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Don't Ignore These Symptoms

Posted by: pshields on Saturday, December 28, 2002 - 08:49 AM Print article Printer-friendly page  Email to a friend

Don't Ignore These Symptoms

Running does not make you immune to pain, injury or illness.

Here are nine symptoms you absolutely shouldn't ignore

Running, despite its many wonderful benefits, does not make you immune to pain, injury or illness. Runners can get hurt, and runners can get sick. Sometimes seriously.

So you need to be just as careful as sedentary folks when you feel certain symptoms before, during or after your runs. Chest pain, nausea, dizziness--any one of these could be a sign of something grave

We consulted several medical experts who helped us identify the following nine symptoms you absolutely shouldn't ignore. These are the problems you must have your doctor check

Pressure in the chest

Feeling chest pressure, often described as a fullness or tightness, could be a sign of coronary heart disease--or even a heart attack in progress. The discomfort often radiates to the arms, neck and jaw, and it doesn't have to last a long time to signify something serious. "Some people suffer from very temporary discomfort, which quickly disappears when they stop running," says George Vetrovec, M.D., professor of medicine and chairman of the cardiology division at the Virginia Commonwealth University Medical College in Richmond, Va. "But this sporadic pain is just as significant as persistent pain."

Advice: Don't run another step until you get checked out by your family doctor or, better yet, by a cardiologist.

Lightheadedness and irregular heartbeat

These symptoms may indicate a rhythm disturbance or a congenital heart defect called hypertrophic myopathy. The lightheadedness or irregular heartbeat can occur during or up to 2 hours after exercise. "People who are poorly trained or overweight are at a much greater risk of a cardiac event," says Dr. Vetrovec. "But even well-trained runners have to be aware of these symptoms.&quot

Advice: As with chest pain, an irregular heartbeat needs to be checked out thoroughly. Put your running program on hold until you see a cardiologist

Unusual fatigue

If you become easily winded or suffer undue exhaustion during a normal training run--and especially if this happens for several days in a row--don't just assume there's something wrong with your training. That could be it, but it might be something else. "Runners often think the answer to diminished performance is to push harder, to push through it," says Dr. Vetrovec. "But this can put you at greater risk if there's something serious going on." Ongoing fatigue may signify heart problems, exercise-induced asthma, Lyme disease, diabetes, chronic fatigue syndrome or any number of other maladies

Advice: If your normal training suddenly becomes much tougher, cut your mileage by 50 percent for a week, and don't do any hard workouts during that time. You simply may be overtraining. If you still feel fatigue at the end of a week or two, make an appointment to see your family doctor.

Localized bone pain

While shin splints result in pain over a broad surface area, pinpointed pain may mean a stress fracture, according to Andrew Cosgarea, M.D., assistant professor of orthopedic surgery at Johns Hopkins University in Baltimore, Md. "Muscles get sore, but the soreness is normally spread out somewhat," he says. "With a stress fracture, you can put your thumb on the spot and identify where it hurts." Ignore this, and the stress fracture can become a complete break, meaning more time healing and no time training.

Advice: If your shin pain is localized and not achy and diffuse, see a podiatrist or orthopedist for a bone scan.

Lumps and bumps on the lower leg

Runners suffer from two common types of lumpy masses: small nodules on the Achilles tendon and lumps on the side of the knee. A nodule on the tendon implies tendonosis, which is a degeneration of the tendon that causes scar tissue to form," Dr. Cosgarea says. Treatment usually involves physical therapy and rest; surgery is rarely necessary. Lumps or cysts on the side of the knee normally form in association with meniscus tears. In these cases, treatment consists of repairing the meniscus and letting the cyst dissolve on its own.

Advice: See an orthopedist if you feel these lumps. Don't put off an appointment; doing so could lead to a long injury layoff.

Disorientation, nausea or cessation of sweating during warm-weather running

Heat illness is much easier to prevent than to treat, so good hydration before, during and after warm-weather exercise is essential, says James Cheno-weth, M.D., a sports medicine specialist in Ann Arbor, Mich. This means: (1) drinking plenty of fluids throughout the day; (2) drinking 16 ounces of sports drink or water an hour before your run; and (3) taking in 5 to 12 ounces of fluid every 15 to 20 minutes of running

Remember, says Dr. Chenoweth, being in good shape doesn't make you immune to heat-related illness. The intensity of exercise is the most significant factor, he says. Which is why heat illness most often occurs during races, when you're more apt to push yourself. He's quick to add, however, that the risk of death is also three times greater for those who are overweight than for normal-weight adults.

Advice: Stop exercising, find some shade (preferably an air-conditioned building or car) and drink plenty of fluids. If the symptoms persist for more than a few minutes, get to an emergency room for intravenous fluids and active cooling in an ice or cold-water bath.

Running-associated headache

Some headaches that come on during exercise can be harmless. Others can signify a life-threatening illness such as a leaking brain aneurysm or coronary-artery blockage. Unfortunately it's hard to tell which, because the symptoms can be similar, says Dr. Chenoweth. Since the cause can be potentially life-threatening, and the severity of the symptoms doesn't always correlate with the seriousness of the condition, any headache brought on by exertion should be taken seriously, he says. Often these headaches feel like migraines, and they include nausea and an increased sensitivity to light.

Advice: Stop running until you see your family doctor.

Cold and flu symptoms

A case of the sniffles shouldn't stop you from running, says Dr. Chenoweth. But watch out for fever, deep body aches and malaise, which are signs of a more serious viral infection. You shouldn't exercise when you have a virus, especially when a fever is present," he says.

Advice: Err on the side of caution. If your symptoms are all above the neck, chances are it's a cold, and you should be able to go for an easy run. But if your symptoms are below the neck, such as chills and body aches, you probably have the flu. In that case, don't run until symptoms cease.

Amenorrhea, or cessation of your menstrual cycle

Women who train intensely--and who don't eat enough to keep up with the demands of that training--may stop having their periods. That, in and of itself, is not harmful, but the estrogen deficiency that causes amenorrhea also can cause bone loss and osteoporosis.

Younger women who suffer from amenorrhea lose bone density at the critical time when they should be building it up," says Mona Shangold, M.D., director of the Center for Women's Health and Sports Gynecology in Philadelphia. Once you lose it, you can never get it up to the level you should have had. This can lead to problems later, when you start losing bone density naturally due to aging." Though running does increase bone density, it can't offset bone loss due to estrogen deficiency, says Dr. Shangold.

Advice: See your doctor, a sports gynecologist or a clinical nutritionist. Again, it's not heavy training that causes amenorrhea. Rather, it's not getting enough calories to support that training--which is why a nutritionist can help.,1300,1-0-0-269,00.html

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