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Let’s start here. If you’re really, really hurt – or think you may be, or are wrestling with a nagging, acute pain, you may want to check-in with a medical professional. With that said, the repetitive activity that is running can sometimes leave you sore, hurting, and seeking relief. The good news is that not every ache or pain requires a trip to your doctor’s office. Applying the right at-home therapy can go a long way to getting you back up-and-running asap.

A question that often looms for those of us seeking that DIY relief: ice or heat? And, which one is a better fix for the type of injury were wrestling with. We asked Dr. Doug Bradberry from Greenapple Sports and Wellnessfor his take on how to make the right call here.

How do we know whether an injury requires ice or heat? 

The only time I recommend using ice to my patients is in the first 4-6 hours after an injury; 15 minutes on and 15 minutes off.  This will help with the initial pain.

Heat is going to be used later in the healing process. Likely, depending on the severity , after a couple weeks. It will help get blood to the area and help loosen the tight tissues and make it easier to move. Ultimately, movement and appropriate exercises is what will speed up healing the fastest.

What’s the best way to apply each type of therapy? 

When applying ice, you want to make sure you have some kind of barrier between the ice and your skin. Also limit the application time to 15 minutes. Ice or frost directly on the skin can cause frostbite. Ice will also cause the blood vessels to constrict. So you don’t want it on the injury very long.

Heat should to be applied for about the same rate; 15 minutes, once per hour. Be sure the temperature is not too hot, and place the heat pack on top of the area. Do not place the body part on top of the heat pack. If you’re using heat on your low back, for example, don’t sit on the couch with the heat trapped between your back and the cushions. This can trap too much heat and cause a burn.

What are signs that I should seek help from a professional? 

First thing you will pay attention to after an injury is what the area looks like. You’ll want to rule out a broken bone if there is a noticeably deformity, significant immediate swelling or if you are unable to move the body part.

A sprained ankle for example…if after you roll your ankle, you are able to move it and walk, chances are it is not broken. But, if it does not seem to be improving after 48-72 hours, seeing a medical professional would be appropriate.

Bottom Line:

Dr. Bradberry sums it up like this: The benefit of using ice is pain relief. Things don’t hurt as much when they’re numb. But, he cautions, using ice long term can slow the healing process.

Depending on the injury, heat is more likely to facilitate healing because it brings blood to the area. Blood contains the oxygen and nutrients that the tissue needs to heal.

Yes, there’s still confusion, misinformation, and disinformation clouding the subject of COVID. Matters get more complicated as we wade into the thick of cold and flu season, and the idea that some of us are just plain sick and tired of hearing about COVID. Hopefully, more tired than sick, though.

So what’s our risk of getting sick this season, and are runners any better off when it comes to staying well in the first place? To sort out the facts, we spoke with Dr. Kyle Ashland, a primary care sports medicine MD at Novant Health Lakeside Family Physicians – Prosperity Church.

For starters, thanks for the time, Dr. Ashland. So… what kind of cold and flu season are we expecting this year? And, do you feel it will be as complicated by COVID as in the last couple of years? 

Dr. Ashland — We are already well into flu season which has hit us hard and fast. Thankfully, recent trends are pointing down. That being said, it is still early enough that we could have a second wave of the flu. Regarding whether it will be complicated by COVID, I may actually frame it the other way. The past couple of years our primary respiratory virus this time of year was COVID-19, and this is still the greater threat to public health in my opinion.

From what we’re reading from the CDC and NCDHHS, typical peak for flu season around here is around now and into February. Do you feel that will be the case this season? 

Dr. Ashland — That was certainly the case in most years past. We’ve had one peak already, but that does not mean we will not have a second.

And about current COVID infection rates… We’ve read that some hospitals have already been postponing surgeries and elective procedures due to beds being used for COVID patients. Are we in better, worse, or about the same position to manage that versus the last couple of years? 

Dr. Ashland — Generally speaking, we have some tools that we did not have in past years such as home test kits, oral antivirals, and readily available vaccines. We also have the experience of going through multiple waves in the past. Unfortunately, vaccine uptake has been poor this fall/winter and there is a lot of burnout throughout the healthcare industry.

