Ask the Coaches: Blood In Urine

Q: Tests have shown that there is blood in my urine. Can running cause this, and is it serious?

A: According to Dr. Cathy Fiesler, numerous factors may cause hematuria (blood in the urine). A stone could be somewhere in the urinary tract. Infections (bladder or kidney) may cause hematuria. Tumors can cause bleeding—either gross or microscopic. 

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Now, for what you want to hear—running can cause hematuria. There are a few theories on why this occurs—irritation of the bladder, a phenomena known as bladder slap, and others. Although reported more frequently in men, it is not uncommon in women. Hematuria tends to occur during or after long runs (marathon plus) and following hard workouts. Use of aspirin or anti-inflammatory medications may exacerbate this problem, as does dehydration.

One other thing to consider is myoglobinuria, which causes the blood portion of a urine test strip to light up abnormally, but if the urine is examined microscopically, there are no red cells visible. Myoglobin is a product of muscle breakdown, seen commonly following long races, but could occur if your are dehydrated prior to the workout.

What I would do... Make sure you stay well hydrated. Take a plain x-ray if you have a history of stones. Retest after a day off from training. If you develop any abdominal pain or have recurrent hematuria, then seek further evaluation.

     --Coach Benson

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