Blood Work – A Post Inspired by Winter

Feeling tired and sore is one of the unglamorous realities of running. DOMS (delayed onset muscle soreness) proves that you pushed yourself to the max, and you body is getting stronger! However, do you ever feel like it’s taking you longer to recover than it should — like your workout on Wednesday sucks because of Saturday’s long run? Or maybe you’ve just been feeling blah for the last couple of weeks, but are persevering in hopes that you’ll get through it eventually?

These are red flags. Fatigue, apathy, and nagging aches/pains that persist for more than a couple of weeks is a sign of impaired healing. You could probably benefit from a couple days off or easy. It’s taken me YEARS to recognize that a few unplanned rest days now and again is much less traumatic than weeks to months of injury diagnosis and rehab down the road. You NEVER want to find yourself in the MRI scanner because of running. Not only is it preventable, it’s incredibly expensive $$$!

Similarly, if you’re sick more often than usual, there’s probably an underlying cause, beyond just the particular bacteria or virus you’re currently fighting. For example, a sick call-out from work in two or more consecutive months, and especially with more than one episode in a single month, is a pretty solid indicator that something’s up. *Speaking from experience, here*

So what should you do? For nagging aches and pains, pull out a foam roller and all the PT exercises you’ve ever had the misfortune to be given. If you don’t have a foam roller, wrap a dish towel around a rolling pin. Massage and coddle every single sore spot, and the muscles/ligaments above and below it, for good measure.  In addition to backing off from aggressive training, go see your doctor.

Now remember, I’m a nurse. Traditionally I’d tell you to put some ice on it and take an Ibuprofen (or Tylenol, if you’re bleeding). We don’t go to the doctor unless we’re dying. My exception to the rule is a chronically ailing runner, because not only are runners more in-tune with their bodies, running requires a higher standard of health than society-at-large, at least for optimal performance.  Moreover, any running ailment that takes a while to manifest (like dietary deficiencies and stress fractures) is also going to take forever and a day to heal. Might as well cotton-on ASAP.

Be aware that a non-athlete (even a smart one, like your MD), might dismiss your symptoms if they aren’t acute (e.g. vomiting, hemorrhaging).

“Feeling tired, eh? Well, maybe running every day is a bit much, ha-ha-ha!”

Or,

“ You’re sick again? Let’s try a different antibiotic this time.”         

If they don’t suggest blood work, ask for it. Explain that, as a runner, you’d really like to know how your ferritin, hemoglobin, calcium, and Vitamin D levels are looking. Chances are good they’ll oblige — it’s not like you’re asking for more narcotics or something. While you’re waiting for the test results (some clinics take a good week or two to get back to you), read up on what to expect. The doctor’s office will probably provide interpretations of the results for you, but remember that the target ranges can be quite broad. As a runner, you want to be well within the recommended range for all of the above markers, as they relate directly to your risk of symptomatic anemia, stress fractures, fatigue, and chronic illness.

Here’s an example (reference ranges per the Mayo Clinic):

The normal range for ferritin in men is 24-336 nanograms per ml; for women it’s 11-307 nanograms per ml. So if you’re a female with 12 nanograms/ml, your doctor’s office might tell you your labs look good. But in reality you are borderline anemic, and your performance is probably suffering. This is why it’s so important to find a general practitioner who understands and supports athletes regularly. A savvy doctor can help keep subtle signs and symptoms from slipping through the cracks.  

Also good to know:

Hemoglobin:  For women 12-15.5 gm/dL; 13.5-17.5 gm/dL for men

Calcium: 8.5-10.2 mg/dL

Vitamin D: 20-100 ng/mL

Again, just because you’re in-range doesn’t mean you’re in the clear. You always want to have some wiggle-room between yourself and rock-bottom.

Posted in memory of the really crummy winter/spring of last year, when I was tired all the time, sick, and atrociously Vitamin D deficient.  Getting back in-range felt as good as basking in warm summer sunshine, which I did frequently, for curative purposes.
Good luck staying healthy this winter!

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