Are You An Iron-Deficient Runner and Unaware Of It?

Jannine Myers

Several weeks ago one of my clients found out that she was iron-deficient, and her family practitioner advised her to reduce both the intensity and volume of her weekly exercise until her iron levels were back to an acceptable level. Prior to that, she had been complaining of shortness of breath on her runs, and also while climbing the two levels of stairs to her second-floor home.

For the longest time, both she and I had attributed her shortness of breath and inability to adapt to running workouts to other factors such as lapses in training, or increased heat and humidity. While it came as a shock to my client to learn that many of her symptoms were likely due to low iron levels, she was at least relieved that she could treat her condition and eventually regain her health and fitness.

In the meantime, while my client is taking a little time off, I decided to do a little research on  “low iron levels in runners,” and was surprised to discover that the results of a study, published in April 2009 (click here for more information), suggests that a little over 50% of runners suffer from iron deficiency, which adversely affects overall performance.

Why is Iron Important for Runners?

Red blood cells, which contain hemoglobin (an iron-containing protein), transport oxygen to your working muscles when you run. If you have low iron levels, you will generate fewer red blood cells and your hemoglobin levels will decline. Therefore, less oxygen will be transported to your muscles, and running performance will suffer.

How Do Runners Lose Iron?

  • Through their feet – First, a process called foot strike hemolysis occurs in runners, especially those who run high mileage. Foot strike hemolysis is a process where red blood cells are damaged when the foot hits the ground, thus reducing your hemoglobin levels.
  • Through sweat – Iron is lost through sweating. While the amount of iron loss isn’t staggering, for a runner working out in hot and humid conditions, the losses can easily add up.
  • Through the intestines – Loss of iron through the GI tract (primarily the stomach or large intestine) is a problem for some athletes. Iron loss through the GI tract is fairly minor, but there may be a cumulative effect over months (of running) that leads to iron deficiency.
  • Female runners – Finally, female runners have an especially difficult time maintaining proper iron levels since they also lose iron during menstruation.
If you suspect that your iron levels might be low, don’t hesitate to go and get a blood test done!
[Here’s a really great article if you’re interested in reading more about athletes and iron deficiency]

Dealing With Injuries: Exercise Guidelines

Jannine Myers

I’ve been running seriously for several years now, and while I wish I could say that I hardly ever deal with injuries, the opposite is actually true. It’s as if every time I start to make progress with my training I suffer a  setback in the way of minor but persistent muscle pain, or a full-blown muscle strain or tear. My most recent (and current) injury is a right hamstring strain, or at least I think it’s a strain. 

One of the most frustrating things about any type of injury is not knowing exactly what it is you’re dealing with, and then of course, not knowing how to proceed with training. In my search for answers on what might be causing the pain in my hamstring, I came across an article (by running expert Jenny Hadfield), which suggested some useful guidelines on dealing with injuries. 

If you’re like me, and prone to injury, please take the time to read Jenny’s advice:

Photo courtesy of

For endurance junkies, an injury is a tough pill to swallow. The good news is the old-school prescription of “rest, rest and more rest” has been debunked by recent research. Evidence now suggests that a modi ed exercise plan helps you heal faster than staying off your feet completely.
The key is to catch an injury at the onset, evaluate the ache and modify your workouts accordingly. Follow the guidelines below to assess the gravity of your particular pain—we’ve separated the stages of injury into four different zones—and to see which exercises are safe for you.


Symptoms: Mild discomfort only after a run.
Exercise Rx: As long as there is no pain mid-workout, you can continue to run. Stick to  at terrain, avoid speed work or tempo runs and cut your mileage in half. Swap every other running workout with low-impact cross-training, such as yoga, weight lifting, elliptical, biking and swimming. Stretch lightly and perform self-massage daily with a foam roller or similar device.
Symptoms: Very mild pain while running that does not cause you to alter your stride or limp. The discomfort may be present (but does not worsen) post-run.
Exercise Rx: Cross-train with low-impact activities for five to seven days. If the pain subsides, gradually incorporate running back into your workouts. For example, if you were biking for 30 minutes, bike for 20 minutes and run for 10. Slowly add more running minutes over the following week or two.


