Wednesday, February 21, 2018

How and When a Keto-Enhancing Diet can Help Triathletes

This post was prompted by Julia Belluz' excellent article on Vox entitled: "The keto diet, explainedIs eating a lot of fat really the best way to lose weight?"

First, I want to be clear that while I am on a keto-enhancing nutrition regimen, I prefer to avoid avoid fads and the word "diet", so instead I say I'm on "carb restriction".  (The title above is so Google will like me more.)

Though I have no need for weight loss, I eat this way for a different reason; to avoid "bonking".

When I started in triathlon a decade ago at age 52, I kept hitting a wall 60-90 minutes into my longer workouts. In triathlon, this wall is called the bonk.

I sought advice from coaches, doctors, fellow athletes, and online. I decided to try pretty much everything anyone suggested that didn't sound harmful.  At worst, I figured I'd just bonk again.

What I first learned is that bonking is most likely due to the exhaustion of stored glycogen, leading to a sharp drop in blood ("serum") glucose levels.  The standard advice was to consume simple carbs during long activities, especially things like gels.

Didn't work for me. I still bonked, even when I ramped up active carb intake to nauseating levels.  I also attacked the issue of "gastric distress", and while some products did better in my stomach than others, none did much for my bonking.

Then it was mentioned that moderate carb-loading 24-48 hours before endurance activities, though "old school", could help. Which for me meant eating more carbs all the time, due to my workout schedule. Tried it several times, and I still bonked.

Others suggested I was simply pushing too hard, or I had inefficient form.  I tried modifying both.  Going slower did help, but I had to go much slower, barely above a jogging pace.  No way I would ever call that "race pace".  Technique changes also helped, though while they make me slightly faster, they didn't affect my bonking; I was just a bit further down the road when I bonked.

I finally started doing my own investigation, starting with the fuel sources of endurance athletes (this article provides a brief overview). It turns out most endurance athletes get about 65% of their endurance muscle energy from carb metabolism (glycogen -> glucose) and the remaining 35% from fat metabolism (triglycerides-> fatty acids). This ratio can shift during activity, with fat dependency increasing with time to 50% or more.

But fatty acids can't be used by the brain or nervous system, so another fat metabolic path in the liver activates to generate "Ketone Bodies" when glucose becomes scarce.  Ketones can replace glucose nearly everywhere.

My working theory for my bonking wasn't just the exhaustion of stored glycogen, but also a simultaneous failure of both of my fat energy systems. While fatty acid metabolism and carb metabolism can work fine together, it is well documented that ketone production shuts down in the presence of glucose or carbs, even when the carbs were just eaten and not yet digested (the stomach sends "carbs coming!" signals).

Perhaps the main problem wasn't my glucose dropping during workouts (a normal effect), but rather my ketones failing to rise to meet demand.

To me, this meant I needed my glucose levels to taper more gradually, to give ketones more time to ramp up.  I also needed my base ketone production level to be a bit higher.  And, ideally, I'd like my peak ketone production rate to also increase.

I studied "ketone boosting", which required I gradually reduced my carb intake while increasing protein and fat to meet my calorie needs (no net calorie change in my diet).  It is important to note that I didn't even try to get to "zero" carbs: That's both impractical and potentially harmful (insert Atkins Diet horror stories here).

I simply banned all simple carbs: Potatoes, rice, and all milled grain (bread, pasta, etc.).  I could have all the dark green veggies I wanted.  I increased my egg intake for protein, and kept my meat consumption relatively low, averaging under an ounce per day.  My fat needs were met by vegetable fats and occasionally a little pork with breakfast (bacon or sausage).

It took several months for my digestion to get the message, but eventually my gut bacteria adapted to the lack of carbs in my meals. Which precisely matched the duration of my carb cravings. As the carb cravings faded, so did my bonking.

A small level of carb metabolism is needed to make fat metabolism more effective (faster and more efficient).  This meant I would still need a trickle of carbs during a race or long/hard workout, but no carbs before.  So I created my own electrolyte + simple carbs + caffeine race "gel" to meet those minimal needs with only abundant water needed otherwise.

With these changes in place, I was finally ready to train at higher levels.  I found I could comfortably handle an 8-minute mile pace, an 8:30 5K pace, a 9:00 10K pace, and a 9:30 half-marathon pace.  These were my "comfortable" limits, with relatively little emphasis on speed work. Still, they were fast enough to ensure PRs in my future races.

