Sunday, June 18, 2017

A Dog Swimming the Kona Race Course? Seriously?/Running Keeps You Physically Younger

Kimo the dog. I wear glasses, but my eyesight's not all that bad. While treading water at the Coffees of Hawaii barge (every year during IM race week in Kona, the good folks at Coffees of Hawaii set up a large sailing craft about 700 m off shore, where anyone who swims up to it is offered a small paper cup of Kona's finest.
Coffees of Hawaii barge, Kona, Hawaii
It's pretty darn cool and I'd suspect they serve over 1000 "customers" each morning. The coffee's hot, too!)
So, while sipping my excellent brew, goggled, without glasses, I noted a group of three swimmers approaching, one with a very odd mask on, but hey, it's Hawaii, home of the underpants run, who's to say what passes for odd around here?  Plus, I'm in the middle of the Pacific Ocean at a coffee barge for gosh sakes. I thought the mask had ears on it. But, once they were closer, I could see that the third swimmer was a German Shepherd.  A German Shepherd with a life vest on.! Now there's something you don't see every day back home. When the couple had had their fill of coffee, all it took was a simple, "Come Kimo," and off they went, continuing their swim.  The three swimmers.

Triathlon Pre-race Check List. Am I really ready?  Am I safe?

USAT has the CHECK yourself program.  It's a good one.  If you take just a minute to read each of these check boxes, agree that each describes you, the potential of you ending your race in the Emergency Room is quite low.

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover."  Mark Twain

Running May Reverse Aging

The below written a couple years ago by Gretchen Reynolds of the NYT.  It's as true today as it was then.  Although it's pointed at running specifically, in my opinion, the cross over to triathlon is as strong if not more so than the single sport athlete.

Running (and likely triathlon) may reverse aging in certain ways while walking does not, a noteworthy new study of active older people finds. The findings raise interesting questions about whether most of us need to pick up the pace of our workouts in order to gain the greatest benefit.
Walking is excellent exercise. No one disputes that idea. Older people who walk typically have a lower incidence of obesity, arthritis, heart disease and diabetes, and longer lifespans than people who are sedentary. For many years, in fact, physicians and scientists have used how far and fast someone can walk as a marker of health as people age.
But researchers and older people themselves also have noted that walking ability tends to decline with age. Older people whose primary exercise is walking often start walking more slowly and with greater difficulty as the years pass, fatiguing more easily.
Many of us probably would assume that this physical slowing is inevitable. And in past studies of aging walkers, physiologists have found that, almost invariably, their walking economy declines over time. That is, they begin using more energy with each step, which makes moving harder and more tiring.
But researchers at the University of Colorado in Boulder and Humboldt State University in Arcata, Calif., began to wonder whether this slow decay of older people’s physical ease really is inexorable or if it might be slowed or reversed by other types of exercise and, in particular, by running.
Happily, Boulder has an unusually large population of highly active older people, so the scientists did not lack for potential research subjects. Putting the word out at gyms and among running and walking groups, they soon recruited 30 men and women in their mid- to late-60s or early 70s.
Fifteen of these volunteers walked at least three times a week for 30 minutes or more. The other 15 ran at least three times a week, again for 30 minutes or more. The runners’ pace varied, but most moved at a gentle jogging speed.
The scientists gathered all of the volunteers at the University of Colorado’s Locomotion Laboratory and had each runner and walker complete three brief sessions of walking at three different, steadily increasing speeds on specially equipped treadmills. The treadmills were designed to measure how the volunteers’ feet hit the ground, in order to assess their biomechanics.
The volunteers also wore masks that measured their oxygen intake, data that the researchers used to determine their basic walking economy.
As it turned out, the runners were better, more efficient walkers than the walkers. They required less energy to move at the same pace as the volunteers who only walked regularly.
In fact, when the researchers compared their older runners’ walking efficiency to that of young people, which had been measured in earlier experiments at the same lab, they found that 70-year-old runners had about the same walking efficiency as your typical sedentary college student. Old runners, it appeared, could walk with the pep of young people.
Older walkers, on the other hand, had about the same walking economy as people of the same age who were sedentary. In effect, walking did not prevent people from losing their ability to walk with ease.
More surprising to the researchers, the biomechanics of the runners and the walkers during walking were almost identical. Runners did not walk differently than regular walkers, in terms of how many steps they took or the length of their strides or other measures of the mechanics of their walking.
But something was different.
The researchers speculate that this difference resides deep within their volunteers’ muscle cells. Intense or prolonged aerobic exercise, such as running, is known to increase the number of mitochondria within muscle cells, said Justus Ortega, now an associate professor of kinesiology at Humboldt University, who led the study. Mitochondria help to provide energy for these cells. So more mitochondria allow people to move for longer periods of time with less effort, he said.
Runners also may have better coordination between their muscles than walkers do, Dr. Ortega said, meaning that fewer muscles need to contract during movement, resulting in less energy being used.
But whatever the reason, running definitely mitigated the otherwise substantial decline in walking economy that seems to occur with age, he said, a result that has implications beyond the physiology lab. If moving feels easier, he said, people tend to do more of it, improving their health and enhancing their lives in the process.
The good news for people who don’t currently run is that you may be able to start at any age and still benefit, Dr. Ortega said. “Quite a few of our volunteers hadn’t take up running until they were in their 60s,” he said.
And running itself may not even be needed. Any physically taxing activity likely would make you a more efficient physical machine, Dr. Ortega said. So maybe consider speeding up for a minute or so during your next walk, until your heart pounds and you pant a bit; ease off; then again pick up the pace. You will shave time from your walk and potentially decades from your body’s biological age.