Symptoms: Pain is present during and after a run and restricts activity. You can no longer run without altering your stride.
Exercise Rx: Cross-train at easy-to moderate efforts with activities that do not cause pain. Consult a doctor or physical therapist to develop a recovery plan with exercises that build strength and flexibility.


Symptoms: Acute, unrelenting pain.
Exercise Rx: Before you hit the gym, you must visit your doctor. Depending on your diagnosis, you can begin to exercise with non-weight bearing activities (e.g. swimming, aqua jogging, rowing) as tolerated. Work with your doctor to develop a recovery plan tailored to your injury. Listen to your body and you’ll prevent overuse injuries from worsening. Remember: If it hurts, don’t do it. If your pain is ever in the orange or red zones, it’s time to make a doctor’s appointment.


The location of your injury will dictate which  exibility, strength and cardio exercises you can perform safely.


Flexibility: Massage and stretch your hip flexors and glutes.
Strength: Perform bodyweight planks, as well as lunges and squats if they do not cause pain.
Cardio: Rowing machine, aqua jogging and swimming. Elliptical trainer or cycling if you have no pain.


Flexibility: None until you can walk pain-free. Then, gently stretch and massage quads, hips and glutes.
Strength: Once pain-free, perform bridges, hip extensions and hamstring curls.
Cardio: Rowing machine, aqua jogging, swimming and ab work.

IT Band

Flexibility: Massage the IT band using a foam roller.
Strength: Focus on exercises for your glutes and hips (squats, single-leg squats, hip raises and lateral band walks).
Cardio: Elliptical trainer, swimming, rowing machine and cycling.


Flexibility: Gently stretch calf. Roll tennis ball under the foot and massage calves.
Strength: Foot and ankle strengthening exercises, including heel raises, single-leg balances and lunges.
Cardio: Rowing machine, aqua jogging and swimming. Elliptical trainer if you have no pain.
Jenny Hadfield is the co-author of Running for Mortals and Marathoning for Mortals. You can find more of her training programs, tips and running classes at

How WOOT Gave Me Back My Mojo

By Marie Lewis

In 7th grade, I had a friend whom I credit with forcing me to discover my hidden potential. At this point in my life I could run around a soccer field, but I huffed and puffed my way through the one-mile fitness test during gym class. I did not consider myself a runner—merely a second-string player on the JV soccer team.
I promise this story is not about my awkward middle school years, but a little background is necessary to understand how WOOT did something special for me.

My new middle school friend, April, invited me to go running with her one day. She was so darn friendly I didn’t have the heart to turn her down. I made it about half a mile before I had to stop and walk. I felt self-conscious about it, but April seemed all too happy to slow her pace to a brisk walk for the rest of the “run.”
After that, I didn’t expect to be invited out to run with her anymore. I was wrong. April asked me to go with her every day that she ran, and despite my trepidation, I enjoyed her company and didn’t feel like she judged me for being slow.

The first time I completed a mile without walking, I felt like I was floating. April quickly became one of my best friends, and she created a running training schedule for me the summer after middle school. By fall, I had made a decision to quit the soccer team (where I’d always felt like a bit of a misfit) and I joined the cross-country team.

Marie is in the back row, third from the right

That was probably the best decision I made during high school. I was never one of the fastest girls, but I enjoyed competing against myself. More than that, I savored the encouragement I received both from my coach and especially from the other girls on the team. I felt a confidence I’d never experienced before.

Fast-forward 12 years and I’ve completed more 5K races than I can count and two half-marathons to boot. Running remained a constant part of my life throughout college and in the years that followed.

There was something missing, though. I never had a running buddy quite like April after we graduated high school. She was always there, always holding me accountable and always game for a run no matter what her schedule looked like. I’d since found that if I didn’t hold myself accountable, no one else would.

If you’re still reading, you can stop wondering when I’m going to get to this WOOT business. When I arrived in Okinawa, WOOT was my first experience really meeting anyone on this island. Our sponsor, Melissa, invited me to run with some ladies she called “Women on Okinawa Trails,” and I was immediately intrigued.

That first day, the women gathered in a circle and each introduced herself before our group run. Their smiles and easy laughs put me at ease, and they made me feel at home in this strange new place. I’d be lying if I said that I faithfully drag myself out of bed every Saturday at 6:00 a.m. to join every single WOOT run, but on the days I do show up, everyone remembers me. They know the last time I was there and they ask me what I’ve been doing since. They ask me about my life and they share stories with me about theirs. They tell me when I need new running shoes. They push me to run faster than I do alone.

