Recovery week

This week was my first recovery week since I started back up again with my training. I could feel some fatigue in my legs at the end of my last build phase, but I was still hitting my workout targets. It was weird to have such a light week, but I know to take advantage of the down time as they will be few and far between. I had two rest days and other than working, that is what I did!!

This week I met up with Danielle for some one on one swim lessons, specifically flip turns.  I understand the concept, but have trouble with the execution.  After some fine tuning and lots of practice I am on pace for nailing it shortly. She also coaches a weekly ass kicking, I mean, swim workout, that never fails to leave me in a trembling, cramping ball of exhaustion at the end. This week was no different. I am playing with a tempo trainer that helps me improve my swim stroke rate. I use it for short swim efforts and it certainly has made a little bit of a difference. My 100/yd times are coming down a little.  Obviously I cannot race with it, but I will train with it and try to improve my stroke turnover.  And after the holidays I will hopefully meet up with Danielle for one last swim stroke to master - the butterfly.

My running seems to be getting better as the weather gets cooler. I hate running in the heat of the summer and count the days for it to cool off so I can run. This week I had two short runs at an easy pace to do.  The paces are coming down and getting quicker, even at an easy effort.  Finally!! I'm not fast by any stretch, but I am not super slow anymore.

I only had two bike workouts this week and it threw me for a loop. I feel I don't ride well with only two rides per week (unless I am totally exhausted). For future weeks, there will be at least 3 rides at varying paces. Today I ventured out with Christa for a short ride. It was a bit chilly out at first, but it warmed up in no time. As usual, we had a blast riding today and I baked some chocolate chip cookie bars for Christa to enjoy post ride as a thank you for coming out to ride the last few weeks.

With the holidays coming up, Christa is traveling and I will be alone to get my swim and bike workouts in.  The Thursday night Iron Fit swims will be on hold after this week until the new year. But between now and then, I will keep my foot on the throttle with no letup. There's too much work to do before my first races of 2015.

My sweet new thermal beanie

Doing the Heavy Lifting

Last season I admit I wasn't very attentive to my strengthening routine.  While I had a long, PR-filled season, I know I left a lot on the table in terms of performance.  My leg strength was just not there.  Not even close.  I waited until my last big race was over at the end of September and set a target of early October to resume weight training.  I developed a basic routine based around equipment I had at home (kettlebells, jump rope, plyo boxes, TRX, medicine balls, etc) and got started.

It didn't take long (1 workout) to see just how weak my right leg was. I had a lot of work to do. I focused on single and double leg strengthening.  I worked on making myself symmetrical (right vs left equality) for both upper and lower body. My left side has always been the weaker side overall, but I want to change that this offseason.

Once I felt like I was making gains/muscle hypertrophy (~2 months) I headed into the gym for the heavy weights.  Now, you won't find me on a smith machine or any machines at the gym. I strictly use free weights, (barbells loaded with plate weights and dumbbells).  I perform compound movements (multiple joints at once) that target muscle groups instead of working out a single muscle.  Machines serve me no purpose and limit/force you to move a certain way.

I have a few influences that I follow from material that I've read over the years. It's nice to finally put it all together.  My program is basically 3 days a week of focused work (2 at home, 1 at the gym).  I also squeeze in some smaller workouts during the day at work (a set of squats or dead lifts here and there with a patient). I keep my 3 sessions short, less than 45 minutes. 

I can finally see my workouts paying off. On my long run yesterday, I felt my right glute muscle engaging every time I wanted to push off. I can maintain good running form longer into a run before I start breaking down.  When I have been racing, I am able to maintain my pacing over the distance of the race - there is no pace drop off.  I am much less sore and fatigued at the end of a run. I am getting the leg and core strength back to support myself when I run. On the bike, I am finding it a little easier to maintain a higher power output during my workouts.

I am on a recovery week this week, so after that I will ease into plyometrics to help build power/speed to go with my strength. This week I'll write up a basic program for myself and implement it soon.

It's exciting to see what changes this will bring to my training and racing next season, but I can see results already. My plan is to keep up with the strengthening throughout the season.

