As I continue to talk about Living with Crohn’s Disease (did you miss the others? Check out my post on the months just after diagnosis as well as an informational post on what Crohn’s actually is), I want to cover both the long term as well as the day-to-day aspects of the disease. But as we are currently in the midst of the two biggest marathon weekends of the spring (congrats to those who ran Boston, and good luck to those taking on London!), I thought I might take a quick aside and discuss marathon training with a chronic illness (in my case, Crohn’s Disease).
Before I get started, I want, as always to remind all of you that I am not a doctor, I’m especially not YOUR doctor, and though I am a Certified Personal Trainer, I am (likely) not YOUR CPT. So please, please, PLEASE always consult with your private physician and fitness professional before beginning an intensive fitness training program particularly if you have a chronic medical condition.
10 Pieces of Advice for Training with a Chronic Illness
1) Start with a stable condition and your specialist’s blessing
As lovely as it would be to say that you pushed through a flare and conquered your training…. it just isn’t worth it. Intense physical activity affects not only the muscles that you are actively working–it places stress across your entire body. Crohn’s Disease is, by definition, an inflammatory condition, and also one that reacts/can be triggered by stress, hormones, and dietary changes, all of which are likely to change/increase during training. So why start a lap behind and try to win the race? Marathon training, in particular, is difficult enough for a perfectly healthy body. Imagine what it can do with one prone to issue.
2) Gradually work up to your big goals
Though I have worked up to the big race rather quickly in the big scheme of things, I didn’t start with marathons. In fact, when I was in 9th grade, I had a doctor’s note to keep me FROM running because of the stress that it might cause. It wasn’t until I was stable later on that I started my running routine, and then it was largely for fitness. As I mentioned a few Fridays ago in my running confessions, I started running more seriously in my final year of undergraduate (I worked up to about 5 miles then), and I took on my first half marathon two years later during my last semester of grad school. I tried my first marathon 18 months later, and my second a full year later. Incremental increases in distances, and numerous set backs and injuries as I had to make up for my lack of running knowledge and physical issues helped me improve.
3) Conservative Training Plans
I’ve discussed this before, but I train very conservatively. During marathon training, I run 3 times a week–2 mid-week runs and one long run. My midweek runs are generally about 8 miles and consistent with regards to pace. I try to throw in speed work when I can, but my goal is a happy, injury and pain free marathon, not elite status.
Every thing that I accomplish is gravy beyond the finish itself. It isn’t that you need to do the minimum or “get by,” it is that you have to know that you are already playing with fire. I think that most of your all know by now that I don’t really use any of the popular ones. My training plan is to get my 3 runs, do yoga at least 2 times a week, PT exercises 2-3 times a week, and strength training of some variety 1-2 times a week. And, of course, rest.
4) Flexibility and Patience
Flexibility and patience are not just keys to successful training, they are keys to living with chronic conditions, PERIOD. So is a sense of humor. Sometimes? Your body is just going to give you the middle finger.
Sometimes? You are going to wake up and not be able to hit your miles or your speed work goal. Set yourself up for success respecting that–pick an objective that you can hit, and move things around a bit. Don’t ruin your chances at your long term by going after what you want in the short term.
5) Learn to Listen to Your Body
One of the most frequent comments that I receive is that I know and listen to my body so well. First of all, I have had a few years with it to do so, but, to be honest, yes, I am one of the most in-tune-with-their-body-people I know myself. Sometimes my body cries wolf, and I have worked hard to figure out what that feels like. Don’t force yourself to fit into some other expectation or mold of what training looks like. Keep notes, figure out what is working, what isn’t.
6) Hydration/Fueling Strategies
This can get tricky. Many people with Crohn’s Disease and Ulcerative Colitis have had resections or colostomies that have removed critical parts of their digestive system and thereby makes it very difficult for them to absorb proper nutrients, especially to keep them hydrated.
Absolutely consult with your doctor about the best strategies for dealing with this. I make sure to hydrate the day before, of, and after my big runs. Same with nutrition. I spread out my refueling over 48 hours.
7) Supplement Use
Again, consult your doctors. I take a selection of vitamins throughout the year (Folic Acid, Vitamin D, Probiotic, Women’s One-a-Day, a few others) throughout the year, but during training, I have also taken iron and stool softeners (Iron makes you constipated, as well as being rough on your stomach. CONSULT A PHYSICIAN BEFORE TAKING). I have a proven history of anemia (thanks to the ulcers and inflammation), thus an iron regimen, but I take a more powerful one when I am menstruating or training. Runners tend toward anemia often, so that + Crohn’s = likely the need to take iron. I did not this past time after my illness in November (and the constipation associated with it), but I have been advised to start again. I do not take herbal remedies of any sort–you MUST consult with a physician before starting any of those, as they can have adverse effects on your medication or condition.
8) Carry the right equipment
Ok, full disclosure here. I run with a few sheets of TP, a little bit of money (in case I have to purchase drinks or the rights to use a bathroom), and ginger with me during my long runs. And I always run in a pantyliner. Let’s just say that I’ve had more than just the “trots,” mkay? I also have Uber on my phone.
9) Rest/Recovery are non-negotiable
You may be taking some powerful medications or downing a green smoothie every day, but that doesn’t mean that you are invincible. Some bodies need rest the day before the heavier days, some like rest after, some need both days. Figure out what works for you, but know that you might need more of it than the average person. That. is. OK.
Also, request more foot and leg rubs. Because, you know, chronic condition and all….
10) Have the right support team
Surround yourself by people who believe in you and want to help you achieve your goals.
Many people scoff at the idea of running a marathon for healthy people, many scoff at leading a “normal” life with a chronic illness. Try putting those two seemingly inconceivable notions together and see what reactions you get! But also? DON’T surround yourself with people who will just blow smoke up your ass. Ask them to be critical, but not critics, if that makes sense. You will be going through the same mental and physical battles as everyone else, after all! Sometimes, you will need that kick out the door, or someone to keep you from taking it.
If you’ve never run a marathon before, or are worried about doing so with little experience, look into joining a charity team. I ran with Team Challenge, and though I did not train with them, they were amazing for many of the runners who were running with chronic illnesses. At races, they have doctors just for TC use, in fact. Many of the mentors have the diseases themselves, or close family members, and they have all done this before–they will help you through. And, the sad truth is, you might not be “successful.” But regardless of what happens on race day, know that you are a complete, unerring success in taking your life to the next level and living beyond expectation.
You are living Your life on Your terms. Know that the terms might change, but they are still yours.
Question time! Any questions for me?
Chronic illness or not, what is your biggest challenge when it comes to training?