Tuesday, June 13, 2017

Posterior Tib Tendon, I'd Take Any Risk to Tie Back the Hands of Time

This is an edited redo.  One of my most popular blogs of all time. Certainly the one that has generated to most "will I ever be able to exercise again?" mail came from that writing.  If you're reading this as one with the problem, why not make a pit stop by the Q&A that follows the previous post. It serves as a good library and just might answer your questions.

Previous post.


Posterior Tibial Tendon Problems

We have to take good care of our feet to do what we do. Many have learned the hard way about Plantar Faciitis, metatarsal stress fractures, interdigital neuromas and the like through unplanned interaction with the medical community. I have always felt the more knowledgeable the athlete, the better. The ones with problems who end up in my office who've already asked around or researched their concerns on the net seem to be in a better place to help me help them.

Athletes frequently complain of two types Posterior Tibial Tendon difficulties. The first is a slow, subtle deterioration process that actually tears or can even stretch the tendon leading to what's known as an acquired flat foot deformity. The tendon has slowly, over time, lengthened and can, in some cases, no longer do it's job in maintaining the longitudinal arch of the foot. In other instances, the tendon will actually rupture frequently leading to surgical repair. Those who seem to be at higher risk for this injury are the obese, diabetic, rheumatoid arthritics including those who may have had a steroid injection in the area.

I used this black and white out of one of my old Anatomy texts as it shows only the business part of the PTT (labeled Tibialis Posterior)coursing behind the tibia and inserting on the navicular.

So, if you have pain over the inside of the ankle, get it checked out. Your doctor will examine the ankle looking for tenderness over the course of the tendon, swelling, weakness...and those with a real problem...a gap in the tendon. The doctor will check your muscle strength by asking you to stand on your toes or determine if there's an asymmetry in the arch while weight bearing. Although this is usually a clinical diagnosis, an MRI may be required. In my office, although tendons are not normally seen on x-ray, a plain x-ray always precedes an MRI.

If a PTT problem is noted in the early stages, a supportive orthotic might be recommended or even a cast. I'm partial to casts. If, over time, the problem continues to worsen, then an operative procedure may be recommended to repair the tendon, occasionally using a nearby tendon as a graft. In the worst case scenario a fusion of the foot bones is done to restore the arch of the foot. As you might expect, rehab is considerable and even with appropriate treatment, one's triathlon future might be in jeopardy.