At this point, most countries — even China — have relaxed travel restrictions in favor of “traveler surveillance,” some states are looking at all-out bans on future COVID restrictions, etc., yet it seems like EVERYONE knows someone who has COVID right now. As a public, have we just grown tired of this as a story? Are we happy to be “blissfully unaware,” or are we just ignoring the facts? 

Dr. Ashland — This is a tremendously complicated issue. First, traveling surveillance by definition does not do much for infection prevention. When it comes to bans, etc., keep in mind that what is best for infection prevention may not go hand in hand with what is best for the economy or other considerations such as mental health; additionally, all of those are fluid situations and the best course of action for any given concern is not going to be the same in another month or year (or more!). Our lawmakers have very complex decisions to make with a lot of voices looking to be heard. Keeping in mind other issues going on in the world, I’m not surprised COVID-19 has taken a back seat in the news cycle.

Medically, COVID-19 is here to stay in some capacity. We know that there are waves that place you at a high risk of being exposed and therefore infected. Data is quite difficult for even experts to interpret due to a number of factors. More people are testing at home (good thing!) so a lot of infections go unreported (bad thing!). Wastewater is a useful tool, but cannot tell the whole story. Data quickly changes. I would highly recommend that individuals keep an eye on the data that is available to assess their level of risk.

Presuming our readers here are runners and attempting to take care of their health. Are they in any better shape when it comes to immunity? What should or can they do to protect themselves this season from cold and flu? And, is it too late to get a flu shot?

Dr. Ashland — We know that those who exercise regularly do get immune system benefits. That being said, it is possible that if you are habitually not adequately recovering from your training or have a particularly intense run (race) that you may temporarily have a weakened immune system. The best things you can do are common sense health practices – maintain good hygiene, wash your hands, consider wearing a mask (particularly in a crowded public indoor space during waves), keep a distance from those who are sick, and get your flu shot. It is certainly not too late to get your flu shot – I would try to get this done ASAP.

Lastly, on the subject of shots, should we get a COVID booster this year, and when?  

Dr. Ashland — I would definitely recommend getting a COVID booster if you have not done so already. The bivalent booster has been out since September, and it is not too late to get this done provided you had your primary series done (a first booster is not mandatory to get the bivalent booster). For those who already got it done – thank you! Stay tuned for future recommendations.

For the record, we’re a coffee crowd here at RunCharlotte. But, sometimes that large Chick-fil-A tea hits just right, doesn’t it? And if you grew up down south, you probably know from sweet tea. Ditch all that sugar, and for the most part, you’re left with the energy drink that dates to 2700 BCE.

That’s a lot of history and a lot of time to study the effects tea has on a person. For centuries, the Chinese used tea as a medicinal beverage before it ever became a daily drink. Today, we have a pretty good grip on the science and nutrition that makes tea the real deal.

Tea Provides Protection

For starters, “tea contains polyphenols, known as catechins, which are antioxidants that can be beneficial for our health,” says Matt Dengler, dietician and owner of RxRD Nutrition. “Antioxidants prevent or delay cell damage and may play a role in the prevention of diseases such as cancer, heart disease, and diabetes.”

Good to know. And as you might suspect, or already know, not all teas are created equally. Dengler says green teas contains a higher amount of antioxidants compared to other kinds of tea, and research shows there is a positive link between green tea consumption and cardiovascular health.

Herbal teas may contain unique benefits. Peppermint tea contains menthol, which can help soothe an upset stomach and improve GI issues. Chamomile tea can be used to ease anxiety and act as a sleep aid, and ginger tea can help reduce inflammation and help with nausea and motion sickness.

Caffeine and tea

While tea contains caffeine, it does not contain as much as a cup of coffee. So if you’re looking for that “jolt” that coffee can deliver, tea falls a little short.

For reference:

• One 8-oz cup of coffee contains 95mg
• An equal amount of black tea contains 48mg
• An equal amount of green tea contains 29mg
• Most herbal teas contain very little caffeine

Compared to energy drinks, tea contains far less caffeine, says Dengler. Most 12-16oz contain between 200-300 mg of caffeine. Also, many energy drinks also contain added sugar, additives, and legal stimulants which can elevate heart rate and blood pressure.

