Dr. Chris Segler: Today on the Doc On The Run podcast I am really excited to bring JJ Mayo onto the show to share his expertise about nutrition and what it takes to fuel athletes not only in races, but in the recovery process.
Dr. Mayo holds a Ph.D. in Exercise Physiology and is a registered dietitian (RD). He is an associate professor and has published close to 50 articles in lay and scientific journals regarding various aspects of fitness and nutrition. Also, Dr. Mayo has been quoted in magazines such as Men’s Health and US Weekly. Don’t worry, he doesn’t just write about this stuff…he walks the talk, too. JJ has done ultramarathons, he qualified for the Boston Marathon and he has finished 10 Ironman triathlons. He knows what it takes to use nutrition and apply it directly to putting miles on the road.
Welcome JJ. Thanks for coming on the show! Maybe you could give us a little additional background on you and your athletic history, and maybe even how you became so interested in nutrition specifically for runners.
Dr. JJ Mayo: Cool! Thanks Chris for inviting me on the podcast. I’m really excited to be here and so a little bit more about me like you said.
I have a PhD in Exercise Physiology and I spent most of my career teaching in Kinesiology and Exercise Science departments and I have done research. But my love is really teaching. I enjoy mentoring students and being there with them and I love being in the lab and so I’m really excited about being on the podcast today. But as I started teaching and I’ve taught quite a few years in Kinesiology and Exercise Science, I started getting more questions about nutrition than I did the exercise and so I went back and got a Masters in Dietetics.
I went through the internship and set for the exam and now I’m a registered dietitian and I couldn’t be happier because the interestingly enough than the last couple of years I have moved from Kinesiology and now I teach in the Department of Nutrition. And so I teach undergraduate and graduate classes in Sports Nutrition.
So I’m really excited about that and as far as my athletic background, I started like a lot of your listeners and your listeners can probably relate to this. I started to lose weight and that’s how I started getting into the running because years ago I weighed two hundred pounds and I’m sure some of your listeners can relate to that. But I weighed two hundred pounds, I drink two liters of coke a day, I used to eat the brown bag special at Sonic. I don’t know if you remember. If you remember two burgers, two fries and two drinks. I used to eat that.
I started running to lose weight and so I lost forty or fifty pounds and I just continued to challenge myself. I started with 5K’s and 10K’s and eventually started doing marathons and I wanted to challenge myself further and so I started doing triathlons and ultimately it led to do an Ironman in 2002. Even the last couple of years I’ve started doing some more trail running stuff and you know when you look at this I never win these races. But I’m always really competitive. I tend to be in the top ten to twenty percent of you know the field and one of the reasons I do go so well, it’s not genetics because I would probably be a better bodybuilder then I would be an endurance athlete. But it’s the knowing the principles of training, it’s the nutrition that really has helped me and help me feel down the road and do well in these events. And so I know that’s what we’re here to talk about so I’m excited to jump into it.
Dr. Chris Segler: Yeah, that’s great! That’s really helpful I mean it does take big changes. But it’s interesting because like you said I mean I’m kind of the same way. I’ve done a couple of recorded episodes with a guy who’s like a really really fast runner. But he is literally half my size and he has a genetic advantage to being a runner and I was actually for running Golden Gate Park one day and I used to rock climb a lot now. I still even though I’m pretty skinny now I’m more upper body mass than most runners and this guy ran up next to me is a friend of mine he’s from South Africa but we we’re running along and I was like “Hey how are you doing?” and he’s like “Hey” and he looked at me and he goes “You know your quick but you carried a lot of weight mate!” and I was like “Did you just call me fat?” and he said “No, no, no, no! No that’s not what I mean, I mean you just look you know kind of bulky for like a runner” and I was just like “Well that’s just how I’m built, there’s nothing I can do about that.
It’s true you know but then what’s the difference. So like why is it that you and I can go and be relatively competitive at these events if clearly we’re not really built for? Why is that, well is it because we pay attention to the biomechanics, the kinesiology aspects and nutrition aspects and we get basically airspeed from just applying what we’ve learned right? And that’s really all there’s to it and obviously going from the brown bag special at Sonic to like having real nutrition is like free speed because you really can tune your machine with just these tools right at all.
