Saturday, February 27, 2010

How Do You Measure Success for 2010?



Some triathletes overcome greater obstacles than many."



I've seen a number of criticisms directed at the print media of our sport lately. Probably pretty easy to do from the outside. The two most common seem to center around glitz, an abundance of adds loosely connected by a few articles, and second, an inability/unwillingness to be critical of say WTC or USAT in defense of the little guy. (A $550 entry fee for a triathlon as one example.) There are even efforts afoot by H3 Publications to present a different Tri publication, seemingly more difficult than perhaps first thought. Whatever your position, as the consumer you have the right to evaluate information and apply it as seems appropriate to your sporting life.

If you haven't seen Mitch Thrower's opening piece in the March issue of Triathlete, you should. He makes a number of excellent points regarding the well worn phrase, "We are what we eat," and the role our current understanding of genetics plays. This relates not only to our bodies ability to process what we take in, but what we become and our control over this outcome. He goes on to show that lifestyle choices can make a significant contribution to the overall end game when combining genetic predisposition along with dietary and exercise choices. Although to some degree your athletic potential is preprogrammed, you are still Captain of the ship!.

Mitch puts you in control to some degree. I had a patient some time back that I used as an example while teaching a course in St. Louis last month to a group of very bright triathlon coaches. This particular young man was being prepared for a knee reconstruction and on his intake form he noted his weight at 380 lbs. When I saw him a couple weeks later for his preop physical, he mentioned erring on his weight which was really 420. An accurate weight is essential in the operating room as, for example, medication quantity is in direct proportion to patient size...and I doubt one would like to wake up unexpectedly having been given too little of a certain drug!

Since the Day Surgery scale, like many of those at home, isn't reliable over 330 lbs, the nurses sent him down to the laundry for an accurate weight where the scale goes to 1000 lbs. And he needed it. His ultimate weight was measured at 550 lbs. In other words, his initially reported value of 380 was 170 lbs. less than actual, something he and I discussed at length after surgery. He admitted that he'd basically lost control of both diet and exercise and anything over 330 was simply a guess. Not a good guess but a guess none the less.

He did well post op, had a stable knee, and the last time I saw him was headed below 500. This is not easy in the rehab period but he'd defined the problem and begun to take back control of his life. I hope he's had continued success. As triathletes, we already have the exercise part of the equation down. We now understand there's a significant genetic component in play here, but we are also being given some bit of control knowing that our own destiny is more than putting bike miles in a training log. Can success as you define it be far off?

Sunday, February 21, 2010

What is the Value of an Experienced Bike Fit? It's Invaluable!


John Cobb counsels a novice triathlete at Glen Ellyn, IL bike fit.

As a surgeon, I think I learned as much from doing my 1,000th, or 10,000th knee arthroscopy as I did from my 100th. When you do something over and over and over again your learning never stops. Bike fitting is no different.

I would speculate that many of you have had a professional bike fit...or two...or three...or...? Personally, I had a noted east coast coach fit me ten years ago. About 4 years later flew with my bike to the west coast to be evaluated with the IR cameras by "the pros." These two fits were quite different from each other. Lots of computers, measurements, images, etc. during the second fit. But, I was never really comfortable, faster maybe, more aerodynamic maybe, but not more comfortable, particularly the seat. (I even had xrays taken of my pelvis.)

That is, until I met John Cobb...who just talked to me. And then we talked some more, before coming anywhere near the bike. It was very similar to the doctor patient interaction where, if the doctor actually listens to the patient, something I must admit that I don't always do as well as I should, the patient will tell you the diagnosis.

We then spent the better part of an hour, first taking the rear end apart and putting it back together. Then the same with the bars and front end, changing bit by bit, until I was simply pedalling for 15-20 minutes talking about the old days of triathlon with John...and I realized it didn't hurt. Hallelujah! My time at Rich Ducar's The Bike Shop in Glen Ellyn was worth the 750 mile drive.

I know that we haven't reached the end point yet but it's nice to have a road map for the future. The take home point here is that our sport is many things to many people but foremost it should be enjoyable. We don't all need to do the Ironman or Race Across America, but if we enjoy the time we do spend training and racing, we'll benefit from it in ways we have yet to imagine.

Sunday, February 14, 2010

Should Triathletes Give Blood?



"For every complex problem, there is an uncomplicated answer; neat, simple and wrong." H.L. Menken

HuliSue's is a terrific barbecue place in Kamuela, HI if you find yourself north of Kona some day. If you ordered a beef sandwich, you'd get plenty of iron to help make red blood cells. Ah, but then what do you do with those red cells? Keep 'em? Donate a few to someone who might really need them?

