Medical Advice

Tips for Running Safely in a Winter Wonderland

Living in the northern latitudes provides the runner with numerous challenges for winter training. This is particularly true when the training is for long distance events and the runner will be outside for long stretches. The cold, wind, snow and ice make for a dynamic environment that all runners must be prepared for, and in some cases to retreat from, to have a successful and safe conditioning run.

The Cold and the Wind
Only occasionally is the air temperature low enough to cause significant dangers to the runner but when you combine cold air with wind, the risks raise significantly for the unprepared runner.

Wind chill
Wind chill is the perceived temperature felt by an individual based on the air temperature and the wind speed. As cold air moves across the body it draws heat away from the superficial layers of the body lowering their temperature. This can cause both local and whole body responses to the decreasing tissue temperature and can affect both the local area and overall body systems adversely. Eventually local area damage will occur and whole body cooling will begin. Wind chill temperatures are calculated when the air temperature is 50 degrees Fahrenheit or below and the wind speed is at least 3 miles-per-hour. Keep in mind that your running speed can affect the wind speed in relation to you. Sunshine can negate some of the cold affects but plan for the worst conditions. Carrying a small piece of skin covering that you end up not needing is much less problematic than suffering from frost nip or frostbite. Visit the wind chill page at National Weather Service website for charts regarding wind chill conditions and the equation for calculating wind chill.

Always keep in mind that when calculating wind chill the speed of your running is not included. You must add your running speed to the wind speed to more accurately gauge what the wind chill will be for you. If the air temperature or wind chill are dropping below 0 degrees Fahrenheit, you may wish to consider an indoor training method for the day. With appropriate clothing considerations you may be fine. A wind chill or air temperature at -20 degrees combined with otherwise ‘ideal’ running conditions will put you at significant risk for frostbite in less than 30 minutes. Conditions which you should strongly consider the need for an outdoor training session versus your ability to protect you body from injury and illness when outside.

Dampness
While an air temperature of 45 or 50 degrees Fahrenheit is relatively comfortable, immersing a body part in water of the same temperature is incredibly uncomfortable. When the temperature in a moist environment is lowered and/or sustained the ability of the body to maintain warmth is significantly compromised and cold illnesses/injuries become probable. Combine the cold, wet environment with wind and the odds of cold illnesses and injuries rise further. When temperatures are low avoid running through puddles, slush and deep snow.

Fatigue
As muscular fatigue builds, the ability of the body to continue to generate heat in cold environments may not be able to match the cooling affects of the running environment. If this continues the runner’s core temperature may drop causing a shivering response. Shivering is a defense mechanism of the body and is an effort of the body to re-warm itself. If the core temperature, normally approximately 98.6 degrees Fahrenheit, continues to drop shivering may cease anywhere below a core temperature of 95 degrees significantly decreasing the body’s ability to maintain a warm temperature.

Cold Illnesses and Injuries

Frost Nip
Generally affecting the superficial regions of the body such as the toes, fingers, nose, cheeks, and ears, frost nip will appear as firm, cold skin that may ultimately peel or blister. This is considered the precursor to or the lowest level of frostbite. Re-warm this area with pressure (not rubbing), warm water soak, or, after entering a warm area, blowing warm air on the affected body part.

Chilblains
Typical of long training runs and long running events in the winter, chilblains is identified by skin redness, swelling, pain, and tingling, itching and/or burning sensations. This condition is most often found in the fingers and toes but can be experienced in any superficial tissue. This condition can be severe and, unlike frostbite which can potentially happen in minutes given the right conditions, usually occurs between 1 and 5 hours of cold exposure. Re-warm with heat pads, warm water, pressure, or exposure to a warm indoor environment.

Frost Bite
Superficial: Pale (white, grayish, or blue), hard, waxy skin that is hard to the touch but has soft tissue beneath the frozen and hard superficial tissue. The body part is difficult to move and often has a sensation of burning or tingling. This may produce blisters.
Deep: This requires hospitalization. This presents with cold, hard, numb, pale or blackened skin with unyielding deep tissues that often become swollen. Painful throbbing or burning sensations are typically present and blistering within a few days will often occur. This injury typically involves tissue death. Both of these require re-warming with heating pads, hot water bottles, and hot beverages.