So that’s a big thing if somebody goes from like you said like your history going from just to lose weight. Someone who goes from a relatively sedentary lifestyle then taking up running. What kind of shift in their diet is going to make the biggest improvement in their adaptation to the new running routine? Like as a nutrition expert like what do you think?
Dr. JJ Mayo: Well I think it’s the simple things. The first thing you would do was just to cut out the junk. I mean when was back in that position that’s what I did is I just really focused on cutting out. You don’t have to cut it all out but you need to cut it back and I usually live and tell my athletes to live by the eighty – twenty rule where eighty percent of the time you eat healthy and twenty percent you can blow it and the twenty percent that you blow it, I would even like have that a little bit planned. When a lot of people do that like on Friday night they know they’re going to have a blow it day where they go out and meet you know pizza and eat a little more than what they normally would. I like the eighty-twenty rule and if athletes, they may have seen this before but as a registered dietitian / nutritionist we talk about the plate method. Where you know half of the plate is fruits and vegetables, the other half is broken up where you have your whole grains and then your protein and if you could get at least to eat in that manner you would get them all on the right track for weight loss and to help their feeling for sure.
And here’s another thing too is often times when you’re out there and runners especially they’re just beginning, they don’t see themselves as athletes. But you really need to see yourself as an athlete and so I think that’s a big key. There are other things too like eating at home, just some of those simple things that we can do.
Dr. Chris Segler: Yeah, it is really, that’s a big part of it. When we talk about the mental aspects of these kind of races and stuff. But how you view yourself really does make a big big difference and I remember like when I did my first marathon. I was, I didn’t view myself as like still even I have been running for really really long time.
I didn’t view myself as like a real runner and I was on my way to go do my first marathon, I was in the airport, I was sitting on the floor in a crowded airport, flights were delayed and I was talking this guy who is actually going to run the same race and he would run like a hundred marathons or something. And so in my mind he was a real runner and I am sitting there talking to him and I was like “Well, you know I’m just going to the first marathon and all that kind of stuff. I still kind of sheepish about it you know, even talking about it” and when his wife came over he said “Hey I wanted to introduce you to this guy. This is Chris, he’s a marathoner”.
And it actually really changed my perspective of myself, really and truly and when you go from switching your diet to actually be in a more serious athlete it really does change things and so I have periods like when I’m really training where I’m super cautious about what eat. I’m really more strict about it and part of it’s because like when I was trying to qualify for Hawaii.
I remember I did this workshop with Mark Allen one time and he was at the time trying to beat Dave Scott. Dave Scott was taking home all the titles right and so Mark tells the story he said he had this realization that like Dave Scott was eating cottage cheese for most of his protein and he would take a strainer. Put the cottage cheese in the strainer and rinse it under running water to get more of the fat off of it before he would eat it and so Mark said, he said “I finally realized that like I have to, you know when it comes to nutrition I’m trying to beat the guy that rinses his cottage cheese and I actually bought a strainer and hung it on the wall in my kitchen to remind me of that and like that’s the thing is that when you realize like if you want to beat that guy you got to even rinse your cottage cheese. It’s true, it’s the small things and it’s that when you’re into sports.
Dr. JJ Mayo: Yeah I agree and so you think about this and you have mentioned it earlier about weight loss. That’s one of the easiest things runners can do to get faster. If you think about it for every pound you lose, your two to seven a seven seconds from out faster. That’s minutes!
Dr. Chris Segler: Yeah, so when people kind of downplay that they think “Well that’s how I’m built” there’s other stuff and they’ll say that. But the truth is the mean like okay we’re from the south right? I’m originally from Tennessee and everybody knows NASCAR there right? You don’t see any back seats in NASCAR you know vehicles right? There’s a reason they take everything out that’s not crucial and it’s that way.
That’s a lot of where my sort of my thought process by a lot of stuff comes from and many years ago I race motorcycles professionally before I went to med school and when I started to actually improve and I was racing professionally I had this interesting conversation with my mentor. His name is Fred and one day I was talking to Fred about all the subtle little changes that can mean the difference between winning and losing. Fred looked at me said “You know Chris, you and your motorcycle are pretty much the same as all your competition and when you get to that level the only difference between first and second place maybe what you have for breakfast.