Thanksgiving Trot

Last Thanksgiving I was unable to participate in a turkey trot for the 1st time in quite a few years.  I was 3 days post-PRP injection in my right patella tendon.  Fast forward one year (and multiple races) later and I am back on the starting line of the Mattituck 5k Turkey Trot.  I met up with some friends down there and was looking forward to going all out.  I hadn't run a 5k in over a year.  It was funny to think that of all the races I did this year, a 5k wasn't one of them.

Bruce, Kristine, Vickie, Me (Scott was MIA for the photo)

I've been trying my best to put small goals into each workout or race. A few weeks ago I ran a 4 miler out in Lynbrook and set another PR. My focus for that race was to not letup for the last mile.  My first mile was the fastest and the last mile was my 2nd fastest.  I was pleased with how I held up (especially since I've done no real speed work in ages).

 Quite awkward looking as I'm going all out to the finish line

(photo courtesy of Jennifer C. - Lynbrook 4 Miler)

 Since I didn't win any hardware, I was trying to steal it ;-)

(photo courtesy of Jennifer C. - Lynbrook 4 Miler)

For the Turkey Trot, I wanted to go all out over the 3 miles and not letup again for the last mile.  I had my garmin GPS watch on, but I wasn't going to look at it.  Once again I was just going to race by feel and worry about the data later.

When the gun went off, I could feel my knee was stiff from standing around in the cold.  It took about 1/4 mile to loosen up and not be cranky. I could also feel I was running a hard pace, but one I figured I could maintain. One thing I forgot is that the Mattituck course is not flat - it's rolling.  I knew I was going to have to work a little harder than usual to maintain my pace.

I got through the 1st two miles feeling good and when I passed through the 2nd mile marker, I knew this was my chance to "go big or go home".  

This is all I thought about over the last mile

I kept a steady pace and knew the last 1/4 mile would be trouble so I had to make up some time in advance for the time I was going to lose going up a short, steep hill near the finish. Most people were running on the shoulder but I opted to run slightly out in the street to save time and my energy and not have to pass people or weave in and out. A straight line is the fastest line.

I made my last slight downhill and then came face to face with my nemesis - The Hill.  Now mind you, this was not a long, grinding hill.  It was very short and steep, but it's location made it difficult. I powered my way up it as best I could, but typical me, I stalled at the top instead of pushing harder (note to self - do some hill training this coming season). Once I got my bearings again, I bolted for the finish line.  I knew I was going to make my goal time, but I started to think about my 5k PR time.  For the life of me, I could not remember it.  Turns out I came up 3 seconds short of my PR.  Had this been a flatter course, or I pushed harder when cresting the hill, I would have broken it. That's what disappointed me the most.  My last mile was my fastest mile, but my happiness was dampened by being so close to a PR. I was searching for another flat 5k to do over the next week or two, but realized I need to keep my eye on the prize.  Specifically, this prize:

Photo Courtesy of Susie R-K.

I am doing the Star Wars Rebel Challenge in January in Disneyland.  It's a 10k on Saturday, then a Half Marathon on Sunday.  It'll be an interesting challenge to run back to back races, but I think it's very doable for me. The finishers medals alone will be worth it!

 

The basics behind running

 Mirinda Carfrae making it look easy

Running is a simple activity.  You don't need much, except a pair of running shoes.  One foot in front of the other at a faster pace than walking. But yet such a simple activity brings many people to my office for treatment. I see many injuries that can easily be avoided by following some basic guidelines.

"Too Much Too Soon"
Right out of the gate many people take on too much mileage when they start running.  You need to give your muscles, tendons, bones, etc time to adapt to the stress of running. When you run, you sustain over 3x your body weight with each foot strike.  Each minute you run you can take up to 180 steps and for an hour run, that's over 10,800 steps.  It takes time to build up to this kind of stress.  Start out with low mileage, 3x week.  When building your mileage, don't add more than 10% each week.  This is to allow your body to adapt to the stresses of running.