Hypothermia
While a normal core body temperature is approximately 98.6 degrees Fahrenheit, hypothermia occurs as the body’s temperature falls below the normal temperature and becomes severe when core body temperature falls below 95 degrees Fahrenheit. Drowsiness, exhaustion, slurred speech, disorientation and uncontrollable shivering are all signs of hypothermia setting in. The individual may present with dilated pupils, become unconscious and/or experience cardiac issues. Generally, significant shivering, diminished motor control, significant changes in skin coloration, and decreasing mental functioning will be the first of these symptoms to develop. If you or a person you are running with recognizes these symptoms occurring get to a warm area immediately and seek medical attention. Remove any damp or wet clothing and begin warming the persons’ torso first (warming the extremities first can worsen the health of the ill individual) using blankets and towels and cover the head and neck with a warm towel or blanket. Use warm rather than steaming hot methods for re-warming the person and provide warm beverages.

In general, if a cold illness or injury is experienced consulting with a medical professional is advisable. Remove yourself from the cold, windy, and wet environment and find a warm environment to re-warm yourself. If, while running, you begin to feel fatigued and ‘foggy’ cease the activity, find a warm environment, and communicate your difficulties to another person. Assistance from another person can be life saving. Remember that your health and well being are far more important than running “just one more mile.”

Clothing Tips for Winter Running
Running in the winter often comes down to one important factor, appropriate clothing. With preplanning and layering of clothing runners should be able to train outdoors throughout the winter with minimal interruption. Maintaining the appropriate temperature levels within the runners Personal Running Environment (PRE), the area immediately surrounding the runners body, is vital to continuing to run outdoors.

Head and Neck
Hats: Considering the head loses more heat per square inch than any other portion of the body this is an important area to cover during cold weather. Fleece hats and wool hats provide an excellent measure of protection while also easily put into a pocket, tucked inside the waistband, or simply carried in hand if the hat should need to be removed.
Balaclava: Used for particularly cold days, these cover the entire head and face. These generally can be worn as just a hat and are often designed to act like a neck ring/scarf.
Neck ring/Scarf: This provides protection for the runner’s neck, acts as a sealer at the top of the jacket/shirt/other, and can be pulled up to cover the runner’s face providing a ‘filter’ for the cold air to pass through to the mouth.

Torso
The torso temperature and moisture level is controlled best through specific materials and layering. It is important that moisture be moved away from the body while at the same time protecting the body from significant air and wind exposure. The layer closest to the skin should be a wicking material that allows moisture to be pulled away from the body. The outer layer should be wind resistant and water resistant while allowing heat and moisture to escape and maintain a balanced body temperature. Further layering between the base layer and outer layer should again be a wicking material that allows the body to ‘breathe’ moisture while maintaining a level of warmth. Avoid cotton materials because cotton will absorb moisture and will prevent further removal of moisture away from the skin. This can prevent appropriate body temperature regulation and can potentially act like a refrigerator when in cold conditions causing rapid cooling of the body. For every 5 miles per hour of wind-speed, consider adding a layer.

Hands
Gloves and mittens are useful for keeping the hands and fingers warm but mittens allow for a greater use of the body’s heat to keep the fingers warm. Gloves single out each finger away from one another and away from the remainder of the hand. Using mittens allows the fingers to utilize the heat of the other fingers and of the hand similar to five people huddled together versus five people standing alone. Collectively, the warmth of each protects the others.

Legs
Often needing only one layer of protection made of a synthetic material, the addition of a wind-resistant layer may be needed as the temperatures drop. While generally not requiring as much protection as the torso, the general layering system should be used as new layers are needed.

Socks
Once again, a wicking material should be used to remove moisture. Wet feet can lead to general discomfort and a higher probability of cold illnesses. Various thicknesses of socks are available and many companies sell socks that can be layered, similar to the methods used with the torso, while not making the shoe “too full.” Cotton should be avoided as the cotton will absorb the moisture and hold it near the skin rather than dissipating it away from the skin.

Shoes
While trail running shoes can provide a measure of water resistance and shoes with minimal mesh can prevent outside moisture from entering the shoe, it is possible to run during the winter in regular running shoes. Be sure to avoid puddles, slush, and snow or your feel will become wet. With appropriate socks and choosing running routes that avoid moisture laden areas you should be able to run with your standard running shoes. If extra traction is needed, there are a number of companies that make items that slip over your shoes for better ‘grip’ on the ground. Keep in mind that even when wearing grip-enhancing products on your shoes avoid running on ice whenever possible.

