DEAR DR. DONOHUE: I have been a distance runner since I was a teen, and I have continued to run competitively ever since. I am 28 now. Running doesn’t tire me, but I am not winning any races. I run seven days a week, so it’s not from a lack of training. What’s keeping me from coming in first? – J.K.

ANSWER:
You might be running too much, and your body could be chronically fatigued without your realizing it.

Don’t practice running right up to the day of competition. Taper your exercise prior to a race. There are three ways to do this: by cutting back on the intensity of your run, by reducing the volume of it or by cutting back on the frequency of running.

The intensity of an exercise is the level of its strenuousness. In running, intensity would be measured by how fast a clip you run at. Intensity is one element that you should not tinker with. Keep your running pace just as it is when you run routinely.

Volume of exercise is the length of time given to an exercise session. You can reduce the volume of exercise by as much as 75 percent when you begin to taper. You won’t lose any conditioning that you have already attained when decreasing the volume of exercise.

Frequency is how many times a week you exercise. In tapering, you can cut back the frequency of your seven-days-a-week run to three days a week without becoming deconditioned.

The purpose of tapering is to rest the body so that on the day of competition it is fresh and can actually perform better.

When do you start tapering? Anywhere from four to 28 days before the race. An average is 14 days.

If you want the unadulterated version of how to taper, get a copy of the journal Medicine and Science in Sports and Exercise, July 2003, and read the article by I. Mujika and S. Padilla.

DEAR DR. DONOHUE: Please explain this to me. I always weigh myself before and after I exercise. I can drop a pound or more of weight after exercising, but the next day that pound has come back. Where did it go, and how did it come back? – R.J.

ANSWER:
You didn’t lose a pound of actual body weight. You lost a pound of water. As soon as you rehydrated yourself, the pound came right back.

A one-pound weight loss equals a fluid loss of 17 ounces (0.5 l). You should try to drink that amount of fluid soon after exercise, or you’re forcing your body to run with a fluid tank that is approaching empty.

DEAR DR. DONOHUE: I have back pain from what my doctor calls spinal stenosis. He says not to do anything more than take Aleve when I need it. I wonder about exercise. Am I taking any chance of making my back worse by exercising? What kind of exercise is best for someone like me? – D.K.

ANSWER:
Spinal stenosis is a narrowing of the spinal canal. Through that canal runs the spinal cord. A narrow (stenosis) spinal canal presses on the spinal cord and the nerves coming from the spinal cord. That’s the source of your back pain. The pain often runs down a leg. Some people do not have pain but have a pins-and-needle sensation radiating down the leg.

I can’t tell you it is OK to exercise. That has to come from your doctor.

I can tell you that exercise is safe for most people with spinal stenosis. In fact, exercise usually helps relieve the back pain. Riding a bike is an ideal exercise for these people. Bending from the waist so that the body is leaning forward toward the handlebars opens up a narrowed spinal canal and takes pressure off the spinal cord and spinal nerves.

Another usually permitted exercise for a person with spinal stenosis is walking. Walking on a path with a slight upward incline makes a person adopt a slightly forward bend, and that, like biking, takes pressure off the spinal cord and nerves.

DEAR DR. DONOHUE: I have been trying to get a straight answer about pill ingestion and its timing relative to meals. Specifically, I take Colazal. I read the information enclosed with the drug, but I am still unsure of the best time to take it — before or after eating? – J.S.

ANSWER:
People who are in a quandary about the timing of their medicine in relation to food and who cannot get in touch with their pharmacist or doctor will usually be safe if they take the medicine on an empty stomach with a glass of water. A stomach is considered empty two to three hours after eating. Then, at a more opportune time, they can contact the pharmacist or doctor for specific instructions.

Some medicines are best taken with meals. Food can counter stomach irritation that some drugs cause. The grinding action of stomach muscles when they are presented with food also helps pulverize some drugs and aids in their absorption. Vitamins and calcium carbonate are better taken with meals, for example. Calcium carbonate is the most widely used calcium preparation for osteoporosis prevention and treatment.

For you, I called the manufacturer of Colazal. You can take it whenever you want – with food or on an empty stomach. As far as this medicine is concerned, it makes no difference.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


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