Open/close main nav Menu Menu MYMETRO Collapse + - ER/URGENT CARE
  • Emergency Cross
    Emergency & Urgent Care

    Is this an Emergency?

    In an emergency, seconds count. If you are alarmed by unusually severe symptoms, seek immediate care. Please call 911 if you feel your condition is life threatening. If a poison is involved, please call Grand Rapids Poison Control Center at (800) 222-1222.

    When to go to the Emergency Room When to go to Urgent Care
  • Hospital ER

    Emergency Room Hours:
    24 hours a day, 7 days a week

    • Directions to the ER



      (616) 252-7200

      ER map
  • Urgent Care

    Urgent Care Hours:
    Open 9 am - 9 pm, 7 days a week

    • Directions to Urgent Care

      4055 CASCADE RD SE


      (616) 252-4010

      Urgent Care map
  • Health Articles

    Zones and Thresholds on Hold
    (Remember—Breaks are Important Too!)

    Ed Kornoelje, DO

    Last time I promised information on zones and thresholds. Articles are coming—likely two or three on these topics as there is a little complexity to them. But in the meantime, I am in the midst of a recovery week (see Perio…what? from the newsletter a couple of weeks ago or at under “sports medicine” for more information on breaks and recovery), and I have had the good fortune of doing some hiking with my daughter. Less running this week, and a little more cross training—next week good hard workouts again. This hiking has also left me with a little less time for writing, so the articles are not done. Look for another one next week—I bet you can’t wait!

    If you do need us visit or call 252-7778 or find us at Injury Wise at Gazelle Sports Grand Rapids 6-7:30 PM each Wednesday night.

    Be active!

    Walk Before You Run—And Maybe During as Well

    Ed Kornoelje, DO

    “Walk—don’t run!” Many of you will remember hearing those words when you were trying to move a bit too quickly around a swimming pool. But what does walking have to do with running? Oddly enough there are several situations during a race in which walking may suit you better than running.

    First things first—it is OK to walk during a race. One of the benefits of my line of work is that on occasion I get to run with some of the many running groups around Grand Rapids. Recently I was running with a group when we stopped at water stop. We stood for a few moments getting a drink when some remarked it was too bad races were different in that you could not stop and drink but had to keep running. Someone else chimed in that he was going to practice not stopping to walk so that he was as prepared as possible for the race. I suggested that instead of practicing “not walking,” consider walking during the race, maybe at aid stations. It’s easier to drink while walking, and your heart rate will drop a bit, making you feel fresher when you start running again. In fact, there are several race plans with walking built in (google “Galloway method” to find some). Half marathons and marathons in particular lend themselves to walking—some data suggests those who walk periodically finish with a better time than similarly matched runners who don’t walk, and they feel a lot less beat up at the end. Bottom line: not only is walking OK, it may help you finish with a better time (and feeling better) than if you run the entire race.

    Now that we have that out of the way, what are some other reasons you may consider walking during a race? The March issue of Runner’s World UK has a great article called “Now You’re Walking” touting the benefits of walking (as we discussed above) as well as noting five other situations that lend themselves to walking. The article will go into much more detail, but here is a brief discussion on these situations. (As an aside Runner’s World UK is a great resource, and slightly different than the domestic version. It focuses a little more on training and the science of running—available in Grand Rapids at Barnes & Noble or via subscription).

    1. Your training was below par. Walking the aid stations or at a predetermined interval helps keep finishing a possibility—running 9 minutes then walking for 1 minute often works well.
    2. You can’t hold back. If you tend to go out too fast (not the end of the world in a 5 or 10K, but big problems in a half marathon or longer), use an interval like the one above during the first half of the race to slow yourself down. If you are feeling OK run the second half or continue on with the interval if it seems to be working.
    3. You struggle with midrun eating. Sometimes eating blocks or gels and then drinking causes a lot of sloshing around in your stomach. Consider grabbing your fuel (from the table or belt), running to the end of the station, then slowing to a walk off to the side to ingest your fuel.
    4. Your course ascends. Hills can really take it out of you. During hill training, running hills is a good thing. However, remember how tired you are when you are done? The goal of the race is to finish. Walking hills can keep your heart rate below lactate threshold (more on that next time), keeping you (and your legs) fresher during the race.
    5. It’s sweltering. If you’re like me a little warm weather right about now would be a welcome thing. But we all know it’s coming, and during summer races your body temperature can really go up causing more blood to be used for cooling, and less going to the GI system, another potential cause of GI upset. Use the shady spots to “fuel and cool” by walking, fueling, and using cool water or a cool rag or sponge on your neck.