Lips
Products such as Chap Stick, Vaseline, or a similar product can be used to help prevent dryness, buffer the effects of the cold, and to protect your lips from the sun.

Hand and Foot Warmers
Hand warmers and foot warmers can be of tremendous use in keeping the hands and feet warm. Sold in a variety of shapes, sizes, and length of heat generation these chemical packs can provide a runner who is out in cold conditions and out for extended runs another means of battling the cold effects to two of the most cold-sensitive aspects of the body, the hands and feet. For some, certain hand warmers can be too warm and experimenting with different brands or styles may be needed.

Skin NOT Covered During Cold Weather Running
As the temperature falls less skin should be exposed to the environment. The skin that is exposed should be monitored for cold related issues and can potentially be covered in Vaseline to provide barrier to the cold and wind or a moisturizer that will help fight skin dryness.

Other Considerations for Winter Training

Visibility
Always keep in mind that the longer hours of darkness, the piles of snow, and the amount of falling snow all will limit the ability of drivers to see you. Just because you can see the car does not mean that the driver of the car can or will see you. Run defensively during these times and do not rely solely on the reflective material and/or lights that you might use. Both reflective material and lights are useful to help make you visible and should be used whenever running in less than ideal conditions but your attentiveness and caution are your greatest ally in avoiding a catastrophe. Whenever possible leave the roads when running as cars approach and always make attempts to have eye contact with the driver to be sure they see you. This is particularly important when crossing streets or crossing driveways where cars may be entering. ALWAYS assume that the drivers cannot see you, make yourself as visible as possible, get eye contact with the driver, and avoid crossing the vehicles path unless they driver has stopped for you.

Hydration
An often overlooked area of winter running is appropriate hydration. Despite the cold temperatures, the body will dispense moisture through breathing and sweating and utilizes energy for both the work at hand as well as regulating the body’s temperature. Regular hydration is needed even during cold weather runs to allow your body to maintain appropriate temperatures, particularly late in longer runs. As the body loses fluids it loses the means to maintain body temperature and muscular control affecting the body’s ability to perform at a healthy optimum state. Cramping, muscle fatigue, and thermoregulatory control problems are not limited only to hot weather. Dehydration affects can occur in cold environments that are just as dramatic as those in hot and humid environments. If you wish to get the most out of your training, remain hydrated in all weather conditions.

Ice
When it comes to ice there is generally one rule: Avoid it. Unless you are planning on donning ice skates and skating across it, ice is simply too unpredictable. There are devices that can be worn on shoes to limit the possibility of slipping on surfaces such as ice but the odds of significant injury that could limit your training or even put an end to your training and race goals increases significantly from a slip on the ice. Whenever possible, detour onto a snowy area or a clear area and avoid the ice. The risks to your race goals and to your health from the dangers of ice are too significant. If the ice is smooth enough there is no material that will guarantee that you will not slip.

Conclusion
Whenever running in the winter always be sure to maintain an overall safe training environment. The dangers of low temperatures, wind, wet conditions, accumulated and falling snow, and slippery surfaces provide unique challenges for the winter runner. With the appropriate preplanning and attentive running, the winter runner should have little difficulty with continuing their training through these conditions safely and largely unimpeded. Enjoy the run!

John McKinley, MS, LAT, is the Manager of Outreach Athletic Training Services for the UW Health Sports Medicine Clinic. He coordinates medical coverage for numerous groups in the area including marathons, cycling events, collegiate sports, youth and high schools sports, and numerous club sports. Choose a topic below for his advice on an array of subjects as they relate to running and your wellbeing.

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UW Health Sports Medicine MultiSport Club - a community of athletes with a common interest in endurance sports such as running, swimming, cycling, cross country skiing, triathlon, duathlon and aquathon.

UW Health Sports Medicine Clinic
The UW Health Sports Medicine Clinic at the UW Sports Medicine Center in Madison, Wisconsin, is led by the team doctors for the Wisconsin Badgers, who are here to serve patients across the region. Our sports medicine fellowship-trained doctors work closely with patients of all ages - kids and teens getting ready for their school sports, older athletes who want to remain on the field - and the rest of the sports medicine team to develop treatment plans that are patient-centered and focus on maximizing participation in sports and recreational activities.