Thursday, November 29, 2012

Will Running/Endurance Athletics Wear Out Your Heart?













                                       All smiles in T-2.


 


A soon to be published study says that it may.  The 11/27/ 2012 Wall Street Journal  includes:  "New Studies on Older Endurance Athletes Suggest the Fittest Reap Few Health Benefits."



 According to the British Journal Heart, "Running too fast, too far and for too many years may speed one's progress toward the finish line of life."  They quote a large study where over 50,000 people were followed for 30 years and while as anticipated, runners had almost a 1/5 lower death rate over the non running population, those who ran greater than 25 miles/week gave back that mortality advantage.  Also, in the British editorial was the claim that the mortality advantage was also yielded by those who ran faster than 7:30/mile.








However, a single editorial/group of studies does not convince everyone.  Quoted as taking the opposite side to this opinion was Sports Cardiologist Paul Thompson of the Hartford Hospital. "The guys advancing the hypothesis that you can get too much exercise are manipulating the data."  Dr. Thompson is an elite marathoner who feels, "They have an agenda."




You've heard the phrase "Lies, damned lies, and statistics" before.  Although this information is contradictory to what we've all grown up with, time will tell.  We'll need to see the article when it is published to see if they met the criteria needed for validity:








1) number to treat




2) what variables they controlled for




3) how many are in the >40 age group, >50 age group, etc.


 4) what didn't get included, etc.




In other words, they may have drawn conclusions rather than "proved" that there was a real connection.




So, for now, I don't plan to change anything I do or think.  I plan to let science do the vetting for me.  Stay tuned.




______________________________________________________________


 Night time finisher in Hawaii.









 





Wednesday, November 28, 2012

Will Running/Endurance Athletics Wear Out Your Heart?


All smiles in T-2.


A soon to be published study says that it may.  The 11/27/ 2012 Wall Street Journal  includes:  "New Studies on Older Endurance Athletes Suggest the Fittest Reap Few Health Benefits."
 
According to the British Journal Heart, "Running too fast, too far and for too many years may speed one's progress toward the finish line of life."  They quote a large study where over 50,000 people were followed for 30 years and while as anticipated, runners had almost a 1/5 lower death rate over the non running population, those who ran greater than 25 miles/week gave back that mortality advantage.  Also, in the British editorial was the claim that the mortality advantage was also yielded by those who ran faster than 7:30/mile.

However, a single editorial/group of studies does not convince everyone.  Quoted as taking the opposite side to this opinion was Sports Cardiologist Paul Thompson of the Hartford Hospital. "The guys advancing the hypothesis that you can get too much exercise are manipulating the data."  Dr. Thompson is an elite marathoner who feels, "They have an agenda."

You've heard the phrase "Lies, damned lies, and statistics" before.  Although this information is contradictory to what we've all grown up with, time will tell.  We'll need to see the article when it is published to see if they met the criteria needed for validity:

1) number to treat
2) what variables they controlled for
3) how many are in the >40 age group, >50 age group, etc.
4) what didn't get included, etc.

In other words, they may have drawn conclusions rather than "proved" that there was a real connection.

So, for now, I don't plan to change anything I do or think.  I plan to let science do the vetting for me.  Stay tuned.
______________________________________________

Night time finisher in Hawaii.





Monday, November 26, 2012

Kinesio Tape, Worthless or Worthwhile?

"Don't call for your surgeon, even he says it's late.  It's not your lungs this time but your heart holds your fate."      Bruce Springsteen, For You


 


Kinesiology Tape reportedly:


1)  Supports muscle


2)  Removes congestion to the flow of bodily fluids


3)  Activates the endogenous anesthesia system


4)  Corrects joint problems


5)  Reduces muscle fatigue


6)  Reduces delayed-onset muscle soreness


7)  Enhances healing by reducing edema


8)  Increases blood flow


9)  Aligns fascial tissues


 Say What?  (How about makes your mortgage payment and tips the waitress?)


 



 


I've been intrigued by the array of tape colors and applications for a long time.  Taping has gotten pretty wide exposure but I'm having trouble understanding the claimed physiology behind these claims. "Lifts the skin," supports muscles and joints," just doesn't seem to add up in my book.  I admit that having so many attributes aligned with a single product can be confusing, at least to me anyway.


 The product originated in Japan in the 1970's by Kenso Kaze, an acupuncturist/chiropractor.  The pieces are cotton based and possess a heat-activated adhesive.  Anecdotally, trainers and athletes have seen success although some describe it as, "Hit and miss."  Unfortunately, there's not a great deal in the medical literature to support it's use. Many of the claims seem to be manufacturer-based.  (Where have we heard that before?)  One study from 2008 evaluating the tape's use in athletes with shoulder pain did show immediate improvement with the use of kinesio tape over a sham. But by day 6, "Both the tape group and the sham group had significantly improved in all outcome variables."  The authors concluded, "Utilization of Kinesio tape for decreasing pain intensity or disability for younger patients with suspected shoulder tendinitis/impingement is not supported."  



