I've recently been checked for the early stages of diabetes. I'm 50, eat very well, complete annual marathon training, and don't drink much, but there is a high occurrence of diabetes in my family (three of my siblings and my mother are diabetic). How do I carbo-load while marathon training without aggravating or creating more diabetes issues? Thank you–Richard Richard, Your's is an interesting question and a tough hand to be dealt. Still, having a family history with probable predisposition to diabetes and actually having diabetes mellitus type 2 aren't the same thing. Without knowing your height, weight, hemoglobin A1c level, and fasting glucose level, it is a bit difficult to say whether you have diabetes or not. You seem to have a healthy lifestyle with good exercise habits and food choices, so I'll assume that you have a BMI less than 25, that you have pre-diabetes, and you are not on any medications for diabetes at this time. I don't think you need to carbo-load for your training runs. You should eat a well balanced diet and try to mix your foods so the glycemic index is less than one. I think of a potato alone as an example of a glycemic index of one, which means that the starch is easily absorbed into the blood stream and blood sugar peaks quickly. Mixing the potato with meat and vegetables pulls the glycemic index down–you get slower absorption and a lower peak of carbohydrate in the blood stream. Eating fewer refined foods does the same thing. If your total calorie intake matches the calories you burn through running and daily activity, you should maintain your weight and muscle glycogen levels. As race day approaches, you may be able to increase the carbohydrate portion of your diet, but you should discuss this with your physician, especially if you are on medications. It sounds like you are doing all you can to ward off the disease, and you're a great example that exercise is medicine. Try the American Diabetes Association for some more reliable information on diet and fitness. Hope this helps. Cheers, Bill Have a question for the Sports Doc? E-mail him at firstname.lastname@example.org . NOTE: Due to the volume of mail, we regret that Dr. Roberts cannot answer every e-mail.
I am a 41-year-old man. I've been running for more than 30 years. An MRI recently confirmed that the tightness and burning in my left glute and hamstring, and my lower back stiffness, are bulges and tears with the L4/5 and L5-S1 discs. I just had a steroidal injection, which reduced my pain by 50 to 60 percent. My question is this: Do you believe that long-distance running has caused my disc issues? I tend to think that my disc problems are the result of age and the bad posture, poor lifting, and the occasional incident (like a wave-rider mishap 10 years ago), but some health professionals are discouraging my running, as though it is definitely the culprit. What do you think? Thanks–Chris Chris, It sure is easy to blame things on running, but there is little data to support the contention that running causes disc disease or hastens its progression beyond an individual’s genetic predisposition. Sports that I consider high risk for disk injury include rowing, football, wrestling, hockey, gymnastics, tennis, and golf; all share some or many of the common mechanisms of herniation-flexion, rotation, and compression of the spine. In straight-ahead running on the roads or the track, the compressive loads are probably minimal compared to the forces that occur in the lumbar spine of a football interior lineman (or woman). So to answer your question, I would say that it is slightly possible that your running caused your disc problems and quite possible that running can make your pain worse at times. I tend to side with your assessment that genetics, bad posture, poor core strength, improper lifting, and the incidental incidents like the “wave rider” crash did more to damage the discs. Herniated discs usually take 6-12 months to “heal” and during that time it is important to stay fit with walking or any activity that does not flair your pain. You should look at your core strength and do simple strengthening activities like forward, side, and back bridges to help support your spine. Fredericson and Moore have a nice article on core stabilization here . I would also recommend that you find a provider who works with athletes and is skilled in manual therapy to assess your pelvis and low back. If the pelvis is rotated, you can get pain in the buttocks, groin, and hamstring that is similar to radicular disc pain. With time and strengthening, you should be able to get back to running, but it will be a long term project. I hope this helps. Cheers, Bill Have a question for the Sports Doc? E-mail him at email@example.com . NOTE: Due to the volume of mail, we regret that Dr. Roberts cannot answer every e-mail.