Wednesday, January 20, 2016

Am I Seeing Double? Married Couple Tackles the Big Island Race

When I was in Chicago for the holidays, I swam at the local "Y."  I met up with a group of guys with whom I blended perfectly.  One was a teacher, one a trucker, one retired and I don't know about the 4th but he was a very funny gent.  It was a great workout.  I told them that, just by chance, my swim group at home is a little different.  We have two mathematics Phd candidates, a JD who works in life insurance, a Computational Geneticist, the CFO of a branch of The University as well as a few others.  But you know what? Upon pool exit, despite some career differences, both groups are exactly alike in two ways:

They both smell like chlorine and both complain that "The pool is too damn hot!!"  I love it!

So if this happens to be the situation where you live, it's obvious that regardless of background, occupation, or outside the pool interests, you have lots company across the nation!  (And it was too damn hot!)
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Just because you know something, don't expect others to.  I "learned" from our 22 year daughter that, of the transmission options in her 11 year old little Volvo, P-R-N-D-4-3-2-1 that "the four is 4 wheel drive, Dad."  Uh, really?  Wonder of Volvo knows that.
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                                                           Double Dog Dare   

Just a minute, something's wrong with this picture?  This husband and wife couple both have on World Championship wrist bands for the 10/10/15 Kona race as they stand outside race registration in the ballroom of King Kamehameha's Kona Beach Resort.  That can't be, can it?  Both are in the event?  Really?  You bet!

I took this picture as the couple was sorting all the goodies they got during athlete check in

I've been a part of this sport for a good while now but I must say that this is a first for me. This is especially true since one of the themes of my writing has been that your triathlon training is anything but "invisible" to friends and family if you do it right (Does it Suck to be Your Triathlon Spouse? Probably.  http://bit.ly/1EMVp7c)  

So when I met 60 year old Bob Price, racer #320 with 67 other athletes in his age group and his 54 year old wife Cathie Price, racer #793 with 71 in her age group, I just had to ask.  They love triathlon and have been racing for about 20 years.  In fact, they've done so many iron distance events that they qualified for Kona through the legacy program this year.  Earlier I was asked by Ironman to do a dozen or so athlete profiles for Ironman.com for the race this past year.  I have a feeling after spending hours on the phone with these Kona-bound athletes that the legacy men and women might be just a tad more thrilled that they'd "made the cut" so to speak.  It's way more than simply paying dues, they were unbelievably grateful for the opportunity.

One of the bigger advantages the Prices felt they had over the average single Ironman athlete family was accountability.  Being from Canada, more often than they would like the weather is not always hospitable for outdoor exercise. Knowing both bikes are waiting in the garage often gets them out the door when others might "roll back over and go to sleep."

It also makes for an understanding such that they never need to make an excuse for training.  Along with work, they both feel that swim-bike-run is priority number one and would easily take precedence over the opening night at a new restaurant down the street or seeing the new Star Wars film at the local video palace.  They even race together most of the time which seems to make sense.  One thing I didn't ask in our short time together was how they handle injury.  I wonder what the psychology is when she is headed our the door for a run but he stays home battling plantar faciitis?  I'll bet they're way ahead of me and have encountered that situation plenty of times.

Now, looking back on the Hawaii race I wish I could report great results and orchid lei finishes for both of the Prices.  But as many of you know - including this author - some days things don't go your way and your desired goal just isn't met.  Plus, the tough Kona course is no walk in the park.  Bob was able to tame the rigorous Kona landscape finishing in 16:23 but after reasonable swim and bike legs with two solid transitions Cathie had to drop out on the run.  Never-the-less, I'll bet that her disappointment was short lived as triathletes are used to adversity and have internal mechanisms for fighting back.  Plus could you have any more understanding spouse on the planet than Bob Price?  I certainly doubt it.  I wouldn't be surprised if they're already planning their next husband and wife Ironman.  Together.  

Monday, January 18, 2016

What to do With No Longer Needed Pills


"You may unwittingly be a big source of prescription drugs your teen is using. And more often than not, medicine cabinets are their go-to spot of choice."




It wasn't that long ago that the medical community was accused of not being sensitive enough to patients complaints of pain.  This criticism was directed squarely at the primary care community, the largest prescribers of opioids.  This class of medications would include morphine, hydrocodone, methadone, oxycodone, various cough syrups, dilaudid, codeine containing compounds etc.

Fast forward to 2016 and abuse of prescription opioids is now at an all-time high.  The docs di basically what they were asked to do but an abuse situation arose.  Let's see what we can do to fix it.