Now Fred was not exactly like the V game kind of guy right so still to this day like now he lives in San Diego. When I go to back to Houston to visit, I always post pictures like when I go to Taco Cabana which is like my splurge place. He’s always like “Oh man I miss Taco Cabana. But Fred knows and knew back then many many years ago that nutrition was key right and that’s a big part of the thing is that like racing motorcycles is an athletic activity. When you think about athletic activities that’s not what most people think of. They think of running marathons, ultramarathons, Ironmans, that kind of stuff and in those things the fuel is incredibly important. And although few runners when you ask them “Why did you win?” few of them will say “Well it’s because of what I ate”. They’ll say “Well it’s because of these training things that I did. It’s this routine that I’ve stuck to its all that”.
I think that a lot of times when you see somebody particularly in Ironman or marathon that’s completely cratered and falling apart on the course, they blame the nutrition and their failure of execution, their nutrition as the cause of failure. They’ll say “Well you know I could you know whatever, blame on nutrition”. So it’s interesting to me that it’s a common scapegoat when things go come apart. But it’s not what people really focus on.
So that’s it! No matter how well trained you are and rested. If you go to the aid stations and you’re eating potato chips and chocolate chip cookies or something, you’re not going to PR. I don’t get it! I mean it really does baffle me when I’m on a race course and I see this completely ripped obviously super well-trained athletes reaching for cookies and potato chips and stuff when they’re going through a marathon. I mean it didn’t make sense.
So I know that you have an entire website in coaching a program built around this idea of optimizing fuel for runners and so when it comes to that stuff, what are the biggest mistakes that runner seem to make when it comes to nutrition on race day?
Dr. JJ Mayo: Well that’s a great question Chris and there are quite a few more than you would think. I kind of bundled it into just a couple things here. But one is not having a plan at all and this is kind of really what kind of led me to create my website, create my programs is a couple of years ago and you know I participate in quite a few advance but also volunteer in a lot of advance too and so I was working at Pack Pickup at this half and full marathon couple of years ago and I just made a point of every person that came in to pick they’re packing up I would ask them “What did you eat? What are you going to eat the night the before? What are you going to eat tonight? What are you going to eat tomorrow in the morning? What are you going to eat and drink during your bid tomorrow?” They have no idea. They hadn’t even thought about it and it makes such a huge difference from the elite level all the way down to the age group or like us.
I was just looking back. I’m sure you probably heard and your listeners have heard of a guy named Haile Gebrselassie. One of the best runners, elite marathoners in history and in 2002 and its previous events he ran well. But he never use sports drink. In 2002 he ran a 2:06:35 in London. Okay, which is great. But then he started actually using sports drinks and nutrition products during this event and that was in London in 2002 and in 2008 in the Berlin marathon he set a world record of two hours, three minutes and fifty-nine seconds and just because he just started using nutrition on the course or having a plan he worked with a sports nutrition individual to help him put together a plan and then in 2014 in a research article, this a really popular article, what they did is a feel based experiment where they had all these marathoners, a group of marathoners and divided them into two groups.
One group they actually put together a plan for them and help them develop a race day nutrition plan. The other group, they just kind of let them do their own thing and they were matched by fitness so their fitness levels were the same and they even gave them one half marathon to practice. This was actually the Copenhagen marathon that they did this and but then they let him run the marathon and as we would expect the individuals that had a race day nutrition plan even though the groups were matched by fitness, they ran eleven minutes faster.
Dr. Chris Segler: Yeah that’s the thing is I mean when people hear this like for people who aren’t marathoners when they hear “Okay look I ran 2:06 anyway and 2:03 or whatever”. Okay that’s only three minutes, like three minutes takes me a lot of time to tie my shoes right? But at that level, taken off three minutes is like you and me chopping off an hour off on Ironman. I mean it’s a huge huge difference right? And it’s world record difference.
Dr. JJ Mayo: Absolutely because of his genetics. I mean his genetics were not going to finish training probably didn’t differ what differed with adding sports drinks, adding a nutritional plan into the mix.
