Learning about the differences between training discomfort and pain/injury

If there’s something this rehab process has taught me (or attempted to teach me anyway) is the importance of understanding the differences between simple training discomfort and an honest-to-God injury.  My current situation is due to stupidity on two fronts:

  1. I grossly neglected core strength and conditioning throughout my training, thinking that my applied training was just enough to get by in that department
  2. When I began to feel a nagging pain in my left hip/groin, I figured I would just find a way to “power-through-it” and suck it up.  After all, triathlon is not for the weak-kneed, sissy-pants type…

I couldn’t have been more wrong on both counts!

I figured, “Who needs planks, when I’m in aero for a few hours per week, and engaging my core in the water for countless laps?”  The reality is that while your core IS working during those work intervals, the direct effect is actually a bit debatable.  Despite the fact that I’ve now gone “full-nerdboy” on triathlon, and I voraciously consume blog and magazine articles and YouTube content on training, I completely ignored the advice of top athletes and coaches.  I blew it all off –  because it was easy an easy thing to do as I kept logging my miles and tracking my Zone metrics on GarminConnect.

Then, when I noticed a nagging pain upon beginning a run (or a run-portion of a brick) I decided that was just the TriathlonGods testing my mettle, and making me earn my gains.  I was able to notice that the pain would subside after 12-15 minutes of running and not really bother me after that point – I believe this was due to both (a) compensation in my gait/stride and (b) compartmentalizing the pain and learning to ignore it.

While pushing barriers and learning to suffer (“Embrace the Suck” as Macca would put it) is important, this process can directly derail your progress and set you back months unless you recognize the difference.

I am still struggling with this area, but I’m now one to err on the side of caution.  I have only two PT sessions left, and while I’m a lot better than I was, I’m not all the way back yet.  I’m at loggerheads with the Managing Partner of my facility, as she initially did my evaluation, dished me off to her assistant (who I really clicked with), and then periodically viewed my file and asked me a simple “Howya feelin?”.  I’ve never clicked well with the Managing Partner, and I view her as a bit of a bully, a complete Type-A manager than runs rough-shod over her staff, and not a particularly pleasant person to work with (as a patient or employee).  She apparently took it upon herself to interpret my file and tell the insurance company “He’s about done…” this week after I experienced a bit of a setback over the weekend.  she hasn’t been hands-on with me for weeks and never asked me what I thought about how my rehab was coming, as she was much more interesting in TELLING me what she thought.  So I now have only two sessions remaining for them to orient me on a continuing program of strength and flexibility.  I’ve been shut down from running since late June, and I haven’t been cleared to swim yet.  I can bike but only for short durations (like a 10 min warmup).  So in the end, I would not recommend this particular physical therapist at all, despite her reputation as a leader in her field.

I am going to change PT providers and go to a self-pay system for a screening assessment and program set up, and then monthly check ins on my progress.  so I guess you can say I’ve gone from “blowing off” the strength and conditioning portion of my training to fully embracing it.

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Getting Better – Resuming Activities Soon

So as I type this, my house is asleep.  I’d normally be out for a long run or big brick, as weekends are the perfect time to exploit my family’s love of late sleep while I go log some hours.  Also, most of my team is gearing up to race – either locally at our little “Top of Delaware” sprint or at Mount Tremblant or Timberman.  Normally I’d be at the local race as a “tune-up” for my intended A race of the Diamondman 70.3 in September, but the Triathlon Gods had different plans.

PT has been going well.  I’m now being pushed pretty hard, and we’ve added stationary bike and elliptical into the mix in small controlled doses.  Most of the work is actually stretching, strengthening, and stability.  My typical PT session looks like:

  • 10 minutes of ultrasound on the affected area
  • Sometimes – my PT does a little bit of “active release therapy” here  – if you’ve never had, it’s like a slightly more violent deep tissue massage designed to break up scar tissue
  • Stationary bike – 10 minute warm up (get a bit of a sweat going)
  • Calf Stretch 4 x 30 sec
  • Lying Hamstring Stretch – 4 x 30 sec (each leg with a strap)
  • Lying Quad/Flexor Stretch – 4 x 30 sec (each leg with a strap – facedown)
  • Using Flexi- bands (black = high resistance) – 4×12 reps straight leg standing lifts all 4 ways (flexion, extension, abduction, adduction)
  • Lying Knee Squeeze playground ball (adduction/groin) – 4 x 10 sec
  • Standard Planks – 3 x 30 sec to start (these kick my ass, and are part of the reason I’m injured in the first place)
  • Abdominal Bridges – 4 x 10 feet on bosu ball
  • Electro-Stim Therapy w/heavy ice pack – 15 minutes

This whole sequence ends up taking about 90 minutes or so.  We’re getting more aggressive with the intensity and the pace of the session, which is a good thing.  I’ve also noticed that injury recovery often involves days where you think “Wow, this stuff is working” and other days where you believe “Aww crap this sucks and I’m hurt again”).  It’s just difficult to know how you’re going to feel the next day or two after you work the injured area, but lots of my day to day functional pain is gone.  It hurt like hell to get out into my car and out of my bed, but those small daily reminders have vanished.