 Quoting AAOS Now senior science writer Terry Stanton, "Other reliable studies find little evidence to support using the tape, although some small investigations reported some positive results......overall, 'the efficacy of Kinesio tape in pain relief was trivial given there were no clinically important results.'"  




 




 















Kona pier, 2010




 




 No study has reported negative results. I think that's an important statement.  The best explanation is that the mechanism is one of placebo.  That said, some would use it even if it only acts as a placebo.  There's no harm in giving it a try and if the athlete improves so be it.  S. Terry Canale, MD of the American Academy Of Orthopedic Surgeons sums it up this way:




 1)  Kinesio taping has some benefit in 40 percent to 60 percent of users: probably works best as a placebo.




2)  It works best in the shoulder, forearm and quadriceps as an adjunct to PT rehabilitation.




3)  More definitive studies need to be done to see if any objective evidence supports it's use.




 So, since we've previously established that triathletes are, in marketing terms, early adopters, willing to try the new and different even if it's unproven, we'll continue to see neon taped athletes from time to time. Whether or not it works remains to be seen.  And, other than the out of pocket expense, there doesn't seem to be any harm.




Sunday, November 25, 2012

Kinesio Tape, Worthless or Worthwhile



"Don't call for your surgeon, even he says it's late.  It's not your lungs this time but your heart holds your fate."      Bruce Springsteen, For You

Kinesiology Tape reportedly:

1)  Supports muscle
2)  Removes congestion to the flow of bodily fluids
3)  Activates the endogenous anesthesia system
4)  Corrects joint problems
5)  Reduces muscle fatigue
6)  Reduces delayed-onset muscle soreness
7)  Enhances healing by reducing edema
8)  Increases blood flow
9)  Aligns fascial tissues

Say What?  (How about makes your mortgage payment and tips the waitress?)




I've been intrigued by the array of tape colors and applications for a long time.  Taping has gotten pretty wide exposure but I'm having trouble understanding the claimed physiology behind these claims. "Lifts the skin," supports muscles and joints," just doesn't seem to add up in my book.  I admit that having so many attributes aligned with a single product can be confusing, at least to me anyway.

The product originated in Japan in the 1970's by Kenso Kaze, an acupuncturist/chiropractor.  The pieces are cotton based and possess a heat-activated adhesive.  Anecdotally, trainers and athletes have seen success although some describe it as, "Hit and miss."  Unfortunately, there's not a great deal in the medical literature to support it's use. Many of the claims seem to be manufacturer-based.  (Where have we heard that before?)  One study from 2008 evaluating the tape's use in athletes with shoulder pain did show immediate improvement with the use of kinesio tape over a sham. But by day 6, "Both the tape group and the sham group had significantly improved in all outcome variables."  The authors concluded, "Utilization of Kinesio tape for decreasing pain intensity or disability for younger patients with suspected shoulder tendinitis/impingement is not supported."  

Quoting AAOS Now senior science writer Terry Stanton, "Other reliable studies find little evidence to support using the tape, although some small investigations reported some positive results......overall, 'the efficacy of Kinesio tape in pain relief was trivial given there were no clinically important results.'"  


Kona pier, 2010


No study has reported negative results. I think that's an important statement.  The best explanation is that the mechanism is one of placebo.  That said, some would use it even if it only acts as a placebo.  There's no harm in giving it a try and if the athlete improves so be it.  S. Terry Canale, MD of the American Academy Of Orthopedic Surgeons sums it up this way:

1)  Kinesio taping has some benefit in 40 percent to 60 percent of users: probably works best as a placebo.
2)  It works best in the shoulder, forearm and quadriceps as an adjunct to PT rehabilitation.
3)  More definitive studies need to be done to see if any objective evidence supports it's use.

So, since we've previously established that triathletes are, in marketing terms, early adopters, willing to try the new and different even if it's unproven, we'll continue to see neon taped athletes from time to time. Whether or not it works remains to be seen.  And, other than the out of pocket expense, there doesn't seem to be any harm.

Thursday, November 22, 2012

Sleep, It Helps More Than You Give it Credit

"Who cares about sleep when you can do it in school?"
                                                    Corny Collins, Hairspray


 

Matt Fitzgerald  -  I've steered you to his writing/philosophy before but let me do it again. I've never met him, but I'd like to one day. I'm not related and we're not in any business deals that I'm aware.  But I own at least 3 of his books.  His writing style is relaxed, knowledgeable and rarely intentionally inflammatory.  But it's always well researched and accurate.

I wanted to focus on sleep this time.

Matt's opening quote in the Complete Triathlon Book: "You can do more than you might think to prevent general fatigue - a great epidemic in our society to which triathletes are especially susceptible..."

More in a minute.
_________________________________________________________________________________

Today is Thanksgiving and the local Turkey Trot goes right by our house.  I think there are about 3,000 runners, walkers and strollers. It's really a fun group with many in costume.  We're almost at the two mile mark of this 5K event and I make it a point to set up my own "aid station" with, well of course, what else would your body cry out for after running this distance on Thanksgiving morning, preparing as it is for the onslaught of food?  That's right, Bloody Mary's.  The competitors reactions have been quite predictable from the, "What, are you kidding me?" to "Alright, you the man!"  Most, however, just wave.  I usually run out.  Life is good - and you can quote me on that.