Many of the injuries I see are runners that are inconsistent with their training and don't allow for a gradual buildup.  You can't run 12 miles a week, then jump to 18.  Same with the long run.  If you are at 8 miles, don't run 14 the next week.  You can't cram training.  All it will do is lead to overuse injuries.

"The Hot New Shoes"                                                                                                         
 Many runners are attracted to what others are wearing on their feet.  One person has success with a shoe, so they think they will do well wearing it as well. Or the shoe company has a great marketing campaign.  There are many different styles of running shoes out there for many runners.  It can take time to find what's appropriate for you.  But the same methodology applies to switching running shoes.  You need to slowly adapt to the new shoe.  You can't be running 15+ miles a week and just switch over to a different shoe.  You need to look at the heel drop (drop from heel to toe measured in millimeters).  If you are in a shoe with a big heel (8mm drop), it's a bad idea to just switch over to a 4mm drop or less.  Your foot strike can change dramatically.  Perhaps you were a heel striker and the new shoe makes you more of a midfoot striker.  Now you are placing stress on different structures of your lower extremities that now have to be adapted to the stresses of running.  Slowly work in the new shoes into your rotation.  Start with 10 min of each run wearing the new shoe, then go back to your older shoe.  Take things slowly as it can take 3-6 months to adapt to the new shoes, depending upon the drop.  And don't make a big jump in your drop.  If you are wearing a big, chunky heel and want to go 'minimal' or wear a shoe with a very low drop, be patient.  Make the transition in stages and take your time.

"Rest, It Does a Body Good"
A basic building period in training comes with a rest week built in.  It usually involves a reduction in weekly miles and time.  It is during this week where your body rests and adapts to all of the training you did the prior weeks.  When you are fatigued from the buildups, your strength goes down and your running form breaks down.  This will make you susceptible to injury.  Listen to your coach or training plan and take advantage of the down time.  You will come out after that week recharged and stronger than before.  Don't skimp on the rest.
 
"Running form"
Heel strike vs midfoot strike vs forefoot - everyone has an opinion.  In reality, there is no right way.  There are many top runners that heel strike.  We look at other things for running efficiency that don't include what part of your foot strikes the ground first.  

• cadence
• contact time with the ground
• vertical displacement
• impact force on landing

These 4 items have a greater impact on your running economy over what part of your foot comes down first.  The higher your cadence (170-190 steps per minute), you will improve where you strike the ground (with your foot under the hip).  It leads to less soft tissue absorbing landing forces (achilles, plantar fascia, tibialis posterior, patella tendon, etc) and more absorbing through joint motions of the knee and hip.  Higher cadence also leads to less contact with the ground.  The less contact time you have, the less vertical displacement (how high you bounce up and down when you run).  The less vertical displacement, the less impact force on landing you have. All of this makes you more efficient.  But again, you just can't jack up your cadence to 180 and expect a transformation.  It comes back to Too Much Too Soon - you need time to adapt. 

"Running Gait Analysis"
If you have been dealing with running injuries or will be doing a lot of running to prepare for a race, a gait analysis might not be a bad idea.  A good analysis would include a complete biomechanical and strength assessment as well.  A great strength training program is important to go along with regular swim/bike/run training.  

"Don't Run Through an Injury"
If you are injured, get it checked out.  There is a difference between being sore and being injured. Sometimes you can run through an injury, but it might require a decrease in mileage or frequency. And at times it requires complete rest while you rehab it.  It pays to get it checked out early so you minimize the loss of training time.  Find a good PT to help you find out whats wrong, why you got injured (was it Too Much Too Soon??), and how to get you back on track!!
 

Setting Goals

I wrote briefly yesterday about thinking ahead to next season and that I had a new set of goals.  My 2014 season was successful and I owe that to being consistent with my training and trusting my plan.  Now that I have laid a good foundation, it's time to build on that and improve.  When planning things out, I looked at my performances from this year to see what I want to improve on.  After some soul searching, I wrote up some goals.