A year ago, at age 60, I did my first 70.3 mile "half-Ironman" triathlon. While I had lots and lots of problems during the 7+ hours of that race, bonking wasn't one of them.

I have found no studies or research covering my specific experience, but the logic seems unassailable.  So I can contribute only one anecdotal datum, to be filed under: "It works for me!"

Since my half-IM I've been experimenting with how much of what I can eat how soon before endurance exercise.  I've found I don't need to be quite as strict as I was before.  First, absolutely no carbs in the 4 hours prior to any workout of 60 minutes or more (instead of a near-total ban).  No meals in the 3 hours prior to a hard workout (mainly to keep my GI tract happy).

Given my exercise schedule, these restrictions still interfered with my eating habits.  So I next tried daily "light" fasting, where my biggest meal of the day was immediately after my last workout (and well before bed).  During the day I could have tiny snacks of nuts as desired, and some fruit (bananas, dried fruit),  I could have a glass of OJ on mornings without a workout.

On days with one or no workouts, I could eat pretty much anything I wanted, so long as I kept my total carbs restricted and met the pre-workout eating exclusions.  I also found that simple carbs were the main issues, allowing me to occasionally have super-dense carbs such as tortillas and bagels.

To make things practical, and to limit temptation, I've banished all simple carbs from my house, so my carb restriction gets attention only during shopping.  This lets me eat anything in the house, whenever desired.  For the few meals I eat away from home each week, I can have whatever everyone else is having.

A rather long multi-year path to what turned out to be a relatively straightforward solution.  My continuing investigation indicates my diet may also be a good aging diet, potentially reducing (or at least not aggravating) the risk and/or severity of  several age-related conditions and illnesses.

When Adding a Glide to the Swim Stroke is Good!

This post is in response to the recent SwimSmooth blog post entitled "Blinded By Aesthetics: The Definitive Guide To Why You Shouldn't Be Trying To Pause And Glide When You Swim"

I have a vital caveat to the "No Glide Ever" philosophy: I believe it is dead wrong and even counter-productive for absolute beginner open-water swimmers.  Giving these folks a glide greatly hastens their initial progress, which soon supports elimination of the glide.  And by "soon" I mean after 4-12 sessions, and certainly after their first couple of Sprint-distance triathlons.

By "absolute beginner" I mean someone who has no open water swim experience, and who can barely survive swimming one length of a pool.  While this is most often due to a simple lack of technique, it can also be due to poor muscle and cardio conditioning and/or poor oxygen update (e.g., asthma).  I have found getting such folks into a triathlon wetsuit as early as possible makes a massive and immediate improvement, greatly encouraging that initial drive to overcome open water fears and weaknesses, and to become a true swimmer.

The largest issue is simply raising the body up so breathing becomes simpler and easier.  That's it.  Hundreds of times I've seen the joy on the faces of previously struggling swimmers (and non-swimmers) when they get their first few strokes while wearing a wetsuit.  That joy often triggers an enthusiasm for learning to swim better that makes my task much easier.

Such folks, who are true triathlon beginners in every sense of the word, are often unready (or unwilling) to add the fourth triathlon training regimen: Strength Training.  So I combine technique and conditioning.  For me, this means making every stroke powerful, to build both "feel for the water" as well as stressing the body just hard enough to encourage rapid conditioning

Few, if any, absolute beginner swimmers can crank out 25m of powerful strokes.  Many coaches advise letting the athlete "back off" to focus on form (a smooth, continuous stroke) and distance/endurance.  I have found this to be counter-productive.  It's like teaching them a "useless" slow stroke, and reinforcing all the associated "useless" muscle memory, rather than taking the shortest path connecting the starting point to the desired beginner end point (typically the first two sprint triathlons).

But even absolute beginners can do a few powerful strokes, even with poor conditioning.  I have found it FAR more productive and effective to simply add some recovery time (a glide) between powerful strokes, even over relatively short drill distances.  That is, I try to bring standard muscle conditioning techniques (load, reps, recovery) into the open water.

