A You might have heard of swimmer’s ear, also known as otitis externa. Inflammation or infection develops in the skin of the ear canal, which leads from the outside to the ear drum. The canal gets itchy, sore and can become sticky with a discharge. It’s called swimmer’s ear, because it occurs most often in people whose ears are frequently wet. If you’re someone who always runs in the rain or frequently showers, then you might be at more risk of developing it, but the biggest risk is for runners who spend hours with ear buds in. The ear buds trap moisture inside the ear, which can irritate the skin and provide a perfect environment for germs to grow. To avoid the problem, don’t wear ear buds for an excessive amount of time and take care to dry your ears after they’ve been wet. Simply wipe around the outside part with the corner of a clean towel or tissue or waft warm air from a hair dryer into your ear, but don’t use a cotton bud to dry inside the canal. Make sure you keep your ear buds clean too. Otitis externa can be treated with ear drops from the pharmacy, but an established infection may need treatment from your doctor.
Eyes
Q Why do my eyes water when I run?
A It can be so frustrating when each time you run you have tears streaming down your face. Eye irritation while running is common and can lead to blurred vision (see question below) and general annoyance. Tears are one of the many ways our body protects itself. They lubricate and stop the surface of the eye from drying out, and prevent foreign bodies, such as dust, getting into the eye, but sometimes they seem to work overtime. Tears are made in the lacrimal glands situated at the top of the eye and they drain away through the tear ducts. You can see a tiny hole leading to the tear duct in the inner corner of your upper and lower lids if you look closely. Tear production might increase if your eye is drying out in cold, hot or windy weather. Eyes might also stream if they are irritated by pollen, dust or fumes. Sometimes people with dry eyes find that their eyes water a lot, which might sound strange, but it’s just the eye trying to correct the dryness. If you’re affected, try to work out what your trigger is. If it’s pollen, then an antihistamine eye drop might do the trick.
Sunglasses will help to keep pollen out, and can also stop dust and bright light affecting your eyes. If you generally have dry eyes, then you can buy a simple lubricating eye drop from the pharmacy to use regularly and before you run. If your eyes water all the time, not just when you run, then it might be due to an infection or a blocked tear duct stopping the tears from draining away, so see your doctor if it persists.
Q I got blurry vision on my last long run. Should I be worried?
A Eyes are so precious and it’s advisable to get advice about any new or unexplained eye problem. Vision can become blurred for a number of minor and some more major reasons too, so be cautious. Minor reasons include irritation of the cornea (surface), which can dry out quickly in the cold and wind (this is a particular problem for contact lens wearers). Sun cream or sweat running into the eyes can also cause irritation. If something flies into your eye and scratches the cornea, even if it flies out again, it can cause some discomfort and altered vision. This is called a corneal abrasion and while our eye lashes and tears are designed to protect our eyes, sometimes the unexpected happens on a run, particularly on a breezy day. Excess tears in the eyes can cause blurred vision too.
If your blood pressure is unusually low and making you feeling faint, then you might have less blood flowing to the part of your brain which controls vision and may experience some blurring as a result. People often cite low blood sugar as a possible cause of blurred vision, but this is unusual unless you are a diabetic on medication that puts you at risk of hypoglycaemic (low blood sugar) attacks. Blurred vision, an area of darkness or some zig-zag lines in your field of vision are typical symptoms of a migraine aura. It may or may not develop into a full-blown migraine.
While all these causes are reversible and unlikely to cause permanent damage, it’s important to know that blurred vision can be a sign of something more sinister. If it’s associated with floaters (black specs floating around like dust in front of your eyes), flashes of light or a curtain appearing to block off some of your visual field, then this is potentially a detachment of your retina and you need to seek an urgent medical assessment as this can cause permanent damage to your vision. Similarly, a stroke that affects your eye can present with a change in vision in one eye. It can become double or blurred or you may lose sight completely. If a stroke affects the visual centre in the brain, then it may cause these changes in both eyes simultaneously. You may or may not have other symptoms of a stroke.
A rarer cause is a condition called optic neuritis where the optic nerve, which carries information between the eyes and the brain, becomes inflamed. If you have optic neuritis it may become apparent after a run, with reduced, blurred vision and pain in the eye, especially when you try to move it in different directions. Optic neuritis needs to be diagnosed and investigated by a specialist to ensure no other medical conditions, such as multiple sclerosis, underlie it.
Blurred vision that develops slowly over time can have many other causes that aren’t directly related to running. Don’t try to self-diagnose. If you have new visual changes then get assessed. If you suspect a stroke or a detached retina, then these are medical emergencies and you should go to Accident and Emergency. If you have a mild or recurrent problem, then see your optician or GP.
Real-life runners
Being a guide runner – someone who supports a visually impaired runner by guiding them, usually by running alongside them – has been a wonderfully enriching and joyous experience for me. I’ve made great friends and learned so much about what it means to live with a disability. Why not give it a go? The most important thing is to listen carefully to what your runner wants and needs from you.
