Monday, June 29, 2015

Knee Arthroscopy and Blood Clots; Do You Know the Risks?






Arthroscopy of the knee is the single most common orthopedic operation done in this country.  Even so, the risk of blood clots in the legs, also known as DVT (deep vein thrombosis) and subsequent pulmonary embolism has been hard to pin down. A recent study by Dahm and colleagues examined the files of 12,595 patients at their institution having knee arthroscopy over a 20 year period and identified 43 patients with symptomatic clots.  Of these, 5 had a PE, or a clot which travels from the leg lodging in the lung (these can be fatal.)  3 of the 43 would develop a PE at a later date.  The overall incidence of so called VTE, venous thrombotic events, was 0.34 percent.

"Classic risk factors" for post operative VTE include: 

Age greater than 65 years
BMI (body mass index) above 30
smoking
use of oral contraceptives or hormone replacements
chronic venous insufficiency
previous episode(s) of VTE
history of malignancy (cancer)

Although it may seem counter intuitive, the type of procedure performed on the knee did not seem to be a factor nor was the presence of coronary artery disease, diabetes, or type of anesthesia.  Also noteworthy, contrary to what was taught to me for years, the length of procedure or duration of leg tourniquet (wrapped around the thigh and inflated at the beginning of the operation to control bleeding and keep a clear visual field) did not seem to play a role.

The take home here, as noted by Dr. Dahm in performing a retrospective study, is that "we are most certainly underestimating the true incidence of VTE."  So if you may be considering a scope and have one or more of the above risk factors, especially if you have two risk factors, you should consider chemoprophylaxis post op. This is already done after hip or knee replacement routinely and should be discussed by you and your physician.

I can tell you first hand that getting paged to the ICU a couple days after what you and the patient both feel was a highly successful ACL reconstruction to find her with an IV drip in her arm and the diagnosis of pulmonary embolism is surprising to say the least.  The time to figure this out is before the arthroscopy.

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Haven't done an obstacle course race yet?  They're lots of fun.

Muddy but very happy!
  Image 1, Google images




Friday, June 26, 2015

Death in Triathlon Part Two, Athlete Responsibilities



This is part 2 of a two part series dealing with this topic, part one was two days ago.

What are your responsibilities as the athlete?

USAT would say the following. (read each slowly to make sure you understand USAT's actual intent.

Athletes Responsibility

Show up for the race healthy, fit and prepared.

Visit your doctor for a physical examination with an emphasis on heart health before participating.  Unrecognized heart problems are the primary cause of sports-related sudden cardiac death.

Consult with your doctor about any warning signs during training such as chest pain/discomfort, shortness of breath, light-headedness, or blacking out. Your health, fitness level, and preparation should guide your selection of an appropriate race or event.

Your race plan should be consistent with your health, fitness level, and preparation.

Choose an event because it places an emphasis on athlete safety, and is sanctioned by USA Triathlon.

Practice and prepare for open water swim venues. Race day must not be your first exposure to an
open-water swim competition.

Thoroughly review the race’s website and all pre-race communications so you are knowledgeable on the timetable for race day arrival and preparations.

Utilize all checklists and information from the event, USA Triathlon and your coach to mentally prepare for the competition.

Make certain your equipment is safe and working properly. Make
certain your wetsuit fits properly.  Get your bike checked before the event.

During the event, STOP at the first sign of a medical problem such as chest pain/discomfort, breathing difficulties, light-headedness, or unusually high heart rate and seek medical attention. Your life may depend on it. This is particularly important during a race swim, in which rescue poses unique
challenges.

During the event, tend to a fellow athlete who has a medical problem.

Learn CPR and be prepared to use those skills when needed. Ask your family and other supporters to
do the same.



Visit usatriathlon.

Wednesday, June 24, 2015

Death in Triathlon Part One, Surviving the Swim

And I wanted the pride that comes with saying I had qualified for, and finished, the Ironman World Triathlon Championship in Kona. One problem, however.  At the time, I had never competed in a triathlon.  With no background whatsoever in swimming, biking and running, my getting to Kona seemed just about as likely as my chances to pilot the next space shuttle into outer space.

