Staying Hydrated On A Long Run

Staying hydrated on a long run - a how toStaying hydrated can be a big concern for athletes at any level in any sport – especially running.  Many runners are minimalist when it comes to what they bring on the run, from synthetic tank tops, short shorts and barefoot/minimalist shoes, it’s all about the elimination of weight, resistance, and annoyance.   So how do you handle a long run and keep hydrated? Here’s some easy steps to follow:

First, plan ahead.  Drink a good amount of liquid 30 minutes before your run and then make an effort to use the bathroom just before heading out.  Being hydrated before will help you keep from getting dry mouth out of the gate.

Second, plan your route.  Try to plan an out-and-back route that would allow you leave a water bottle at the half way point.  You may have to run with the bottle for the first part of your run, but once you put it in a safe (easy-to-find place) you are good to go.

Third, power to the suck candy.  Bring a peppermint candy with you. When you start to feel your mouth getting dry pop that bad boy in and you’ll have three things going for you, fresh breath, a little sugar, and no more dry mouth.   Tuck the candy in your cheek and you’ll find that it will last a few miles while keeping your mouth moist and allowing you to breath. It also give your brain something else to think about, eliminating a lot of mental stress.

Fourth, pack the bottle.  It may be a pain, but use a fanny pack, or jersey pocket and pack a small bottle of water.  On hot summer days when you slept in, but still feel the need to get your run in, having that bottle will make life a lot more bearable.

Fifth, drink after the run.  Drink, drink, drink.  After a long run you’ll need to replenish your body for the rest of the day.  Drinking in small sips over a longer period of time will be far more effective than just gulping down two litters – most of which will go straight to the bladder.  Adding electrolyte agents is also a good idea to stay hydrated and recover lost electrolytes.

What do you like to do to stay hydrated? What advice do you have for ‘newbies?’ When do you drink water vs an electrolyte drink like Gatorade?


Runner’s Knee

                Out of all the injuries I see, this is the most common among runners and non-runners alike.  For some it is a short-term problem and others it is a life-long struggle.  Runner’s Knee is usually associated with an increase in activity.  This can be increased mileage, increased hills, or just over-doing it on one particular day.  Pain is often worse after exercise.  The pain can be felt on any side of the knee, but most often on the front.  Pain is worse after getting up from rest, with sitting for a while with your knees bent (the Theatre Sign), or with going down stairs. 

                So what causes it?  The answer is really in the name- Patellofemoral (meaning knee cap and thigh bone) Syndrome.  It is essentially a problem with alignment.  A good comparison is that of a rope in a pulley.  If the rope stays in the center of the pulley then everything runs smoothly, but if the rope is pulled off to the side then there can be uneven wear and fraying of the rope.  The knee is just the same.  There is a groove in the bottom of the thigh bone that acts like a pulley.  The knee cap, its tendons, and the quadriceps muscle act as the rope.  So, if the alignment of the knee is off, then there is uneven wear under the knee cap, causing inflammation and pain.

                There are a variety of things that can contribute to runner’s knee.  Some of these issues cannot be changed like the bone anatomy, the tightness of ligaments, and how ‘knock-kneed’ you are.  Others can be influenced like muscle strength, foot arch, and pelvic alignment. 

                The mainstay of initial treatment is relative rest, strengthening of the thigh and hip muscles, and anti-inflammatory medications.    Other treatments of benefit are bracing, taping, and pelvic adjustment.  Rarely, is surgery a considered option.  So, if this sounds like something that you may be dealing with I would suggest taking a step back on your training and search the web for ‘Patellofemoral exercises’.  It will take 2-4 weeks to see improvement with these exercises.  If these are not helpful, pay your friendly neighborhood sports medicine doctor a visit.

Matt Evans, MD

Dr. Matt Evans is a sports medicine doctor practicing with Utah Valley Orthopedics & Sports Medicine. He lends his expertise at RACETRI events by patching up road rash, helping athletes overcome hypothermia, dehydration and with his team runs overall triage at the race. More than a medical expert Dr. Evans is an athlete who has completed triathlons. Do you have an injury or sports medicine question? Find Dr. Evans near the finish line for an exam & expert advice.