Dr Simon Tobin, GP and parkrun ambassador for health and wellbeing
Q Exercise seems to be good at preventing so many diseases. Does it help prevent eye disease too?
A Reading about blurred vision above you might feel a little worried that exercise is bad for your eyes, but in fact it’s quite the opposite! Exercising regularly can help protect your eye health. Many serious eye diseases are linked to high blood pressure, high cholesterol and diabetes, which exercise is well known to help either prevent or manage. Take glaucoma, for example, a leading cause of blindness worldwide, where pressure builds up inside the eye. Some studies have shown that exercise may lower the pressure inside the eye. One study done in 2017 found that moderate to vigorous exercise might be particularly beneficial. The participants who were the most physically active had a 73 per cent lower incidence of glaucoma than the least active. For every 10-minute increase in this type of physical activity per week, the risk of glaucoma decreased by 25 per cent. If you already have glaucoma, then vigorous exercise may not be suitable for you, so please check with your ophthalmologist. Similarly, several studies found that people who exercised were less likely to develop a common eye condition called age-related macular degeneration (AMD) than those who were sedentary and didn’t exercise. The macular is part of the retina at the back of the eye. When it degenerates central vision is lost and the periphery is spared, so although you don’t lose your vision completely it can be very debilitating. There is still much we don’t understand about the link between the two, but it seems clear that we can add eye health to our list of reasons why we run.
Headaches
Q Why do I get a headache after I run?
A Safety first. If you get a severe, sudden onset of a headache during a high intensity workout, where you feel as if someone has hit you over the back of the head, then this is a medical emergency. This could be a burst blood vessel in the brain causing a subarachnoid haemorrhage (SAH), where blood bleeds onto the surface of the brain. SAH is more common over the age of 50 and happens when small swellings on blood vessels, called aneurysms, burst. The severe headache may be associated with vomiting, double vision or even a loss of consciousness. It is a type of stroke so you
should dial 999 for an emergency ambulance.
What is much more common, however, is a headache which starts when you come back from a run or even later that day. There are lots of reasons why this can happen and thankfully most of them are reversible, so you should be able to avoid a post-run headache:
• Dehydration You can lose lots of body water when you run, through your breath as well as your sweat, so make sure you adequately replace your losses, because dehydration is a major cause of headache. This might mean drinking extra fluid in the hours after you run, rather than just relying on a quick post-run guzzle.
• Hunger If you haven’t properly fuelled your run, then a headache might strike. People don’t often feel hungry straight after a long run, but if you frequently get a headache, then eating within half an hour of stopping might prevent it.
• Poor running posture Carrying tension in your neck and shoulders can trigger headaches. Try to relax your shoulders, holding them down and back, and keeping your head held high. You might benefit from intermittently shaking your arms out and circling your shoulders.
• The weather A blast of cold air to the head or a strong wind can bring on a headache. Some people find air pressure is a trigger and tend to get headaches on heavy, muggy days. We can’t change the weather, but we can wear hats, cover our ears with headbands and take a paracetamol if we’re badly affected.
• Bright sunlight Headaches often strike on very bright sunny days when the sun’s glare is strong. Many runners say they don’t like running in sunglasses, but if you invest in a lightweight pair that fits you well then you won’t even notice they’re there. Wraparound glasses will really keep the light out and a hat with a brim will help too.
Q Will running improve my migraines?
A This very much depends on what causes your migraines. Sometimes they happen out of the blue, but very often there’s a trigger and this may be where running can help. For example, if sleep deprivation is a trigger for you, then it’s reassuring to know that regular running can help you sleep (see here). Similarly, if stress is a frequent cause of your migraines then using running to help you manage your stress levels could be life-changing. Lots of the triggers such as diet, alcohol and hormonal changes can’t be improved by running, but sometimes a gentle run will ease a mild headache from a migraine. It’s important to be aware that running could potentially trigger migraines so make sure you know how to avoid post-run headaches.
Top tips for a healthy runner’s head
• Run regularly to get the most benefits from running.
• Find your tribe. A real or virtual community will support and motivate you.
• Head outside to run whenever you can to get the boost that nature gives your mood and brain power.
• Know that you are enough. You have nothing to prove.
• Be happy without running. Make sure that your happiness doesn’t depend on running. You should be happy and fulfilled without it.
• Don’t let running become a pressure. Check in with yourself intermittently to make sure you are enjoying your running.
• Volunteer regularly or from time to time. Giving back to others, including the running community, is rewarding and life-enriching.
• Never be afraid to ask for help. Find someone you trust to share your thoughts and problems with.