                                                              Raymond Britt, Qualifying for Kona
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Considering Obstacle course racing as a change of pace from triathlon? I highly recommend it.  You can do it with your spouse and/or older kids


Many donate their shoes after events like Tough Mudder

Even the clean up shower can be muddy after one of these fun events

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Lawrence Creswell is a terrific swimmer and physician. As a thoracic and cardiothoracic surgeon, he may be especially qualified to comment on an article first published in Bloomberg.  Like me, he is interested in keeping the sport safe for all regardless of age or experience level.  Below is a reprint of one of his recent posts but first a few words.


I first became interested in death in triathlon once it was sensationalized by the media.  As a swimmer, seeing that the deaths were listed as drowning, I took particular interest in the swim portion of the race and why we as a group of smart people didn't have a better handle on causes and cures of this issue. 




What's  really happening here?  Well, some would have us believe it a 50-50 proposition that we make it to the finish line alive.  But, sadly, there are those who, in fact, do not make it, participating in a sport they love.  They usually do not make it through the swim.


 When observing any mass swim start like than of an IM, people starting, people stopping, swimming over, and getting swum over by fellow entrants, who can say that triathlon isn't a contact sport?  But that's not what we want.   Even in wave start events like the 2011 NY tri, a 64 year old gent was pulled from the water, cause of death listed as heart attack.  Also in that race, a 40 year old mother of three, and stated to be, "in great shape, swam the course the day before," succumbed, her autopsy inconclusive.




 Unlike marathons where those who die seem to do so in the final mile, partiularly males, in our sport it's the swim.  Some lake, some ocean, some olympic, some half, some IM.  Many of these athletes are both experienced and adequately trained...just like you!  A cardiologist would tell you that the stress of the swim is more like likely to produce a rhythm disturbance of the heart, or fluid collecting in the lungs.  It's called pulmonary edema.  Add to that the anxiety the swim produces which can be significant, the difficulty being spotted in the water if in trouble, lack of ability to rest, and so many of us coming from a swim-bike background, and at least a series of possible partial explanations comes forth.


There's a lot more to this discussion but suffice it to say that a lot of people are looking at it, and although I didn't think so for the longest time, you and I should be one of them.   So to summarize, at present, deaths are rare but they do occur.  When they happen, it's in the swim, cause(s) unclear.  Arrhythmia and pulmonary edema are being studied the most, heart disease in the older athletes.  The USAT Report can be read in it's entirety at  A quick summary to enhance your understanding.
file:///C:/Users/Owner/Downloads/USATFinalReport_24OCT12%20(1).pdf
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From Dr. Larry Creswell


@athletesheart


Cardiothoracic Surgeon, Jackson, MS

Last week, Bloomberg published an on line article by Natasha Khan and Shannon Pettypiece, entitled "Men Over 40 Should Think Twice Before Running Triathlons," that opened with the line, "For men competing in triathlons past the age of 40, the grueling slog to the finish line could be their last."

I can tell from inquiries I've received and from on line and Twitter chatter that this article received a lot of attention.  Of course, there are a lot of male triathletes older than 40!

I don't ordinarily think of Bloomberg or BusinessWeek as a source for information about personal health.  That Bloomberg would publish this article speaks to the current general interest in the intersection of health and endurance sport.  And men older than 40 must certainly be an important demographic for Bloomberg.

At the outset, let's agree that the headline and lead sentence--probably furnished by an editor for the sole purpose of garnering attention--are sensational.  The rest of the article is more balanced, though, and there's a fair amount of factual material that should interest male athletes.  Let's take a look:

1. A personal account.  As a jumping off point, the article shares the sad story of 55-year-old business executive and triathlete, Michael McClintock, who died of cardiac arrest after a training session.  When athletes die at high-profile events like marathons or triathlons, the incidents capture the public's interest.  When athletes die on the treadmill, the high school track, or the local swimming pool, they receive little attention.  A handful of athletes die at running races or triathlons in the U.S. each year; several thousand athletes die each year in non-race settings.  The story of Mr. McClintock is typical.  One of my heart surgery partners died on a hotel treadmill a while back.