Triathletes not only have the same medical problems as the general population, injuries from tendonitis to migraines as well as bike crashes occur in our segment of the population leading us to our practitioners for everything from tetanus boosters following dog bites to narcotic pain meds after accidents.  We may have short term reactive airway disease, some type of arthritic pain, etc. and be given a prescription which helps at the time of use but leads to a half filled bottle in our medicine cabinet later on.  At some point we're going to want to get rid of these no longer wanted capsules but may not know exactly how.  In our community, both hospitals have occasional days each year where they take drugs of any sort back, no questions asked.  You're not asked for any explanation, ID or anything.  You simply drop you unwanted medication into a box and leave.  Many believe that this absolutely eliminates any possibility of abuse, either from an offspring invading your medications to someone who might go though your trash looking for just such a treasure.  Yes, these people do exist. 

The Mayo clinic expounded on this recently, especially if you don't have the above option or don't want to wait.  It's fairly short, may even be worthy of printing off and saving should
questions arise in your future.  

Your actions with extra or unused medicines may end up keeping them out of the wrong hands in your neighborhood.

Thursday, January 14, 2016

Every Athlete Should Strength Train and Here's Why


Strength doesn't come from what you can do.  It comes from overcoming the things you once thought you couldn't.



Believe me, there's more than meets the eye when considering strength training.
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Most triathletes are well aware that a complete training program involves considerably more than swim-bike-run.  Nutrition, strength, rest, etc. balance the athlete giving him/her the greatest chance for success come race day.  Some use CrossFit or it's local equivalent, barbells and free weights, stretch cords, weight machines, Ergs, mat exercises, etc.  The obvious benefit is a higher level of physical strength where the hidden benefit of weight laden exercise is improved bone health.  With that comes a lower level of so-called pathologic fractures due to weakened bone or osteoporosis.  Exactly what is that?  Well, the easy answer is weak or brittle bones often accompanying age, inactivity, vitamin D or calcium deficiency as well as hormonal changes.  In other words bones that break more easily.

Ask any orthopedic surgeon.  As we age, most of us have a lower activity level, some with sub optimal nutrition, and slowly we lose total bone mass, particularly after the age of 40.  That's right, 40!  It surprised me too.  Although not likely in the tri crowd, bones can fracture with a minimal fall or simple misstep.  The ortho doc sees hip and wrist fractures, breaks in the humerus and low back, you name it.  Many of these two million or so fractures annually  will require surgery and a substantial percentage of those people never really get back to their pre-injury state.  So if there's something that as a triathlete you want to do - get faster - and the pathway there gives you this bonus effect, woowee!  Joe Friel, in Fast after 50, writes "high-load year round strength training has been shown to improve performance in experienced athletes, both male and female, in a variety of endurance sports."

Basically what you're looking for is to put stress across the bone.  A quick review of the literature shows that strength training slows the process of bone loss and some authors have suggested that it can even reverse it.  The end result is a stronger bone now and into the future.  So, whether you are a coached athlete or one who follows one of the published or on-line training regimens, most likely there is a strength training section to it. Or how about Pilates or yoga?  As always, I direct athletes to the entities that support out sport.  Dave Scott is known for imaginative and effective strength programs, Mark Allen as well, and a quick visit to their web sites may be "just what the doctor ordered." You just might start right here http://bit.ly/1nGMucR .


Monday, January 11, 2016

Time to Move on From Tri






Maybe it's time to think that you may have packed your last special needs bag.  Put a different spin on your future.  But then, to one degree or another, don't we all think about the future?  Some of us more than others?

 There comes a time when we need to move on.  Triathlon becomes a less significant factor in life, less of a priority, and training becomes more an obligation than a challenge.  That early morning swim is a burden, not an opportunity to work on a race limiter. Drudgery sneaks in to your lexicon.  We don't intend to give up sport altogether but perhaps revert to predominantly being a cyclist or runner.  Get more sleep.  Spend more quality time with the family, the work mates.  Not be afraid tonight to watch the 4th quarter as Clemson and Alabama play for the National Football Championship because you're supposed to be at the pool at 5:30 am tomorrow. 
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 The sword of time will piece our skin,

It doesn't hurt when it begins,


But as it works its way on in,


The pain grows stronger, watch it grin.   

                                           Suicide is Painless, Johnny Mandel. M*A*S*H, the movie
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 I know a number of people who were in triathlon for a short while and out.  On to something else.  It was a fling, an accomplishment, but not a lifestyle.  They didn't own a power meter, never found out the answer to a question on Slowtwitch. They weren't certain of the date of the World Championship in Hawaii. (It is in Honolulu, right?)  In fact, they had more on their plates than triathlon. Work, family, hobbies, other passions, etc. were all part of the game and while important, tri didn't take front and center stage.

 Not so for the woman I met in Kona this year on Friday,16 hours before race start in Kona last year. This was bike check-in, on the pier, for what would be her 40th, that's right, fortieth Ironman distance race.  I'm no Psychiatrist but in discussing the importance of triathlon in her life, the word addiction would have to have entered the conversation somewhere. I got a very pleasant note today from an athlete who just did her 91st IM.