The take away is that patience is key in the athlete with early symptoms and just because you may have had a scan which shows a tear, you still may not require surgery and wouldn't think about it until after 3-6 months of rest in many cases.  So as Maxwell Smart might have been thinking in the TV show of the 60's or movie from the movie from 2008, if you have a musculoskeletal issue, do your homework, read up on it and "Get Smart."

Tuesday, June 6, 2017

Why Can't You Swim Straight?

Pay Your Lifeguard With Wet Dollar Bills

On Saturdays, a sizable group of triathletes and open water swimmers meet early in the season at one of the area man-made lakes for open-water training.  It is invaluable to work on swimming in a pack, sighting, getting used to a wet suit for some, etc.  Some claimed it to be their most advantageous swims of the year.  Those seeking to improve had better swimmers and coaches literally an arm's length away.  We get one of the swimmer's kids to be our canoe-bound life guard and each swimmer pays "per mile" from money they stash in their suit and swim with.  When finished, they simply swim up to the canoe, pay cash, wet cash, to the smiling guard who's making a good living on a Saturday morning.  Even though it's wet.

We're pretty lucky.  We're able to use the same lake and course where some years the USMS Two Mile Cable Swim National Championships are held.  You see, in the late 60's, the area was home to Virginia resident and future world class distance swimmer James Kegley.  His dad wanted to help James with his swimming efforts.  In addition to building a home with a lap lane pool in the basement, Jack Kegley helped place two telephone poles into lake bottom exactly one quarter mile apart.  Mind you this was in the pre-GPS and computer days.  And it's over water.  Interestingly, using current methodology, the course has been remeasured since and found to be withing 9" of perfect.  Not bad for a "Little League Swim Dad!" James would go on to win the two-mile several times with a PR on this course of 38:32. Two miles exactly.  This guy can move!

 At a triathlon a couple years ago, I was in a bit of hurry having forgotten to spray on sunscreen.  I grabbed the clear bottle, shut my eyes really tight, and got a good covering of my whole face.

Unfortunately I still had my glasses on!

Swimmers exit the lake after "enduring" recent swim

Why Can't You Swim Straight?

"Swimming in open water feels different from swimming in a swimming pool.  The salt water makes you float higher and the fresh water feels good against your skin."   Lynne Cox

We had our first open water lake race of the season last weekend.  A little chilly for some at 66-68 degrees depending where you measured the lake and the wetsuited swimmers far outnumbered those simply in a suit and cap. Once in the water, although most traversed the shortest distance between every two buoys, that being a straight line, we had a fair number of Wrongway Peachfuzz navigators charting a path not unlike the zigzag setting on your Mom's Singer sewing machine.

The two main causes seem to be the refusal to learn to breathe bilaterally and the need to improve their sighting skills.  Cox points out that "swimmers in the open water who breathe only on one side are blind on one side and compensate by lifting their heads to see what's going on around them."  Two excellent sources of a step-by-step way to learn this can be found in Cox's terrific book, Open Water Swimming Manual, $12.46 on Amazon or Sara McLarty's well-written piece from Triathlete a couple years ago, Why (and How) to Bilateral Breathe, .  I think so highly of Cox's book that last week was a triathlete friend's birthday, and guess what her birthday present was?

Secondly, sighting is a skill easily mastered in a pool when you have your own lane to practice a few simple drills.  Here Coach Sara has explained this so even people like us can figure it out.

Perhaps, if you can perfect these two techniques, then you'll have a faster, more enjoyable swim, and you won't feel the sting of being punched in the ribs by the swimmer you just tried to crawl over on your "blind side" in your next open water race.

Plea for Bike Safety

Six months ago a friend of mine had just retired.  Mayo Clinic trained, 3 lovely daughters. She was just making plans on how she was going to get to all the things she'd put off during medical training, raising the girls, etc. when she was killed on her bike.  She was following the rules but the driver of the truck was not.  Please, think before you ride, leave the tunes at home, choose your route carefully and let someone know where you're headed doing 110% of your part to be safe 100% of the time. Local triathlete Emily tries to envision any obstacles along possible bike routes doing her best to avoid construction, big yard sales, events where there are likely a fair number of automobile rubber neckers who are unlikely to see you on two wheels. If she knows of an alternative road, she takes it.  We should too.