A powerful stroke with a glide also helps ensure proper rotation.  A weak stroke often leads to flailing and wriggling to get a breath, or breaking the stroke to add a side thrust.  Successful open-water breathing comes primarily from two sources: Height in the water and a solid extension for good rotation.  That's another reason to teach a strong stroke first, with a glide on one's side for easy breathing.  To emphasize this, we also teach "no neck rotation" to enforce body rotation, with the initial motivation being to avoid painful and unsightly "wetsuit hickies".  Later on, we refer to full rotation as "swimming skinny", which makes it easier to get through dense packs.

Note: To be clear, we tell beginners to stay wide of packs and turn buoys.  But shit happens, so beginners must cope with it, rather than become startled, afraid or confused.  The goal is to complete the swim course no matter what happens, and no matter how slow their progress, always to "just keep on swimming".  (To emphasize this, in later drills instructors will bump into them, swim over them, and even get tangled up with them.  We call it "sharking the drill".  We also do nasty things like go off course during later drafting drills.)

Once their stroke looks good, with however much glide is needed to cover a significant distance (say, 100m), I then add two drills: "Form to Fatigue", where I have them select their own initial glide duration, then go as far as they can while maintaining stroke power, rate and glide.  Being caught in a form break is the ultimate no-no: They must stop when their form suffers, which means becoming very aware of what a good stroke feels like, both in the body and in the water.  Any stop before the finish means adding more glide during the next attempt (not backing off on the force of each stroke).

Remember, the initial goal is to simultaneously build strong swim muscles and cardio, as well as develop a stroke that will be ready to make instant and full use of their rapidly improving conditioning.  Nothing but the "final" stroke is taught, with glides initially present only while the body develops.

The second drill is "Glide Reduction".  Once they are able to do "Form to Failure" over a Sprint distance swim, subsequent drills focus on maintaining that power, form and distance while gradually reducing the glide across subsequent workouts (not within individual drills or workouts).

I do not time their drills (though they are free to time themselves).  I only monitor their form, see where/if they stop, and check how they feel after each drill.  The ONLY exceptions to this are occasional Time Trials, where we record their time over a Super-Sprint distance, and give silly prizes only for "Most Improved" by percentage gain from their prior TT, never for place or time.

Teaching absolute beginners to vary glide instead of backing off on stroke effort has several benefits, especially in the Sprint distance.  First, it gives beginners a usable burst stroke, such as to get through a slow pack or catch a draft, simply by temporarily eliminating their glide and changing nothing else.  If they overdo it, they can add in whatever glide is needed to recover.  But underwater, The Stroke is always The Stroke.  This is the KISS Principle applied to absolute beginning open water swimming.

For some absolute beginners, especially older "casual" triathletes, this is all they want or need, at least for their first several races.  If they are going to stop instruction early, I want it to be with at least a good, reliable and powerful underwater stroke, with or without a glide, and in a wetsuit.

Then there are those absolute beginners who quickly become Monsters of the Swim.  I've seen several absolute beginners go from zero to fast in just 2 sessions.  Most are kids, who I promptly refer to a youth coach.  The rest are referred to intermediate coaches and clinics.  Basically, I kick them out so I can focus on the other absolute beginners.  The feedback I get from other coaches is that my graduates are among their most determined and compliant clients.  Those who insist on sticking around become coaching assistants.

There are always some absolute beginners who have trouble swimming a Sprint distance, even when their stroke is good and their fitness is adequate. It's often more of a psychological limitation than physical, but I believe a physical approach works best even here.  For these folks I add in a "Super Glide", where they can glide so much as to nearly come to a complete stop (if needed), so long as they "never stop swimming".  Which is practical only in a wetsuit.  The goal is to always be fresh and alert, and never let the stroke fall apart.  The glide provides moments for brief reflection, refocusing, and making that next stroke perfect.  Typically, 1-3 Super Glide drills gets them past any psychological block.

Understanding the glide also helps with open water spotting/sighting, where it may occasionally be necessary to press the extended arm down to get the eyes high enough to see over waves.  Some beginner triathletes with smooth continuous pool strokes have trouble integrating a "high spot", where gliders seldom do, even after they have eliminated their glide.  This is especially valuable to absolute beginners during their first races, even if in a sheltered bay or lake.

This is very different from how I teach beginner run and bike, where I emphasize a consistent high cadence first, last and always.  Adjust stride length in the run as conditioning improves, similarly for the gearing on the bike.   I never emphasize stroke cadence with absolute beginner swimmers (I mention rhythm as feel and consistency, not as cadence or time); the emphasis is always on a powerful stroke underwater.