My in laws live in the Chicago suburbs and we'll spend Thanksgiving there occasionally.  A couple of years ago, the local Turkey Trot course came very near their home.  It was also a 5K race on the local streets. However, sometime later in the day, someone not connected with the event noted "an unidentified white powdery substance" on the ground!  The authorities went ape.  The area was cordoned off, 100 on/off duty police and fire fighters were mobilized to protect the good citizens from what was eventually determined to be.... soccer field lime from the mornings Trot.  Ha!
_________________________________________________________________________________
Sleep

Triathletes are used to squeezing more into a day than most folks.  When given the choice between lunch with the gang or shoehorning in a 5 mile run, the run almost always gets the nod.  At the end of the day when much needed rest is in order, frequently everything's not checked off the list yet. And sleep gets short changed.  Hey, it always worked in college right?

But we're not in college anymore.  And it's not academics on the plate, it's physical effort placed on a body that oftentimes is still a tad beaten down from yesterday's work outs.  Or beaten down from that half marathon last Saturday. Repeating Fitzgerald's quote, "You can do more than you might think to prevent general fatigue - a great epidemic in our society to which triathletes are especially susceptible..."

It's pretty obvious that many younger athletes can live this way and still perform at a very high level.  We all know someone who can party till 3, get close to no sleep overnight, and still toe the line at 7:30 am for the local 5K expecting to perform at a high level. And do it.  Aging athletes just can't.  And by aging I don't just mean the Medicare crowd.  This means you Ms. Forty-seven year old.  Recovery is not a four letter word but one in which adequate rest/sleep is essential.  As one gets deeper in to the training year, and the intensity of training increases, the body simply must have regular sleep to combat the accumulating physical stress.  It's during this sleep that the body releases testosterone.  This hormone has gotten more than it's share of press recently but it's certainly important.

So, particularly as we get older, we need to be careful not to compromise sleep (yes, I know it's easy to say and harder to do. And, yes, I'm as guilty as the next athlete of occasionally cutting this corner.) It's one of the few things in triathlon that doesn't cost more money, right? So, while you're contemplating that turkey with sleep inducing agents of it's own like L-tryptophan, take just a minute to think how this sleep recommendation can fit into your lifestyle.  Sweet dreams. You'll be a winner if you do.
__________________________________________________________________________

This is the lobby of the King Kamehameha Hotel, the headquarters hotel in Hawaii. No, these people have not been felled by sniper fire. They are families waiting while their athletes running IM.  Maybe they all had turkey for breakfast.



Sleep, It Helps More Than You Give it Credit

"Who cares about sleep when you can do it in school?"


                                                    Corny Collins, Hairspray


 


 


 


 Matt Fitzgerald  -  I've steered you to his writing/philosophy before but let me do it again. I've never met him, but I'd like to one day. I'm not related and we're not in any business deals that I'm aware.  But I own at least 3 of his books.  His writing style is relaxed, knowledgeable and rarely intentionally inflammatory.  But it's always well researched and accurate.


 


I wanted to focus on sleep this time.


 


 Matt's opening quote in the Complete Triathlon Book: "You can do more than you might think to prevent general fatigue - a great epidemic in our society to which triathletes are especially susceptible..."


 


More in a minute.


_________________________________________________________________________________


Today is Thanksgiving and the local Turkey Trot goes right by our house.  I think there are about 3,000 runners, walkers and strollers. It's really a fun group with many in costume.  We're almost at the two mile mark of this 5K event and I make it a point to set up my own "aid station" with, well of course, what else would your body cry out for after running this distance on Thanksgiving morning, preparing as it is for the onslaught of food?  That's right, Bloody Mary's.  The competitors reactions have been quite predictable from the, "What, are you kidding me?" to "Alright, you the man!"  Most, however, just wave.  I usually run out.  Life is good - and you can quote me on that.


 My in laws live in the Chicago suburbs and we'll spend Thanksgiving there occasionally.  A couple of years ago, the local Turkey Trot course came very near their home.  It was also a 5K race on the local streets. However, sometime later in the day, someone not connected with the event noted "an unidentified white powdery substance" on the ground!  The authorities went ape.  The area was cordoned off, 100 on/off duty police and fire fighters were mobilized to protect the good citizens from what was eventually determined to be.... soccer field lime from the mornings Trot.  Ha!


_________________________________________________________________________________


Sleep


Triathletes are used to squeezing more into a day than most folks.  When given the choice between lunch with the gang or shoehorning in a 5 mile run, the run almost always gets the nod.  At the end of the day when much needed rest is in order, frequently everything's not checked off the list yet. And sleep gets short changed.  Hey, it always worked in college right?


 But we're not in college anymore.  And it's not academics on the plate, it's physical effort placed on a body that oftentimes is still a tad beaten down from yesterday's work outs.  Or beaten down from that half marathon last Saturday. Repeating Fitzgerald's quote, "You can do more than you might think to prevent general fatigue - a great epidemic in our society to which triathletes are especially susceptible..."