I’ve just entered into a period of heavy travel for my job.  The fall season is chock full of industry events and functions, and since my company’s primary marketing tactic is to exhibit and present/speak at these events, off I go.  I’m on the road and speaking 12 out of 14 weeks, but a lot of those trips are just 2-3 days in duration.  It’s going to be a stressful 3 months, and my biggest challenge is not blowing up like a fat balloon while grabbing fod on the road.  Salads and oatmeal will be my friend, and if I can begin some very light easy running soon I’d be a happy guy.

I just purchased a new heart rate monitor that will be compatible with my iPhone5.  I am going to play around with a Heart Rate Variability app called SweetBeat.  A Twitter buddy of mine is a big believer of using HRV to guide day-to-day intensity and monitor the body’s changes, and it’s been proving very effective especially in guarding against over-training.  I believe that I’ve been pushing the envelope here, and that over-training at least contributed indirectly to my injury.  I’ll explore this app and it’s benefits in some future posts, but you can read about my friend Brian’s experiences here – http://bri-tri.com/tag/heart-rate-variability/

 

 

Meet my new coach, sort of…

So being injured, I’m trying to keep this time both productive and positive.  Unfortunately my mood has been a little dark, as I am truly one of those sick, demented people that feels like a slacker when the workout gets cancelled!  Not “Jack-from-Shining” or anything, but just a little “off”…

"Did you do your BRICK yet?"

“Did you do your BRICK yet?”

 

Back in the summer of 2011 is when I began to take my fitness and body seriously – so I became compelled to start running.  You can read about my backstory here, but once upon a time if you took away my ability to train, I’d say “So what?  Bring me a beer.”  Now it’s an entirely different ballgame.

 

So I’ve been mildly bummed that I can’t do anything, and as I’m sometimes wont to do I have been eating very poorly.  I had been viewing my clean(er) eating as a way to fuel workouts, but take away those workouts and – why bother? – right?

Of course not, but we’re not always rational and logical beings.

So I arrived at a point where I needed to SNAP out of it, and I did.  Rather than focus on what I can’t do, I am making the choice to focus on my goals.  So two things were accomplished this week:

  1. I’m hiring a swim coach locally to get me more efficient.  He’s actually a teammate that happens to be a tremendous high school swim coach with about 20 years of experience.
  2. I’ve made a deal with myself that once I get down to goal racing weight I will make a gear acquisition – CARBON WHEELS!
Not my bike, but these would look great on my Cannondale Slice5!

Not my bike, but these would look great on my Cannondale Slice5!

 

As for program coaching, I’ve decided to go with BeginnerTriathlete.com and their online coaching program.  I’ve joined as a GOLD member, and mapped out my 2014 season back to front.  The phases look like a little like this:

  1. 16 weeks of sport-focused training on my two areas of improvement (8 for swim, 8 for bike) focusing on technique and power/speed.
  2. “70.3 and beyond”  16-week program that brings me to my first 70.3 the EAGLEMAN in early June 2014.
  3. 20 week program to build to Ironman Arizona 2014.

These 3 (actually 4) programs all dovetail from one to the other with at least a week of rest as well as a taper into the milepost race.  I’ll be adding a couple of shorter tuneup races early-season locally, but for the most part its going to be about training and less about race shirts and swag next year.

As for BeginnerTriathlete, the online training and program layout is very solid, and I like what I see.  I’ve imported in all of my Garmin data and it was shockingly simple.  I like what I see, and once I am cleared to ramp back up into training mode I’ll be activating the online coaching function.  All in all it seems like a great value for an organized, geek data-driven athlete that has some clue as to what they’re doing.  If things do not go well, I can always move to a more traditional coach, but I’ve got ample resources at my disposal so I might as well save the money.

 

Ups and Downs, and Changes in Plans

I’ve been putting this post off for a while, but I guess it’s time to get it all out.

After my DNF/DNS at the Philadelphia Triathlon, I kept training focus.  I did have a small nagging pain in my left hip/pelvis that tended to flare up in the first 10 minutes of running.  I decided that this was nothing to worry about, and that I could push through it.