I want to emphasize the glide is only intended to be a temporary expedient, to be eliminated as soon as muscular and cardiovascular development permits.  But it's not a top priority, especially not compared to simply finishing the course. Some folks come to prefer the Zen-like feel of a long glide, and choose to keep their glide forever, which is absolutely OK!
A number of my absolute beginners eventually became familiar podium finishers in local races.  After one race that had particularly brutal ocean conditions on the first half of the swim, I overheard one graduate exclaim to his neighbor on the podium: "It was so rough out there I had to add in a glide after the first buoy!"  Made me proud!  Even if not desired under normal conditions, it's useful to have a glide in one's bag of tricks.

I believe it is better to do whatever is needed to get through a rough spot, then add some glide to recover after.  I see way too many swimmers who are fast in calm conditions fall apart when things get rough for a while.  I see them become unable to sustain their customary stroke, and simply start flailing at the water and fall behind, or come to a complete stop to recover.  I strongly believe a glide is an ideal fall-back to use when the unexpected happens.

I do not teach absolute beginners how to swim in the open water without a wetsuit.  Instead, I encourage them to join pool groups and clinics.  To me, there is no reason for an absolute open water beginner to enter a non-wetsuit race!  Which makes getting rid of the wetsuit a solidly intermediate skill.

There is much more we teach our absolute beginner open water swimmers, particularly race skills and tactics, but a powerful strength-building stroke with a glide is always where I start.

Sunday, November 19, 2017

Running Shorts and Tights

A year ago I spent the winter training for my first 70.3 triathlon.  An important step in that training was to run my first half-marathon.  Training for that race meant more running in cooler weather, for which I purchased my first-ever pair of running tights.

The tights were the 2016 Nike PRO Hyperwarm model, and after getting over being self-conscious wearing them (and shaving my legs to keep gray hairs from poking through), they immediately proved their worth.  They kept me warm without overheating by using a fabric that was both insulating and wicking.

They were also my first tights providing full-leg compression.  I've long enjoyed my De Soto Forza trisuits with their compression fabric over the hips and thighs, but the Nike tights added calf compression, which was new for me.

Best of all, these Nike thermal compression tights were significantly less expensive than the other major brands.  They provided top quality at an affordable price.  They also let me run in cooler weather with fewer upper layers.  My only remaining cool-weather obstacle was the cool dry air triggering my asthma, which was resolved by adding a walk-jog warm-up.

I highly recommend these tights!  I don't know why I didn't review them earlier, but the recent cooler weather reminded me.

These tights made me want to also get compression in my running shorts.

For well over 30 years, my running shorts have been fairly minimalist, a liner with some sort of outer fabric.  For nearly all of that time my favorite shorts were by Scott Tinley, and featured a liner with little more than a breechclout, a flap of brightly colored and patterned fabric at the front and rear, with the outside of the legs exposed up to the waistband.

I've missed the compression from my De Soto trisuit, and started to run in regular a pair of trishorts. But the trishorts lacked the small key pocket generally present in running shorts, adding a frustrating complication in addition to not providing much compression.  I did look at compression shorts by De Soto and all the other major brands, and was discouraged by the prices.

A brief note about my use of compression garments:  The research clearly shows the main physiological benefits of compression garments come as part of recovery, with little or no physiological benefit measured during activity.  However, I am both bow-legged and flat-footed, and my running gait places a fair amount of torque on my hips, in particular placing extra load on the piriformis.  Given my history with severe sciatica, piriformis issues can quickly lead to both hip and sciatic pain.

Most often, if I'm paying strict attention to my form and am doing my foam rolling, I don't consciously feel any hip or sciatic pain during the run itself.  But it is there at a sub-conscious level, and it adds to my fatigue. The pain always shows up the moment I finish a long or hard run, and during the first day or so of my recovery.

For me, piriformis compression markedly improves my ability to run both farther and faster with greater comfort and quicker recovery.  My performance gains over weeks and months are both more consistent and more rapid.

For years I went to TCSD meetings hoping to win a pair of compression shorts in the raffle of products from club sponsors.  While I managed to win almost every other piece of gear I desired, I never did win any compression garments.

For my birthday my nephew gave me a gift card to RoadRunner Sports.  My initial intention was to get more of the low-crew WrightSocks I love so much, only to find that they were no longer carried!  I wandered through the store when I came across the compression running shorts.  The Big Name Brands were all $80 to $140, which I thought was a bit much. Fortunately, the RoadRunner house brand was under $40.

