Maggie McKay (Host): If you're gearing up for a 5K, 10K, or even a marathon, it's a good idea to be fueled with all the information you can. This is part two of two in our series with Physical Therapist, Chad Boehm, on running.

In the first episode, we talked about a beginner's guide to running. This episode is for people who already run and would like to increase their mileage or intensity. Welcome to To Your Health, a podcast from Jefferson Healthcare. I'm your host, Maggie McKay. So good to have you here again, Chad. Nice to see you.

Chad Boehm, DPT, CSCS: Nice to see you. Thanks for having me.

Host: Let's start with increasing training intensity and miles. What should we do to do that safely?

Chad Boehm, DPT, CSCS: So if somebody is coming to me wanting to increase their mileage or their intensity, there's a couple of rules we follow, one of which is the 10 percent rule that says, you really shouldn't, increase your mileage or increase your time week over week more than about 10%. So, you know, just to make the math easy, if somebody's running

10 miles one week, they don't want to increase it more by one mile the next week. And when it comes to the balance between intensity and volume, usually what I recommend is increasing your volume first, then increasing your intensity kind of as the race gets closer. And so you might spend more about like 80 percent of your time, gradually increasing your volume or your mileage or your time week over week until you hit kind of like a peak mileage, and then once you kind of hit that peak mileage, then you start slowly increasing the proportion of higher intensity running you're doing, where you might introduce like one hard workout in a week, if you're pretty fit, you might do two, if you're really fit, you might do three. Those are the two kind of rules of thumb we tend to follow.

Host: Also, a lot of athletes are getting ready for the Jefferson Healthcare Rhody Run, our community's biggest road race and a beloved community tradition. So many people participate in it. How can someone transition from complete to compete in regards to racing?

Chad Boehm, DPT, CSCS: I think one of the biggest things when going from complete to compete is kind of like having a plan essentially. For most people, if you're just taking up running as a, like a recreational activity, you do to kind of like blow off steam or just kind of stay in shape, you know, you can kind of just go out, you know, do two, three, four miles, you know, day after day, you don't have to like think too much about it.

When we start competing, when we start thinking about like higher intensity and wanting to improve our fitness, then we need to start taking a bit more of a gauged approach. We have to have some kind of a plan and usually what I tell people is, either get online, find a plan from Hal Higdon or, Andy Burfoot or Greg McMillan or Jack Daniels.

They all have like really great kind of introductory plans or novice plans. Or even better yet, like buy a book. Some people, or a lot of running books will have plans in the back and they give a really good like oversight into like why you do certain types of runs and when to pepper them through your training schedule.

But that's kind of the overarching thing is like, have a plan and in that plan, you are going to want to do more kind of higher intensity running. And that's where having like a week to week, like I'm going to do one really hard run, or maybe I might do two hard runs. And I want to schedule in some rest too.

Some people kind of get in this mindset of like, Oh, like if a little is good, more is better. But really when it comes to an athletic endeavor, rest is training as well. So that's like the two biggest pieces of advice to have for people who want to get into more kind of competing or like pushing themselves or improving their times is yes, you want to run harder.

Yes, you want to have recovery in there, but at least have something down on paper that you can look at and follow and kind of know I'm on the right track, or I kind of fell off my path a little bit, kind of hold yourself accountable. But also do it in pencil, you know, because it's never going to go 100 percent right.

So you want to have it like a pencil to kind of like change. You can modify your, where you put your workout, all that kind of stuff.

Host: You touched on it briefly, but let's talk about how to increase your mileage safely without causing an injury, increasing mileage and increasing intensity. The idea is, like you said, have a book, have a plan, but you don't want to get an injury. So, what else about that?

Chad Boehm, DPT, CSCS: So actually there's kind of two schools of thought. One's the 10 percent rule. The other one is more of a Dr. Jack Daniels, is a running coach. He's been in coaching since like the 70s or 80s or something. He's got a lot of research into running.

 Intellectually, he's one of the higher level, like more accessible coaches, writes a lot of books and stuff. But one of his rules is, however many runs you do in a week, you can add that many miles every third or fourth week. So if I, if I'm running 20 miles, but I'm doing it in five runs, I might maintain that volume for about three weeks.

And then on the fourth week, I could increase that to 25 miles. And I can hold that for three or four weeks and increase. I'm still doing five runs. I can increase that by another five miles. And so really when you, when you do the math, it kind of works out to be about equivalent. One is more just kind of like chunked.

You know, you spend a certain amount of time here and then you spend a certain amount of time there and a certain amount of time there. The other one's more kind of graduated. It's kind of like week after week after week, it's a little bit higher and a little bit higher, but either case I've had success with progressing athletes in a safe manner. And usually along with that, as mileage or time goes up, the ancillary tasks like stretching, foam rolling, get to be more important or want to be sure we're doing them kind of consistently to avoid some of the injury risk.

Host: I'm not a runner, but five runs a week sounds like a lot to me. How do I know if I'm over training?

Chad Boehm, DPT, CSCS: Ah, so, the tough part about overtraining is there's no real kind of like diagnosis for it. It's more of a diagnosis by most common symptoms, I guess, would be difficulty sleeping. A lot of times if people are exercising too much or running too much, that sympathetic nervous system is kind of in overdrive all the time.

And so they have things like elevated heart rate, hard time sleeping. They might feel kind of anxious, frequently, they can't like calm down, And then sometimes people have recurrent, upper respiratory tract infections, you know, they have like a cold that basically kind of like never goes away, you know, those are all kind of signs that, you just, you're overdoing it.