See his Full Bio by clicking here

Schedule an appointment by calling the number here

Initial Injury Treatment

Injuries are not uncommon with endurance athletes.  In fact, some may feel that they are always nursing along some injury just to get them through the next race.  Here, we will discuss when it may be a good idea to see a doctor and some initial principals in caring for new injuries.

Obviously, pain is concerning, but pain is often a way of life for endurance athletes.  Muscles hurt, lungs burn, and feet get sore.  Thankfully, most all these things generally get better after exercise and improve with more exercise.  Pain that is asymmetric, progressive with exercise, or worse after exercise is more likely to be a sign of an injury.  In addition, it is generally easier to treat an illness in the first few weeks than after a few months.

So now you are injured what do you do?  Most of us have heard of the acronym RICE and most athletes are good at doing the ICE part.  Let’s review it briefly.

Rest:  “What?!?  I have to rest?!?  I can’t rest right now!”  One of the hardest parts of my practice is getting people to rest, but it is often the most important.  Healing takes time.  Now, rest can mean different things to different people and we often use the term ‘Relative Rest’.  Individual situations vary, but essentially this is allowing you to do anything that does not increase you pain during or after the activity.  Usually, cross-training is alright.  Remember we are trading a short-term sacrifice for a long term gain.

Ice:  Never the wrong answer.  Use anytime you have swelling or a new injury.  Up to 20 minutes at a time and at least 30 minutes in between icings.  May increase blood flow when removed more than heat does.  A variation is ice massage.  Fill a paper cup with water and freeze it.  Tear off the rim and use the smooth ice surface to massage the affected area toward the heart for 15 minutes.  On the other hand, heat is great for relaxing muscle spasm and to help you warm up before exercise.

Compression:  Another way to decrease swelling.  May support injured muscles or tendons.  Use an ACE bandage or Neoprene Sleeve.

Elevation:  Once again, decrease swelling.  Get that fluid back into the blood stream.

Over the next few weeks we will address some of the most common running injuries.

Good Luck,

Matt Evans, MD



If you are considering training for a triathlon-this is a great choice!  Aerobic exercise has been associated with decreasing your risk of obesity, type II diabetes and cardiovascular disease (including heart attack and stroke), lowering high blood pressure and cholesterol, and improving depression.  Wt bearing exercises, like running, increase bone mass, yet triathlons are the epitome of cross-training, thus decreasing your risk of impact injuries like stress fractures.

For those who have not competed in distance/endure races in the past there may be some things to consider before beginning.  Now, logically it makes sense that if you have been exercising at a certain level of intensity for a certain length of time it is likely that you can continue to do this with little health risk.  But, even people who seem to be in ‘good shape’ can have underlying medical conditions that can put them at risk for sudden cardiac death.  Congenital heart abnormalities are more likely to cause symptoms in those under the age of 35.  In those older than 35, coronary artery disease (this includes ‘hardening of the arteries and heart attack) is more common.

These people need to see their doctor before training for a triathlon:

  1. People who have had a family member die before the age of 60 from a heart problem.
  2. People that have a significant heart murmur or other issue.
  3. Men over 45 and women over 55 who are changing or advancing their exercise routine
  4. Anyone with the following symptoms associated with exercise:
    1. Dizziness, Fainting or near fainting
    2. Racing heart
    3. Shortness of breath
    4. Excessive or long-lasting fatigue
    5. Chest Pain

I’m sure there are a lot of people who are saying that they always experience shortness of breath, fatigue and an increased heart rate with exercise.  But this needs to be taken in context.  If these symptoms don’t quickly improve with rest or if they are more dramatic than those of others who you are exercising with, then it would be a good idea to see your doctor.

You should also see your doctor for these other health issues:

  • Seizure Disorder
  • Asthma
  • Sickle Cell Anemia
  • High Blood Pressure

Good Luck!

Matt Evans, MD
Utah Valley Sports Medicine
1159 E. 200 N., Ste. 100
American Fork, UT 84003