2. Sports-related sudden cardiac arrest (SCA) is truly much more common in adult male than adult female athletes.  Like the article suggests, men older than 40 should think twice about exercise.  Men in this age category should due diligence, with their physicians, to their heart health and any potential risk of participating in an exercise program or training for and competing in events like triathlon.  That's only common sense.  Sports-related SCA can happen with any sport, regardless of how strenuous it might appear.  But other forms of heart disease are common in athletes and non-athletes, alike.  Prevention is worthwhile. Finally, it's important to remember than women and younger men are not immune from the problems of SCA or heart disease in general.

3. Triathlon swim.  In triathlon, the greatest risk for SCA does indeed occur during the swim, for reasons that are not entirely clear.  The article mentions one potential theory related to the body's neurohormonal systems that has been proposed by British physiologists.  I've written about this possibility here at the blog.  This is just one theory.  The truth is that we don't yet know enough about SCA during the triathlon swim.  USA Triathlon prepared a checklist that may help athletes reduce their risk.

4. The experts are triathletes.  It's nice to see the article quoting expert cardiologists who also happen to be triathletes.  Dr. James O'Keefe is a very capable triathlete and Dr. Andre La Gerch is an exceptional runner (think 1:10 half marathon) and triathlete (think ~4:10 half Ironman).  Perhaps some extra credibility on these issues!  Their advice is sound.  In particular, Dr. La Gerche reminds us to pay attention to warning signs of potential heart disease:  chest pain/discomfort, difficulties breathing, palpitations, unusual fatigue.

5. The long-term.  Dr. O'Keefe introduces the concept of some sort of "sweet spot" for exercise and the idea that "more is not necessarily better."  We know very little at present, but there may well be important heart risks associated with prolonged involvement in endurance sport.  We should pay careful attention as new information becomes available.

6. Competition changes. The article mentions the recent initiative by World Triathlon Corporation (WTC), called SwimSmart.  I've written here at the blog about this initiative and a corresponding initiative by REV3 Triathlon designed to improve race safety.  It's encouraging to see major event producers work to promote better race safety.  WTC just introduced a terrific short video about swim safety narrated by acclaimed triathlete, Paula Newby-Fraser.  It's worth watching.

In part two we'll look at the responsibility of the athlete.

Thursday, June 18, 2015

Can You Walk the Entire Run Portion of Your Race?

Ron Clarke Dies

In today's New York Times you'll find the obituary of 78 year old Australian runner Ron Clarke, former holder of many running world records in distances from the half mile all the way up to the full marathon.

It also recalls one of the greater acts of sportsmanship in modern Track and Field history:

Clark was involved in what has been called one of the great moments of sportsmanship. In the 1956 Australian championships, he was leading halfway through the mile when another runner clipped his heel. Clarke fell, and the world-record holder John Landy, trying to hurdle over him, cut him with a spike.

Landy stopped, went back, helped Clarke to his feet and apologized. Clarke said he was fine and urged him to keep going. Landy, by then 30 yards behind, resumed the chase and, in a tremendous burst of speed, caught the rest of the field and won.

Landy's reaching out to help Clarke up was memorialized in a bronze statue of the two that stands at the entrance to a sports-and-entertainment complex in Melbourne.


To read the very well done obit, go to:  http://nyti.ms/1Blw33y
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Walking in Triathlon


Walk/running in T2.
I think at some point, every athlete is forced to walk in an event.  Sometimes, just a little, sometimes a great deal.  I heard an un-thinking athlete once utter, "I'd quit before I'd walk."  My sense is that he just hasn't been entered in enough contests to come across one that possibly through injury, abdominal issues and cramps, or any of a number of other reasons, alters the original race plan.  You know, the one carefully and painstakingly planned to the smallest detail that now goes completely out the window.  In short, everyone needs a plan "B."  That's everyone from Ironman Champion Tim O'Donnell all the way to the ploddingest age grouper, one day the bottom will fall out of your race and improvisation will be the next step.