Dr. Chris Segler: Exactly so that it really does matter. So again like I’m not a lead athlete by any stretch but I have for years I have followed a very strict schedule when it comes to race day. It’s like I have an actual thing that I have written out which I did years ago after I did a bunch of Ironmans like I figured out what works and I have this very clear schedule of when I eat the days before the race, the morning of the race. How many minutes before the gun goes off and I actually do a gel and all that stuff and a whole schedule. And I have it actually taped on my bike and so people like last week like “What do you think about you know when you’re doing those races?” and I’m like “Well, when I’m on my you know really aggressive position of my bike and I like I literally watch my power meter and I look at the schedule and the time and all I do is like I look up every you know, I count to a hundred and I look up to make sure that I’m not going to hit anything and I keep my head down and I eat and I watch the power meter. That’s all I’d do until I get off the bike”. Because it’s all that matters. It didn’t matter who’s passing me. It doesn’t matter what horses are on the side of the road. It doesn’t matter and it’s just about getting a fuel and maintaining the power and you know so it is a small thing. But that’s where we said like the genetics don’t change your training unless you have a lot of free time isn’t going to really change appreciably.
But you can get huge gains and it’s like the free speed. It’s like having a lighter weight race car or going downhill kind of. It’s just makes a huge difference.
Dr. JJ Mayo: Yeah and rehearsing that plan is also important too Chris. If you haven’t put this plan together but then in training you got to figure out what’s going to work, how much fluid can you consume per hour, how many calories can you take in per hour and those are all really important.
Dr. Chris Segler: That’s true. Yes I actually tested that step two myself. I had a period where I spent one summer when I was doing races like Texas and Louisville. They changed them now but they were really hot races historically and knowing they were going to be hot, I train for those.
I actually spend a time doing all much training rides and runs midday in the summer in Alabama where I would go in and I actually charted out and tracked like how much could I take in on these hard effort rides and runs. How many ounces of fluid could I take in when I was on the bike? How many gels can I take in without upsetting my stomach and I figured it out. So I don’t have to wonder now. I show up on race day and I know exactly how much I can take and not throw things off course.
It is not just racing, so what about in training. I mean are there big mistakes that you see athletes commonly make that really can inhibit their whole developmental process, the whole performance building or even like put them at risk of injury with nutrition?
Dr. JJ Mayo: Yeah that’s a good question. So the training aspect is also really important like as you now and what I’ve seen most of the time is this injury was athletes running too much. So we talk about runners and just doing too much and if that happens then that increases the risk of injury and I learned this, this is what happened to me. I didn’t get injured but I just continued to think that I could run more, run more because I set my sights years ago to qualify for Boston and so I trained, I trained and I must not be training enough so I just continued to run more and guess what? My not times did not improve. What really helped was the fact that our honed in my race nutrition and so I think just doing too much is one of the big common ones and also another thing I would say and all of us are guilty of this is running the same paces, the whole year round running the same pace. You got to manipulate that so you’re running faster on some days, a long slow distance on others, manipulate that in training too.
Dr. Chris Segler: Yeah so it’s interesting because like we like to do the same things right habits or habits for a reason. We get that with lot of different stuff. What about the vegan diet and protein? I mean I see a lot of vegan athletes get stress fractures and not just metatarsal stress fracture. I see vegan runners who get hip fractures, femoral neck fractures. All kinds of different stress fractures and a lot of these athletes are strictly vegan athletes not just vegetarians and don’t get me wrong, I understand the appeal of this kind of diet. I mean I appreciate the potential for inflammation reduction just by having a super clean diet and I know a lot of books written about this.
But the simple fact is that somebody who eats meat can take in and absorb a whole lot more protein than somebody who does not eat meat and it’s not some kind of moral discussion. I’m not trying to convince anybody should start eating meat if they’re vegetarian. I’m just curious about your thoughts on the topic of protein intake and then making sure that you’re getting your appropriate nutrients when you have a strict diet like somebody who’s vegan. I mean we’re really wondering what your thoughts are on that. I know that’s a tough thing to get everything you need.
Dr. JJ Mayo: Absolutely. Protein intake is definitely important especially if you are a vegan but it’s just the kind of backup a second when we look at protein requirements.
The RDA (recommended dietary allowance) for protein is .8 grams per kilogram of your body weight and then for endurance athletes it ranges from 1.2 grams per kilogram of body weight up to 1.7 / 1.8 grams of protein per kilogram body weight and endurance athletes if they’re training more they need to have higher levels and when you look at the vegan diet I think protein can play a role but it sounds like we’re talking more about bone health here.