    To recap: whether or not you “run” the entire race distance has nothing to do with anything. You do NOT need to run the entire race distance in order for it to count. Walking may actually help you get there faster than running the entire distance. There are several specific situations that lend themselves to walking—I am a big proponent of walking and fueling at some to all of the aid stations. So, use walking to help you get across that finish line by any (legal!) means possible.

    Next time we’ll begin to look at zones and thresholds and what they mean for training and racing.

    Metro Health-University of Michigan Health Sports Medicine now has 10(!) Primary Care Sports Medicine Physicians all over West Michigan. We are by far the largest group in the area, and one of the largest in the country. Being trained in family practice as well as sports medicine means we can treat any and all medical issues, take care of injuries, and serve as your primary care physician. For a list of physicians, services, and locations (and all of these articles) check us out at and search “sports medicine.” We are also continuing our weekly InjuryWise clinic at Gazelle Sports in Grand Rapids every Wednesday from 6-7:30 PM. Open to athletes of all sports and ages it is an opportunity to get some info on injuries and training, and to see if an appointment with one of the sports med docs may be necessary.

    Be active!


    Ed Kornoelje, DO

    What inspires you? Not just related to running (or walking), but for all things life? I’m watching the Oscars tonight—there are a lot of good movies around right now—and whether you are a movie person or not, these movies started with someone having a stroke of inspiration. Sometimes the outcomes are quite spectacular, other times not so much, and often which is which is in the eye of the beholder.

    Running (and being active) is spurred by inspiration as well. What gets you off the couch, or making a jump from 5K to 10K (or 26.2 to 50K)? Whatever change you are attempting to make (even if it is still “gotta get off this couch”) does not really matter—what matters is what gets you going. Internal competition, external competition, health improvement, and running for a cause are just a few.

    In upcoming editions of “Marathon News from Grand Rapids” we will look at items that inspire us to be active, training tips, health related information, and other concepts that advance the cause of active individuals everywhere. If you have read these articles here and elsewhere in the past—thanks! Hopefully you found them insightful and will again going forward. If you enjoy what you read let someone know. And if you don’t, let someone know anyway—they just might! The Metro Health Grand Rapids Marathon is still several months away, but it’s never too soon to be inspired!

    Be active!

  • Slow Gets It Done—Over and Over Again

    Ed Kornoelje, DO

    In running there are several (perhaps many) things we do over and over again. The act of running is probably the most obvious (left-right-left-right…), but we often do the same races over and over again, eat the same pre-race meal over and…you get the point. This repetition serves a purpose—we find out what works and stick with it. Running science can be the same way. We look for concepts that seem to hold true over time, and work on ways to refine the information so that we are using the info to its fullest. One of the truisms that keeps popping up is “in order to run fast, you need to train slow.”

    This may sound odd at first. A more complete way to put it may be as follows: most of your training should be rather slow or quite fast—stay away from the middle. In previous articles I have described staying away from the “black hole”—the comfortable middle running zone (I’ll describe zones below). In a recent article titled “It’s Okay to Run Slow… Really” from Trail Runner magazine, David Roche describes “two pillars of endurance training—polarization and periodization.” Polarization refers to the easy OR hard running that should be done, staying away from the “grey-area” moderate zone. And, when I look back at the running literature and tips I have received from seasoned runners over the years, this is a theme that pops up (you guessed it) over and over again! (We’ll look at the other pillar periodization in the next newsletter).

    To get started here is a little info about running zones. There are whole books on zones (I should know—I have a number of them), so this will be a VERY brief explanation. There are typically three to five zones. The lower zone or two are typically reserved for recovery runs and long runs, the upper zone or two for speed work, and the middle one for “tempo” efforts. It is important to train in ALL zones, but when the low zone runs are performed at the relatively comfortable tempo pace there can be issues.

    Although tempo pace is comfortable, spending too much time at this pace and faster causes injury rates go up, and we miss out on some training benefits that occur at slower paces. The goal pace would be about 1.5 to 2 minutes per mile slower than marathon pace. As noted in the article above, running at this pace (or even slower) allows several training benefits occur. First, slow running facilitates angiogenesis, the process of capillary growth. The more capillaries there are the better—these small vessels transport oxygen and nutrients to muscle and remove waste products. Second, easy running increases the number of slow-twitch muscles fibers, the type used in endurance events. Third, easy running days allows the hard days to be more effective while decreasing the likelihood of injuries. Moderate to fast running produces more of the stress hormone cortisol “which can contribute to injury and slow down aerobic adaptations.” Just as with weigh training the body needs a day or two to recover between hard workouts, and this recovery day needs to be slow.

