Insight about Running from Lari: Thoughts from a Nurse Practitioner

Lari shared a little about her running journey a couple months back on the blog (here) and she was recently asked to share some of her thoughts about running and health at our Tuesday running club night. I thought what she shared was very interesting (I have been told to watch my A1C as I am in that pre-diabetes range with a 5.7 score) and we had talked about it one evening as we ran. I thought these insights would be appreciate by all of my readers expecially the ones who run and have some interest in how our bodies work. Here is what she shared, thanks, again, Lari!

RUNNING, HEALTH AND THE POWER OF COMMUNITY

Physiology has always interested me. The human body is amazing and there are so many things we don’t understand. Just when we think we do understand something new research or theories come along to challenge our assumptions. Running has been proven to improve mood, circulation and sleep while reducing the risk of chronic disease. It has not been proven to hurt your knees or cause arthritis. Science is always evolving and so should we. As a nurse and now a Nurse Practitioner I have seen how inactivity and certain habits affect long term health. I don’t see many runners in my Family Practice.

THE ERA OF MEASURABLE HEALTH

The ability to track our bodies has never been more accessible. Continuous glucose monitors (CGM), heart rate variability (HRV) and heart rate (HR) have become more accessible and given us new insights into training, recovery and stress. At one point, I considered getting some of you to wear a CGM because I had a hypothesis runners might have higher A1c levels than the general population- not as a sign of disease, but as a normal physiologic response. A1c is an average blood sugar over 3 months and is used to diagnose diabetes. In the past 5 years there has been more emphasis on pre-diabetes as a possible warning sign of future diabetes. Peter Attia is a longevity doctor who emphasizes blood sugar control as critical to long-term health. I have listened to his podcast for years and he published a book called Outlive in 2023. Emerging data suggests that a slightly elevated A1c might be expected in athletes due to prolonged physical exertion. There is a glucose metabolism specialist named Nicola Guess who is in the process of proving this. I think at this point the data from a CGM in
athletes is not that helpful unless you are diabetic or have problems with low blood sugars. Being labeled as pre-diabetic should not keep you from fueling with carbohydrates for your runs or restricting calories needed for training. There is much
more emphasis now on fueling your body well for exercise to enhance performance and prevent injury. Heart rate variability (HRV) remains a bit of a mystery. It is reading offered by your watch that indicates whether your body is rested and in balance. A higher HRV is oftenna sign of good recovery, but it can also indicate training overload as the body struggles to bounce back. The tools we use to measure HRV, such a Garmin, Apple watch or whoop all give very different readings. I don’t think it has proven to be a good gauge overall of recovery and fitness. Of the three, I believe heart rate, particularly your relative heart rate to baseline resting heart rate, has proven to be the best indicator of recovery and overall stress. Your resting heart rate will be elevated in response to stress ie: not getting good sleep, coming down with a virus or drinking too much alcohol. Garmin wrist based heart monitors have improved greatly and now the upper arm monitors by Coros and Polar sync well with Garmin and provide very accurate readings. Using your baseline restingheart rate you can adjust your training and rest schedules. Lab work has become easier to access. With services like Walk in Lab or Inside Tracker you can order nearly any test. Inside Tracker will give you personalized recommendations. These results have begun to form a larger data bank hopefully oneday showing how some of these lab results may differ in athletes and active people.

LESSONS FROM INJURY AND AGING

In the past 2 years I have been dealing with some low back and right hip pain after increasing my mileage training for my first marathon at age 62. I really didn’t know what was going on because it was more of a tailbone/pelvic pain/discomfort. I cut back on my running and it very very slowly improved. Several people asked if I should stop running
and you know what our answer is to that! Finally after seeing the chiropractor, doing strength exercises and being told everything was ok by my doctor I decided to go to a running PT. I had to see an Orthopedist to get a referral and when I told him I was a runner the first thing he said was “Oh God”. Anyway, my xray was fine and he said “keep running”. First of all, it is not easy to find a running PT and second when you find one it’s not cheap! I had to give it a try because I have always hoped to run until the day I die or die running. The first visit was a thorough evaluation and I was given exercises. The 2nd visit my running gait was analyzed on the treadmill and Elizabeth my PT noticed I was dipping my right shoulder. She showed me how to correct that and corrected my arm motion; hands hip to heart. I noticed a difference after the first couple of runs and now my pain is resolving. As someone who has run for about 50 years now, I hope by example I can inspire you
to keep running, to modify your training,and adjust to setbacks. Just remember, if you don’t slow down too much you move up in the age group rankings by attrition!

THE UNEXPECTED JOYS OF RUNNING

Now to a lighter note. We all find things when we’re running. I have found cell phones, some which I was able to reunite with their owners. I once found an amazon package intact and for one day I became an amazon delivery person and took it to its assigned address. One day I was running in the rain and found a wallet by a mailbox. I carried it home and when I looked inside I saw so many bills I was afraid to count them. Luckily there was some identification and I took it to the Calhoun Police Dept. They counted the money and there was $1400 dollars in there. The police department was able to return it to its owner and she wrote me a thank you letter. The one thing I can never find when I’m running is pony tail holders. I see them everywhere when I’m not running but if mine breaks there are none to be found.

THE GREATEST FIND OF ALL

The best thing I have found is W2W and all of you. I was at the first meeting. I left a big tennis community in Acworth when we moved to Cartersville and was having a hard time finding my place. Having all of you who also share the passion for running, which so many people call crazy has been my most valuable “find”. I appreciate so much what Matt and David have built by being here every week rain or shine.