Friday, October 30, 2015

When Is It OK To Just Do the Race as a Workout?

Great Opportunity - have a close look at your stroke!


"I hate running!" Swimmer Magazine, January 2013

The article goes on to say, "What famous swimmer posted that at usms.org?  If you're guessing every swimmer there may be a grain of truth, because swimmers, by definition, practice a water-based sport rather than a land-based sport.  But not every swimmer hates running, and increasingly, more runners are getting into swimming thanks to the triathlon craze."*

Triathlon and some of the personality types that gravitate to the sport can, in some cases make us our own worst enemies.

I had someone tell me once that they'd think twice before hiring some one deeply involved in this sport.  Sure, the old adage about giving something you want done to the busiest person you know is part of this, the positive part.   But does the distance triathlete think, plan, drown in triathlon during their work day to the point that it sometimes diminishes their effectiveness?  From a personal perspective, when I was still racing iron distance events, the answer approached, dare I admit it but on occasion the answer might be yes.

 Running or Racing?


We've all been in this setting.  You are just about completely recovered from your first/latest(?) major running injury, gradually increasing your mileage as ordered. Then you remember that your very favorite race is coming up next week.  What do you do? Enter anyway?

 This question is asked repeatedly and the answer is hard to come by.  If you run it do you race it, seek that PR, look for the podium?  Is there a reason not to?

Race?  Don't race?  Just run it?  It all depends, in my mind, on how your rehab is coming and your physical condition.  There will be 100's more races down the road and from a physicians perspective, just like shutting down Stephen Strasburg of the Washington Nationals after his Tommy John elbow surgery, in my opinion, you always think long term.  Always.  Is there a level of effort, after which I risk worsening my injury and delaying my being at 100% healed?  Only you can answer this.

But there are several reasons why running a race, but not racing it, makes good sense:

1) you're coming back from injury as noted above.
2) You had a hard race last WE, and maybe the WE before, and can treat it like a work out.
3) Fun. You just want to run for the fun of it. Maybe conversational pace with a friend.
4) A friend is looking for a PR and you've agreed to pace him/her.

 So just because you're not at full steam, you don't necessarily have to drop race participation. Just think before you do, make a game plan, and stick to it.  That may be the hardest part.


 Big Toe Problems


 We covered bunions a couple weeks ago with some pretty good pictures if you missed it. Your big toe is really important as it carries 40-60% of your body weight, twice the lesser toes!  So, anything that might affect the big toe may also alter your running gait.

Some athletes will suffer an injury with subsequent loss of motion of the big toe.  This stiffness of the joint can be known as "turf toe" from it's initial frequency on artificial turf.  Imagine you pause to tie your shoe in a race with lots of runners around you - and one trips - landing on the heel of your back foot driving your forefoot into the pavement.  If this becomes sufficiently symptomatic, one fairly drastic treatment includes fusion of the first metatarsophalangeal joint.  Obviously this leaves bone where a joint used to be, not acceptable in some.   Other options called interpositional arthroplasties can maintain some of the motion and diminish pain. Basically, avoidance is your best option.  That said, after surgery, almost all noted improvement and there was a 75% patient satisfaction rate.  I doubt many were triathletes. 


* Jim W. Harper

Tuesday, October 27, 2015

Blast From the Past; A Letter to Ironman Athletes from 1982 Ironman Race Director Valerie Silk


This is really nice!  I found this letter to all athletes after the race from then Race Director Valerie Silk. It was only the third race in Kona and 6th overall. There was no qualification, time cut offs for the swim, bike or run, and all three courses were different.


 Image result for valerie silk

         Thank you so much for your participation in the Ironman.  You have certainly added a new dimension to my life, and the warmth I feel from knowing how much you gave of yourself to compete in this race is more than I could ever tell you.  It’s awesome enough that you did what you did on October 9 [1982], but what I find so admirable is what it took for you to prepare for that day.  I can only imagine what it must have been like to have devoted the amount of time and energy to training that you did, and whatever obstacles, whether injury, family or career pressures, inclement weather, or you own self-doubts, you didn’t give up.  That level of discipline and commitment takes my breath away, and I stand in complete awe of you.
        In my comments to last February’s Ironman contestants, I mentioned a verse that capsulizes for me the picture I have of you.  As I write this, the same verso comes to mind again, and I feel it bears repeating….
                                                                    THE DIFFERENCE
It’s easy to run at the start of the race
With a free and swinging tread;
To keep in the going and follow the pace
When the whole track lies ahead.

But the time when the finish line heaves in sight,
When the veins and the muscles swell,
And the eyes are glazed and the lungs feel tight,
It’s the time that class will tell.
May I be so fortunate to see such a classy person as you at the Ironman again.  If not in ’83, then perhaps one day.  Until then, good luck to you.
                                                                Aloha nui loa,
                                                                Valerie Silk
                                                                Race Director
    

Wednesday, October 21, 2015

I Have Bunions, Funny Toes. Can I Still Podium in Ironman?