When we’re talking bone health then that really is more of a calcium issue in particular dairy and so when we talk about vegans, they’re cutting out the dairy, they’re cutting out the animal products in general. So when you look at the vegan diet, what I would say for those of your listeners out there who are vegan, you’ve got to be really diligent. You’ve got to be a diligent vegan. If I can call them that because you do have to make sure you’re getting in what you need and we’re talking Calcium here obviously, and Vitamin D and the Iron is huge, you know B12.
There are a lot of really important nutrients that if you’re not consuming on them on a regular basis that put you in increased risk for injury, stress fracture and those types of things and so no question about it. What I would recommend is go into, most of you athletes hopefully are going to get a yearly physical where they’re getting these tested through the blood and making sure that they’re able to find out if there’s a need of consuming supplement or something like that.
Dr. Chris Segler: Yeah, you know that’s interesting because you can’t do that right? When you can go and if you tell your doctor because you doctors don’t know right? Let’s face it they don’t know and they don’t understand. One time I was actually training for Ironman Florida and I got pneumonia and I mean I wrote on my intake sheet like twenty servings of fruits and vegetables or whatever it was like at the time like I wrote down everything. I wrote like how much I was running. I was training twenty five hours a week and then the doctor was going to prescribe Cipro and I was like “With all due respect Sir did you even read my information? I mean you won’t even have to put on a suit if I get an Achilles tendon rupture if you give me suit Cipro after you read my intake form” I mean he’s have to send the check in. This is like totally malpractice and he was like “Oh really busy here”. I was like “What are you thinking dude?” I mean it was just so far off and that was the thing is like I went in and explained to them that I was training and that I had this issue and they completely ignored it. And they like my diet was a part of the consideration.
There’s a lot of them. You say “I’m a runner”, they just think “Okay well that means you go to the gym and you get on the treadmill you run for twenty minutes after you do your weights or something”. They don’t really know what you’re doing and if they’re not runners they may not appreciate it all. It’s really critical that like people go in and they explain to the doctor “Look, I’m a vegan. I want to qualify for Boston marathon. I’m doing heel repeats. I’m doing all this stuff”. So that they really kind of get the gravity of your full training routine and then you can ask specifically like what is their way to check because when athletes will call me and they think they have a stress fracture they say “We’ll check it like bone density study or something?” That’s like calling the insurance adjuster after you’ve had a crash not trying to figure out how to not run into somebody. It’s a totally different thing.
But they’re not even aware that they can do this but they can and the doctors, sure they may discount that because they’re like “Oh that’s unnecessary, why don’t we check your serum calcium by just doing a blood test?” But they certainly can and if you don’t know that there’s a problem I mean how are you going to figure it out? So, same thing they can check your prealbumin levels and see like is your protein is really on track or not. And if you’re concerned about it because you have a strict diet, it’s certainly reasonable. We do this with testing, with runner’s right? We want to test their fitness. We go and we track our progress.
So if you have one of these limiters I think in terms in nutrition it seems like it’s reasonable to talk to a doctor about it right?
Dr. JJ Mayo: Absolutely and also we talked about Calcium and Vitamin D and if you’re not getting enough Vitamin D then that will affect Calcium absorption. So these nutrients work together with one another and like some nutrients like a B12, you really only get those from meat products. You need to think about do I eat foods that are fortified with B12 and Iron and some of these vital nutrients that you may be missing.
Dr. Chris Segler: And if you have to have some sort of additional supplementation it’s crucial that you get high quality supplements. I mean there was that whole fiasco a couple of years ago with all the grocery stores and all these places got slammed where they people went in and they did a whole bunch of random testing of over the counter nutritional products and some of them had like actually zero percent of what was claimed on the label.
Dr. JJ Mayo: Absolutely, yeah! There a couple of independent supplement testing labs, www.consumerlabs.com is one and then there’s USP. It has that USP label, consumer labs label and you know it’s been independently tested and you can assure that is a good quality product.
Dr. Chris Segler: That’s really helpful because I mean you think like if you go to a big retailer whether it’s a grocery store or anything else you assume that everything’s safe in this level and I mean the retailers are not in charge of that. They’re selling it but they’re not really in control of it at all right?
So yeah that’s helpful and most can look for that label and actually know what they’re getting, what they expect to be buying. So that’s a big thing. I mean it’s difficult to incorporate all this stuff obviously into your training. But it’s the thing where you have to know these subtle differences right?