Well, I'm prejudiced. I recently donated my 99th unit of blood to Virginia Blood Services. If you realize that when a "pint" comes out of your veins, only about a third of it is blood cells, the other two thirds being plasma. The fluid portion will be replaced in a couple hours but it will take the bone marrow 3 or more weeks to restore the RBC's. Each person's reaction is different, and changes from donation to donation. One may have to reduce the intensity of work outs for a short time, and probably would cease donations a month to 6 weeks before an important race, or the racing season in general. That said, platelet need is always in season, requires no loss of red cells (or oxygen carrying capacity), and can be done virtually any time in the year.

There are lots of reasons not to give blood...a needle stick, a few days of non-maximal training, rumors from the uninformed, etc. But, there's never an over abundance of blood, it's needed for patients getting dialysis, heart surgery, cancer and trauma victims, etc. Heck, Lance might have even needed a transfusion following his orchiectomy and subsequent chemo.

Lastly, who among you hasn't had a bike crash? One day, the need might be yours.

Monday, February 8, 2010

Training Advice From Heaven

ALII DRIVE, start and finish of the Ironman World Championship. You can bet this snowy picture wasn't taken in Kona!

Dick Tomlin was a friend. A super triathlete, he podiumed twice in Kona and even won Worlds one year. He was killed on his bike in June 2005 when he was the victim of a hit and run by a motor home while training near his Kingman, AZ home.

The last time I talked to him was in February or March of that year when he was trying to help me get faster and I was trying to help him with some pain control issues he was having with arthritis in his lumbar spine.

The following is going to be a little disjointed, just like a phone call, where we talked about whatever came to mind. Even though Dick is no longer with us, you'll see that he has a number of important training points to make: he credited his age group best bike speed to consistency, lots of winter miles indoors, abundant one-legged drills. He would decrease the resistance and do 100 revs with the right leg and then the left. Repeat this 6 times, "like wiping your feet on the floor mat." Learn how to cycle with each of your legs."

For short course tri preparation, he'd ride "really hard sprints." He'd set up a one mile course near his home where he'd ride faster than race pace and, "Do a dozen with 15-20 seconds rest in between." He didn't do much hill work as "The races I do don't have 'em." Although he usually rode alone, he had one friend, a CAT cyclist, who he'd been riding with for 12 years allowing, "Those guys know so much, it really pushes me up." Weights were important as he'd follow Joe Friel's Training Bible, "Except the max weights," 3X's/wk in the winter and once/wk in season. An average training week would include 110-120 miles on the bike, 25-30 miles running and 8-9,000 yds in the pool, he'd "Work up to double this for Ironman." This would be "22 hours/week in late July and hold it to September." He wanted 8 consecutive weeks over 250 on the bike and 50 on the run, reserving one weekend day for a 5 hour bike and a 2-2.5 hour run. Or, for variety, it would be a 2hour bike and 3 hour run. Clearly he was motivated.

But, Dick was not without pain as he'd had both knees scoped in 1998 noting, "I'd run in pain for a decade." He took his share of Glucosamine. Plantar faciitis was a continuing issue. And I already mentioned his back. But he did not shy away from what he perceived as the work required to be tops in the age group.

And he was a nice guy.



Training a bit of a problem on your street, too?

Monday, February 1, 2010

Self Induced Injury, Tibia Fracture


I have given a name to my pain, it is Batman." Jack Nicholson as
The Joker

And speaking of pain, I was recently asked asked about a blog I did on stress fractures a little while back and thought the following important as we set our training plans for the upcoming season. Although our weather forecast here in Virginia calls for 6 - 12" of snow tonight, athletes everywhere are creating training plans to fit race schedules this Spring and Summer.

So many athlete's questions involve self-induced injury! Time and again when a triathlete reports a physical issue, and then comes up with an, "I know when I did it" type of answer, I think about prevention. Any list of the most common overuse injuries in runners would include : 1) Patellofemoral pain (21%), 2) ITB friction syndrome (11%), 3) Plantar faciitis (10%), 4) Meniscal injuries (6%), 5) Shin splints (6%), 6) Patellar tendinitis (6%), 7) Achilles tendinitis (6%), 8) Gluteus medius injuries (4%), 9) Tibia stress fractures (4%), 10) Spine injuries (3%) as noted recently.

In one medical study, 6 young men presented with midshaft tibia stress fractures which failed to heal with the usual conservative care of rest, immobilization, etc. and 5 went on to complete fractures!! Think having a rod place down the middle of your tibia might alter your training?

We also think of the metatarsal bones in the foot as commonly seen sites of stress fractures but I was taught that they've actually been reported in all 26 bones in the foot and the sesamoids.

The take away lesson here is that none of us is immune. Running programs which ramp up more quickly than the athletes body can take can be hazardous to ones health, and that when weather or life get in the way of training, the better choice might be to just forget a work out or two rather than accept overload at a later date. Each of us is different as we define overload so just because a training partner can work at a certain level does not necessarily mean we can. If we just think before we make choices and listen to what our legs are telling us, we reduce the potential for self induced injury. And, we're more likely to kick butt in that first tri. Good luck.