Tuesday, May 30, 2017

Mindset. Your Best Training Attitude for Success

"I had once had a pro athlete who had a bad race in Kona and so was walking the marathon. Some spectators offered him a beer. He drank it. Someone reported it. He was banned for 1 year. We never knew that was a rule. After that we did. Doubt that very many would know this." J. Friel 

We all know some triathletes who are work out fiends.  You might even be one yourself. Possibly even to the point of excess and your own detriment.  Couple folks around here sure fit that description.  But for the rest of us, dragging your sorry self out of bed in the pre-dawn darkness can really be a chore.  Especially in my neighborhood where there's a bear who raids the bird feeders and garbage cans regularly.  (It goes something like, "You know, the bear might be back in the neighborhood.  I'd best stay right here, for my own safety and as bread winner for the family of course.  Yep, right between these soft, warm sheets and this pillow just the way I like it.  Uh, yep, right, for my own safety!")  But somehow you overcome this silly argument with yourself, lace on your Adidas, and out the door you go. But you do look behind trees for you know who. 

It's the practice, the repetition, the honing of tri skills that gets us the reward we seek on random summer Sundays.  The payoff so to speak.  Although many of your friends might not understand the sentiment, the feeling you have, when you cross the race finish line in PR style.  Even if it's only a small improvement, you're better.  Faster!  A podium finish is immaterial.  That little voice inside your head goes "Yes!" After you catch your breath....maybe even before you catch your breath, this stepping stone to personal greatness has been mounted and you're planning the next one.  It's human nature.

You may be familiar with author Daniel Coyle, The Talent Code, The Secret Race about Tyler Hamilton (which if you haven't read gives you a well-written different perspective on Tour de France doping.  Recommended) or Lance Armstrong's War.  Coyle is fascinated with the Patriot's Bill Belichick coaching style.  He writes:

"The main problem with practice is that we all have a powerful instinct to avoid it.
There’s a perfectly good reason for this: your unconscious brain. Practice involves spending lots of energy struggling for an uncertain payoff, and your unconscious brain really, really dislikes spending energy for uncertain payoffs.

After all, evolution built your brain to behave like an ultra-conservative banker — investing energy only when there’s a clear, tangible benefit. As a result, we’re all natural-born geniuses at coming up with excuses not to practice, or to cut corners, or to skip it and hope things work out."

Coach Friel would point out that training time spent in race simulation goes a long way.  So do frequent shorter races to build not only your endurance but your confidence when things aren't going according to plan.  Regardless of your situation, practice and race simulation give you the proper state of mind.  Like the old poem goes:

All in the State of Mind

If you think you are beaten you;
If you think you dare not, you don't;
If you would like to win and don't think you can,
It's almost a cinch you won't.

If you think you'll lose, you're lost;
For out in the world you'll find
Success begins with a fellow's will;
It's all in a state of mind.

Full many a race is lost;
Ere even a step is run.
And many a coward fails
Ere even his work is done.

Think big and your deeds will grow,
Think small and you'll fall behind;
Think that you can and you will-
It's all in the state of mind.

If you think you're outclassed, you are;
You've got to think high to rise.
You've got to be sure of yourself before
You can ever win a prize.

Life's battles don't always go
To the stronger or faster man;
But, sooner or later, the man who wins
Is the fellow who thinks he can.

For those of you who are WSJ subscribers, and want a little more on Belichick, try .

Sunday, May 21, 2017

Don't Tug On Superman's Cape. Or Ironman Head Ref Jimmy Riccitello

Jimmy Riccitello, Ironman Head Referee

You don't tug on Superman's cape
You don't spit into the wind
You don't pull the mask off that old Lone Ranger
And you don't mess around with Jim*

*If you happen to be in an Ironman triathlete that is!

Before the blog, first this about the enormous good done by Jimmy's team. 
2014 Race Across America Team Intrepid Fallen Heroes

 From Intrepid Fallen Heroes web site:  June 27, 2015, Team Intrepid Fallen Heroes won their division in the Race Across America- a 3000 mile competitive endurance bike race- this year as a 4-person mixed team. Riding from Oceanside, CA to Annapolis, MD in 6 days, 13 hours and 49 minutes raising $640,000 to support American military personnel suffering the effects of traumatic brain injury (TBI) and their families.  