 However, eventually the luster grows dull for most of us and we want to, or have to in many cases, secondary to chronic or recurrent injury, pass the torch.  And you know what, it's OK when that day comes.  Really, it is.


 "Cal" is one of the best triathletes in our area.  Like a fool, I let him talk me into a workout at the pool a couple years ago, something different he said, just for fun (Cal's kind of fun obviously.) We'd swim 100 yards, jump out on to the pool deck and do ten push ups, and be back in our lane to push off for the next 100.  Can we do it on 2:00? Yes.   Can we do it 1:55?  And the 1:50?  Etc., you get my drift.  Yes, Cal we can.  I think we needed a funeral home consult after that work out.


 But, Cal's life has gotten more complex lately as his kids have gotten older and entered wrestling, travel wrestling, you name it.  Cal's moved away from tri despite having the ability to run a half IM sub 4:30 in the very competitive 45-49 year old age group.  (I'm certain that some of you read this as discarding a gift that you, or I for that matter, will never have.  I feel your pain!) In short, your day to step back from the sport will come.  When it does, it'll be just fine.  Honestly. I saw that day a while back, and it's just fine.






The race is run, how did you fair? How about those other pesky people in your age group?


Image 1, Google Images

Wednesday, January 6, 2016

Triathlon PR in Your 40's, 50's and 60's? Sure?


It's January, and you have your entire triathlon life planned out till your "A" race, right?  Well, be prepared for some bumps along the way. 
Embedded image permalink
Tip of the hat to @linda_alread
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Masters Triathletes Can PR in the Swim


It’s never too late to get faster

You mean I can have a lifetime best swim in my 40's or 50's?  Sure.  We see triathletes enter the sport from all walks of life, at all stages of life.  Although some were active swimmers "in a previous life" and others look to the sport for new challenges somewhat later in life, many get better.  Lots better actually.  They surprise even themselves.  Even folks who were competitive during collegiate days can get near performances they haven't seen in decades.  

This came from the USMS a while back and it's quite good.  See if the shoe doesn't fit.

One of the most powerful traits that swimmers can take advantage of is their belief that they can achieve a certain time or level of performance. For many returning swimmers that hit best times decades after their college or high school years, knowing that they’ve been there before is a big factor.
In sport and in life it’s generally accepted that what you tell yourself repeatedly in your head has an affect on your performance. If you take a positive approach to a realistic goal and believe that you can get better, you probably will. Conversely, if you’re cynical about your performances or downplay your potential to succeed, you might be left wondering why you can’t get faster. I’m not advocating just sitting on your couch and visualizing yourself to an amazing performance, but if your mind isn’t in sync with your training, your true potential will always be a “What if?” thought.

Focus


Many Masters triathletes don’t train nearly as much as age group or pro triathletes. However, a little less training is a good thing because it allows you to be more focused on what you’re actually doing in the moment.
If you only get to the pool three times in a week, you might be more likely to make those practices count—everything from your technique to your pacing. Whereas if you had six practices a week, you might be more likely to coast or zone out—justifying it because you have a lot of practices, so you don’t have to be intentional all the time.
The best coaches are adamant about intentional practice—practicing with total focus. Even with less time in the water, if you’re swimming intentionally, you’ll be more productive than if you were swimming more often with less focus. Be present and get the most out of each practice you attend, whether it's in the pool or the gym.

Strength


Triathletes who see lifetime best times later in life are often physically stronger than they were in their younger years. Strength can be achieved later in life, but it requires a well-planned training program that includes appropriate rest and recovery. You can still gain strength if you stay consistent and on a planned program.
Gaining strength won’t happen overnight, but I’ve worked with many swimmers who couldn’t do a single pull-up and watched them progress to full-range, bodyweight pull-ups—some even with added resistance, such as a weight belt. It took commitment, but they followed the plan and the results speak for themselves.
Bottom line: Don’t sell yourself short on the potential that you have inside of you right now. Put these tips into action and you’ll be amazed at how high you can raise your performance level.
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And what of Masters Triathletes who want to think big? Kona isn't out of the question. It wasn't for 64 year old Jim. (It could just as easily be 34 year Jim now couldn't it?)  He writes:

I started doing triathlons in 1990 at age 42. I got better quickly, but topped out as a guy who might come in 3rd in his age group at a local event. My greatest achievement in the years between 1990 and 2005 was the best bike split in Memphis in May. I made it in just under an hour. Of course, I was passed by hundreds on the run.
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 V02 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 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.
I was never world class, but depending on the race, I always felt I had a chance.
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Dear Reader, your take away is exactly that.  You always have a chance!

