The Akron Marathon staff keeps providing Blue Line Beginners with some amazing opportunities, and at Saturday's group run/walk in Copley they brought along their medical director, Summa Health's Dr. Nilesh Shah, to answer all those nagging questions we've had about our nagging pains.

Dr. Shah first answered the obvious: How much pain is too much?

There are three simple rules for determining whether you should cease training that day, focus on strengthening exercises, and even consider whether it's time to be checked by a physician.

1) Your pain should not register more than a 3 on a scale of 1-10. A 4 means the pain has become the focus of your activity so much, you can't think of anything else. You can't lose yourself in other things, like conversation with a running partner or what's playing on your iPod. If you are working out and can stop thinking about the pain from time to time, you're probably at a 3.

2) Your pain should not be affecting the mechanics of how you walk or run. Are you doing something unnatural, such as turning your foot or changing your gait, in order to lessen the pain?

3) Your pain shouldn't significantly affect your daily life outside of your run.  For instance, are you getting through your run fine, but then limping and feeling miserable the rest of the day?

If you fail any of those tests, you need to figure out what your injury or weakness is and look for online videos aimed at strengthening that area. If you need to see a doctor, consider a sports medicine physician since they are more likely to understand the time and effort you've put into training and work with you to see if there are ways to continue your training while correcting your issue.

BLBers asked some specific questions about issues they are having, and Dr. Shah answered them all, even demonstrating some exercise routines. I can't be that detailed, but here is a brief synopsis of a few problems he tackled:

***

Q) When we did the first 5-mile walk, my hands swelled up so much that I couldn't make a fist.

A) Especially in the heat, some people just have hands and feet that swell. Sometimes it's because you lose salt and bring fluid to the surface. One recommendation is to get the salt back, perhaps by eating salty snacks. Your hands might also have swelled because you held them low at your side.

***

Q) What can I do for shin splints?

A) Shin splints are on a continuum that can grow, if not checked, into periostitis or even stress fractures. If your shin pain goes away when you warm up, you are probably okay. If it comes back at the end of the run or if it takes you 3 miles to warm up instead of one, then you are sliding along on the continuum into more troubling areas. If you suffer from shin splints, find the appropriate exercises to strengthen that area, including heel walks, toe walks and calf stretches.

***

Q) I feel a pain on the top of my knee. What is that?

A) That's runner's knee. You know you have it if it feels worse going up and down stairs, or there's more pain after a long car ride. It can come from three things: Weakness to the quads, tight hamstrings, or weak gluteus medius (butt) muscle. Among the exercises you can do are side leg raises, or use a stretch band and do the clam shell.

***

Q) What can I do for lower back pain?

A) That can be a core strength issue. Do planks, side planks, pelvic tilts, bridging.

***

Q) I heard that it's bad for runners to use anti-inflammatories like ibuprofen. Is that only when doing runs and can we use it on days we don't run?

A) Definitely don't use anti-inflammatories on race day, but I recommend never using them (including Advil, Aleve, Naproxen and aspirin.) Tylenol is safe for pain management. When you take an anti-inflamatory, it can lead to renal failure, and we've had that happen to people during the race. For the most part, I'd rather find out what the underlying problem is. Do stretching and fix it that way, rather than throw medicine at it. Use ice, lots of ice, if you need to.

***

Strength training is so important, Dr. Shah said, that if time is an issue for you, cut some running to make room for those exercises every other day. If you're injured, you're not running anyway.

To learn how to do any of the routines Dr. Shah mentioned above (planks, calf stretches, side leg raises) search Google or YouTube for videos!

- Paula