When it comes to walking, the answer to the title question is "probably."  In a sprint tri there's usually less need. But even here, for athletes not yet in peak race condition who kill it on the bike on a hot day, more than one will be forced to back off a time or two before the 5K is completed.  In a longer event like a 70.3 or full distance Ironman where time cut offs exist, the likelihood goes up.  In fact for many, especially the first timers and more "seasoned" (read older - like this author) athletes, it becomes an actual probability.  In Kona a few years ago one athlete, a nurse from AK if memory serves, suffered a foot fracture of some type between the race in which she qualified and the World Championship in Hawaii.  Her doc said she could still go the distance on the Big Island if she wore one of those knee-high plastic walking boots.  She did, walked 26.2 miles with a smile on her face, and is a finisher today.

So how exactly does one do this and still make the various time cut offs?  When I asked one Ironman veteran, the quick response was, "find a cute guy to walk with you!"  Although it's generally accepted that you can walk 4 mph, usually this isn't attempted after swimming 2.4 miles and biking 112.  Most of us wouldn't be walking if we hadn't some time ago run out of gas so it might not be easy to maintain that pace.  But a goal pace as close to 4 mph should be chosen and adhered to if possible.  As noted above, finding a partner in crime may be the most important piece, however.  Believe it or not, when you're this tired, sometimes it's just plain hard to think and having a like-goaled individual with you can be a big help.  The other significant benefit to a walking partner is that no matter how exhausted or close to dropping you may be, the encouragement of another aching tired athlete will almost always get you to the finish.  The longest recorded split for an Ironman run that I was able to uncover was a gent named John Bales 9 hour and 54 minute "torching" of the distance.  Of course he managed this lightning time in 1981 prior to the addition of time restrictions.  You don't have that luxury!

So a walked marathon at 4 mph is about 6+33 in duration if you don't count aid station stops, bathroom breaks which there surely will be, re-tying a shoe or two, talking with the roving med team reassuring them you're just fine.  Seems like we're at or maybe over 7 hours here.  (At 3.5 mph you're looking at a time approaching 8 hours.) As long as you're off the bike and out of T2 moving by the 10 hour mark of the race (9 hour for a 3.5 mph wayfarer), this should be something you can do knowing that you'll be cutting it awfully close to the maximum time allowed.  Even Cinderella's coach turns into a pumpkin at midnight. 


Tuesday, June 16, 2015

Why T2 is So Important






Aren't people nice? I had a root canal done about 15 years ago and got a call from the doctor's office telling me that he was doing a study and would I possibly be available for a follow up xray.  Reluctantly, I agreed having been in that position before putting together lectures and am always grateful when patients will go out of their way to help out. When I got there this morning, he mentioned, "I think about you almost every day."

"Right, I believe that!" I replied.  "No, really I do. You taught me that copious irrigation, really washing out surgical wounds, would decrease my infection rate.  And you were right.  So whenever I operate on a patient, I think I'm doing the John Post wash out."
__________________________________________________________

While I thanked him very much, my suggestion was hardly original.  But if I saved any patients from an infection, then it was more than worth it.

The same thing is true in triathlon.  How often, say before a race, are you just sitting in transition waiting, and you see another athlete with different tires, or a funny transition area set up and you ask her, "say, why do you do that?"  People are very willing to share this information with you.  If fact, they consider it a true compliment of that you wish to emulate them.  So for the remainder of your tri career, every time you set your transition area up like you learned that day, you could tell that athlete, "right, I think about you almost every race."


Slow transition? Whadya mean my transition is slow?
T2 - A Place to Regroup

I've always thought that T1 and T2 served different functions in longer races.  In a sprint, my goal is to have the absolute fastest transitions, both of them, in my age group.  If you've read this blog previously, you know that I preach repeatedly that giving away time in transition is just plain dumb for the serious triathlete.  I enter the race thinking, "how close to 1 minute can I make each of these discipline changes?"  And just like practicing flat tire changing, rehearsing transitions before ever race is just plain smart racing.

But, in a 70.3 (when did the half ironman get that title?  When WTC wanted to corner a larger part of the long distance market. Charlottesville, VA attorney and 2004 Kona finisher Mike Hemenway said "nobody wants to do a half anything.  They should call it 70.3.")