Yes!


While some in our sport have pretty feet, others do not.  Is the appearance of one's feet predictive of performance?




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Bunions, hammer toes, toe nail fungus, you name it we can have lots of things go awry in our forefeet.  But it doesn't mean that we need to find another sport.  We need to learn to adapt to these issues, not be a slave to them.

When told that we have one of these issues we do our best to understand the problem, the natural history of the disease, and what we can do to both slow it's progress and adapt our footwear, running/biking style, etc. for the best out come.

I took this picture in Hawaii 2015.  Both of these men had qualified for Kona.  The feet on the right belong to a gent who was #1 in the World AWA ("The IRONMAN All World Athlete program is our way of rewarding age-group athletes' hard work, dedication, and performance across IRONMAN and IRONMAN 70.3 racing." Source:Ironman.com).  Those on the left to a gent who was standing on the Hawaii stage following this year's race receiving his podium bowl.  With dogs like these, although they may not be the most eye catching, there's no limit to what you can accomplish.





So here's a touch of information on bunions.
If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.

More than half the women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes, and high heels. Bunions may occur in families, but many are from wearing tight shoes. Nine out of ten bunions happen to women. Nine out of ten women wear shoes that are too small according to some sources.

Too-tight shoes can also cause other disabling foot problems like corns, calluses and hammertoes.

With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. An advanced bunion may make your foot look grotesque. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Relief from Bunions
Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into a shoe that doesn't fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You may also try protective pads to cushion the painful area.

If your bunion has progressed to the point where you have difficulty walking, or experience pain despite accomodative shoes, you may need surgery. Bunion surgery realigns bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Orthopaedic surgeons have several techniques to ease your pain. Many bunion surgeries are done on a same-day basis (no hospital stay) using an ankle-block anesthesia. A long recovery is common and may include persistent swelling and stiffness.
Adolescent Bunion
Your young teenager (especially girls aged 10-15) may develop an adolescent bunion at the base of his or her big toe. Unlike adults with bunions, a young person can normally move the affected joint. Your teenager may have pain and trouble wearing shoes. Try having your child's shoes stretched and/or getting wider shoes. Surgery to remove an adolescent bunion is not recommended unless your child is in extreme pain and the problem does not get better with changes in shoe wear. If your adolescent has bunion surgery, particularly before they are fully grown, there is a strong chance his or her problem will return.
Bunionette
If you have a painful swollen lump on the outside of your foot near the base of your little toe, it may be a bunionette (tailor's bunion). You may also have a hard corn and painful bursitis in the same spot. A bunionette is very much like a bunion. Wearing shoes that are too tight may cause it. Get shoes that fit comfortably with a soft upper and a roomy toe box. In cases of persistent pain or severe deformity, surgical correction is possible. (From AAOS, Orthoinfo.org)
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With just about any deformity, we can protect our feet in the short run.  But the sport of triathlon can be pretty hard on feet in the long run.  When racing 70.3 or full iron distance, in some it may not be possible to completely shield your toes from injury and they end up like this:


Following the finish of IMKona 2015.


Monday, October 19, 2015

Even Kona Has Flats - Big Screw in Podium Athlete's Front Tire


"This Could Happen to You!"  
                                                       The M.T.A, Kingston Trio, 50- 60's folk singers**






Alii Drive was the finish of the Ironman World Championship last Saturday.  It is every year. In the race's infancy, the course involved more of Alii drive than it does now. In fact, it went seven miles south of Kona to the area known as Keauhou where your bike-to-run gear was waiting at what's known today at the Sheraton Keauhou Bay Resort and Spa. Racers  still head that way for pre-race training rides and that's where the below occurred.

Steve Smith of Strafford, NH and one of my condo mates this year, was flying down the hill on Alii Drive extended when he picked up the below.  Needless to say it put a dent in his ride. But it also brings up some good lessons for the rest of us.  Steve easily addressed and remedied this problem, could you have?





Questions for the average triathlete
1)  if this were your front tire, on a downhill, and the air escaped the tube rather quickly, are you a good enough bike handler that you probably won't crash?
2)  If this were either of your tires have you practiced tire/tube changing enough that you'd be able to remedy this in short order and get back on the road?
3)  Same consideration only now what if this occurs in a race?  Your "A" race?
4)  If the tube starts to protrude from either hole do you know a really quick fix that will last till race's end?*

One of the reasons I ask these questions is that during the swim-to-bike transition in Kona, I hung out with the panic mechanics who felt that many of the bikes on the pier were "on fire," In other words, they had not been given proper average maintenance.  I'll be writing more about this separately on LAVA Magazine's web site.  For today, let's just say that it's imperative for triathletes to be able to handle routine bike issues.  Don't be one of those helpless folks who, when some sort of mechanical issue arises, they just look at their bike waiting for divine intervention.