In June 2014, Team Intrepid Fallen Heroes participated in the Race Across America winning the 8-person team division and raising $650,000 to support our wounded military heroes suffering from traumatic brain injury. The team races again this year with a goal of once more achieving victory and raising even more funds for our wounded troops. Please join us in this great challenge.


Refereeing an Ironman

Several years ago, while on a rolling section of the Queen Ka'ahumanu Highway portion of the IMH bike course, one of the motor scooter bound bike refs was just itchin' to get someone. They sat off to my left rear. Lurking. Waiting. Like a mosquito on a hot summer day. There was a sizable group of athletes whose positions relative to the other bikes were totally dictated by the terrain. A spreading out occurred going downhill with the inevitable bunching up come the next short up hill. And that's when the ref struck nabbing a slew of folks allowing them a short "unplanned rest" in the penalty tent. I sent a note to the race office describing what I felt was just not the standard I'd
expect of an Ironman referee, unfair really, and the following year I saw no ref behavior of this kind. Thanks guys.

Fast forward to 2010 when I first met the Ironman Head Referee, Jimmy Riccitello, the man does indeed set the standard. Multiple times I saw him help out an athlete or aid in race conduct at that years event, never drawing attention to himself. On the Friday afternoon before the race, during bike check in, one woman's race wheels didn't make it to Kona and here's Jimmy, butt on the pier, stretching out some sew ups, which he helped this woman mount. All real casual like this happens every day. (Maybe it does.)

12 hours later, the transition area is a madhouse with 2100 nervous, fidgiting athletes, volunteers providing assistance, and bike mechs making last minute fixes. And where's Jimmy?  Helping an age group woman trying to figure out if her speed suit was legal for the swim. Sure you might say why would someone wait until an hour before arguably the most important athletic event of her life to figure this out. But he didn't. He researched the
question and determined that a short run of this particular suit was not legal, unfortunate for her - this was one of them - but she was able to follow the letter of the law with a clear conscience.

I have three kids, and, at the heat of action during the race, I asked Jimmy how many he had. "Two," was the answer. I told him I hope they married my kids if they were anything like their dad.  He just smiled.  Later, when recounting this interaction to an IM employee, she added, "I feel honored to have gotten to know him and work with him the last several years. I have also been with him and his children outside of our work worlds and can validate that he is a wonderful father…a better parent than many. He’s not just the good time dad."

There are other examples but these three illustrate the point. In 2017, where the national pastime is complaining, we are so fortunate to have this gentleman help us both follow the rules and have a successful day doing so.  Maybe he thinks of the athletes as his 2100 children. Who knows. Thanks, Jimmy. Thanks, Dad. But if you plan to stretch the rules, watch out, Jimmy's right around the corner behind you.

Images 1, 4 from Team Intrepid Heroes web site.

Sunday, May 14, 2017

Being Afraid. The Injured Triathlete, Possibly You?

Climbing Mountains, Being Afraid

The finish line, you can stop, your day is a success and it's not even 10am! Woot, woot!

    Although we as triathletes push pretty hard sometimes, we’re rarely outside our comfort zone in other than a physical sense.  In a previous blog, I briefly described hiking the John Muir Trail with my son Ben a couple years ago.  

This was a six day journey through wooded areas, over many creeks and streams, as well as some fairly steep mountain trails culminating in standing atop Mount Whitney, the highest peak in the lower 48, with it’s seeming 100 mile view.  It's hard to imagine doing something better with one of your kids.  On the third day, our longest, after traversing some pretty difficult to navigate terrain (since we were so early in the season and didn’t have the benefit of hikers before us marking the correct trail), we crossed one particular river and unbeknownst to us, were off the trail.  Way off the trail. We tried to back track to a known point, but we were lost.  Lost in billions of acres of land…with no GPS…no cell service…no plan “B”, no nothing.  The only way out of this was to think our way out.