  So in a 70.3 or 140.6 race, the transition areas take on a whole new significance.  Especially at the Iron distance

In these longer duration contests, frequently larger races, fewer athletes may be aiming for the podium. The remainder of us just want to finish with a respectable performance and the ability to maintain a near normal gait pattern the next day.  T1 after a 1.2 or 2.4 mile swim is the same.  Animated chatter with the volunteers, see how fast can you get into biking mode after a refreshing morning dip with 2500 of your closest friends, and get a heaping dose of sunscreen to head for your waiting 2 wheeled steed.

112 miles later, with dried salt on your bike outfit, a nutrition plan that may or may not have worked as well as planned, maybe a little less enthusiasm or brightness than upon completion of the swim, you enter T2.  For some, like T1, it's continued press. Push, push, push. But for the remainder of us, T2 can be race changing.  It can be a big contributor to race success.

On one hand, especially for first timers, Iron distance racing may now seem a whole lot harder than last winter when filling out the entry on line with one of your kids in your lap.  It's supposed to be.  But with this brief interlude, like the mango sorbet you get between courses to cleanse your palate at a fancy restaurant, you can clear your brain of the past few hours and focus squarely on the upcoming run.  For some it can be almost spiritual as they blast out of T2 teasing the volunteers who are putting even more sunscreen on you pointing toward the transition exit and the first steps of the marathon.  Even those athletes who may have experienced self doubt and possibly considered turning in their chip feel this rejuvenation. Stimulation is a good thing.

This will sound odd, but for those of you who've been around for a good while, you'll remember that T1 in Kona was on the pier and T2 was at the old Kona Surf Hotel some 7 miles to the south in the golfers locker room.  What made this T2 cool was that you were encouraged to take a full shower in the golfers shower room before your run.  Soap on a rope anyone?

Then you remember why you signed up for this crazy adventure, and another athlete pulls up along side you smiling. "Care to run a little?" you're asked. "Why sure," you answer.  The finish line may be a good ways away, but a journey of a thousand miles begins with.....



Image 1, Google Images

Wednesday, June 10, 2015

Why Do Athletes Weigh the Most on Monday?

Why the Weekend's Change in Schedules leads to packing on a little extra tonnage but one's weekly routine will strip it off again











When we stagger out of bed on Monday morning thinking about (dreading to some degree?) the first work out of the new week, we're likely hauling a little more weight than before the weekend.  For most of us this is no big deal though as these Friday to Monday fluctuations are really normal for the majority of athletes.  Although this may be more true of non-athletes, to one degree or another, we too just seem to eat more on the weekend.  Like that second beer and a couple appetizers after work on Friday.  Some would counter that their long ride, long run, or both occur over the WE but they don't seem to create a negative calorie balance.  Our sleep/wake cycles tend to be different on WE's as well.  If you sum these behaviors, they can effect not only weight loss/gain but mood and energy balance as well.

In a 2014 study by Orsama, et al., they followed the daily weights of 80 adults finding the above to be true.  But even more interesting data showed up when they examined whether each individual was trying to lose weight or not.  Intuitively, one would expect that those in the study protocol who were able to maintain control of their eating right through the weekend, not just on weekdays, would have the biggest overall weight losses.  But just the opposite occurred.  Orsama reported that "successful weight losers were allowing themselves some serious dietary leniency over the weekend."  Janiszewski suggests, "maybe this is exactly what allowed them to persist on their respective diet for a longer duration."

So the take away here is:

1)  Weighing yourself every day has been associated with the highest likelihood of weight loss.
2)  Don't be surprised on Monday morning when you tip the Toledos at a slightly higher level than on Friday.
3)  Relaxing the iron grip on what goes into your mouth over the weekend may actually result in getting you closer to your racing weight than you think."

I read once where a triathlete was quoted saying, "I wear all black to work out in. Like it's a funeral for my fat."  Sounds OK to me.