Tea and performance

Research shows that green tea consumption may be beneficial for athletic performance, says Dengler.

Prolonged or high-intensity physical activity increases energy requirements in the body’s tissues, which in turn can induce muscle damage and cause fatigue. This is referred to as oxidative stress.

Due to a high amount of catechins, the consumption of green tea can be protective against oxidative stress which is normally produced during prolonged or high-intensity exercise. It’s tea for the win here.

While nothing’s perfect, tea has some distinct benefits for runners and endurance athletes. Canned or bottled teas with flavorings and sugars will outweigh most of the upshots of including tea in your routine. But brewing up some tea is not much more difficult than boiling water, and that’s a pretty low bar to hop for a performance and recovery boost that’s easy to swallow.

Whether you watched it happen, saw it, read it, or just heard about it, the cardiac event that felled Damar Hamlin was – and is – just plain scary. As of this writing, the 24-year Buffalo Bills safety is recovering at home, after being hospitalized since suffering cardiac arrest during the January 2 Monday Night Football game versus the Bengals.

While Hamlin was resuscitated and whisked from the field; worry, tears, and prayers quickly rippled from the sidelines, to the stands, to around the world. As his condition improved and the news cycle churned, “what” and “how” were common questions.

What was so unique about that seemingly routine football play? How could something like that happen to an athlete at the pinnacle of their sport? And, could it happen to me?

Few among us will play professional football, but most of us appreciate the potential risk of physical injury players are subject to.

There are potentially several possible causes for Hamlin’s cardiac arrest, a term most of us are familiar with. But many experts are suggesting he experienced a rare phenomenon called commotio cordis, when the chest is hit at just the right time to cause a potentially deadly disruption in the heart’s rhythm.

“You know about it, you read about it, it’s on board exams, but it’s not something you regularly encounter because it is so very rare,” said Dr. Keith Anderson, a Novant Health Family Medicine and Sports Medicine Physician, and Medical Director for the Novant Health Charlotte Marathon.

Research from the American Heart Association state that only 10 to 20 cases are reported each year. Most cases involve adolescents; few reported victims are over 20 years old.

“There’s probably not a genetic predisposition for an occurrence like this,” added Anderson, “and I don’t believe one person is more susceptible than another, unless they’re involved in activities that involve high velocity, but even then it’s a very freak thing to happen.”

Anderson pointed to incidences at little league parks that eventually led to AED devices (defibrillators) being standard equipment at ballparks. Anderson suggests those are more likely to save the life of a parent or grandparent in the stands rather than a player experiencing commotio cordis. Or, presumably healthy people – like runner and author Jim Fixx* – who died of a heart attack after his morning run.

“There are countless reasons to be active,” finished Anderson. “There aren’t many not to.”

“I tell all of my patients, the information and research are overwhelmingly clear that regular exercise, like running, is proven to reduce the incidences of heart attack, cardiovascular disease, and stroke. Not to mention the mental and emotional benefits, the reduced risk of depression, dementia, and Alzheimer’s.”

Few among us will play professional football, but most of us appreciate the potential risk of physical injury players are subject to on a regular basis. When we updated this story for publishing, the Bills had left it up to Hamlin as to when he’ll return to the team facility.

Although our lives and livelihood aren’t necessarily tied to our ability to run; injury, illness, or setbacks may affect our ability to participate in our primary activity. Anderson recommended having a plan B, C, D, or whatever it takes to remain physically active. (Spoken like a true multisport athlete.) For us runners, having a side sport like swimming, cycling, weightlifting, etc., can actually ward off injury and make us better runners, to boot. More on that later…

And if you’re worried whether something like this could happen to you? Anderson suggested looking beyond the headlines and into the details.

“If the most recent incidences or examples that are being cited are from years ago, it should give you an idea that the condition or opportunity is pretty rare.”

If you have questions about your own risk factors, or your heart health in general, talk to your doctor. Or, find a remarkable Novant Health physician here: https://www.novanthealth.org/pf/

*It has been well-studied that Fixx had underlying genetic conditions and other risk factors that led to his heart attack.