    It’s times like this that occasionally you don’t think terribly rationally.  Like during the run in a 70.3 or 140.6 mile race.  In the former, although you have a tent and food for a week, you don’t know where you are.  And, the in latter, you’ve trained for this for an awfully long time but are rapidly running out of energy and ideas at the same time.  You may have to…oh, don’t even think it…walk!  And walk a lot.

   But for me and Ben in Sequoia National Park, it was one of those times that, with no other option, no chance for help from any outside source, that with a little luck, you “just do it” as Nike would have you think.  You take the information you do have, think the problem through such as you might have done in a college course, and you’ll likely find your way back to the trail. With great relief I might add!

   Injuries to the triathlete can follow a similar path.  One can have a physical problem, seek help from a friend, an internet forum or local medical professional.  But in the end, you know vastly more about yourself athletically than any physician.  This would include the specific training load your body has seen including any recent overload situations, one of the most common sources of injury in my experience.  With just a little help pointing you in the right direction you can frequently come up with your own right diagnosis. 

Hardly a day goes by that I don't get some tri related medical question from an athlete.  I try to put myself in their position, likely one of simple lack of knowledge.  Sean Connery, in the movie finding Forrester asks, "You know what people are most afraid of?  That which they don't understand."  I believe he's correct.  Local triathlete Emily told me once that for her, one of the worst things about an injury is not knowing when it will resolve.  "Will I have this a week or six months?  It seems like you just don't know when you'll get back to regular training.  And your regular approach to each day.  Family. Job. Sport."  It's a pebble in your shoe, an alteration to your routine.  In my mind, both of these rather astute opinions are correct and descriptive of the injured triathlete.

 So how do we get to the next step?  Like being lost in the woods, you think the problem through.  Do what you need to accurately diagnose your problem, and from this diagnosis, the route though the woods back to your training path is revealed like the yellow brick road.
So, next time you find yourself injured, think it through.  Use your available resources, especially your own brain, and sometimes you’ll surprise yourself.  I’ve seen it happen. Sean and Emily would agree.

Good luck, Dorothy! 

Local triathlete finishes her first sprint triathlon.  Yea!!

Monday, May 8, 2017

All Triathlon Careers End Some Day. Is Today Your Day?

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 the following day. 

 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

 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 in their lives.

 Not so for the woman I met in Kona last 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 a while back from an athlete who'd done her 91st IM.

 However, eventually the luster grows dull for the rest of us and we want to, or have to in many cases, secondary to chronic or recurrent injury, pass the torch.  Doesn't matter if you do more than the local spring tri or iron distance racing,  And you know what, it's OK when that day comes.  Really, it's OK.

 "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 fare? How about those other pesky people in your age group?

Image 1, Google Images

Wednesday, April 26, 2017

Bike Crashes; If You Ride Long Enough....

The author with three elated 2016 finishers

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do." 

                                                                               H. Jackson Brown, Jr.

Low back pain, pretty common in our group, is often treated with a non-steroidal anti-inflammatory drug, a skeletal muscle relaxant and a narcotic pain killer.  A recent study published in JAMA with 323 patients who suffered acute, non-traumatic (nonradicular) low back pain found that adding the muscle relaxant and/or oxycodone to the NSAID naproxen alone "did not improve functional outcomes or pain at 7 days' follow up."  


       "A high school runner in Whitely County, KY was set to compete in a regional cross country meet when she was assigned the bib number 666, "the number of the beast" according to the Bible.  Thacker and her coach appealed unsuccessfully for a new number, so she decided not to race.  "I didn't want to risk my relationship with God," she said.  Sports Illustrated

        In contrast, I was issued race number 666 for an early summer triathlon in Virginia Beach a couple years ago,  prominently displayed on both arms, legs and hands following body marking.  It was a beautiful day to race, hot and sunny, leading to a tad of sunburn in most competitors. I was even lucky enough to win my age group so I might have stayed outside at the post-race party a little longer than usual. Later that day, when showering at home, washing off my race numbers, I learned that heavy Sharpie use works as an excellent sunblock.  Quite tanned from the race, I had noticeably white 666's on both arms, legs and hands, a fact that was pointed out to me repeatedly over the next couple days at the pool!  I wonder if it played a role in my performance.