 It's pretty obvious that many younger athletes can live this way and still perform at a very high level.  We all know someone who can party till 3, get close to no sleep overnight, and still toe the line at 7:30 am for the local 5K expecting to perform at a high level. And do it.  Aging athletes just can't.  And by aging I don't just mean the Medicare crowd.  This means you Ms. Forty-seven year old.  Recovery is not a four letter word but one in which adequate rest/sleep is essential.  As one gets deeper in to the training year, and the intensity of training increases, the body simply must have regular sleep to combat the accumulating physical stress.  It's during this sleep that the body releases testosterone.  This hormone has gotten more than it's share of press recently but it's certainly important.


 So, particularly as we get older, we need to be careful not to compromise sleep (yes, I know it's easy to say and harder to do. And, yes, I'm as guilty as the next athlete of occasionally cutting this corner.) It's one of the few things in triathlon that doesn't cost more money, right? So, while you're contemplating that turkey with sleep inducing agents of it's own like L-tryptophan, take just a minute to think how this sleep recommendation can fit into your lifestyle.  Sweet dreams. You'll be a winner if you do.  __________________________________________________________________________


This is the lobby of the King Kamehameha Hotel, the headquarters hotel in Hawaii. No, these people have not been felled by sniper fire. They are families waiting while their athletes are running IM.  Maybe they all had turkey for breakfast.


 




Sunday, November 18, 2012

You've Fractured Your Clavicle - Time For Surgery?

"As a child, my family's menu consisted of two choices. Take it or leave it."   Buddy Hackett

Triathlon nutrition has made incredible strides since then.  Any time you have the opportunity to read anything written by Matt Fitzgerald or Asker Jeukendrup, it could end up being a significant addition to your training.






_______________________________________________________________________

Thanksgiving to Christmas! 
You are about to enter The EATING Zone!! http://tinyurl.com/2r6kxy

With the four major food groups of butter, salt, alcohol and pie crust just waiting around the corner for you, do you have a non-over eating plan?  Hmm?  Me neither.
_______________________________________________________________________

I've written about clavicle fractures a number of times in the past few years, most recently 5/6/2012 http://tinyurl.com/anq9ols .  The basic point has been that we as an Orthopedic community are changing our thoughts and approaches toward this injury.  From a fracture which was invariably treated conservatively, read non-operatively, the thrust today is toward expanding the indications for repair of this injury with a host of available plates, screws, and intra-medulary devices (placed inside the bone).  In short, we are much more facile at reapproximation of the bony ends and achieving an anatomic or near anatomic result.  The out come is one in which the original clavicle length, position and orientation are restored to the way they "came from the manufacturer."  As a swimmer, or any upper extremity athlete for that matter, where the repetitive nature of sport allows for consistent, reproducible hand and elbow position having restored the shoulder to it's original geometry.

Clavicle fractures are so very common in cycling accidents specifically, and any fall where a reflexively out stretched arm to break the fall is involved.  In fact over 40% of shoulder injuries involve this bone as it constitutes almost 3% of adult broken bones.  When indicated, surgical fixation is generally carried out under anesthesia, an approximately 3" incision is placed over (or in some instances, under) the clavicle, and most often a plate with screws employed to reduce and hold the fracture. The surgeon will wait until there's x-ray evidence of fracture healing - usually about 3 months post op (range 8 - 24 weeks) before releasing you to full activity. If you read the tri forums, after the repair of the clavicle fractures of Lance Armstrong and Luxembourger Frank Schleck, were reporting them back riding, at least indoors on a stationery bike, less than 24 hours later.  Last time I looked in the mirror, I was neither Lance (fortunately given recent events) or Frank.

In short, the 2012 conservative treatment, immobilization, remains the treatment of choice for simple mid-shaft clavicle fractures, but for displaced and comminuted fractures surgical intervention may be appropriate, especially when considering the overall outcome results and the occupation/avocation of the patient.

When I was in medical school one of the professors pointed out that during my medical career the questions I would be asked would be constant.  It was the answers that would change.  This injury would be a pretty good example how technology and the passage of time allow for better treatment of a common injury.

As the 2:20 deadline approaches, the final two swimmers struggle mightily not to get left behind. 
Kona 2012.




Saturday, November 17, 2012

Lube That (Early Arthritic) Knee

Quaker State, Pennzoil, Synvisc, Orthovisc Knee Injections


 


 "Take calculated risks.  That is quite different from being rash."


                                                                        General George S. Pattton                                                                               ____________________________________________________________


I met an athlete at Starbucks this morning to talk a little about Ironman, specifically my experiences in Kona this year and the privilege of writing for Ironman.com.  I've written here before about how easy it is for triathletes, people seeking excellence in multiple disciplines, to be obsessed with, even addicted to working out. (Workout Guilt, Of Course You Have It - 8/30/10) Although currently suffering mild to moderate knee issues with cycling and running, like many of you now in the off season, she sees no real need to push the exercise.  With a wry smile, she understands the benefits of spending a little more time pool side working on that limiter. I believe many of us could say that about time in the water. I can see the heads nodding from here.