Goal writing is nothing new for me.  I do this on a daily basis for my job as a PT, but it's for other people.  When a patient comes into my office for an evaluation, I have to diagnose the problem, identify impairments, create a 'problem list', and then write goals.  The goals I write need to be measurable and specific for that patient.  We follow a format of "ABCDE":

• Audience - who is expected to change
• Behavior - what behavior changes or results are expected
• Condition - under what circumstance will the result be accomplished
• Degree - how much change will occur
• Evidence - how will the change be measured (outcome measures)

Insurance companies look for these when I submit my evaluations.  I need to be realistic when I write these up.  Insurance companies have a general idea how long the rehab process takes for certain injuries.  If a patient takes longer, they will question my effectiveness as a therapist. As you can see, goals need to be very specific.  Generalizations just won't work.

When it comes to my training, I try to be specific as well.  Very basic goals just won't work.  There's another pneumonic used to help with this goal writing: "SMART"

• S - specific/significant
• M - measurable/meaningful
• A - attainable
• R - relevant/rewarding
• T - time bound/trackable 

I set short, medium and long term goals.  A short term goal might be on a week by week basis.  I review my workouts for the week and set a goal based on that.  I use a medium term goal that might be based on a month-long training cycle.  Long term might be a goal that I am working towards over a season or a long training cycle leading into a 'A' race.

I also need to be mindful about what is realistic.  I won't set a goal like "Finish an Ironman in 10 hours" when my last one was over 14 hours.  I look at my previous times and if I am racing a similar course (or an easier course), then I figure for maybe a 5-8% change. I have to look at my previous times when figuring all this out.

My goals for this year are based on racing times and power goals (cycling).  I also get an objective opinion on my goals as well.  It's important to have a detailed conversation with my coach to get her input on what I hope to achieve.  She will come up with the details to help me achieve my goals.  With each workout, we analyze the data and see if I am on target to making my goals. 

It's important to write your goals down.  I keep a copy on my nightstand or on my phone so I see it every day and am reminded about what I want to accomplish.  What are your goals for next year?

2015 is right around the corner

My 2014 racing season is finally over.  I completed the Army 10 Miler last weekend and squeaked out another PR.  That makes 7 PR's over 9 races this season.  There is no secret to my success.  It comes down to consistency in training.  I had a good buildup to my races and incredible recovery this season. I chose each race very carefully and had a purpose in mind for each one.  I didn't race just to race.

Each race was used to help prepare me for Ironman Lake Placid.  I didn't focus too heavily (mentally) on them and expend too much energy.  I can't handle too many ups and downs that come with racing. My main goal that I was gearing up for was IMLP so I had to keep my mental focus sharp for that race.  Any races leading into it, I didn't get too nervous over. I was able to tune-out the noise around me of other people training and not get caught up in what they were doing to prepare.  I knew what I had to do and I trusted my coach's plan.

When IMLP rolled around, I really felt sharp and well prepared, thanks to Danielle.  There was never a doubt in my mind that I wouldn't finish.  It was just what time I would finish in.  I went through just about every type of weather pattern that day, and I still managed to finish fairly well.  After that race I had a little downtime prior to refocusing my efforts for the rest of the season.  I used my Ironman training fitness to knock out a new PR in the Olympic and Half Iron distance events and then a few running races.

Right now I am in a month-long hiatus from any structured training. I am still training, but it's more of a "what do I feel like doing today?" and just doing that.  It's a great mental break for me as I don't have to worry about getting the work done.  I can relax and just enjoy the idea of working out.

I learned a few things this season that will hopefully stick with me to next season. I've been racing since 2003 and I think this season is where I finally learned a lot about myself (better late than never I guess).  If you race and never learn anything or take anything away, then I think you are really missing out.  It helps me goal plan for future races.

For 2015, I have a few races already in mind.  I am using the same philosophy as I did this season: I will not race just for the sake of racing. Each race will have a purpose/goal that will help me improve. This process takes a lot of self-reflection on my part.  Last month I sat down and mapped out what I want to achieve next season with my racing and what do I think I need to do to get there.  It was fairly detailed and some honest criticism of myself.  I typed up my goals and tentative race list and sent them along to Danielle.  In a few weeks she and I will sit down and figure out what exactly I will need to do to hit my goals next season.  I was very specific with where I want to be and am excited about my journey to get there. Next season won't be as long as this one was, but it will be just as important to me. 