Have you ever had a bike crash that required medical attention?

This is a question we put to to the athletes who passed by our questioner following bike check in Kailua-Kona, HI for the 2015 event

Before sun up, a few last minute adjustments

I wondered what I'd find out if I polled the athletes at the top of our sport, mostly age groupers like you and me, about bike crashing.  I've written here before about it as the wider my circle grows the more this topic comes up.  It's hard these days to watch a single stage of a pro bike race or talk up tri at the local pool when somebody doesn't walk in with a swath of road rash running down their leg or shoulder.  Or how about your buddy with the femur fracture following a mountain bike accident?  In my Sunday bike group alone, over the course of several years we've had a hip fracture with surgery, facial fracture with broken jaw during an IM,  and a pelvic fracture mountain biking requiring hip replacement. Oh, and before I joined them, one guy tried to Evil Knievel his way up a ramp.  Bad news though, the bike just stopped and my friend broke his neck. Fortunately, no surgery was required and he's back riding.  

Of the 215 athletes in Hawaii who answered the poll, almost half admitted to serious bike crashes.  Of 149 men, 72 said yes.  And of 66 women, 28 had required a visit to the doctor or hospital.  Of these 72 men who were told to seek further medical treatment, not all did. Surprised?  No, probably not.  But, all 28 of 28 women in our survey who were advised further treatment did so.  One woman claimed 35 accidents.  That, to me, is long past time to find a new sport.

In short, approximately 48% of responders crashed hard enough that at least one care giver felt medical treatment was in order.  To me, this is pretty concerning. I believe we as a group need to be a little more attentive to the potential for injury when we ride becoming a little more selective about the riding surface, surroundings, fellow bikers bike handling skills, you name it to try and get this number to drop precipitously.

We all know someone seriously injured or killed on a bike. Sadly, some of us more than one! Make your Spring resolution one where you will assume further responsibility for your own personal bike safety.  If you need to stay home or ride indoors because of questionable riding surface conditions or it's just too dark with too many cars then so be it.  Better to alter your training...and still be able to train than the opposite.

Sunday, April 23, 2017

April is National Donate Life Month. Might You Have the Need One Day?

"I been up, I been down. Take my word, my way around.  I ain't askin' for much."         ZZ Top

Volunteers, the life blood of any race.

Organ, eye and tissue transplants offer patients a new chance at healthy, productive and normal lives and return them to their families, friends and communities.

Nearly 120,000 men, women and children currently await lifesaving organ transplants and hundreds of thousands more are in need of corneal and tissue transplants.  On average, 22 people die each day because the organs they need are not donated in time.  Fortunately, one donor can save or heal the lives of more than 75 people.

Registering as a donor is a gift to your family, giving them certainty of your decision to help others in need.  It is also a symbol of hope to those awaiting a lifesaving or healing transplant.

Facts About Organ, Eye and Tissue Donation

People of all ages and medical histories should consider themselves potential donors.  Your medical condition at the time of death will determine what organs and tissue can be donated.

All major religions support donation as a final act of compassion and generosity.

Donation should not delay or change funeral arrangements.  An open casket funeral is still possible.

There is no cost to the donor's family or estate for donation.

In the United States, it is illegal to buy or sell organs and tissue for transplantation.

Living donation is an opportunity to save a life while you are still living.  It is not covered by your donor registration.  Living donors can provide a kidney or a portion of their intestine, liver, lung or pancreas to a waiting patient.

Triathletes are giving people.  This is just one more way.

This information courtesy of   

Sunday, April 9, 2017

"Why is it That the One Who Snores Always Falls Asleep First?

The federal Centers for Disease Control and Prevention calls sleeplessness a public health concern. Good sleep helps brain plasticity, studies in mice have shown; poor sleep will make you fat and sad, and then will kill you.  Where we're concerned, it'll help make you the athlete you want to be.