Lastly - ever consider an Alcohol Free January?

Check this from Ironman. 
http://www.ironman.com/triathlon-news/ironman-life.aspx#axzz3wJTXKhxG

Happy New Year

Monday, January 4, 2016

Foot Pain - The Accessory Navicular Bone, The "Extra Foot Bone"

Happy New Year to all!!

January can be a deciding month.when it comes to triathlon.  One local athlete with three kids, a time intense job, and a mortgage never really maxed out her tri efforts.  "You know, I've always wondered how fast I could go if I really got behind the sport for once."

It's never too late to improve.  Why not make 2016 your year too?

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At least half of patients with stress fractures who had their vitamin D levels tested had insufficient levels, according to a retrospective cohort study published in the January–February issue of the Journal of Foot & Ankle Surgery      From Twitter yesterday, see below.
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Feet.  Sometimes they can give even the most careful athlete problems.  Most of us are pretty careful to follow a methodical, well-thought out training plan.  Maybe the plan is concocted with the help of a professional coach.  A plan based on the periodization model to improve our fitness with minimal chance for injury, right?  Even so, as Steinbeck wrote in 1937 while borrowing from the poet Robert Burns, "The best laid schemes o' mice an' men /Gang aft agley" (often paraphrased in English as "The best-laid plans of mice and men / Often go awry.")  We can't plan for absolutely everything.  We just can't.

One interesting problem that pops up later in life, not caused by some sort of training error, can be an "extra foot bone" the so-called accessory navicular.  Each of us has a navicular bone on the inside of our foot at the top of the arch.  Most get through an entire life garnering adequate service from both of these tarsal naviculars.  Sometimes, however, it can be the source of an interesting problem.  Interesting to the doctor that is!





This is from the American Academy of Orthopedic Surgeons and was written by Salene Parekh of Duke University.

"Over the years, I have had a number of patients who come in with complaints of pain in the inner center part of their arch. Typically, these patients tend to be athletic, however not all are. Oftentimes, these patients have a bump in this inner center arch area. What is this bump and why is it painful?
Accessory navicular
As infants and children, many of our bones start off as cartilage. These cartilage “bones” are difficult to see on x-ray until they become calcified. The calcification process occurs at a variety of different times in life depending on the bone.
An accessory navicular is an extra bone that is on the inner center arch of the foot. Up to 2.5% of individuals are born with the accessory navicular. Throughout early childhood, this condition is not noticed. However, in adolescence, when the accessory navicular begins to calcify, the bump on the inner aspect of the arch becomes noticed. For most, it is never symptomatic. However, for some, there is some type of injury, whether a twist, stumble, or fall, that makes the accessory navicular symptomatic.
There are three different types of accessory navicular. This extra cartilage, which is turned into bone, is found attached to the posterior tibial tendon, just medial (inside) the navicular bone. The accessory navicular can affect the insertion of the posterior tibial tendon. This tendon has a job of keeping your foot aligned and helping to maintain an arch. The accessory navicular can be associated with a normal foot posture and alignment, or sometime with a flat (pes planus) foot.
An initial assessment is an orthopaedic office begins with a thorough history and complete physical exam, including an assessment of the posterior tibial tendon and areas of tenderness. Associated misalignments of the ankle and foot should be noted. Finally, weight-bearing x-rays of the foot will help in making the diagnosis. Sometimes, an MRI may be needed to see if the posterior tibial tendon is involved with the symptoms or getting more clarity on the anatomy of the accessory navicular.
Initial treatment is conservative. With the first episode of symptoms, a medial heel wedge, anti-inflammatories, and physical therapy can be helpful. If very painful, a cast or boot may be needed for a short period time before the wedge and physical therapy can be initiated. Very rarely is a steroid injection warranted or recommended. As the pain improves, patients can resume activities. For a minority of patients, an arch support or custom orthotic can help to take some of the extra pressure off of the accessory navicular and the posterior tibial tendon.
For patients who have failed conservative care or who have had recurrent symptoms, surgery can be considered. Surgical intervention requires an excision of the accessory navicular and reattachment of the posterior tibial tendon to the navicular. Often times, this is the only procedure necessary. However, if there are other deformities such as a flat foot or forefoot that is abducted, other procedures may be required.
In summary, an accessory navicular is a fairly uncommon condition which is rarely symptomatic. Oftentimes non-surgical treatment is successful. In the minority of cases, surgical intervention is required. Patients typically do very well with conservative and surgical treatment. Athletic activities can usually be restarted once symptoms have improved or the patient has recovered from surgery."

So if this describes you per chance, there's no rush to have some kind of surgery.  See if you can't wait it out.
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This from Medscape Orthopedics on Twitter yesterday on stress fractures and vitamin D:

Study: Low vitamin D level linked to increased fracture risk. .