Anyway, right now like I’m sure there’s some runners listening, they’re trying to get past in their injuries. They’re trying to get back to running as quickly as possible. So when it comes to nutrition and recovery from an injury, what is the one piece nutritional advice that you think can help them on their journey?
Dr. JJ Mayo: Okay good question. What I would say is if you are injured and you’re trying to return from an injury. Key things is to make sure you’re getting in adequate calories because think about this, often times individuals if you’re not getting in enough calories and you’re under fueled then that protein is just going to continue to be broken down at a very rapid rate. But at the same token though if you’re over consuming calories then you’re going to be gaining weight. You can be gaining fat and you don’t want that.
Those adequate calories are number one and then also at that point you can increase your protein levels at that point when you have a stress, you have a fracture, that type of thing. Two grams of protein per kilogram of body weight, two-and-a-half even would work.
Dr. Chris Segler: Almost doubling it.
Dr. JJ Mayo: Yeah absolutely. You need more protein.
Dr. Chris Segler: I have seen several athletes that have gotten injured and it’s a fascinating thing and I don’t know if it’s like just sort of switching back to comfort food or what it is. But like I have seen a number of athletes or they’re like the really hardcore runners and they have what seemed like obsessive diets and then when they get injured they like they kind of switch to pizza and ice cream and they’ll say like “What does it matter? I’m not training” I’m like “Well all training is where you go and you do deliberate tissue damage so that you can repair it and become stronger and so now what you have is a larger version of that, an over training injury.
It’s really like it’s the same thing. It’s just a bigger scale of a problem and so like if you’re really obsessive about getting the right nutrients and so you can rebuild this tissue on a daily basis when you have a big catastrophe like an over training injury. Why would you not want to do the same thing? But they just think of it is like well they’re not putting out the same, it’s just like a calorie in, calorie out kind of attitude and they’re like “Well I’m really not doing anything” like yeah you are, you’re rebuilding tissues. Something that’s really been broken. You’ve got to get the feeling for that.
Dr. Chris Segler: Yeah it’s got to be high-quality stuff that’s for sure. It’s not easy to do. But it’s critical right? To move athletes that have these issues whether they’re trying to figure out what to do on race day, they’re trying to do figure what to do in training, they’re trying to figure out like even where they really get started with improving their nutrition, altering their nutrition to really optimize their performance and become a better faster runner you know? Where can they find you? Where is it that they go find you and get help from you directly?
Dr. JJ Mayo: Thanks Chris my website is www.fuelforendurance.com and that’s where I blog and that’s where I have all my goodies. If you want to call it that. I’ve got a close to fifty or sixty blog posts on all kinds of topics, injury, carbohydrate utilization, hydration, you name it it’s on their because I’m just trying to help my goal for 2017 is you know how runners they set this goal and you probably have friends that do this. They want to run 2017 miles and I want to help 2017 runners feel better in 2017.
That’s my goal and you can go there and I’ve got a one of the key things is I’ve got a free download, it’s the “7 steps to creating a marathon nutrition plan” for anyone that’s interested.
Dr. Chris Segler: Excellent! So yeah, so they can go there and they can get that for free. Wow that’s great! Okay, we’ll put that in the show notes too so that people have a link to get there directly from our side as well. But that sounds great.
All right JJ, any other closing advice with for the runners out there trying to get on track?
Dr. JJ Mayo: No, I think that we’ve covered quite a bit. I think the key thing is just to train hard and feel well and you’re going to see positive results.
Dr. Chris Segler: All right JJ! Well thank you very much! I appreciate you coming on the show! It’s all been a super informative, I mean I’ve learned a lot certainly during this episode and I’m really grateful that you came on to share all of your knowledge with all the runners out there.
Dr. JJ Mayo: Thanks so much Chris. Thank you for your time.
If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast.
Dr. Christopher Segler is a podiatrist and ankle surgeon who has won an award for his research on diagnosing subtle fractures involving the ankle that are often initially thought to be only ankle sprains. He believes that it is important to see the very best ankle sprain doctor in San Francisco that you can find. Fortunately, San Francisco has many of the best ankle sprain specialists in the United States practicing right here in the Bay Area. He offers house calls for those with ankle injuries who have a tough time getting to a podiatry office. You can reach him directly at (415) 308-0833.
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