They remind me of April.

If you’re a woman—or if you have a pulse—you probably know that women are not always pillars of support for one another. We compete, we gossip, we sometimes behave in ways we wouldn’t want our daughters to model. But too often, we do not hear about women lifting each other up.

WOOT lifts me up every time I hit the trails with them. When I lace up my running shoes, I step into a judge-free zone full of encouragement. We share parenting tips (those who are moms), nutrition advice, and laugh at ourselves. I know I belong here.

If you’re new to Okinawa and struggling to find a niche, I encourage you to come meet the WOOT and see for yourself why I love this group. There is no fee, no commitment requirement, no catch. We would just love your company.

Social media: Bane or Boom to Trail Running

Jannine Myers

Each month Trail Runner magazine invites bloggers to write about and share their opinion on a chosen topic – this month’s topic pertains to social media and it’s impact on trail running.

I’m going to go ahead and admit right off the bat that I know zilch about social media, well maybe not zilch but very little. I’m also somewhat unenlightened when it comes to technical gadgets of any kind, so much so that it’s getting kind of ridiculous. I don’t know for example, what the difference is between my daughter’s ITouch and my husband’s IPhone, nor do I know how to capably use an IPod or an IPad, or even how to take photos with any of these I-thing gizmos.

As for social media, I know about Facebook since I have my own account, and I know a little about blogging, but if you hadn’t noticed already, this is a basic, no-frills blog. I also know about twitter, google +, LinkedIn, and various other types of information and photo-sharing sites, but my lack of knowledge deters me from using them. Pathetic, I know, but before you all feel the need to start firing cynical comments my way, let me assure you that I don’t plan to stagnate in the land of “unknowing” forever. Until then however, let me share with you my archaic views on how I believe trail running fares without the intrusion of social media.

For starters, let’s take a look at trail races and the use of race websites and forums to help runners better prepare. Traditionally, I have turned up to races relatively ignorant of what kind of course I might be running. Details that other runners would need to know in advance, such as the degree of course difficulty or elevation, or expected weather conditions and temperature, have ordinarily not been a priority for me.

I appreciate that for some runners, race preparation can be greatly enhanced with access to online sources of information, but there is something liberating about running in a race with little prior knowledge about it. Rather than noting each hill or bend in the trail as a mile marker to be mentally checked off, the runner is free to truly capture the beauty of the course. It’s difficult to be cognizant of your surroundings when you’ve cued yourself to be looking for certain landmarks along the way.

I also believe that trail runners who use social media regularly, might develop more of a propensity, in general, towards planned and organized runs. Trail runners tend to seek adventure and challenge, and spontaneity often adds to the excitement. The internet, with it’s wealth of information on the “best” places to run trails, and the “best” trail running gear and apparel to buy, makes it easy to forego any desire to be spontaneous and succumb instead to online recommendations. The downside, as I see it, is that the element of surprise is lost, much like when a runner turns up to a race already knowing what to expect.

Social media has also played a huge role in changing the scope of all sports, including trail running. It has enabled mass dissemination of information that at one time, would have been exclusively available to much smaller populations. I asked a few trail runners what their thoughts were about this, and how this will likely cause a significant surge of interest in trail running, and though their answers varied, most were skewed towards one of favorable acceptance.

My thoughts, on the other hand, were not so embracing, but they also reeked of selfishness and immaturity. On a very simplistic level, I compare my thoughts to that of my favorite vegan cafe here in Okinawa, and how I am reluctant to tell too many people about it because it’s like a best-kept secret. I realize though that some secrets should be shared, and as one trail runner reminded me, there are enough trails in the world for everyone to enjoy.

None of my arguments are obviously very compelling, but I do have one final thought to add. Unlike other sports, such as football and baseball, which are steeped in years of nationally-observed traditions and a staunch public following, trail running is much more intimate and hardly reliant on enormous crowd support. That’s not to say that it isn’t popular, or that I don’t wish for it to be popular, but trail running is so close to nature, that attaching it to various media platforms and social networks somehow seems to diminish it’s raw appeal.