She's a pretty good example of calm in the middle of the training storm typifying the quote, "In the doldrums of training, a sense of humor is more important than I ever would have imagined."  Oh, and Starbucks has darn good coffee.




___________________________________________



 -So you think arthritis is only an old persons problem? (Watch it  there, Post. Who you calling old?) 


-You wouldn't be even close!  Many of those physicians with practices heavily weighted toward knee problems see the total age spectrum of patients presenting with wear and tear cartilage problems. Specifically, this is articular cartilage, the pearly grey stuff that lines the end of the bones. In fact, a recent quote from the Journal of Bone and Joint Surgery notes "Women with physically active lifestyles, such as athletes and workers in occupations that involve exposure to traumatic injury or mechanical stress, are more prone to develop early osteoarthritis."


With accumulated wear and tear, or even after trauma, the bone covering articular cartilage of the knee joint can erode.  Erosion = arthritis. In addition to the various types of cortisone which can be injected, a class of agents focused on one of the building blocks of cartilage, hyaluronic acid, is also available for injection.  They are known as hyaluronate preparations and can be effective diminishing both joint pain and swelling.


These agents (Euflexxa, Hyalgan, Synvisc, etc.) can be costly and are usually not considered until the patient is a failure to other conservative measures like limb strengthening exercises, Tylenol, possibly a non-steroidal anti-inflammatory drug like ibuprofen (Advil) or naproxen (Aleve) and even a cortisone injection.


An office procedure, after sterilely prepping the skin at the intended point of injection, and aspirating (sucking out) any effusion (excess joint fluid) which may be present, the physician takes great care to ensure exact placement of the needle tip into the joint.  Depending on the product, there can be 1-3 injections over 3 weeks and other than the sting of the needle stick, seem to cause very little in the way of pain.  Post injection the patient is asked to refrain  from vigorous exercise (like triathlon!) for 48 hours.


The success rate in lowering pain and swelling, while increasing patient activity levels, can be impressive. Upwards of 80% patient satisfaction has been reported.  One company advertises “Over 1.8 million knees treated….and still going strong.”  It can be repeated if/when necessary.  And, if it’s included in an overall program to maintain/preserve knee health as well as forestall a larger procedure like joint replacement, it’s role is clear.



DSCN0292














As night falls on the Kona bike compound, athletes head toward "the last supper."




Friday, November 16, 2012

Lube That (Early Arthritic) Knee


Quaker State, Pennzoil, Synvisc, Orthovisc Knee Injections


"Take calculated risks.  That is quite different from being rash."
                                                                           
                                                                            General George S. Patton
________________________________________________

 

I met an athlete at Starbucks this morning to talk a little about Ironman, specifically my experiences in Kona this year and the privilege of writing for Ironman.com.  I've written here before about how easy it is for triathletes, people seeking excellence in multiple disciplines, to be obsessed with, even addicted to working out. (Workout Guilt, Of Course You Have It - 8/30/10) Although currently suffering mild to moderate knee issues with cycling and running, like many of you now in the off season, she sees no real need to push the exercise.  With a wry smile, she understands the benefits of spending a little more time pool side working on that limiter. I believe many of us could say that about time in the water. I can see the heads nodding from here.

She's a pretty good example of calm in the middle of the training storm typifying the quote, "In the doldrums of training, a sense of humor is more important than I ever would have imagined."  Oh, and Starbucks has darn good coffee.
___________________________________________

-So you think arthritis is only an old persons problem? (Watch it  there, Post. Who you calling old?) 

-You wouldn't be even close!  Many of those physicians with practices heavily weighted toward knee problems see the total age spectrum of patients presenting with wear and tear cartilage problems. Specifically, this is articular cartilage, the pearly grey stuff that lines the end of the bones. In fact, a recent quote from the Journal of Bone and Joint Surgery notes "Women with physically active lifestyles, such as athletes and workers in occupations that involve exposure to traumatic injury or mechanical stress, are more prone to develop early osteoarthritis."


With accumulated wear and tear, or even after trauma, the bone covering articular cartilage of the knee joint can erode.  Erosion = arthritis. In addition to the various types of cortisone which can be injected, a class of agents focused on one of the building blocks of cartilage, hyaluronic acid, is also available for injection.  They are known as hyaluronate preparations and can be effective diminishing both joint pain and swelling.


These agents (Euflexxa, Hyalgan, Synvisc, etc.) can be costly and are usually not considered until the patient is a failure to other conservative measures like limb strengthening exercises, Tylenol, possibly a non-steroidal anti-inflammatory drug like ibuprofen (Advil) or naproxen (Aleve) and even a cortisone injection.


An office procedure, after sterilely prepping the skin at the intended point of injection, and aspirating (sucking out) any effusion (excess joint fluid) which may be present, the physician takes great care to ensure exact placement of the needle tip into the joint.  Depending on the product, there can be 1-3 injections over 3 weeks and other than the sting of the needle stick, seem to cause very little in the way of pain.  Post injection the patient is asked to refrain  from vigorous exercise (like triathlon!) for 48 hours.