Peanuts for a friend
I've been to the Big Island a number of times now and the draw of October is as much for the Island and people of Hawaii as it is for the Ironman.  So just like you, I try to occasionally do something to pay back the folks who've been nice to me. Like Karen, the most pleasant waitress at Lava Java, or Jason, the friendly omelet chef at the King Kam race headquarters hotel restaurant.  Being from Virginia, a state which exports a large amount of peanuts, selecting a gift from the many varieties of peanuts for these folks would be easy.  In the film Finding Forrester, Sean Connery (yes THE Sean Connery) plays a writer named William Forrester who offers the following advice to a younger companion that "the key to a woman's heart is an unexpected gift, at an unexpected time."  I would suggest this to be true in a majority of situations, not just limited to romantic ones.

So in my suitcase I carried a can of Virginia's finest for each and they were a big hit.  They wanted to give me free food!  I thought that management might disagree with that sentiment so it was easy to say thanks but pay for the meals.

I had one more can of peanuts.

David Huerta is in charge of all things Transition for Ironman.  Quiet and unassuming, he carries himself with an impressive leadership presence.  You just know that he's in charge.  He needs someone to handle gate dutes race week monitoring what vehicles go off and on the Kailua pier so he offers the job to a homeless gent named Brian who does a splendid job.  David very quietly compensates him from his own pocket.  Get this. In his spare time, Brian stands at the stairs leading down to the small beach offering an assist to those yet to regain their land legs following a dip in Kailua Bay.  Just to be nice.  And he does it over and over and over again.

My third can of peanuts went to Brian.  
________________________________________________________

* Easy. Put some kind of "liner" inside the tire between tire and tube.  I've seen people use a piece of a Power Bar wrapper or such foil.  I've heard that a 1 dollar bill works quite well also.

** https://www.youtube.com/watch?v=aP1bvY7IqZY




Wednesday, October 7, 2015

Seriously? Cell Phone Chatting in 7' Waves in Kailua Bay?

Kailua-Kona October 4, 2015


Way out west, they got a name, for rain and wind and fire.
The rain is Tess, the fire's Joe, and they call the wind Mariah
                                                                  The Musical Oklahoma

It's windy in Kona.
________________________________________________________________
As I write this, from a condo on Alii Drive, I'm listening to two of my roommates talk nervously as they hunker over one's lap top.  This is an in-depth discussion of the various weather web sites regarding both current wind and wave heights as well as future weather conditions for Saturday's World Triathlon Championship here on the Big Island.  Named Tropical Storm Oho dominated conversations earlier in the week with charts and grafts attempting to predict whether or not the track to storm would take might include the Hawaiian Islands.  It would certainly effect the outcome of the event for many athletes, especially those for whom the swim is their weaker of the three events. Fortunately for all it appears that it will miss us but current conditions are far from ideal.  In fact, it was so windy today that a large tree was felled by a tremendous gust of wind and half the power to this side of the island is still out some 10 hours later.  

To the reader, if you are one of the above referenced swimmers, as the 2015 season is ending, this would be an excellent time to commit - make proficiency/comfort in open water swimming - your 2016 New Years resolution.  It truly is one of those practice makes perfect skills that if given proper attention will pay huge dividends come next race season.  Honest.

This brings me to the title subject.  On Sunday, my first swim of the year in Kailua Bay, I tweeted afterwards that the conditions in the water were as challenging as I've ever seen them.  And I've been coming to Kona for more than thirty years. Planning to complete about half the Ironman swim course before getting in, I was immediately hit with 7 foot waves.  To make any progress, you just had to put your head down and punch through waves.  Certainly doable but a lot more work than planned.  Viewing the coral on the ocean floor amplified your slow progress appearing almost treadmill-like.  "I'm still looking at the same coral."

After doing this for about 30 minutes, when the swimmer turns to head back, it's good body surfing and the elapsed time was about 75% of the outbound journey or less.  But as I approached the turn, nearly 500 meters off shore in this roiling, churning, angry sea, when the waves approached their nadir, I spied a guy treading water talking into a cell phone!  Right, talking into a cell phone.  Bouncing, turning, water crashing around, he's doing his best to just gab away.  When asked by this author why he was doing this, the totally illogical response came out as "I'm talking to my wife, she's in New York."

How do you respond to that?  I just swam back to the pier.
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GPS Goggles

One of my roommates this week has these terrific GPS powered open water goggles that let him swim straight without much sighting.  The concept is that you swim 10 meters in the beginning of an event, straight of course, and the GPS establishes your track.  Then, once enroute, you simply "swim to the light."  Green in the center, you're on course, get a left yellow and you're right of course and need to swim to the left.  I'm told that it's really easy to follow the commands.  


