A: By asking for help, you’ve taken the first step towards better health and freedom from drugs and alcohol. There are many resources for young people struggling with drug or alcohol abuse. Find a counselor at school that you feel you can trust and talk to her/him about your problems. S/he can direct you to appropriate community resources. You might also try the National Drug and Alcohol Treatment Referral Service helpline (1.800.662.HELP) or call local chapters of Alcoholics Anonymous or Narcotics Anonymous and ask them about special programs for teenagers. No single treatment works for everyone, and it doesn’t happen overnight. You may benefit from individual or group counseling, related not only to drugs or alcohol, but also to other problems that are affecting your life. You can learn strategies to help you resist drug use and find new activities and friends that take you out of the lifestyle. When you’re in control, you’ll feel better and play better, on and off the court! Good luck!--Robyn M. Stuhr, MA.



Q2: I'm involved in cross-country, basketball and track. Lately during track, after I run less than a mile, my feet start to hurt really bad. I feel like I need to stop, sit down and take my shoes off. The pain starts in my feet, then if I run like 3 miles, it starts moving up to around my ankle also. Is this just a normal thing or should I go to our trainer?

A: There are several possible reasons for your foot and ankle pain. One of the most common is lack of support in your running shoes. It would be worth seeing your trainer to have him/her assess the alignment of your foot and to determine if the running shoes are giving you adequate support. If they are not, a simple change of shoes or addition of an arch support may be helpful. Another potential cause of your foot and ankle pain is lack of appropriate strength and/or flexibility in your calf muscles. Again, a visit with your athletic trainer or sports medicine physician will be helpful. There is no reason to train in pain, so let someone knowledgeable take a look at you. --Jo Hannafin, M.D.



Q3: I want to become a jogger. What is the best way to begin safely? How do I maintain this safely?

A: : Many people enjoy jogging because it’s an effective and efficient way to improve cardiovascular health, control body fat, get some fresh air and explore the neighborhood! The biggest mistake people make when starting a new program is to do too much too soon. Don’t let that happen to you! Start by building up to a 30-45 minute walk and then begin to incorporate intervals of jogging into your walk. For example, after you’ve walked for 15 minutes, jog a block, then walk 2 blocks. Repeat several times. Select a jogging pace that feels challenging, but not exhausting. Each week add a little more distance or shorten your recovery time. Increase your running time or distance by no more than 10-20% each week. Eventually you’ll be able to jog the whole time! The most important piece of equipment is, of course, shoes. Make sure you purchase a good-fitting and supportive pair of running shoes. It might help to find a friend who wants to start jogging and do it together! --Robyn M. Stuhr, MA



Q4: How do I know when it’s time to buy a new pair of athletic shoes?

A: Most athletic shoes lose 50% of their cushioning after 250 miles of wear. If you’re a runner, a good rule of thumb is to replace your shoes every 200 to 300 miles. Remember that your shoes will wear out faster the heavier you are, the more you work out and the rougher the terrain on which you exercise. Set your shoes on a flat surface and look to see if they are starting to break down. You might observe that one or both shoes collapse inward or outward. This means that the shoe has lost stability and will no longer support your foot the way it should. The outer sole (the part which touches the ground) is twice as durable as the midsole (between the outer sole and the inside of the shoe). Don’t wait for the outer sole to break down to replace your athletic shoes. The midsole, which is designed to provide extra cushioning and may include materials such as EVA, polyurethane, air or gel inserts, will degrade more quickly. Look at the midsole for signs of wrinkling. If you exercise regularly, replace your shoes every 6 to 12 months regardless of how they look. If you start to experience pain in your knees, hips or feet, check your shoes. You may save yourself a trip to the doctor by replacing your athletic shoes in a timely fashion. Robyn Stuhr, MA



Q5: I'm 44 years old, and I have quit smoking for just over 1 year and have gained 20 lbs. I have tried swimming lengths daily for months, with no results. For the past 2 months I have been circuit training for 30 minutes 4 - 5 days per week and have lost only 5 lbs. (I am also watching what I eat.) Aerobically, where should my heart rate be for my age while working out and for how long must it be maintained to burn fat?