The success rate in lowering pain and swelling, while increasing patient activity levels, can be impressive. Upwards of 80% patient satisfaction has been reported.  One company advertises “Over 1.8 million knees treated….and still going strong.”  It can be repeated if/when necessary.  And, if it’s included in an overall program to maintain/preserve knee health as well as forestall a larger procedure like joint replacement, it’s role is clear.


As night falls on the Kona bike compound, athletes head toward "the last supper."

Monday, November 12, 2012

The Amazing Walt Stack - 26:20 Hawaii Ironman Smiling


Let Me Take You Back to 1981


"Start off slow...and taper back."    Walt Stack


 Triathlon has become a highly regulated sport.  There are governing organizations, certifications on many levels, with ever changing rules and regulations.  We occasionally need to fall back to the pioneers of the sport, those adventurous souls who, when presented with the idea of swim long, bike long, then run a marathon thought, “Now that sounds like fun!”  Mostly they did this on faith alone. 

“Cowman” Ken Shirk, one of these early pace setters, was able to complete the entire original Kona course wearing a cow head complete with horns.  Why would he want to do that you ask?  (The answer doesn't come to me immediately either.)  And he's completed many more since. A strong individualist, he fit right in to the then prevalent mindset of people at the far end of the endurance sport bell curve.  Ken’s pedigree includes being the second man to finish the Western States 100 mile race. Or, more accurately, the second human to finish the event not horse bound! 

His Ironman swim required a modified breast stroke which Ken labeled the “cow stroke.”  Well, of course.  Wouldn’t you?  I don’t know how many times he’s finished the event, both as a legal registrant, and I’m told as a bandit, but it seems the event has gotten too big, gone in another direction, for the Cowmans of life.  Sad.


Many of you were not born in February 1981. The race was still in February back then and this would the first time for the Big Island course, the race having been run in Honolulu from 1978 - 80. It had just gotten too big to be contested in the populous state capitol.

San Francisco's Walt Stack was part of Ironman before everyone and his brother was labeled hero, a real larger than life guy. He’d done countless races before coming to the Big Island and had established himself as a legendary figure in our young sport.  Not fast, but steady, he could always be counted on to be one of those still standing at race’s end. (Seven years later he would do a very cute Nike commercial.  http://www.youtube.com/watch?v=QCJ7G-vY4vA
_____________________________________________________________________________
And, from a piece about Walt in Sports Illustrated: "Stack was out running the hills near his home. It should be called climbing. He was with a group of young women from his running club, the Dolphin South End Runners, when suddenly, one of them recalls, "I heard a sharp crack. I looked back, and Walt was stretched out on the sidewalk, bleeding from a cut on the head. 'Walt, what happened?' I yelled.
" 'That's what comes from being a dirty old man,' he said. I dropped back to look at your legs, and I ran into an overhanging branch.' "

If you'd like to read the whole article - it's particularly good - go to http://sportsillustrated.cnn.com/vault/article/magazine/MAG1090586/index.htm .
_____________________________________________________________________________

His first, and only, Ironman in Kona was in 1981 when there was only one Ironman, no WTC and no separation of pro’s and age groupers.  Everybody was an age grouper!  You need to remember that these were the early developing days of the sport and we didn’t know a great deal about aerodynamics on the bike, refueling or nutrition, and if you mentioned compression it was assumed you were speaking about the compression ratio of your car’s engine.  Ironman had no swim or bike times, no cut offs, and only a rudimentary course.  

The swim had no buoys, no course, and according current Swim Director Jan War, “You just swam out to a canoe and back.”  When asked about turn around help for any competitor not from Kailua-Kona, or perhaps the directionally challenged in ocean navigation, to aid even finding the turn around boat, he laughs loudly as one who knows the punch line of a joke before you do.  According to Jan, his predecessor, crusty Mo Matthews, was fond of reporting, “If they can’t find the turn around boat, they shouldn’t be doing the race.”  Uh, OK.

 Stack was ready for the event and at 73, the oldest competitor to attempt the distances.  After a 3 hour swim and leisurely bike, history has it that he was pretty tired on the run. So, he just eased off the course, lay down in someone’s yard, and took a nap.  Once refreshed, he set off on his 26 mile jaunt and near it’s conclusion got hungry.  So what do you do when your stomach starts talking, head for the restaurant naturally.  The Kona Ranch House which used to be on Palani Road but is no more.  The way I heard it, he was eating his waffle breakfast, reading the morning paper, with the results of “yesterday’s” Ironman race in it. The race in which he was still competing!

 Once breakfast was finished, he got back out on the course, finished the event in a speedy 26 hours and 20 minutes, and still holds the record for longest race time in Kona.

 It’s a shame that the sterility of present day doesn’t seem to have a place for Cowman, the Amazing Walt Stack and countless other characters who put this event into the national spotlight..  But they are the rocks on which this sport is built.  And if you happen to be walking around Kona one day and spy a guy with cow horns on, don’t simply assume him an asylum escapee but walk over, shake his hand and say thanks.  Maybe he'll share some of the finer points on the cow stroke!