The one drawback that we found in our "test kitchen," Kailua Bay, was that when you're tossed around a good deal by a moving sea that the GPS had a hard time keeping up.




Thursday, October 1, 2015

I'm an Athlete, Do I Need a Bone Density Test? Do I Need Extra Calcium?


I'm pretty low risk, do I need a bone density test?  What would I do with the results?

I would suspect that at least half of you have had a serious bike accident, some even with a broken bone.

Embedded image permalink
Watch me pull a rabbit out of my.....spokes?
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Bone density tests help to determine if a patient has the diagnosis of osteoporosis, a condition that causes thinning of the bone. There are specific criteria that are used to determine when this test is appropriate.

Having an abnormal bone density test may guide treatment, but the treatments often involve medications that can have significant side-effects

Patients who don't need a bone density test, may be best served by waiting until they meet appropriate criteria for the test.

What is Osteoporosis?


Osteoporosis is a condition that weakens the bones of your skeleton. Bones, like other tissues in your body, are living structures that constantly are changing. New bone is made and old bone is taken away. Osteoporosis develops when the pace of new bone formation cannot keep up with the loss of bone. 

Current Recommendations - The U.S. Preventative Services Task Force recommends a bone density test at least once for all women age 65 and older.

Who should have a bone density test?*

  • all postmenopausal women under age 65 who have one or more additional risk factors for osteoporosis (in addition to being postmenopausal and female)
  • all women age 65 and older regardless of additional risk factors
  • postmenopausal women who sustain a fracture
  • women who are considering therapy for osteoporosis if bone density testing would facilitate the decision
  • women who have been on hormone replacement therapy (HRT/ERT) for prolonged periods
Using Osteoporosis Drugs:
Many people think of bone as a structure, like the frame of your house or the chassis of your car. But bone is a living tissue that is constantly changing. New bone is always being made, and old bone taken away. Osteoporosis develops when the rate of bone loss exceeds the rate of bone formation.
Treatment of osteoporosis focuses on trying to increase the rate of bone formation and decrease the rate of bone loss. This can be accomplished by different methods including exercising, stopping smoking, eating right, and taking medications.

Calcium
Calcium is a mineral found most abundantly in our bones. It's one of the building blocks of normal bone, yet many people do not injest enough to maintain healthy bone stock.  With society living longer, this creates a significant problem if the bone loses it's strength and becomes susceptible to fracture.  All of us should consume calcium every day and a small number of need extra, possibly in the way of some kind of supplementation if one's diet is insufficient.  There are both dairy and non-dairy forms of calcium.  Some have previously recommended larger doses of calcium but this has come under fire recently and may even be harmful.

Vitamin D
Vitamin D works together with calcium to help maintain normal bone health. Vitamin D is necessary for your body to absorb calcium; even if you are ingesting calcium, your body may not be able to absorb it if you don't also have enough vitamin D.
Children who do not get enough vitamin D have a condition called rickets, and adults who don't get enough vitamin D have a condition called osteomalacia.

Bisphosphontes:
Bisphosphonates are a type of medication known as antiresporptive medications. These medications prevent bone loss by inhibiting the normal function of cells called osteoclasts. These are the cells responsible for removing old bone. When osteoclasts are working harder than the cells making new bone, the development of osteoporosis can be accelerated.

Calcitonin:
Calcitonin is a hormone produced in your thyroid gland. Calcitonin is naturally made in your body when blood calcium levels are high. This tells your body to retain calcium within the skeleton, rather than use calcium in the bone to replenish the calcium in the bloodstream. Calcitonin works by limiting function of the osteoclast cells that consume bone to release calcium in the bloodstream.
Calcitonin is usually administered by a nasal spray. Side effects of calcitonin include runny nose, headaches and nose bleeds.

Hormone Therapy/Estrogen:
Estrogen therapy (ET) or hormone therapy (HT) are effective treatments for preventing bone loss and reducing risk of fracture. ET has been shown to cause an increased risk of uterine cancer, and is therefore used alone only in patients who have had a prior hysterectomy. In others, combination estrogen and progesterone treatment (HT) is used.
Concerns about increased risk of breast cancer, stroke, and blood clots have surrounded the use of these medications for osteoporosis. Therefore, the FDA recommends the use of ET/HT only if other medications cannot be used and there is a significant risk of osteoporosis.

Bone Forming Medications:
A new medication is being used to help the body make more bone. The medication called teriparatide (Forteo), is a synthetic version of parathyroid hormone. Parathyroid hormone is your body's internal signal to make more bone. Given by injection, teriparatide stimulates the body to increase the amount of bone formation

The take away here is to be aware that the problem exists, may exist in you, and at least be aware of the diagnosis and that there are treatment options.  Happy Training.

Photo credit: Google.com
Much of this info is taken from Ask.com, about.com and a variety of other sites