, I've actually done more cross training in the past few years than I probably ever have since we got a Peloton. We actually got ours pre-COVID, but definitely used it a lot more during COVID with all the kids home and that type of thing. So for the workforce run, I knew about this run and a 5K is a pretty manageable distance. I tend to run about five miles, probably, when I run. So it was a distance I probably was already training for and didn't do anything really particular for it. But I think the atmosphere of the Workforce Run and being with other runners, running in a group, there's a lot of camaradarie, but also a competitive spirit, so I think that pushes you to do a little better than you certainly do running the residential streets in your neighborhood.

Host Amber Smith: So your training leading up to this was the Peloton bike, the bicycle workouts, and weightlifting and running as well?

Emily Albert, MD: Yeah, I would say now I probably run like, like, three times a week and then do the Peloton twice a week on average, which is the bike. There is a treadmill as well, which we don't have, but I think that cross training actually helps with a shorter race like a 5K. I think that cross training probably gives you a little more speed, when you don't need as much endurance for, like, a 15K or a half marathon or a little longer distance race. So I think that combination is probably really good for 5K, even though I wasn't specifically... I think I signed up pretty late, actually, for the Workforce Run, so I wasn't specifically thinking of that, but that was just kind of my normal routine, which I think happens to be good, if you're looking at a race that distance.

Host Amber Smith: So do you have a race day routine, or how do you prepare for a race? Once you know that you're going to be doing it, do you have any good luck charms, or do you have any routine that you do every time?

Emily Albert, MD: You know, I really do not. I think when I was like younger and really competing in races, we did have some rituals, or when I was on teams, there were certain like handshakes that we would do before race. But I think since I've gotten older, and I have kids, I'm usually like last minute getting things ready for them as I'm running out the door to even get to the race. Like this race, we had to catch a shuttle to get there, so I wasn't even like thinking about pre-race rituals or anything like that. One thing I do try to do and think about during the day, in general, is staying hydrated for sure. I think the older I get, the more painful it is to get dehydrated. So, I'm a little more cognizant of that with races. But I don't have anything particular I eat. I've done the Mountain Goat (10-mile run) here and have done a marathon and some halves. And there's this whole philosophy of like carb loading two nights before. So I'll sometimes do that if I'm doing a longer race, but for the 5K I don't have any good, exciting pre-race rituals. Just get there on time -- which I did.

Host Amber Smith: Now you mentioned that you've been running since you were like 12 or 13. So were you an athlete in high school or college? Did you run track?

Emily Albert, MD: I did. I think I ran track when I was probably in like 8th grade, I started that spring and kind of did it throughout. I played other sports as well, which I think was maybe good. I know especially around here, there's pretty strong cross country teams and people who are hard core runners year round, but I think it helped me actually keep my enjoyment for running to do other things in other seasons. And I think that's true, even now, of cross training. And, I discovered doing triathlons since I've been older. And I actually think that also probably helps prevent injury that a lot of strictly runners do get as well. I think there's some evidence for that, too. So yeah, I think playing other sports, potentially made me a better runner and vice versa. Staying in shape year round, hopefully helped for those other sports as well. But definitely running was, I discovered it early and have run for many different reasons throughout my life. But I think at that time being an athlete was a big part of what motivated me to stick with it and work hard at it, I guess.

Host Amber Smith: During medical school at Upstate, and also while you were working on your masters of public health, did you find time for running or other types of exercise?

Emily Albert, MD: I did. I think until we got the Peloton a few years ago, I actually ran... I think I've become a weaker runner, like as far as my resilience to weather and that type of thing because of the Peloton, but I used to run outside, you know, in Syracuse winters and pretty much anything. I had those, what do they call them? Like crampons, or the traction cleats, I think they call them, to get outside and run in the winter. So, I think as I got older and in medical school and when I was getting my MPH, I think it was a stress relief as well. So I kind of found time to squeeze it in. Probably the hardest time, even more so than medical school or residency, was when I started my first job. I was getting my master's. I had my first daughter. Somehow I would find ways to just squeeze it in, the morning, the end of the day, sometimes the middle of the day, if that's what worked out. But I think because of I know those endogenous endorphins or the endocannabinoids, whatever it is that you release, I think that helps keep me going through those times. And also having a husband who appreciates exercise and running as well. So he would come home and hold a baby, so I could get out there even if it was 30 minutes, or I've run with a lot of strollers throughout my life. I've had a single, and a double, and a dog strapped to my waist. So anyway, to get out there and get it in, I think there's no simple schedule. I think for most people, life is pretty complicated these days.

