Hematuria Blues

There were several races last weekend I was contemplating running. The Cornwall 5K is a local race just minutes from my house. The Polar Bear 5K run in Dillsburg is held by the Northern High school XC team. Also, the Thon 5K with over 4,000 participants was held in State College, PA. I opted to train this weekend for the York White Rose five mile run next weekend.

Coming off the heels of my excellent training runs of recent I decided to test my mettle on a ten mile training run this past Saturday. The weather was excellent, partly sunny with a slight wind, and temperatures in the upper 50's.

On the whole I felt pretty good for the run. I average a nine minute per mile pace for the first five miles and a 9:30 pace for the last five miles. My standard fare for long runs is to carry a 20 ounce Nathan Sports bottled filled with Gatorade.

I was not sure how my kidneys would respond to a run of this length. In the past I suffered from severe hydration issues - which I had hoped to rectify by drinking fluids during long runs.

Much to my dismay I had blood in my urine (hematuria) for hours after this run. From a hydration standpoint I was fine - the color had not darkened due to dehydration. As much as I would like to train for a half marathon or even a marathon next year I have to listen to what my body is telling me.  I have to do research why I would have this problem.  This issue did clear the next day, Sunday. (after drinking cups upon cups of water all Saturday evening)

excerpted from Sports Doctor.com

Blood in the urine (hematuria) has been recognized in athletes since the 1700s. It is most common in runners, but has been reported in sports as diverse as field hockey, cross-country skiing, boxing, and bicycling.
Studies have shown that anywhere from 20 to 90 percent of marathoners will have some blood in the urine after a race. The blood can either be visible (gross hematuria) or invisible (microscopic hematuria). Microscopic hematuria is by far the more common type, appearing equally in men and women. Gross hematuria is more common in men.
If the hematuria is exercise related, it usually clears up within two or three days after abstaining from exercise. Most often the blood comes from the bladder. The jarring of an empty bladder during running causes bruises and bleeding from the bladder wall.
The bleeding is occasionally accompanied by lower abdominal pain and the passage of clots of blood in the urine. Bicyclists can also experience hematuria from the impact of the bicycle seat during bumpy rides.
Sometimes the blood can come from the kidney. While the exact mechanism is not known, shunting of blood away from the kidney during intense exercise is thought to cause a temporary, reversible leak of blood cells. Dehydration will worsen the shunting and also the bleeding. If the dehydration is severe enough, serious damage to the kidney can occur.
Most cases of exercise-associated hematuria do not cause permanent damage. Because it is a diagnosis of exclusion, doctors often order a medical evaluation if the bleeding does not resolve itself within two to three days after stopping exercise. Bladder infections, kidney stones, cancer of the bladder or kidney, or other kidney diseases are some of the problems that need to be excluded by tests such as cystoscopy and an x-ray or scan of the kidneys.
In your case, I am very suspicious that "running on empty" is the cause of your problem. Try drinking plenty of liquids the night before a run. Have your physician run a urinalysis after a well-hydrated run. If the hematuria persists, you may require a full work-up.