Wait a minute. We’re barely into the new year and we’re talking “off-season?” At the very point on the calendar, when we should be embracing coming adventures, events, and opportunities, we’re getting into rest and recovery? Why, yes. As a matter of fact, we are.

Whether you trained full-tilt during the holidays, or still can’t recall where you put your shoes after that last long run or race of 2022, the “off-season” can mean different things to each of us. This also means it can be just about any time for any runner, and for any reason. No matter why you take time away from running – and most of us should – there are better ways to make the most of it. We mined some of our favorite Charlotte area coaches for these bits of gold.

Reflect and Recover

Take the appropriate amount of time to reflect and be proud of both the training cycle and the race before moving on to the next one.  Not only are we pushing the body physically over an extended period of time (training), but we are pushing the body mentally. There are psychological and physical changes happening in the body.

Regardless of the outcome of a race, it is so important to sit in recovery and reflect. What were the things you learned you need to work on as you got further in the training cycle? What were the things you did better this training cycle? Each time we prepare for a big race we are already better prepared for the next. Experience builds confidence. – Coach Jen Dufresne, Cross Conditioning Training @crossconditioningtraining

Assess the Situation

It’s very important to have an off-season after a season of building fitness and going after PRs. Athletes typically dial back (but don’t eliminate) their volume and intensity and focus on recovery, strength training, etc. For example, if coming off a marathon training cycle, the first thing that I do is take a full week off with absolutely no running. This allows me time to assess injuries I might not know I sustained during the race once the normal soreness goes away and gives my body the much needed rest that it has earned. Next, I reverse taper for about a month to ease back into my normal base mileage. After a month, I start adding back running workouts.

For some, this is also a great opportunity to remember why they enjoy running, which can be forgotten in the throes of the training season while focusing on race goals. The off-season is a great setup for the next season of PRs! – Coach C.J. Langley, @unc4me82

Mix It Up, Slow it Down

Now is the time to mix in things you don’t normally get to do – take some yoga, go for hikes, play pickleball, etc. Reconnect with family and friends during this time, too. It’s ok to enjoy a little of what you normally do in season (for example if you’re a triathlete, then swim, bike, run) just to keep up your technique, but the ultimate goal is to keep everything at a super low level for the next few weeks. Take advantage of this post-season time; it’s all about mental and physical rejuvenation.  After a few weeks of this, you should feel ready to start easing into a structured training routine again.  – Coach Karen Wood, @karenwood1003

Stretch and Strengthen

The off-season is a great time to create a stretching routine that works for you. Dynamic stretches before starting a run, and static stretches after are a great way to boost your recovery. Improving flexibility and mobility can only help you and your stride, as well as reducing the risk of injury. Strength training. As a personal trainer, this one is near and dear to me. When I was in high school and college running cross country, no one emphasized the importance of weight lifting. It helps keep your bone density strong, helps develop muscle strength, balance, and core stability. All of these things can assist your running! Incorporate 2 days of strength training into your maintenance training, and grow those fast-twitch muscles that will help you kick to the finish line when race season begins again. Coach Kate Hamilton, @k.ham5

Ditch the Numbers

Every athlete’s post-seasons look different based on a variety of factors. Overall, it’s essential to take a few weeks without any structure and then gradually get back to some structure. The post-season is a good time to lose the metrics, run by feel, get on some trails, and remember the reason why you do this sport in the first place. It’s also a great time to do some different activities such as yoga, hiking, or cycling.

In order to have long-term sustainability, it’s important to reset. Once athletes take an appropriate amount of time off, then it’s time to start being a healthy human exercising (not training), and doing what feels good to them. I think it’s essential to embrace getting out of shape. It sure feels good to start getting back in shape during the pre-season. Coach Meghan Fillnow, Fillnow Coaching @fillnowcoaching

The spring running season will be on us soon. Yes, the 2023 Six Pack Series begins March 11 with the Shamrock 4-Miler. If you’ve yet to take time away from running and training, you know the drill. The best time to start was yesterday. The second best time is today. For now; rest, recover. We’ll see you at the races this spring!