FURTHER HELP AND ADVICE
Mind: www.mind.org.uk
Moodcafe: www.moodcafe.co.uk
Anxiety UK: www.anxietyuk.org.uk
Action on Addiction: www.actiononaddiction.org.uk
The Samaritans: www.samaritans.org
Macular Society: www.macularsociety.org
International Glaucoma Association: www.glaucoma-association.com
The Migraine Trust: www.migrainetrust.org
Dementia UK: www.dementiauk.org
Headspace: www.headspace.com
Chapter 2
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The Cardiovascular System
There is no denying that running is good for your heart. The heart is a muscle and by using it regularly, gradually increasing the work you ask it to do and looking after it, it will become stronger and more efficient. Regular running can reduce your risk of developing coronary heart disease and stroke by 30 per cent. From blood pressure to palpitations, from a family history of heart disease to freezing cold fingers, running and circulation questions are many and varied. This chapter explores them all and also gives you tips on how to keep your heart healthy.
The heart collects blood that has already made its journey around the body, pumps it to the lungs, where it is replenished with oxygen, and then forcefully pumps this oxygenated blood to the organs and muscles. A fast, continuous supply of oxygen-rich blood is essential for skeletal muscles to function and perform well during running. A good blood supply is also needed to take away the waste products that result from exercise.
The collecting chambers of the heart are called the atria and the pumping chambers are called the ventricles. There are valves between these to prevent blood flowing in the wrong direction. Large veins called the superior and inferior vena cava bring blood that has circulated around the body to the right atrium. The right atrium pumps it into the right ventricle, which then pumps it to the lungs via the pulmonary artery. Once it has been enriched with oxygen in the lungs, the blood returns to the heart via the pulmonary veins. It collects in the left atrium, which pumps it into the left ventricle. The left ventricle is the strongest pumping chamber as from there the blood exits via the aorta (the body’s biggest artery) and makes its way around the entire body, giving up its oxygen to tissues and organs before returning back to the heart via the veins.
The average person has approximately 5 litres of blood in their body (women have slightly less than men). It takes about one minute for that entire volume to go once around the body and back to the heart. When you exercise, however, that increases by four to five times. So when you’re pounding your way down that finishing straight, your heart could be pumping 20 to 25 litres per minute! That’s an incredible amount and you can see why running is an intense workout for your heart.
Thankfully, the heart muscle, or cardiac muscle as it’s known, responds well to training. As it strengthens, the force of the contractions and therefore the effectiveness of the pump increases, and more blood is pumped in one heartbeat. A heart that is used to working hard when you’re running will find life pretty easy when you’re at rest. This is why, as you get fitter, you will see a reduction in your resting heart rate. It’s very satisfying to see this number falling as your fitness increases.
TRY THIS
AT HOME
Resting heart rate
You can measure your resting heart rate by feeling your pulse first thing in the morning, before you get out of bed. Count how many times it beats in 30 seconds and then double it to calculate your pulse rate in beats per minute. Resting heart rate varies by age and gender, but an average would be 70 beats per minute. A fit runner could expect a resting heart rate of around 60 beats per minute, but some highly trained athletes can have a rate as low as 30 to 40 beats per minute. Keep a record of your resting heart rate and watch it fall as you get fitter. If it increases, it may be a sign that you are training too hard, have an illness or are suffering stress; consider an easier session or a rest day.
Did you know?
Heart rate variability (HRV) might help us to manage our wellbeing. HRV is a measure of the variation in time between our heart beats. It’s controlled by our autonomic nervous system. When you’re relaxed and well, the HRV is high. Low HRV has been linked to cardiovascular disease, depression and anxiety. Heart rate monitors and apps can help you track your HRV and you will see it increase as you become fitter and more relaxed.
Q What should my maximum heart rate be when I’m exercising?
A Due to technological advances in recording body stats and also because they want to use it for training purposes, more and more runners are measuring their
heart rate. Generally, the harder you work and the more effort you put in, the faster your heart will go. The most accurate way to find out your maximum heart rate (MHR) is by being measured using specialised equipment while on a static bike or treadmill. Obviously, we don’t all have access to this, so there are many equations for calculating what your MHR should be and one of the simplest is 220 minus your age. So, at age 45, your MHR should be about 175 beats per minute (220 minus 45). As you get older, your MHR decreases. However, your heart rate depends on factors other than age, including body size, medical conditions and how fit you are. No one size fits all – isn’t that always the way?
As a general guide, exercise should be done at between 50 to 85 per cent of your MHR (88 to 149 for a 45-year-old). When you’re training well below your MHR you’ll be able to sustain running for longer periods of time. The closer you are to your MHR, the harder it will be to keep going. As you get fitter, you can push your heart rate closer to its maximum for longer and even increase your MHR.
Heart rate can be used to direct your training. Your long slow runs should be done at 50 to 70 per cent of your MHR, threshold and tempo runs at 70 to 85 per cent of MHR, and short intervals at above 85 per cent of MHR. You should spend time in all of these zones for good all-round training. It’s all about setting the training zones that are right for you and adapting them as you get fitter. If you’re interested in heart rate training – and it’s not for everyone – then there are lots of useful resources online and you can consider working with a running coach experienced in the field.
Remember, though, that you can use your perceived effort, for example whether you’re gasping for breath or can talk, to guide your training in the same way, without having to measure anything (see here).
Run Well Page 3