One of the negatives of being a triathlete, or having the personality that gravitates toward triathlon, is that each of us wants to get six things done in the time allotted for four.  Something has to give; frequently that's time in the sack.  The old, "I know it's bedtime, I'm almost done with ______________"  When you have a couple minutes, this is a good read.  Sleep is the New Status Symbol

While on a Sunday bike ride recently, the topic of snoring came up. I ride with an older group, several of whom will have wine or beer with dinner most nights or maybe something 
later in the evening and that snoring was becoming more of problem.  Two agreed that it was considerably worse on weekend nights after a race.

I'd remembered a couple of things from med school that could contribute, one being alcohol that can overly relax the upper airway tissue.  The other was having a fat neck, not much of a concern in the bike group. But I was sure there were other contributing factors of which we should be aware. The piece from Harvard below covers the subject pretty thoroughly, isn't overly "med speak"  and could be a big help if one is interested.  My thanks to the folks at Harvard.

Snoring solutions

Simple changes can help to turn down the volume.
If your wife or sleep partner often seems bleary-eyed and resentful in the morning, you may be one of the millions of adults who snore habitually—a condition that affects twice as many men as women. Snoring occurs when your upper airways narrow too much, causing turbulent airflow. This, in turn, makes the surrounding tissues vibrate, producing noise.
Snoring is a sign that there is a really narrowed space,” says Dr. Sanjay Patel, a sleep disorder specialist at Harvard-affiliated Beth Israel Deaconess Medical Center. “That happens either in your nasal passages or in the back of your throat.” Some men are snorers because they have excess throat and nasal tissue. Others have floppy tissue that’s more likely to vibrate. The tongue can also get in the way of smooth breathing.
Once the source of the snoring is identified, you can take appropriate steps to dampen the nightly din. These include not drinking alcohol at night, changing sleep position, avoiding snore-inducing medications, and addressing causes of nasal congestion.

How to alleviate snoring

Here are some factors that contribute to snoring and what you can do to alleviate them.
Alcohol. Alcohol, a muscle relaxant, can slacken the tissues of your throat while you sleep. “We see this all the time,” Dr. Patel says. “Spouses say the snoring is tolerable except for the nights when their partner has had a couple of beers.”
Body weight. Extra fat tissue in the neck and throat can narrow the airways. Losing some weight could help to open the airways if the person is overweight or obese, although many people who are lean also snore.
Medications. Medications that relax muscles can make snoring worse. For example, tranquilizers such as lorazepam (Ativan) and diazepam (Valium) can have this effect. In contrast, antihistamines may actually alleviate snoring by reducing nasal congestion.
Nasal congestion. Mucus constricts the nasal airways. Before bed, rinse stuffy sinuses with saline. If you have allergies, reduce dust mites and pet dander in your bedroom or use an allergy medication. If swollen nasal tissues are the problem, a humidifier or medication may reduce swelling.
Sleep position. When you lie on your back, slack tissues in the upper airways may droop and constrict breathing. Sleeping on your side may alleviate this. You can also try raising your torso with an extra pillow or by propping up the head of the bed a few inches.
Smoking. Men who snore are often advised not to smoke, but the evidence this will help is weak. Needless to say, there are already plenty of other good reasons to quit smoking.

Anti-snoring products

Many products claim to help with snoring, but few of them are backed by solid research. One potentially effective option is wearing an anti-snoring mouth appliance, which pulls the jaw (along with the tongue) slightly forward to open the upper airway. An appliance made by a dentist can cost around $1,000. Do-it-yourself kits cost much less, but may not be as well tailored to your mouth.
Nasal-dilating strips are inexpensive and harmless, and some small studies suggest they may help reduce snoring. You apply these adhesive strips across your nose at bedtime to help to open up the nasal passages. Breathe Right is one well-known brand, but there are many others available at relatively low cost.
If you are unsure what to do about snoring, a physician can advise you and also make sure your snoring is not related to an underlying sleep disturbance, common in men, called obstructive sleep apnea. “The louder the snoring, the more likely it is to be related to sleep apnea,” Dr. Patel says. “Not all men who snore have sleep apnea, but if the snoring is frequent, loud, or bothersome, they should at least be evaluated.”