A: Congratulations on quitting smoking! It’s one of the best things you’ll ever do for yourself. Many ex-smokers are frustrated by weight gain during the year after they quit, but that excess poundage doesn’t have to last. Check with your doctor to make sure there aren’t any medical reasons why you shouldn’t exercise. Take a second look at your diet and ask yourself whether you’ve substituted a little extra eating for smoking. Aerobic exercise and strength training play different, but equally valuable, roles in weight control. Strength training helps maintain muscle mass to increase metabolism, and aerobic exercise helps you burn lots of calories. Circuit training is a form of strength training that incorporates intervals of aerobic and strength exercise to keep your heart pumping. You should perform weight training of any kind no more than 3-4 nonconsecutive days/week. You’ll want to build up to 5 days/week of aerobic exercise, with your heart rate between 125 and 150 beats/minute (or a personally challenging pace). Some people find that swimming alone doesn’t help them lose fat. They see better success when they add weight-bearing “land-based” exercise into their routine, such as walking, jogging, elliptical trainer or aerobics. Just keep moving and find a variety of ways to burn calories. It may take a while, but you’ll eventually feel fitter and be leaner. --Robyn M. Stuhr, MA.



Q6: My coach says I need more protein in my diet. How do I figure out what my body really needs?

A: How much protein your body needs is dependent on your weight, the amount of calories you consume, and your degree and intensity of training. If overall calorie or energy needs are not met, then the protein you eat will be used by the body for energy instead of for vital functions. When the body gets enough energy (calories) and protein daily, it can provide all the necessary body functions, maintain strength and heal effectively. Protein needs are greatest for endurance athletes such as distance runners, swimmers, soccer players, cross-country skiers, triathletes, and road cyclists. Strength-training athletes also have increased protein needs (to a lesser degree than endurance athletes). A rule of thumb method for determining protein needs for a healthy, active person (male or female) would be the following: Multiply your weight in pounds by 0.5 - 0.7 grams protein per pound. Example: If you weigh 120 lbs, multiply 120 x 0.5 - 0.7 = 60-84 grams protein per day (4-6 protein equivalents). In addition to protein foods, a 120 lb person would require 3 calcium/dairy servings and plenty of carbohydrate servings per day. Terry Karl, MS, RD



Q7: I run about 15-20 miles a week. What stretches should I be doing? Should I stretch before or after I run?

A: As a runner/jogger, your stretching program should focus on the muscles in your legs (from your hips all the way down to your feet). It is important to choose stretches for your hamstrings (back of your thighs), quadriceps (front of your thighs), hip flexors (front of your hips), and calves. Although there are a few different stretching techniques, static stretching is recommended. Perform the exercise movement slowly, until you feel a stretch in the targeted muscle. Hold this position for 30 seconds. Repeat the stretch 3 times. Remember, there is a fine line between feeling a stretch and feeling pain. Make sure you feel a good stretch. If you feel pain, your muscles will tighten up to protect themselves. Should you stretch before or after you run? You should always stretch after you run to help increase your flexibility. The question is "Should you stretch before you run?" Stretching before you run will not necessarily decrease your risk of injury during that training session; however, it may help ready your muscles for running and ultimately make you feel good during the exercise. If you stretch before you run, remember to warm up first (5-10 minutes walking or jogging at a comfortable pace), because a warm muscle is more elastic than a cold muscle and will stretch more easily. Adequate muscle flexibility may decrease your risk of injury. Inadequate flexibility or muscle tightness may lead to injury by increasing the stress on your body (your muscles, tendons, bones, and/or joints). Stretching once a week will maintain your flexibility. To improve your flexibility you should stretch 3-5 times/week. Theresa Chiaia, PT



Q8: I work out a lot, but I’m tired all the time. I thought exercise was supposed to give you extra energy. Could I be anemic?

A: Fatigue is an almost universal complaint among women (which, given the average woman’s daily “to do” list, is no surprise). It can have many roots, from chronic sleep deprivation to insufficient nutrition to a variety of medical illnesses, such as anemia, hypothyroidism, or depression. All of these medical conditions are common in women, so if you suspect you are suffering from a medical cause of your fatigue, ask your doctor for an evaluation. In my experience, many women who are “tired all the time” are not suffering from a single fatigue-inducing medical condition, but rather from several small energy-sapping lifestyle factors, such as diets with inadequate calories or too much sugar and caffeine, limited or interrupted sleep, and a sedentary lifestyle. Whether your fatigue is related to lifestyle factors or a medical condition, exercise can be very helpful in improving your energy level. Getting your heart rate up through brisk aerobic exercise sends blood surging through your body, boosting the delivery of oxygen and nutrients that your tissues thrive on. Exercise also stimulates the release of a variety of hormones that support your immune system, elevate your mood, and leaves you feeling relaxed and energized. Similarly, weight training, playing a sport, and stretching can all help combat fatigue. It’s important that you get enough---but not too much---exercise. Excessive exercise, especially chronically, has the opposite effect. Instead of improving your energy level, over-exercising (for example: 7 days/week of exercise, no recovery days) will raid your energy stores, leaving you exhausted. Lisa Callahan, MD