  

Monday, June 8, 2015

Triathletes; Avoid This Kind Of Medical Care

Some Negative Changes in the Practice of Medicine

The Medical Tent.  With luck, a place most athletes avoid
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The pressures physicians feel these days have never been more intense. The gradual switch to electronic medical records, decreased reimbursements, major alterations to resident education, etc. have many docs changing the style of practice they manage. The use of physician extenders like nurse practitioners, PA's, and Athletic Trainers has never been higher. In many instances this can be a good thing. These bright, motivated medical care givers often have a great deal of knowledge and experience, plus the time to answer questions possibly omitted by the surgeon. They frequently choose this line of work because they enjoy teaching, and your information thirsty triathlon loving brain is just what they like.

 That said, I know of two docs in my community who take advantage of this situation. The physician extender not only does the initial work up, orders and interprets tests like MRI's or CT-myelograms, they make the decision for surgery and do the work up, all before the patient has ever even met the surgeon. In fact, it's so bad, rumor has it that one our docs meets the patient for the first time in the OR!  4 years of med school, 5 or more years of surgical training, and the first time they ever lay eyes on the patient is in the OR!

 Short of listing some kind of patient bill of rights, in my opinion, this just really short changes the patient, YOU.  When you give your history to the doc, your story of the problem, he/she may glean something different from it completely than the extender.  Sometimes, what may seem to you like the smallest detail, can completely change the way the data is interpreted.  I learned this many times in my fellowship where I thought, after talking to the patient that I had all the answers.  But when it came time to present the patient to the attending physician, I had missed one or more very important facts that he was able to elicit which made a difference in patient management.This then may significantly alter the tests that are ordered and your ultimate treatment.  I guess this is why you do a fellowship.  In some settings, whether you've seen the physician or not, your charges reflect that you have. Remember to check.

 So, think about this next time you need medical care, ask initially what the standard is for this particular medical team or office.  Don't be afraid to state your expectations.  If things don't seem right, they probably aren't, for you as an individual anyway.  And, you can always vote with your feet.

Pre-dawn, Kailua Bay. It's really going to happen.

Friday, June 5, 2015

How Would You Handle a Flat in Your Race?


One Triathlete's Success Story.  Will Yours Be Next?

"Never intending to do an Ironman, I headed to Madison, Wisconsin in the late summer of 2005 to watch a friend do his first Ironman. This was the fellow who got me started in Tri. The atmosphere was so infectious that I stayed overnight and signed up for the following year.
I decided I might need some help and decided it might be a good idea to get a VO2 Max test to set my training zones. I liked the tester so much that I signed up as one of his coached athletes. Being coached by Adam Zucco was one of the best decisions I ever made. My improvement was incredible. I started winning local races. I qualified for the Boston Marathon and completed my first Ironman in 2006. By 2008, I was confident that I could break the age group record at the Wisconsin IM. I did break it by a half hour and went on to race Kona in 2009. In 2010, I qualified again at Ironman Lake Placid, this time by only 11 seconds, beating a charging competitor to win my Age Group."  

                                                                                                        Jim Dicker, Denver

You've Heard It Before, Nothing New On Race Day

Flat Tires- **it Happens

You've seen it.  You're half way through the bike in your local triathlon when you crest a hill to find some poor racer, off to the of the road standing next to their dead bike, struggling mightily to change a flat tire.  Struggling is the key word here as she is running out of mental energy when she could be taking other steps.
Practicing changing tires is one of those things that many of us put off.  You'll get to it one day. Who knows, your luck may hold out. (I've never had a bike related issue in 6 iron distance events.  Note crossed fingers.) Race day is not the time to bone up on that tire changing expertise.  So here's a suggestion. One weekend, after a group ride, get a couple bike buddies to stay after for remedial flat tire repair 101. Here's a couple tips formed from years of messing this up. Since the rear wheel is harder, do it first. If you were moving following a flat, you'd shift to your smallest cog while coasting to a stop. I prefer the aluminum tire levers over plastic even though I occasionally scratch the wheel slightly.  To me, they have a more positive feel.  Once the tube is out, please take 10 seconds with a finger and sweep the inside of the tire, first clockwise then counter clockwise.  Do this carefully as there may still be a sharp object poking thru the tire.  With a little air in the new tube, it goes in pretty easily making sure it's not being pinched by the tire bead all 360 degrees.  I like the CO2 inflators and try my best not to over inflate. Reinstall the wheel making sure that it doesn't touch the brakes and is mounted securely and straight.  Boom, you're done, not pissed off, just a little behind where you thought you'd be.