You're kind of grinding a little too hard. And so, back it off for a week or maybe even two weeks and just until you feel good, you know, that's the other thing is we expect you to feel kind of tired, but we want you to feel good, day after day, like I get tired, but I could do it again tomorrow and I still feel tired, but I could do it again tomorrow.

But when it keeps going, and you just feel worse and worse, just take a break.

Host: I often see runners wearing those knee braces, not a brace, but kind of those elastic sleeves. what's that all about?

Chad Boehm, DPT, CSCS: I think a lot of people's hearts are in the right place when they say something like, oh, my knee kind of hurts. So I'm going to get a brace like as, as protection or something. The tough part is most over the counter braces actually aren't really robust enough to provide

actual stability. I mean, if you look at an actual kind of unloading brace provided by like an orthopedic surgeon, I mean, they're big, they have really big metal stays, they're hinged. They go kind of from your hip all the way down to your ankle. That's providing like stability. Most over the counter braces, the benefit mostly comes in the fact that they provide some compression so they can kind of keep some swelling down and they keep the joint warm, which oftentimes kind of makes it feel a little bit better. But in terms of like injury prevention or providing stability or something, the jury's out on that.

I personally, I wouldn't recommend it for injury prevention necessarily, but it makes you feel good, it's not going to hurt. So.

Host: So, let's say it's your first race, maybe a marathon, you're getting ready for it, you're planning. How do you prepare for a race if it's like your first one and you've never done it? You don't know what to expect.

Chad Boehm, DPT, CSCS: Personally, if I'm going to prepare for a race or if I have an athlete who's going to prepare for a race, if available, which for the Rhody Run, the great thing is like the course is like just right in town. So, if you can, you know, try to mimic the course as much as possible.

And so like for our race, there's, I think it's mile two to three, something like that is basically all uphill. It's a huge climb up Discovery at Hastings. And, it's not particularly fun. And so, you know, if you can incorporate certain sections of the course, like into your running, so you know kind of what to expect. Practice strategies like your fluid intake, your food intake, practice those while on your training run so that the day of you don't have any kind of gastric distress because of it.

And you know, for something like a longer race, like a marathon, it's a kind of unreasonable to say like, oh yeah, go practice the course, cause it's 26 miles, but you can do sections. Go on the race website, find the elevation profile, see like, okay, mile 15 to 16 is pretty hilly, or mile 18 to 19 is downhill, you know, so find places around where you live, to practice hills, to practice downhill, as uphill, all that kind of stuff. And so basically kind of taking bits of what you plan to do on race day is practicing it. So, you know, kind of what to expect or know how to pace yourself or that type of stuff that's going to get you kind of mostly mentally prepared and physically prepared so.

Host: Yeah, I would say, you know, people who've been running for a while and then they want to try running a race, definitely prepare for it, right? Don't just willy nilly jump into it and think, okay, it's fine.

Chad Boehm, DPT, CSCS: Right. It's definitely not a and especially if you're really like pushing yourself, wanting to get a new PR or on the far end of the spectrum, you want to qualify for Boston or something. It definitely takes, it's not a non trivial event, right? It takes dedication, it takes sacrifice.

You really got to be, especially as a new parent, I've had to be very set aside certain pieces of time. I'd be very like, I have to guard that time because I like, this is my running time. Like I have to get, go for a run. It doesn't matter if it's windy, if it's raining, whatever. I got to do it because I want to get better. I got to do it.

Host: It's a lot different to prepare for a race rather than just your routine running sounds like. What else should we know to prepare for a race? Anything else in closing?

Chad Boehm, DPT, CSCS: I think we touched on most things I would recommend. Yeah, just practicing what you plan to do, use the same shoes you're going to use, lace in the same way, eat the same breakfast, you know, nothing, basically like nothing new on race day.

Host: What about water?

Chad Boehm, DPT, CSCS: Just like during the race or?

Host: Yeah, like you don't want to be carrying a heavy thing, but you need to be hydrated. Should you just rely on the people giving it to you from the side?

Chad Boehm, DPT, CSCS: Oh. I see. Even that in and of itself is a little bit of skill. Drinking from a paper cup while running is surprisingly difficult. Like if you get half of it in your mouth, you're, you're doing well. Personally, I've done a few races where actually, they sell like straps you can put on your water bottle to like, so it straps to your hand and so you run with that.

And, a couple of times I have tried that and it does make the experience of drinking more desirable, it's like, you can drink more often, kind of when you want. Luckily most races around here have adequate aid stations that you could rely on that. And really, I make a joke about like drinking from it while running is tough.

Theoretically, you could just stop and drink too. I mean, you're only going to lose like 15 seconds or something. It's not going to take very long at all. But, you know, you do see a lot of people like Camelbacks and stuff too.

Host: What about those little gel packs?

Chad Boehm, DPT, CSCS: The gel packs are great. I personally, I really like them. And that's one of those things to where you definitely want to practice with them primarily because of the sugar content and the calorie content is really dense. And so usually what we say is, or what I recommend anyways, if you take a gel, like take it with water.

So you might have, personally, I will save a gel. If I know a aide station is coming up, take the gel so that when I get there, I can take my water, swish it around, get it down, and then the water kind of dilutes the the sugars and the proteins and everything in the gel. So it's easier to digest.

It's like when it's really dense, it's hard to absorb. And so you want to dilute it a little bit to actually get into the body. You know, definitely kind of like paising it or timing it, but they're definitely, they're excellent supplements to keep you going during a race.

Host: Thank you so much for this useful information. I'm sure it's going to help a lot of runners.

Chad Boehm, DPT, CSCS: Oh yeah, no problem. I'm always happy to share.

Host: Again, that's Chad Boehm. Get more tips at jeffersonhealthcare.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to To Your Health, presented by Jefferson Healthcare.