It’s a little like Wii bringing sports indoors and masquerading as a “close-to-the-real-deal” experience. No matter which way you slice it, playing imaginary tennis in front of a television screen is never going to be the same as hitting an actual ball, with an actual tennis racket, on an actual tennis court. With that said however, Wii brings immense enjoyment to those who use it, and I think it’s safe to say (despite my resistance to using it), that social media offers the same; it too, can bring enjoyment and other benefits to trail runners who choose to use it.

Running Vs. Inactivity – Which Is Worse For Your Knees?

Jannine Myers

I met with a lady last week who had some questions for me regarding a private matter, and as we greeted each other and shook hands, the first words out of her mouth were, ” So you’re a runner?” Now when someone asks me if I’m a runner my first inclination is to get all excited and expect to commence a dialog about a mutually-shared passion. In this case, my enthusiasm was quickly shot down, as the lady proceeded to tell me that running was not “her thing.” In her opinion, running plays havoc on the knees and she hoped to avoid knee problems as she aged.

I found her stance on running particularly interesting, because I had just read an article not so long ago by lifelong runner Bob Wischnia, who proposes that running may actually slow the process of wear-and-tear on the knees. Read his article below:

The Planet Wave: Is Running Bad For Your Knees?


How many times have you heard this one from some well-meaning, non-runner: “If you keep up with all that running, it’s going to ruin your knees. Pretty soon, you won’t be even be able to walk.” If I had a breakfast taco for every single time I’ve heard that, I could compete with Taco Bell.

Heck, I’ve been running since fourth grade and my mother still insists on telling me before every marathon that all this running around I’ve done has trashed my legs and makes me too skinny. Not that I’ve ever listened to her. (Sorry, mom). 

Gotta admit though, intuitively it does make some degree of sense that the longer you run, the more wear and tear you place on the knee. One of these days it’s just gonna wear out, right?

Actually, no. Nor, does running lead to the onset of osteoarthritis or any other crippling disease. In fact, just the opposite. Inactivity is the crippling disease of millions of Americans, not running.

A study at Boston University School of Medicine looked at the continuous impact of the foot with the ground and the commonly accepted belief that running causes degeneration of the knee and can lead to all sorts of arthritic conditions. Said lead researcher and epidemiologist David Felson of BU: “We know from many long-term studies that running doesn’t appear to cause much damage to the knees. When we look at people with knee arthritis, we don’t find much of a previous history of running, and when we look at runners and follow them over time, we don’t find that their risk of developing osteoarthritis is any more than expected.” Felson added that recreational running doesn’t increase the risk of arthritis.

Yet another study—this one conducted in Sweden—found that exercise, including running, may even be beneficial. In this study, researchers took one group of older people at risk of osteoarthritis and had them engage in exercise, including running. The other at-risk group didn’t exercise at all. After looking at the joints of the participants in both study groups, they found that the biochemistry of cartilage improved in those participants who ran.

Multiple studies have shown that movement boosts the knee’s cartilage. Running also helps people to maintain their weight which is another key to slowing arthritis. Lack of movement is the killer. The one caveat is if you already have knee osteoarthritis—a slow, steady loss of the knee’s cushioning cartilage—running is not recommended. Especially if you’re already overweight. Running won’t cause arthritis of the knees, but it may hasten or worsen the condition, once it started.

Without question, your muscles sustain some minor damage when you run, but, say researchers, exercise (or running) stimulates cartilage to repair much of the damage. It is theorized that the impact of your body weight when the foot contacts the ground, increases production of certain proteins in the cartilage that make it stronger in the same way that running increases bone and muscle mass.

This is especially good news for older runners who naturally lose some cartilage after the age of 40. But, says researcher Nancy Lane of the UC Davis Center for Healthy Aging,“If you have a relatively normal knee and you’re jogging five to six times a week at a moderate pace, then there’s every reason to believe that your joints will remain healthy.”

Lane, who has done long-term studies of runners of the 50-Plus Running Club when she was at Stanford University, adds: “We wanted to answer the important question of whether, if you continued to run into your 50s and 60s and even 70s, do you also ran the risk of damaging the knees?” Her answer, based on years of studying older runners: Regardless of your age, running will not damage the knees.

But, there are a few caveats. Lane says that if you have suffered a knee injury, especially one that required surgery, running can increase your risk of knee arthritis. So can routinely running really fast — at a five- or six-minute-mile pace — or running a marathon.