It's been a while.....

I haven't updated this blog since January of 2014 and it's time to 'dust it off'.  Last I left off I had 2 PRP injections in my right patella tendon.  I am happy to say that it healed quite nicely. Many things happened over the course of the year.  One of the most important changes I made when it comes to my training and racing was to work with Danielle Sullivan as my coach.

I was going to go the self-coached route, but coming off the knee injury I knew it would be wise to have someone objective leading the way. I spoke with her on the phone in early January and then we met in person. I knew after that meeting that she was a good fit for me.  I had some ambitious goals for the season and I was concerned about how I was going to hold up.  She let me dictate my run schedule for the 1st month as I eased back into running while she handled the bike and swim.  After that, I was completely in her hands.

She's a very 'hands on' coach and I like that approach.  Her attention to detail is amazing.  She carefully tracked my progress and had me ready to go for all of my races.  What I loved the most was the group atmosphere she creates with all of her athletes.  I've met a good number of them and have the good fortune to consider them friends.  Jose and I met up for track workouts and open water swims with Danielle in preparation for Ironman Lake Placid.  Christa and I get together and do various workouts as she prepares for Ironman Florida.  It really is a fun group to belong to.  The group rides and swims are awesome.  I love being part of the Iron Fit Endurance Team.

This season I had a full schedule:

May
Long Island Half Marathon (had a PR)

June 
Quassy Half Ironman (solid race all around)
Challenge AC (aquabike Iron distance)

July 
Ironman Lake Placid (had a PR under some epic weather conditions)

September
Springs 10k (had a PR)
Mighty Hamptons Olympic Distance (had a PR)
Princeton 70.3 Half Ironman (had a PR)

October
Entenmann's Great South Bay 10k (had a PR - you see a trend here?)
Army Ten Miler (next week)

This was by far my most successful and longest season since I've been racing (2003).  I can't wait to see what improvements I can make next season.  There's a lot of work to be done.  I will sit down with Danielle next month and review my plan and goals for 2015. I already emailed her a tentative race schedule with some goal times/power on it.

So far this off season she has taught me some new swim strokes to break up my workouts.  She's also added a weekly group swim workout starting this month. I love the idea of getting a 'push' in the pool from others in the lane. Anything that will make me faster........

I also worked with Dina Griffin to clean up my race nutrition.  Over the last year I had cleaned up my daily nutrition, but really needed help with my training/race nutrition. Dina was very instrumental in helping me with that.  My race nutrition worked very well. No stomach or intestinal issues.  She helped me come up with a detailed plan and it was actually quite simple. It worked like a charm and I was able to train and recover very quickly from my long workouts (and boy did I have many long workouts).

I had the opportunity to change jobs.  I worked with Sinead when she owned the PT practice, but she left in December of 2013 to pursue new opportunities.  I saw the writing on the wall and knew it was time to get out.  I found a new job that is much closer to home. The added bonus is I work 4 days a week and have Friday's off. So far things are going well at the new job.  They keep me busy and don't micromanage me.

Currently I am taking a few weeks off from structured training to give my mind and body a rest. I was very focused all season and need this downtime to avoid a burnout. My goal is to get back into the swing of training in November. I am really excited to see what is in store for next year!!

What have I been up to?

Well, the last ~6 months have been pretty uneventful.  I injured my knee in July running on a cross country course with some major downhill running.  It was a little too much stress to the knee.  When I woke up the next morning, I was in agony - patella tendinitis.  I tried to rehab it and over time it felt like it was getting better. But when I ran the Army 10 Miler in October, that was the final straw.  I was unable to squat, kneel, or bend (which are major components of what I do at work).   Walking up/down stairs was painful.

I finally broke down and asked the doctor down the hall from my office for a prescription for an MRI. I was suspecting some tendinosis and a possible tear. Well, the MRI came back with that and more. Tendinosis, small tear and a 'stress reaction' of the patella. I knew the only thing that would bring me back fairly quickly would be a PRP injection.  PRP is Platelet-rich plasma that has growth factors and and cytokines to bring about healing.   This would pretty much be my last resort to get this to heal.