Once you've mastered the skill, why not have a tire changing race?  Say, for who buys the beer?  It's not only good competitive fun, it will give you a rough idea how long this entire process takes you.  No cheating using a bike stand, you won't have one in your race.

One other method would be the prefilled latex/CO2 cannisters like caffe latex:

I learned to like these quick, one step fillers in the winter since cold weather tire changing can be pretty darn difficult with cold fingers or when it's raining.  I've probably fixed 5 flats with this over the years and so far it's worked every time.  I would suggest that if you plan to use this, again, race day shouldn't be your first time.  Take a day, ride a block from home, pretend you have a flat by deflating a tire (but not a Superbowl football!), then reinflate it with the caffe latex.  

I know there are latex products designed to work prophylactically in the tire but I just couldn't get my head around the concept and have no experience with it.

On race day, after the repair is complete, pick up your litter and drop it off at the next aid station. Here's one piece of advice.  After bike repair for any reason, the tendency is to want to ride like the wind so you can make an effort to catch up.  Don't. Try to ride at a controlled pace for a few minutes, calm down, reassess exactly the time you've lost, and then maybe ramp it up just a little.  You have a long way to go.

Two Tire Changing Tales if you're not pressed for time




Nothing New On Race Day


by Scott Fliegelman (First appeared on Triathlete.com)

Avoid disaster in your next triathlon by following this golden rule.

After surviving the chilly, choppy and chaotic swim at the 2008 Ironman Coeur d’Alene, I set out determined to make up time during the early miles of the bike course. Less than 20 miles in, the rear of my bike started to feel a little squishy and I noticed a hissing sound. I’d flatted one of the brand-new tires affixed to my sexy rental race wheels.
Fortunately, I’d installed and changed a few tubular tires in the past, and I calmly started the process of working the tire from the rim. After struggling for a few minutes with still-frozen fingers, I took a little walk break to calm down and find a private place to pee. When I returned, a utility knife appeared on the ground near my wounded wheel. I gazed inquisitively at the small group of spectators nearby and noticed a friendly gentleman with a hint of a smile and an M-dot tattoo on his calf. Surely he would know that racers are not permitted to accept “outside assistance,” so I must have been fortunate enough to have flatted in the exact spot where a helpful tire-removal tool was previously laying. (That’s my story and I’m sticking to it!)

Even with the lucky knife now in hand, I failed to separate the tire from the dried glue on the rim. Only after slicing the tire horizontally was I able to peel it off clockwise and see that the rental wheel company had used an incredibly tenacious brand of tape instead of glue. After 55 exacerbating minutes, I had the spare tire tenuously affixed to the rear wheel, but without any dried glue to help with adhesion, I rode ahead fearing catastrophe. I made it to T2 with my emotional tank on zero, turned in my timing chip and called it a day.
Of the many lessons I learned that day, “do nothing new on race day” was the most valuable. There are numerous unplanned experiences that come your way during 140.6 miles, but now I try to limit those during months of training and key race rehearsal sessions.

And #2, on a local ride here in Virginia


How many times have we heard that tire changing is just one of those things you have to know?  Not enough I guess.  Picture my bike group, a bunch of highly educated professionals including a Psychiatrist, Law School faculty member, large animal Vet, 2 IMH finishers, etc.  One of them flats.  You observe the owner of the flat as he selects a "new" tube from his saddle bag, it has that grey, dusty appearance of very old rubber that you've seen before in silent movies.  You wonder if instead of your friends saddle bag, it came from Eddy Merckx's saddle bag, but you don't want to challenge a friend.  So you ask, "You sure that'll still work?"

No answer.

Step 1)  Friend installs "Eddy's" tube but fails to realize CO2 cylinder isn't fully screwed in...and when activated, CO2 goes up friends sleeve.  Not particularly helpful.