26 hrs 20 Minutes for IM Hawaii...and He's Humorous

Let Me Take You Back to 1981



 



 


"Start off slow...and taper back."    Walt Stack  


 Triathlon has become a highly regulated sport.  There are governing organizations, certifications on many levels, with ever changing rules and regulations.  We occasionally need to fall back to the pioneers of the sport, those adventurous souls who, when presented with the idea of swim long, bike long, then run a marathon thought, “Now that sounds like fun!”  Mostly they did this on faith alone. 


 “Cowman” Ken Shirk, one of these early pace setters, was able to complete the entire original Kona course wearing a cow head complete with horns.  Why would he want to do that you ask?  (The answer doesn't come to me immediately either.)  And he's completed many more since. A strong individualist, he fit right in to the then prevalent mindset of people at the far end of the endurance sport bell curve.  Ken’s pedigree includes being the second man to finish the Western States 100 mile race. Or, more accurately, the second human to finish the event not horse bound! 


 His Ironman swim required a modified breast stroke which Ken labeled the “cow stroke.”  Well, of course.  Wouldn’t you?  I don’t know how many times he’s finished the event, both as a legal registrant, and I’m told as a bandit, but it seems the event has gotten too big, gone in another direction, for the Cowmans of life.  Sad.


 



 Many of you were not born in February 1981. The race was still in February back then and this would the first time for the Big Island course, the race having been run in Honolulu from 1978 - 80. It had just gotten too big to be contested in the populous state capitol.


 San Francisco's Walt Stack was part of Ironman before everyone and his brother was labeled hero, a real larger than life guy. He’d done countless races before coming to the Big Island and had established himself as a legendary figure in our young sport.  Not fast, but steady, he could always be counted on to be one of those still standing at race’s end. (Seven years later he would do a very cute Nike commercial.  http://www.youtube.com/watch?v=QCJ7G-vY4vA


_____________________________________________________________________________




And, from a piece about Walt in Sports Illustrated: "Stack was out running the hills near his home. It should be called climbing. He was with a group of young women from his running club, the Dolphin South End Runners, when suddenly, one of them recalls, "I heard a sharp crack. I looked back, and Walt was stretched out on the sidewalk, bleeding from a cut on the head. 'Walt, what happened?' I yelled." 'That's what comes from being a dirty old man,' he said. I dropped back to look at your legs, and I ran into an overhanging branch.' "




If you'd like to read the whole article - it's particularly good - go to http://sportsillustrated.cnn.com/vault/article/magazine/MAG1090586/index.htm .




_____________________________________________________________________________


 His first, and only, Ironman in Kona was in 1981 when there was only one Ironman, no WTC and no separation of pro’s and age groupers.  Everybody was an age grouper!  You need to remember that these were the early developing days of the sport and we didn’t know a great deal about aerodynamics on the bike, refueling or nutrition, and if you mentioned compression it was assumed you were speaking about the compression ratio of your car’s engine.  Ironman had no swim or bike times, no cut offs, and only a rudimentary course.  The swim had no buoys, no course, and according current Swim Director Jan War, “You just swam out to a canoe and back.”  When asked about turn around help for any competitor not from Kailua-Kona, or perhaps the directionally challenged in ocean navigation, to aid even finding the turn around boat, he laughs loudly as one who knows the punch line of a joke before you do.  According to Jan, his predecessor, crusty Mo Matthews, was fond of reporting, “If they can’t find the turn around boat, they shouldn’t be doing the race.”  Uh, OK.


 Stack was ready for the event and at 73, the oldest competitor to attempt the distances.  After a 3 hour swim (check this) and leisurely bike, history has it that he was pretty tired on the run. So, he just eased off the course, lay down in someone’s yard, and took a nap.  Once refreshed, he set off on his 26 mile jaunt and near it’s conclusion got hungry.  So what do you do when your stomach starts talking, head for the restaurant naturally.  The Kona Ranch House which used to be on Palani Road but is no more.  The way I heard it, he was eating his waffle breakfast, reading the morning paper, with the results of “yesterday’s” Ironman race in it. The race in which he was still competing!


 Once breakfast was finished, he got back out on the course, finished the event in a speedy 26 hours and 20 minutes, and still holds the record for longest race time in Kona.


 It’s a shame that the sterility of present day doesn’t seem to have a place for Cowman, the Amazing Walt Stack and countless other characters who put this event into the national spotlight..  But they are the rocks on which this sport is built.  And if you happen to be walking around Kona one day and spy a guy with cow horns on, don’t simple assume him an asylum escapee but walk over, shake his hand and say thanks.  Maybe he'll share some of the finer points on the cow stroke!







