To get the best treatment and to keep training well, your doctor should be informed about your daily KMs.
For all our eagerness to ramble on about our long runs and recent races, runners can be tight-lipped in the doctor’s office. Many would rather not mention their pavement-pounding hobby at all.
“They’re afraid that with an injury or some other problem, the doctor is going to look at them and tell them, ‘You really need to stop that,’” says Delmas Bolin, a family practice and sports medicine physician. “So they do what I think most of us would do: they just withhold the information.”
But your running habits can explain a lot about your health. In order to provide you with the most accurate diagnoses, the safest treatments, and your best hope for running well, your doctor needs to know you’re a runner. Here are six reasons why:
1. Your Heart May Act Differently
Runners may have athletic heart syndrome, in which years of endurance training have enlarged the heart, allowing it to beat slower, as each beat pumps more blood. But enlarged hearts and slow heartbeats can be mistaken for pathological conditions. “Athletic heart syndrome, where these changes are adaptive and benign, can mimic early disease states, like cardiomyopathy,” says Todd Miller, a cardiologist. Because of the overlap, distinguishing a healthy athletic heart from a pathologic one can be challenging if your doctor doesn’t know your running history, he says.
But symptoms like chest pains, difficulty breathing, or a racing heart that is out of proportion to the level of effort should be taken more seriously in someone doing high intensity exercise, says Carl Lavie, a cardiologist in New Orleans. “My colleagues and I have described potential risks, although relatively small, of extreme endurance exercise, such as marathon running and longer triathlons, so it is worth the clinician knowing about this,” he says.
On the other hand, the only symptom a runner may notice is a decline in performance. “Somebody might have coronary artery disease but not have typical chest discomfort or shortness of breath,” says Miller. “But it’s showing up as worsening fatigue with exercise and declining performance.” In either case, a doctor should be alerted of your running history as more specific tests may be warranted.
2. Some Treatments May Impair Performance…
Runners being treated for hypertension should tell their doctors about their running goals because certain medications may slow them down. Beta blockers impair cardiac output, which needs to increase during exercise. “Unless it is absolutely needed, one should avoid using beta blockers in runners, especially at higher doses,” Lavie says. For people living and training in hot climes, diuretics – another hypertension treatment – should also be avoided as they increase the risk of dehydration. Good alternatives to ask your physician about include ACE inhibitors or angiotensin receptor blockers and calcium channel blockers.
3. And Other Treatments May Lead to Injury
Last May, the US Food and Drug Administration issued a warning that taking fluoroquinolones, a class of antibiotics including Levaquin and Cipro, can cause tendon damage and quadruples the risk for Achilles tendon rupture. The medications – often prescribed for kidney, respiratory, urinary tract, and sinus infections – weaken tendons to the point where running on them can cause them to rupture, requiring a lengthy time off and a lot of rehab. Runners needing antibiotics should ask about other options. In cases with no alternatives, talk to your doctor about decreasing training while on the meds and for a few months after.
4. A Few Unexplained Kilos May be a Red Flag
Because many runners are leaner than the general population, doctors may let them off the hook if they gain a little weight. But if you put on a few kilos despite your activity levels remaining constant, alert your doctor. Unexplained weight gain might be a red flag for a condition like sleep apnoea or hypothyroidism. Additionally, because gaining weight means you hit the ground with more force with every step, putting you at a higher risk for injury, you might want to address the cause, even if it’s an unnoticed change in diet and not a serious medical issue.
5. Your Skin May Need Special Attention
Doctors may also be able to give runners specialised advice about skin treatment. Being active can mean being outside a lot, which increases your risk for skin cancer. Bolin frequently reminds all his athletes to wear sunscreen, even in the wintertime, and thinks it’s incumbent that all doctors who work with athletes do the same.
Runners with diabetes need to pay special attention to the skin on their feet. Some diabetics develop neuropathies so they don’t feel blisters or pebbles in their shoes. If you are diabetic, Bolin advises examining your feet as soon as you come back from your run. “Make sure there are no blisters, cuts, bruises, or anything like that because, in the setting of diabetes, it could get more serious much more quickly,” he says.
6. Borderline Iron Levels May Be Hurting Your Running
Unexplained fatigue – when your times go up and your stamina goes down – could also be a sign of a thyroid problem, a bad viral illness, or an iron deficiency. While typical medical evaluations should pick up thyroid and viral issues, iron is trickier for runners. Fatigue can occur from iron levels at the lower end of normal, which some doctors may consider okay for non-runners because it doesn’t indicate anaemia. But as stamina can still suffer, ferritin levels should also be checked. “Ferritin gives you an idea of what your total body stores of iron are and if it’s low than that suggests that you want to take an iron supplement,” Bolin says.
If you’re still reluctant to talk to your doctor or if your practitioner seems to be unnecessarily discouraging you from running, it may be best to find a new doctor, perhaps a sports medicine specialist. Clinicians should work with athletes to allow them to continue the sport they love; after all, the benefits of running far outweigh the risks. “Doctors ought to know that you’re doing it and they ought to be encouraging it,” Bolin says.