The discomfort would normally lessen as I ran.  Whether it was my ability to compartmentalize the discomfort and force it into the back of my mind (a desirable for any endurance athlete), or perhaps a modification to my gait and stride I do not know.  What I do know is that eventually the discomfort followed me into the pool, and began showing up at off places (rolling out of bed, stepping out of my car, climbing steps, etc).

After taking a morning run out in San Francisco (business trip) with this discomfort, I thought that this was crazy.  I decided to shut down running and focus strictly on recovery, and thought that this thing would vanish given the proper amount of rest.  Coincidentally I sustained another injury on the flight back from San Fran, as I apparently pinched my ulnar nerve (most likely in my elbow) due to the way I fell asleep in the grossly undersized coach seat on the red-eye.

I gave it a few weeks of zero running and biking, and decided just to swim it out.  It wasn’t until very recently that I noticed a trend in my Garmin data – I was slowing down big time in the pool, and feeling like I was getting a lot less speed for a lot more effort.  I’m taking this to be my compromised core (turns out it was a strain in my left iliopsoas group and adductor group – lots of little, overstretched muscles) was diminishing my kick, rotation, and leg position in the water.  Mind you I do not have proof of this, but I know my 100yd averages increased the wrong way by 20 seconds.

So for the past two weeks I’ve been shut down – zero activity.  As a result I missed the NJ State Triathlon and therefore was not able to qualify for USA Triathlon Age Group Nationals in Milwaukee.  I’m bummed but it’s not the end of the world.  What’s a little more upsetting is that this setback has pretty much eliminated my 70.3 in September.  I just don’t think losing 6-8 weeks of bike and run and 4 weeks of pool time is going to let that happen.

But, on a positive note – therapy is going well, and I’ve been pain-free for the last several days on all functional movements.  On Monday we begin the stretching and strengthening part of the program.  I’m still a few weeks away from anything resembling training (at least in my way of thinking), but small steps in the right direction will lower the risk of a setback.

Now for the exciting part – my new massive goal is actually a 2014 task.  My wife and I are flying to Tempe Arizona this November to volunteer for Ironman Arizona, so that I can register for the 2014 race!  I know it’s completely bat-shit crazy ambitious to register for an Ironman without having successfully completed a Half Iron distance (70.3), let alone an Olympic or International distance race.  Truthfully I was amply prepared for the Olympic distance for the two races I missed this summer, and I’m confident that I would have arrived on the starting line in September ready to not just survive a 70.3 but to tackle the challenge.  I know with good rehab, a solid functional movement screening and strength and conditioning program, and actual organized coaching for 2014, I’ll be ready.  

More on that shortly.  Otherwise, I’m off to fetch my compression shorts and ice to rest and recover!

Quick healthy recipe for the 4th – Grilled Cauliflower

I don’t do a lot of recipes here on PersonalReboot, but this one is good enough to share.  I’ve never eaten cauliflower before we tried this – not even off of a veggie plate with ranch dip.  I’ve been completely uninterested in that odd-looking white abomination of the vegetable family…

First get yourself one of these:

Product Image

Secondly – something like this grill top smoke box will enhance ALL of your grilling.

 

Here’s what you do:

  • Cut up your cauliflower head into small florets – it doesn’t really matter how big or small, but they should be universal in size (tough to do but try).  The larger the pieces the more heat and smoke they will be able to take and still have some tenderness inside.
  • Put your “cauliflower-shrapnel” into a big ziploc bag, and marinate with your vinegrette of choice.  Any basic salad dressing will do, but I like something really simple, like garlic, southwest seasoning rub, lime juice, water, and a touch of olive oil.  Marinate for a couple of hours.
  • Get your grill hot – I have a very basic gas grill, but get your grill wok oiled and warm and your smoke box up to temperature.  If you soak your wood chips you’ll get more smoke, but it will take a lot longer for that to occur (I usually go dry).
  • When ready – slam that cauliflower down on the grill!  By now your smoke box should be going good, but again you really don’t need it.  The throw-off marinade should flash some flames up onto your wok and it’ll be all good!
  • Move your cauliflower periodically – you should be browning them evenly, but if smoking be sure not to open the grill hood TOO MUCH (you lose your smoke every time you do that.
  • You can cook as thoroughly as you like – we like ours pretty cooked through and crunchy.

 

Thank me later – this is really a cool way to enjoy a pretty plain-vanilla veggie!

First DNF – Actually a DNS…

So we just returned from a week in the Caribbean – Turks & Caicos is a wonderful island, and the wife and kids and I had a wonderful experience at Beaches T&C.  It’s all inclusive and a terrific place for families with kids.  It’s also a safe island which made some long morning runs possible.  They also have a roped-off swim area where end to end distance was exactly a quarter mile.  It made for some excellent OWS sessions.