Host Amber Smith: This is Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith, and I'm talking with Upstate internist, Emily Albert about running for fitness.

So why running? What do you like so much about running?

Emily Albert, MD: I think what got me initially and probably what's kept me with it is it's so versatile. I mean, I can remember running in so many cities and states and on vacations. All you really need is a decent pair of sneakers. They really don't have to be fancy, in my opinion. And you know, you can kind of do it anywhere. It's something you can do with other people. You can do it for a cause. You can train for a goal or just do it just to stay fit, or release stress or whatever kind of drives you to do it. But I think probably the versatility of it, the minimal equipment.

I mean, I think of getting all of our family skiing in these past few winters and the amount of effort and equipment and money. I mean, we love it, but the amount of work that goes into a ski season, compared to be able to go out for a run, it's really a fraction of that. So I think that's one of the things that has made it very doable over, across many different transition periods in life and locations. It's worked out.

Host Amber Smith: I was going to ask for advice that you would have for someone who wants to start running. Now, you mentioned shoes, or the sneakers. How do you go about choosing the right sneaker?

Emily Albert, MD: I think there is a lot of research and probably money put in from different companies to try to get, convince people of certain aspects of a good running shoe. I actually think Fleet Feet here in Syracuse -- I don't know if I can give a shout out to them -- but I think they do a pretty good job of kind of assessing people without going too overboard in technicalities. Honestly, I've run in so many different brands of shoes. I've really never had any serious injuries in all these years of running, no matter which shoes I've worn. So I think, you know, finding something that's comfortable, unless you have a specific overuse injury or some indication to look for something specific, I actually think there have been studies that show if you spend, I don't know, over $150 or $200 in shoes, you're more likely to have running related injuries. Now that potentially could be those people run more, or whatever. They're higher risk for, a lot of confounders there. But I think it just goes to show you don't have to spend $200 to get a decent sneaker.

Host Amber Smith: What about other gadgets? Do you have any other items that you run with? Some people use water belts. Some people rely on watches because they're trying to time themselves.

Emily Albert, MD: I do use an Apple watch, and I will clock my run and kind of see what my time is. And I've probably had one for five years. And all the years before that, I think, I mean, I didn't really have anything fancy. I could gauge the amount of miles I ran just based on time and what it felt like. But I do think a watch with -- and a lot of people like a Garmin. I've never run in a Garmin, but there is a cult following of them, I think, who swear by them, my sister included. She's someone who didn't enjoy running earlier in life and now probably runs more than most people I know. And she swears by her Garmin, and then she has a waist belt that she loves to run in. I do run with my phone, and I actually will listen to podcasts and sometimes music when I'm running. I think if you live in an urban area, that's pretty dangerous, but where we are with all sidewalks, and I often run in Green Lakes (State Park.) I think it's, as long as you're aware of your surroundings, there's certainly dangers anywhere, but I think it's doable.

But I can remember running with a Discman, like way back in the day, that I had to like hold steady so it wouldn't skip when I was running. And so nowadays there's lots of things. If you need something for a little entertainment, just with a little caveat of knowing your surroundings, I would often run with like one headphone in and one out so I can hear traffic, or if I had a stroller or something.

Host Amber Smith: When you run these days, are you running for distance or for speed?

Emily Albert, MD: I kind of have run about the same amount of as far as distance goes, except, you know, there have been a few times when I really was training for a longer race. So most of the time I'm running a certain pace of mile and kind of keeping track, but not, you know, if one day I run a little slower, a little faster, I'm not too hard on myself, if I'm getting out there and getting the miles. But I'm kind of a person of moderation. So I do like a 5-mile loop. I've trained for a few longer races, but, you know, there's those ultra marathoners out there that really get into those, those long, long races. And I think one of those every once in a while, if you train, could probably be a lot of fun. I think over time, those runners certainly do have more overuse injuries and things. So yeah, I think, you know, just moderation, and that works out well for these kind of 5Ks, and putting in a little more miles. And, maybe following a training schedule for those longer races.