I've owned other RoadRunner branded products, and my general impression has generally been "good enough".  Not super high-end in design or materials, but always with solid workmanship, a very fair price, and a great warranty.

However, compression garments are a very different from T-shirts, hats and jackets.  Comfort is everything, and function is critical.  How would the house brand compare to the big brands?

I won't mention the name brands I tried, only to say they all were great. Solid compression around the hips and thighs without crushing the crotch.  The RoadRunner shorts were different, with comparatively less hip compression for the same leg compression.  This wasn't due so much to the different fabric being used, but more to the number and shape of panels used and how they were sewn.  The RoadRunner shorts had simpler construction.

This simplicity also extends to not having a liner over the crotch, which I hope won't cause any issues.

A very positive design feature of the RoadRunner compression shorts is the presence of two large side pockets just behind each hip, next to the glute. One of the pockets has a zipper!  These pockets are easily big enough for a phone or a flat water bottle, reducing the need for a FuelBelt or arm band.

My De Soto trisuits also have generous pockets, but they are on the outside of the leg: When stuffed with gels or a flat water bottle, my arm swing can hit them. I do not expect to have this problem with the pockets on the RoadRunner shorts.

For 1/2 to 1/3 the price, I expect the RoadRunner shorts will certainly meet my needs.  We'll see how they survive in use, but I see no reason to worry.

You may have noticed I haven't mentioned what it's like to run in these shorts!  I have an annoying lung infection at the moment that has zeroed my endurance cardio workouts, but I'll update this review soon after it clears up.

Tuesday, July 25, 2017

Jock sock stock: Knock or rock?

I've previously talked at length about the process of how to find the running shoe that's best for you, and how the result of that process can be affected by age and gait changes.

But I've said relatively little about socks, mainly because I had nothing useful to share.  I've tried over a dozen brands of specialty running socks, some of which were quite expensive, and while there were many that were total failures for me, none of the rest ever seemed in any way special.

I'm not going to mention the socks that failed for me, simply because they may work great for you!

I had gotten to the point that I simply ran on whatever "good enough" socks I could get for free, or at discount, from events and TCSD sponsors.

That all changed in late 2016, when I received a pair of WrightSocks as a gift.

I had foot problems during runs longer than 5K, creating misery when training for my first half-marathon.  My feet got hot, and it felt like my forefoot was swelling (it wasn't, but it just felt that way).  I had thought it was a shoe ventilation and toe-box size issue, and that was partially correct, but the problems remained.

Until I got my WrightSocks.

The WrightSock design, like many others, uses two layers.  My prior experiences with dual-layer socks had not been good: I always felt like I was sliding around in my shoe, with my toes getting jammed into the end of the toe box (I run with a forefoot-strike).

The WrightSock inner layer is a thin, snug-fitting friction-resistant Coolmesh moisture-management layer.  It sticks to your foot and stays put.

The WrightSock outer layer is a thicker, durable, ventilation layer that also helps with moisture transport.  WrightSock offers a choice of two outer layer materials:  Coolmesh 2 and Merino TRL.  I have tried only the Coolmesh, which is recommended for all uses.

WrightSock offers several weights and styles.  I tried only their lightweight "Coolmesh" model.

On my first 4 mile run in the socks, the difference was immediate, obvious, and, well, wonderful.

However, there was one small problem: The pair I was given was the "low" below-ankle style.  My foot is very narrow, so the heel tends to be a loose fit, which causes my shoe to "eat" low-cut socks.

So I had to stop once in a while to pull my socks back over my heels.  A very small price to pay for such comfort.

After a couple weeks I knew this wasn't a fluke: The WrightSocks were actually transforming my running, making longer distances far more comfortable, and thus both faster and less fatiguing.  I purchased three pairs of the WrightSock "Quarter" sock ($13 for a single pair, $11 each in a 3-pack) in the low crew style, which kept my shoes from eating the socks.

I took one pair to wear all the time, every day, to see how they aged.  My toenails tend to slice right through most socks, my sandals tend to chew them up, as does using socks as slippers in the house.

It's been 6 months, and my WrightSocks still look and run like new.