On Friday after our unpacking and laundry efforts were underway, I headed up to the TriRock Philly Race Expo.  I was excited and felt ready to take on my first Olympic Distance race.  I’ve been working hard and felt prepared for the distance and the intensity needed.  I was super hyped for this bigger event.

I also had a chance to meet up with an old friend of mine Derek Fitzgerald.  Derek is a cancer survivor, as well as a heart transplant recipient.  He has been to hell and back, and found endurance training as an outlet.  Derek and I are from very similar backgrounds, and we both were active in the drum and bugle corps activity (I blogged about it here) and a big part of our personality makeup is the ability to push through barriers.  Our competitive nature lends itself well to triathlon and endurance training, and while neither of us are threatening any podiums any time soon, we believe that our physical best days are in front of us.  I’ve been in touch with Derek more in the last couple of years and he’s been answering my questions as I throw them at him.  By the way, Derek has a fantastic story and you can read more on his blog here.

So Saturday I went for a short swim in the pool just to shake out the nerves and blow off some steam.  I had a quick emergency issue with my bike that my shop helped me with, but I loaded up my bike, packed my gear and transition bag and went to sleep on time.

Then I woke up around 12:15am yacking my brains out.  I have no idea how or why.  I’m assuming it was a viral bug and NOT nerves since I was excited but pretty chill and confident over the whole thing.  I was laid low for a couple of hours in which every gram of carbs and ounce of hydration left my body.

Then the tough decision had to be made.

Do I:

  1. Tough out the race in hot humid conditions, testing myself at a new longer distance and risk a terrible race experience and possibly set myself up for physical setbacks and extreme dehydration?
  2. Play it safe knowing that the odds were against me and that the two real prizes of the season were to be the NJ State Triathlon (July), a shot at USAT Age-Group Nationals (maybe a remote shot) and my Half Iron race in September?

 

I chose #2.  There is too much riding on the next couple weeks of training to get ready for the 70.3 distance.  Beyond that there are two additional things that have been added to the bucket list:

  • Philly Marathon in November
  • Ironman 140.6 race TBD in 2014.  Considering either Lake Placid (relatively nearby and able to practice the course ahead of time, but hilly as f&*k) or Arizona (early November so more time to train, modest hill elevation but its in the freakin desert for cryin out loud).

 

So in the end, I’m feeling pretty good.  I’m re-hydrated and well-fed and looking forward to cranking up the training this week.  It’s time to focus on the long goal and relaxing on the short-term in favor of the big prize.

 

First Aid on the Move

So I sustained a minor injury yesterday.  No I wasn’t out running on a remote trail in the wilds of Delaware (I prefer the roads and neighborhoods most of the time), but I was a scant .5 mile away from home in a neighboring development.  I was running on the sidewalk as there were cars parked along the road when I looked up and saw a tree branch I was going to need to get under.  I was about 1:40 into my long run and feeling really good so I went to duck under.  I made the first branch and never saw the second branch which must of been lower, and I smacked myself right on top of the head.

This is after I showered and cleaned up.  Nice and scabby now.

This is after I showered and cleaned up. Nice and scabby now.

So I saw stars for a moment, but quickly gathered myself.  I thought to myself, “Wow, now what do I do?”  Here’s was what I did, and while it might not be exactly as a medical professional may recommend, here’s my thought process…

(1) First thing, sit down and get low to the ground, because if you faint you have less distance to fall.  I also thought that the faster my HR is reduced, the better.

(2) I applied immediate pressure with my hand.  It hurt, but between the sweat and the blood I couldn’t tell how bad it was.

(3) I was on the lookout for light-headedness, nausea, and a headache.  I waited about 5 minutes and didn’t sense any of these things.  I also sensed that the bleeding was close to stopping.

(4) Call for help.  I debated calling my wife to come and pick me up, but decided to walk it back home.  I’m certain I looked ridiculous walking with my hand perched atop my noggin, but I wanted to walk slowly and still apply pressure.  I drank the remaining bit of water I head left.  Overall I felt more embarrassed than anything, and a little pissed to have such a great run derailed like this (I was gunning for 2 hours).

I got home and showed my wife.  It was a fairly large cut, but very much on the surface and not much to be stitched.  I jumped in the shower and cleaned up and the cut bled very slowly and very little.  I applied anti-bacterial cream and left it open to air out.

I usually run around town with my FuelBelt with one pouch which holds my iPhone, a tin of EnergyBits or a gel, and sometimes some cash.  It made my think of what I would’ve done if I were out on a remote trail somewhere.  I did a little research and gathered some resources concerning first aid.