I scheduled an appointment with Dr. Paci @ Stony Brook. He's a great sports orthopedist and I knew I would be in good hands with him.  I went with my MRI and we talked it over.  He agreed that PRP was the solution. His protocol is 2 injections into the tendon a week apart. He uses diagnostic ultrasound for accuracy of the injection. The only major downside of the injection was I had to pay out of pocket for it as insurance won't pay for it.  Each injection was $500 ($1,000 total).

So right away I agree and they bring in the equipment. He left the room and his PA and the nurse drew about 15cc of my blood and spun it in the centrifuge to separate the blood cells from the plasma.  When it's done it looks like this (but less fuzzy):

The yellow/clear fluid was injected back into my tendon

 

Then the doctor came back in and performed the injection. I think he used the biggest gauge needle he could find.  I have to say the needle didn't hurt, but the pressure from all the fluid going in was incredibly uncomfortable.

 The yellow stuff outside my leg is the ultrasound gel. 

All of that yellow fluid in the syringe went into my tendon.

 The big black section is where my tendon was breaking down

All of that missing tissue.......

After the injection I got down off the table, was handed some crutches and a prescription and told to return the next week for injection #2. My instructions were very specific - no NSAIDs, only tylenol; ice it like crazy to bring down the acute inflammation. And NO RUNNING.  No worries there as I couldn't even walk.

The next two days I spent on crutches trying to gently load my leg. Once I could walk normally, I got on my bike trainer in the basement and gently pedaled for ~10 minutes. I started doing some basic rehab stuff to load the tendon. Before I knew it, I was back at Stony Brook for injection #2. 

For some reason injection #2 was more uncomfortable than #1. It seemed to take longer as well. The injection itself is maybe 10-15 seconds, but when you are very uncomfortable it seems like minutes.  I reviewed my rehab plan with the doctor and he was on board with it.

I survived this injection and repeated my same protocol. After a few days I was off the crutches and working out. I did some cycling (indoors), walking, squatting, dead lifts, kettle bell exercises, etc.  1 week after the 2nd injection I started some easy rowing.  I was progressing with no major set backs. Just prior to Xmas, I started noticing that I would do things at work (squat, etc) and it wasn't until after the activity that I realized it didn't hurt. Needless to say I was thrilled. I started to jump rope for low level plyometrics to prepare myself for my return to running. I had a soft date of January 4th to begin running if I had no pain.

 

Earlier this week I was doing 12" box jumps with no pain after activity. This was a huge step. I was that much closer.  I was testing the tendon with every activity.  I wasn't necessarily monitoring for pain during activity, it was coming down to how it felt 24-48 hours afterwards. So far, so good.

 

I went on 3 hikes with my friend Teresa and the Wingman. I brought my trekking poles to help offload the knee.  We had two 6 mile hikes with almost 500' of elevation and one 7.7 mile hike with almost 600' of elevation.  The last hike was New Year's Day.  I brought the poles but didn't use them until 5.5 miles in when I was getting tired.  I mentioned to Teresa that my plan now was to run for 10 minutes January 2nd if I felt good after the hike.

 

Well January 2nd rolled around and my knee was sore and tired.  I erred on the side of caution and skipped the run. There was nothing to be gained by pushing it.  I've waited 5 weeks to run, what was one more day.  When I woke up this morning to a blizzard outside I headed down to the treadmill and warmed up. I then set my timer for 10 minutes and off I went.  The time seemed to fly by and I felt great. But when 10 minutes arrived, I stopped running and continued to walk. Once the workout was done I was ready for the next test. In the past, when I would step down from the treadmill I would get a sharp pain in the knee.  Not today!  Progress!! I was so relieved to feel nothing. I did my regular rehab afterwards.  We'll see how it feels tomorrow.

My 6 week ortho follow up is Tuesday. Got my fingers crossed that when we look at the ultrasound, that black hole is smaller, if not gone.  I've got big things planned for 2014 and I can't have this slowing me down anymore.