If you're having foot discomfort while running that your shoes aren't handling, then it may be your socks.  Before getting yet another new pair of shoes, be sure to try some WrightSocks!

Then wear them when buying your next pair of running shoes.

Saturday, February 11, 2017

Intervals? Who, me?

I've been gradually adding these things called "intervals" to my workouts, particularly for my strength training sessions and my runs.  Just what is or is not an "interval" seems to have lots of different interpretations.

At the softer end of the spectrum is what I'd call "surges", such as is done during fartleks, adding push and recovery segments to an otherwise ordinary run.  At the softest end is switching back and forth between "race pace" and "cruising" on a longer run.

At the harder end is doing sequential 50 meter all-out sprints separated by brief pauses.  The hardest of the hard end is doing them on hills or stairs, or while carrying weights.

I choose to be somewhere in between: Low enough to avoid damage to joints, tendons and muscles.  High enough to be well beyond my endurance capabilities, to challenge my body's ability to mobilize energy in the muscles, to just shy of the point of being unable to continue with good form.

In strength training, my current practice is to do a sequence of exercises without breaks, each affecting different muscle groups, resting only briefly (under 2 minutes) when the entire sequence has been completed.  Individual sets of muscles get challenged in each exercise, but not for long, typically 30-60 seconds.  The cardio-respiratory system is challenged throughout the sequence.

The phrase used most in the literature is "High-Intensity Interval Training" or HIIT.  A great term that also has lots of definitions and perspectives.  Until recently there has been relatively little "hard" science done to quantify the effects of HIIT on various slices of the general population, with much of the prior work focused on elite athletes.

And as any age-grouper will know, what works for elites can easily fail for the rest of us.

However, it seems HIIT is special:  Done right, HIIT seems to benefit just about everyone!

Let's start with some definitions and limits:

I. There are no absolutes in HIIT.  What is normal activity for one person can easily be HIIT for another.

This is true even for the weakest of us: There is unambiguous medical evidence that doing limited HIIT immediately after surgery is of clear benefit to both cardiac and hip replacement patients.  In the past it was thought that just getting these folks mobile was all that was needed, and in a general sense that's true, since for some even basic post-surgery movement is HIIT.  But the bigger picture for these patients now is to get them up, work them hard (yet safely) for a moment, then get them back in bed.

For the rest of us, it is important for us not to all do the same workout.  Each of us needs to tailor our HIIT to meet our abilities and goals.  So doing HIIT as a group is not a good idea, though it is always OK to do your own HIIT workout while others are doing their own HIIT workouts.

II. HIIT is adaptive: What starts out as nearly impossible can soon become much easier.

How can this be?  What's going on?

There are many components that go into "fitness", "strength", "endurance", "power" and related terms.  Collectively they describe how hard we can use our bodies and for how long.  Intensity versus time.  There are many steps in the overall process that involve everything from eating, breathing, carbohydrate (glycogen) transport and utiliztion, fat catabolism, fatty acid transport and utilization, muscle mass, composition and density, ATP metabolism (mitochondria), and so on.

The primary (most obvious) measurable physiological effect of HIIT is increasing the number of mitochondria in muscle cells.  We are still largely ignorant of much of what goes on in mitochondra.  We can't tell all that much about the mitochrondrial activity going on within a muscle by examining the blood. It takes a muscle biopsy, then putting the cells under a microscope and simply counting the mitochondria.

What we do know is that more mitochondria means better energy production in the muscle, both for the long (endurance) and short (sprint) terms.  There are certainly other factors involved, but the change in the mitochondrial count is a dominant factor.

Recent HIIT research has shown a simple result: Muscles utilized during HIIT exhibit an increase in the number of mitochondria present.

I want to make this point very clear:  HIIT directly helps endurance performance.

There's a favorite triathlon truism: "Train like you race; race like you train."  That is broken where HIIT is concerned.  Train with HIIT, but never do an all-out 30 second sprint in a race.  Other than to beat your buddy at the finish line, of course.

III. HIIT must be performed well within the body's limits.

Injuries are very common among folks "suddenly" adding HIIT to their workout regimen.  It is important to start out gently, to prepare the body for the increased stress.

The most common HIIT injuries are muscle and tendon pulls, with severities going all the way up to detachments and tears.  Taking any HIIT interval too far can also lead to joint injuries as form falls apart, and other injuries if falls occur.