Host Amber Smith: Are there any common injuries that you would caution runners about?

Emily Albert, MD: So there's probably two things I think of. One is plantar fasciitis. I think that is such a common running injury, and I've had it myself. I've done one marathon, and after that marathon, I had horrendous plantar fasciitis. The plantar fascia is a thick, white tissue on the bottom of the foot that connects the heel to the toes. And usually it is from an overuse of that. It can be affected by form. But when that becomes inflamed, it can become very painful along the bottom of the foot and is one of probably the most common running injuries, especially when you're first starting out. I think just being aware of that, and there's a lot of different stretches and massage techniques. And certainly if you can take NSAIDs -- which are like ibuprofen and Advil -- that's the best and most simple pain medicine for that. And sometimes rest and ice -- that old RICE saying -- compression, elevation. Those things, you know, for a lot of running injuries, those are pretty beneficial. And just kind of listening to your body, being aware of those things, especially early on when you're starting out. And if things don't get better with those kind of simple measures, seeking advice. There's a lot that physical therapy can do nowadays as well.

The other injury that comes to mind are tight IT (iliotibial tract) bands, especially in female runners. The IT bands run kind of down the side of your thigh and comes around the lateral aspect of the new joint, and can cause knee pain. And I actually had that as well. And that's another common injury. I think I've been lucky to get through them both fairly quickly, but that injury, I thought I had deranged my knee for sure. I was in college at the time, at Clarkson, and went to the trainer for the hockey team. And he did some special tests for my knee, assessing the ligaments and the meniscus, and diagnosed that, and taught me some stretching and some strength training for the muscles around the joint, which is a common treatment for a lot of injuries -- for runners, it's usually ankles and knees -- strengthening those muscles around the joint made a huge difference, and I've not had a problem with it since, really. And that was 20 years ago, to date myself.

Host Amber Smith: What advice do you have for experienced runners who would like to be more competitive in races like the Workforce Run?

Emily Albert, MD: I think the biggest thing is just squeezing it in when you can and being flexible, especially people who have jobs and have kids. I think a lot of us type A personality is like a schedule, but I think you've got to be flexible and squeeze it in. Sometimes it's the morning, sometimes it's not.

And also, I think there's a lot of resources now. I mean, I always just kind of ran and honestly guesstimated how many miles I should put in to train for a marathon or whatever. But there's a lot of schedules out there now that are easily accessible through the internet that give training schedules if you have three months to train or six months to train, depending on how long of a race you're wanting to do, and trying to kind of follow one of those schedules. And again, with a little bit of flexibility and knowing it might not, you might not be doing the exact schedule every day, but I think sticking to one of those can be really helpful. There's a program called Couch to 5K, which is kind of a good program. My sister was telling me about that, too, because she did that when she initially started running. And I think that's a good way to just kind of get into it. And once you're there and you find this running community and, it's one of those things, you can always find a race to enter if you want, if you want to do it on your own or with people in your neighborhood or whatever, it's a pretty versatile in that way too. But there's a lot of resources and training schedules out there.

Host Amber Smith: Do you think that a crowd of runners at one of these events, do you think that helps or does it hurt your performance?

Emily Albert, MD: Personally, I think it helps a lot. I think most runners when they do a race, at least for me, for sure. My time is a lot faster than a training race. I think running is one of those sports where as competitive as it is, as you are with each other out there, there's so much camaraderie and especially in a race when you're pushing yourself and there's like a little bit of pain and suffering -- not to say running is always painful and suffering involved -- but certainly in a race, it can be like that and it's kind of fun, and that camaraderie and you push each other. So I think personally, I think it helps a lot, and it gives you that little bit of extra push in making it fun and kind of making you look forward to the next one.

Host Amber Smith: Well, Dr. Albert, I really appreciate you making time for this interview.

Emily Albert, MD: Thanks very much for inviting me.

Host Amber Smith: My guest has been Dr. Emily Albert. She's an internist and an assistant professor of medicine at Upstate -- and a really fast runner. "The Informed Patient" is a podcast covering health, science and medicine brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe. Find our archive of previous episodes at Upstate.edu/informed. This is your host, Amber Smith, thanking you for listening.