Dear Running Doc:
After this weekend’s Manhattan Half Marathon my nipples bled, I’m in pain still, and my favorite T-shirt needs cleaning. I can’t keep doing this. Please help me! Will this cause permanent damage?
– Raymond G., Port Washington, NY
Raymond: Oh, do we all feel your pain. In fact, the most common spectator comment at finish lines is, “Wow, that must hurt!” We all know it does. The good news is this is easily prevented, especially in men who may not be protecting this sensitive area properly.
Nipple bleeding is a direct result of chafing from the direct effects of rubbing against clothing, sweat, and salt. Nipples first become irritated and tender, then open wounds develop with bleeding. The raw skin and salt from sweat in these open wounds irritating a significant nerve supply are not comfortable in the least and take days to heal. Sscar tissue may develop from healing and re-healing that will eventually make your nipples less sensitive.
Fortunately, prevention is easy: Dress properly. Wear softer, looser shirts; avoid a new, unwashed shirt. Switch from cotton to a synthetic sweat-wicking fabric as the base layer next to the skin.
If the weather is warm enough, men can go topless; I know on cold weekends, this is unrealistic. Please remember on warmer days when you do go shirtless to use a sun block. Use a product that is waterproof so that your sweat doesn’t wash it away. Don’t fear not sweating since your other areas without the sun block are enough to allow your sweat mechanism to work properly.
Hydrate properly. We do not want you to run out of fluid – you need it to sweat. Without proper fluid, the sweat will dry up, leaving salt flakes that irritate. Do not drink too much or too little; use thirst as a guide. And check your urine. You want yours to look like lemonade; if it’s clear, you are drinking too much; if it looks like iced tea, you are drinking too little.
Lube up (and/or cover up). Vaseline, Bodyglide, Band-Aids, and “nipguard” products all offer good prevention against rubbing.
Remove any nipple jewelry. Seems like a no-brainer, but I have seen participants who haven’t relaized that their fashion statement was the cause of their problem. An easy pre-workout removal saves days of discomfort.
A short note to women smiling as they read this: You are not immune to nipple bleeding. Improper or poorly fitting sports bras are the cause. Avoid cotton, which keeps moisture in so that the soggy bra shifts back and forth; switch to a synthetic sweat-wicking fabric that pulls moisture away from the skin. And make sure your bra fits snugly, both in the band around your chest and the cup. If it’s loose and moves, chances are it will cause chafing.
As a physician, I would be remiss if I didn’t mention that if your nipples are bleeding and you are not chafing, that is a time to see your doctor as something more serious may be going on. If you are chafing, following the above advice should alleviate this problem forever.
***
Lewis G. Maharam, better known as Running DocTM, is the author of “Running Doc’s Guide to Healthy Running.” He is the past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series and is thes medical director of the Leukemia & Lymphoma Society’s Team in Training program. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
Want your question answered in this column? Write to running doc@nydailynews.com or put your question in the comments section below.