In my own case, I had been doing lots of lunges, squats and jump squats, so I thought I was ready to add HIIT run sessions.  On my second HIIT run session I got a moderate hip flexor pull:  None of my preparation had included increased rearward leg swing.  It is best to ramp up gradually, and let the body adapt to the actual exercise being attempted.

Vital point: Always stop at the first sign of pain!  The old adage "No pain, no gain" is total bullshit.  Fatigue and discomfort, even "the burn", are OK; the pain of damage never is.

IV.  HIIT needs far more recovery compared to conventional workouts.

While many of us have no problem doing daily runs, daily HIIT run sessions are not a good idea!

The medical studies have various observations of the muscle's condition after HIIT, as well as that of the body in general.  The overall picture is that HIIT depletes not only the energy stored locally in the muscle (needed for the mitochondria to convert ADP to ATP), but also depletes the muscle's ability to use energy.

I started out with one HIIT session per week, on the day before my day off.  Even doing a light run on the day after a HIIT run session could be surprisingly difficult.  I think the best plan is to not run at all on the day after a HIIT run session, having either a day off or just a swim and/or light bike day.  And the next run should not be a hard one.

Pardon me while I climb back on to one of my favorite soapboxes:  Foam rolling after HIIT greatly aids the recovery process.  While you shouldn't do HIIT daily, foam rolling daily is a massive plus.

OK, enough about HIIT in general.  What about the specifics?  How am I, a perma-newbie in triathlon, using HIIT?

In my strength training workouts I use only my own body weight, and my only piece of equipment is a TRX.  The specific exercises included in each workout cycle vary every time, and include random selections to push and pull with each skeletal muscle group (push-ups + pull-ups, squats + hamstring curls, kicks face-up + face-down, etc.), static and dynamic exercises for the core (planks, side planks, sit-ups, crunches, crab-crawls, etc.), integrated exercises to work secondary muscle groups (walking lunges, twisting lunges, kneel-to-stand, etc.), and finally runs with varying gaits (regular run, skipping, side-to-side, ice skaters, backwards run, etc.).

The only exercise type not presently included in any of my sequences are plyometrics, such as jump squats or clap push-ups.  Doing these with perfect form as fatigue grows is almost impossible, and they simply add injury risk for minimal gains.  I'm not saying I'll never include plyometrics, but only that they're not at all a priority.

Other than the run, each exercise is done for only 30 seconds, with no pauses between exercises within the sequence (not quite a scramble between exercises).  After each sequence I take a sip of water and a brief rest that never exceeds 2 minutes. The goal is to have good sets with minimal rest.  But always rest enough to ensure the next round is a good one!  If two minutes isn't enough rest, then you're done, and no more sequences should be attempted.

It is important to note that I said nothing about the number of reps or the duration of each rep within each exercise.  It is most important to always maintain perfect form.  After that, it is important to maintain smooth flow, without jerking or tugging or bouncing.  Finally, it is important to just keep moving, never stopping, but always permitting yourself to back off the level of effort when and if needed.  It's the contact time that's important, done while always maintaining perfect form.

That's quite a bit of description for the strength HIIT sessions.  My runs are much simpler.

First, it is important to never do a full-intensity run interval on a cold muscle (much like stretching), and it is also important not to stop cold after HIIT.  So every HIIT run session should start with a warm-up run of a mile or so, then the intervals, then a cool-down run and/or a brisk walk for another mile or so.

Each of my intervals starts at a jogging pace then smoothly builds over about 5 seconds to a flat-out sprint.  When I start to feel fatigued, I smoothly back the sprint down to a brisk walk.  Wait up to two minutes and repeat.  I'm done with intervals if I'm not recovered in two minutes.  The goal is to start the next interval as soon as I feel I'm recovered enough for it, and not automatically wait a full two minutes.

That's where I am now.  As I improve, I expect to eliminate the walk between intervals and use a jog instead.  At this point, I see no reason to ever do more than a dozen intervals.  Starting out, three can be plenty!

Again, it's not about the number of intervals or the amount of time spent at top speed.  It's about always having perfect form, and letting the rest period dictate when or if the next interval happens.

I lost two months of winter training due to injuries, illness, weather and holidays.  I need to get ready for SuperSeal and O'side 70.3 (my first half!) with the time I have left.  HIIT has taken on a higher priority for me simply because of the large payoff for a small time investment.