Tuesday, November 6, 2012

Compression Clothing, Maybe Not Worth the Money




“Something’s happening here … what it is ain’t exactly clear,”          Buffalo Springfield

Lew Hollander, 3rd place, 80+, Ironman World Championship 2012

I've noted before that triathletes are "early adopters" in marketing terms.  In pursuit of athletic improvement, they're willing to try new (and perhaps not completely accepted) treatments, products, methods that have the potential to make them faster. That's no more true than in the biking realm.  While standing on the pier in Kona last month, with Transitions Coordinator Stu Convery during bike check in on Friday afternoon before the Ironman World Championship, Stu noted that the number bikes with electronic shifting had risen dramatically, "And likely the expense too!"

With respect to what goes their mouths, the triathlon supplement market is alive and well, rife with claims of faster times, quicker recovery, the ability to leap tall buildings at a single bound.  Respected triathlon author Matt Fitzgerald wrote in Competitor Mag, "A balanced diet of natural foods, mainly fruits and vegetables, is the one thing every runner needs nutritionally to establish a foundation for health and performance."  He went on to select 7 additional substances including Vitamin D, fish oil, creatine, iron, etc. that have been pretty well worked out as important to the exercising body.  But only 7.  http://tinyurl.com/ag537lf  

I had a condo-mate in Hawaii one year who mixed up 18 different pills, powders, gels, etc. every morning in the blender ...and drank it.  It looked worse than simply not tasty.  More reminiscent of something you scraped off the bottom of a dumpster! 

 I would suggest that the reader be flexible as it wasn't that long ago that "everyone" should take daily large does of vitamin C daily and "everyone" should run by striking the outside part of their heel first. That which we know to be correct is constantly changing.

With regard to compression clothing, in my mind, the myriad of claims just don't seem to add up. There doesn't seem to be a consistent message or consistent methodology with respect to type, size or elasticity of the product, or body part being compressed.  My calves, for example may have grossly the same circumference as yours but the muscular contours are undoubtedly different. An what if I'm a 5K racer and you do IM's?  Does the degree of compression remain constant after 10 uses, 50 uses or 50 washings?  Look at the elastic in last years underwear.

I'll let you read one of the more promising pieces on this subject by MacRae, et al. to come to your own conclusions.  For example, "Results are inconsistent for post-exercise limb swelling" or "In general, the effects of CG's {compression garments} on indicators of recovery performance remain inconclusive." http://tinyurl.com/6cofrns

I would, however, keep an open mind as to the ultimate use in keeping a limb warm or, for example, in calf sleeve usage where athletes tend to cramp. We'll see what time and future research bring us.  Until then, I'd say you spend the money on something nice for your spouse who tolerates you and triathlon! 




Compression Clothing, Maybe Not Worth the Money?


“Something’s happening here … what it is ain’t exactly clear,”          Buffalo Springfield
















Lew Hollander, 3rd place, 80+, Ironman World Championship 2012




I've noted before that triathletes are "early adopters" in marketing terms.  In pursuit of athletic improvement, they're willing to try new (and perhaps not completely accepted) treatments, products, methods that have the potential to make them faster. That's no more true than in the biking realm.  While standing on the pier in Kona last month, with Transitions Coordinator Stu Convery during bike check in on Friday afternoon before the Ironman World Championship, Stu noted that the number bikes with electronic shifting had risen dramatically, "And likely the expense too!"



With respect to what goes their mouths, the triathlon supplement market is alive and well, rife with claims of faster times, quicker recovery, the ability to leap tall buildings at a single bound.  Respected triathlon author Matt Fitzgerald wrote in Competitor Mag, "A balanced diet of natural foods, mainly fruits and vegetables, is the one thing every runner needs nutritionally to establish a foundation for health and performance."  He went on to select 7 additional substances including Vitamin D, fish oil, creatine, iron, etc. that have been pretty well worked out as important to the exercising body.  But only 7.  http://tinyurl.com/ag537lf  



I had a condo-mate in Hawaii one year who mixed up 18 different pills, powders, gels, etc. every morning in the blender ...and drank it.  It looked worse than simply not tasty.  More reminiscent of something you scraped off the bottom of a dumpster! 



 I would suggest that the reader be flexible as it wasn't that long ago that "everyone" should take daily large does of vitamin C daily and "everyone" should run by striking the outside part of their heel first. That which we know to be correct is constantly changing.



With regard to compression clothing, in my mind, the myriad of claims just don't seem to add up. There doesn't seem to be a consistent message or consistent methodology with respect to type, size or elasticity of the product, or body part being compressed.  My calves, for example may have grossly the same circumference as yours but the muscular contours are undoubtedly different. An what if I'm a 5K racer and you do IM's?  Does the degree of compression remain constant after 10 uses, 50 uses or 50 washings?  Look at the elastic in last years underwear.



I'll let you read one of the more promising pieces on this subject by MacRae, et al. to come to your own conclusions.  For example, "Results are inconsistent for post-exercise limb swelling" or "In general, the effects of CG's {compression garments} on indicators of recovery performance remain inconclusive." http://tinyurl.com/6cofrns



I would, however, keep an open mind as to the ultimate use in keeping a limb warm or, for example, in calf sleeve usage where athletes tend to cramp. We'll see what time and future research bring us.  Until then, I'd say you spend the money on something nice for your spouse who tolerates you and triathlon!