Step 2) Friend borrows another CO2 cylinder. Screws 2nd CO2 cylinder in tightly (thank you) but realizes tube is no good when it won't hold inflation

Step  3) Friend borrows a third CO2 cylinder.   Borrows another tube from me. But then watches as two friends make the repair. Friend takes barb after barb from other riders. All well deserved of course.

Step 4) Finish ride




Wednesday, June 3, 2015

How to be Best Prepared for Your Triathlon Swim

Pre race Planning Makes All the Difference in the World
Getting ready, 45 minutes before the gun

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They say that a journey of 1000 miles begins with the first step.  Well, 1000 miles would be quite a long triathlon!  All I want to do is get you to the first buoy of your swim, set for the absolute best race you can have.

In my mind, this all starts several days before your race as you are putting together everything you will need, and some things that you might need, for the trip to the race site. (Better to have stuff in your car that you don't need than something sitting on your work bench back home that you do.

Your daily work outs would likely include transition practice as you set up a little T1/T2 out side your garage, wet suit on in the front yard (yeah, I know the neighbors think you look like an idiot.  You do look like an idiot.  So what?)  You have your goggles and cap on, standing 50 yards away from the house.  Then you say "go," and run-jog to your home made T zone stripping off your suit, goggles and cap while running.  Or at least walking.  You've watched a number of Youtube tri transition videos, especially  https://www.youtube.com/watch?v=brHcsqKM_mo , so you know what to do and when to do it.  

In the local sprint tri this weekend, the transition times in my age group were interesting. The first place guy spent 5 less minutes in T1/T2 than the last place guy. He picked up 5 minutes just by knowing how to get in and out quickly.  Imagine the improvement you could make. You just need to practice it over and over to make it a known motor skill that can be performed quickly but controlled.  It also cleans up your actual transition area getting down to only the actual items needed.  Lowers chances of a mistake

If it's early in the season, or your tri career, if the race is in open water, regardless of other commitments or planned workouts, something has to give as you definitely need open water practice before race day.  Honestly, I think it's the one thing you can do to ensure race success and a reduced level of race morning nerves.  An alternative would be to visit the race site the day before your event, with a friend for company to act as lifeguard. Get in for 20 minutes along the exact course you'll be racing, see what you'll be seeing and sighting.  It's also not a bad idea to walk from the swim exit to the bike corral, then to the bike exit, etc. so you have the rudiments of traffic flow before you have race morning yipps.  Everybody gets the race morning yipps!

Whether you've come to the race venue the day before for a practice swim or the morning of the event, I see no reason not to get there way early. Way early.  I have seen races where there was a shortage of body markers, port-a-potties, bike inspectors, etc. all slowing the athlete down. What if you got stuck in traffic, or maybe a draw bridge was up?  But if you were early and had nothing but time, you'd take these delays in stride.  I was in a sprint tri a few years ago where one rack of bikes - that's right, mine was one of the 100 or so steeds - collapsed just before the start.  They had to separate all the bikes, check them for damage, repair the bike rack then re-rack the bicycles.  And that took some time.  In short get there early. Set everything up, repeat the walk through several times noting landmarks where your bike is racked, transition exit/entrance, etc. 

I'm a big fan of the warm up swim for several reasons.  It loosens your shoulders up, it loosens YOU up and makes your wetsuit, if in use, fit for a swimming, not simply walking around with goggles and cap in hand. Now you have to make a decision.  Where do I want to be in my wave when the gun goes off?  At the front since I'm a great swimmer?  At the point that's closest to the first buoy?  Or more likely off the front a tad?  If you're at all unsure, line up toward the back, wait for the gun, and then count 1 one thousand, 2 one thousand, 3.......till the others get rolling leaving you a small patch of clear water and no worries that you'll be run over by a faster swimmer just as you're getting cranked up.

You may have someone swim right up you, or you may gag on a mouthful of water.  Happens to everyone at one time or another, and that's OK.  Slow down or stop, tread water if you need to, get your wits about you, regain control as you fix the problem, then once under control again, put your face in the water and start swimming again.  First buoy here I come!  Yahoo!