    Hopefully this all makes sense. Slow runs need to be slow, and, as in life, variety in running is a good thing. Not all running need be slow, nor should it all be fast. Spending some time in the “comfort zone” is OK, but not too much (we’ll look more at how much time should be spent in a given zone in an upcoming newsletter).

    Next time we’ll explore the concept of periodization. In the meantime stay safe! Metro Health-University of Michigan Health Sports Medicine now has 10! Primary Care Sports Medicine Physicians all over West Michigan. We are by far the largest group in the area, and one of the largest in the country. Being trained in family practice as well as sports medicine means we can treat any and all medical issues, take care of injuries, and serve as your primary care physician. For a list of physicians, services, and locations check us out at and search “sports medicine.” We are also continuing our weekly InjuryWise clinic at Gazelle Sports in Grand Rapids every Wednesday from 6-7:30 PM. Open to athletes of all sports and ages it is an opportunity to get some info on injuries and training, and to see if an appointment with one of the sports med docs may be necessary.

    Be active!


    Ed Kornoelje, DO

    Now that we are all running a little slower (at least part of the time), let’s turn to the other important concept we identified last week: Periodization. This topic can be a bit confusing, but there are several principles I will highlight to help you run and train better. (As a reminder polarization was the other concept—see last week’s newsletter or for that article).

    How is periodization defined? Owen Anderson, PhD in Running Science states “Complicated definitions of periodization exist, but the term simply means the division of an overall training program into periods that accomplish specific goals. Since everything cannot be accomplished at once, training must be periodized into discreetly different units of time.” In its most basic form many training programs (including the River Bank Run or Metro Health Grand Rapids Marathon training schedules) utilize a form of periodization by increasing weekly mileage. By gradually increasing the load on the body, adaptation will occur to allow a person to run longer distances.

    Taking the concept a little further, Hans Selye (an endocrinologist who lived in the mid 20th century) “was the first scientist to describe how stressing our physiologic systems would result in adaptations that are specific to those stresses” (Running Times Jan/Feb 2014). This article (“Schedule a Breakthrough” by Jonathan Dugas) notes that Selye described a continuum of reaction to stress: no stress/no adaptation on one end, too much stress/failure of the system (injury) on the other, and in the middle enough stress to stimulate physiologic change. “Periodization applies these concepts of stress, adaptation and specificity in a systematic way—using different time periods. . .to accumulate a larger sum of adaptations than you could by working all areas of running fitness simultaneously.” (The article and book referenced above are excellent sources of information—take a look at these for a much deeper explanation of periodization and how it can be utilized).

    So what does this mean for you? First, find and follow a reputable training program. Whatever program you follow will likely have some periodization principles built in. Second, REST is a key component of periodization. Both between training cycles (which we did not discuss here—read the article!) and during, schedule breaks or periodic weeks of lower mileage to allow repair to the system. As Dugas notes “Too many runners never schedule downtime in their annual or monthly plan because they are too tied to weekly mileage totals.” Keep this in mind as you follow your plan—even if your plan schedules a lower mileage week every 3-4 weeks, at times you may need to schedule an easier week than noted in your particular training schedule (lower mileage and intensity) if you are feeling tired or run-down (over-trained). Finally, for those of you who run multiple events during the year, consider mapping out a yearly periodization program and watch your performance improve.

    So, remember to vary the pace of your training runs and keep some slow (polarization), and to make sure every 3-4 weeks your weekly mileage is down by about 25% (periodization) to improve your running and decrease your risk of injury. In the future we’ll look at how to put these together in a variety of ways to create a training plan that works for you. Next week: when is it OK (and even desirable) to WALK during a race (and yes—walking during a race is just fine).

    If you (or your child) are injured we have locations with sports med doctors all over town—check us out at for more information. We are also seeing patients at the Metro Health Sports Medicine Center inside the Spartan Stores YMCA at the Metro Health Village. Call 252-SPRT (7778) for more information or to schedule an appointment. And don’t forget about Injury Wise at Gazelle Sports Grand Rapids every Wednesday night from 6-8 PM. These are brief one on one sessions open to active individuals of all ages and sports. Contact Gazelle for more information.

    Be active!