Sunday, January 22, 2017

What I Do For "Trigger-Point" Upper Back Pain

The following plea for help was recently posted to the TCSD email list:
I'm looking for some advice/knowledge. In November, I suddenly had intense pain in my right upper back, near my shoulder blade. It made it difficult to move or turn my head. After quite a bit of trial and error, some research, and a couple visits to a doctor and masseuse, I figured out it was a "trigger point" of muscles that have a hard time relaxing, and instead stay completely contracted. It was caused by biking, as swimming and running really didn't irritate it at all. I would wait about a week for the pain to go away completely, get on the bike, and be in intense pain again within 24 hours. It eventually led to my entire right arm going numb because the muscles were hitting nerves. So I stopped biking for a little over a month. I got back on for a short trainer ride yesterday, and unfortunately the pain still came back. I'm at my wits end, and am really not sure what to do. I have gotten my bike re-fitted already and have tried muscle relaxants. Massages help immensely, but I can't afford to keep going, and it doesn't seem to be preventing it.

Does anyone have any experience with this type of injury? How can I expedite recovery and/or insure recovery at all? I'm on a budget, so cost-effective recommendations are greatly appreciated!
Please take everything that follows with a grain of salt.  It's simply the results of my own search, and what wound up working for me.  YMMV, and so on.

If you don't presently have this problem, please feel free to jump ahead to the "Cause and Prevention" section.

First, some terminology: "Trigger Point" pain is a catch-all term equivalent to a localized combination of a nerve inflammation and/or muscle spasm.  There may also be muscle damage involved, where the swollen muscle pushes against a nearby nerve.  Or a nerve may be damaged, and the local muscles are overreacting with cramping/spasming.  The central idea is that it manifests as localized point-like pain.

Let's start with finding out what's going on.  There are multiple distinct injuries (including fractures and disc problems) that can result in similar upper back pain.

Assessment #1:
Get a FREE Injury Screening from TCSD sponsors FunctionSmart or Rehab United.  Your medical insurance may cover specific forms of treatment/therapy.  Work with them to find out.  Starting with a good, focused treatment (such as ART), even if only a single session, can serve as a reset button to hasten overall recovery.

Assessment #2:
Go to the gym (or a fitness equipment store) and do a 20-30 minute high-cadence light workout on a recumbent trainer.  Push just hard enough to work up a sweat, but not so hard that you're forcing yourself against the back of the seat.  Keep your arms relaxed.  If you have a power meter available, average anywhere from 120 to no more than 250 watts.

My hope is that this recumbent spin session goes perfectly fine, with no additional upper back discomfort at all.  If so, then recumbent is your bike workout plan for a while.  If not, then stick to swim and run.

Assessment #3:
Go see your Sports MD.  I can't say it often enough: A Sports MD is an athlete's best friend and advisor in all things medical.

I'm not talking about a doctor who does sports.  "Sports MD" is a separate board-certified qualification.  Every local medical system has them.  If possible, try to select a primary physician who is also a Sports MD.

Next, let's get our toolbox together.

Recovery Equipment List:
  • Tennis ball
  • Foam roller
  • Hot/cold pack that has a strap allowing it to be worn on the pain area while moving (like these).
  • Breathable heating pad (not the sealed plastic ones)
  • Epsom salts (optional)

Please notice that pain relievers are not on that list!  I use them only when I have to reduce the pain in order to sleep.  Otherwise, keep all lines of communication with your body wide open.

Another thing not on the list are motorized massagers or pressure-point devices like the "Back Buddy" or "TheraCane".  These can be useful, but it is way too easy for them to make an injury worse.  Only if you are experienced using them as part of your regular workout recovery can they also be used as part of injury recovery.  It's best to avoid them completely if there is any doubt.

Here are the two major things I do to prepare for an injury recovery session.

Preparation #1:
Always be fully hydrated.  Aim for a gallon of water per day when sedentary, especially when injured.  If your pee is yellow, you aren't drinking enough water.  It should be very close to clear.  You should be peeing fairly often, at least once every hour or two.

I can't overemphasize the importance of thorough hydration as part of both the recovery process and also of pain management.  Both the initial injury damage process and the subsequent healing process release byproducts into the blood that can cause their own irritation: Diluting and eliminating them ASAP is the way to go.  Also, pain causes the release of stress hormones such as cortisol, where again dilution and elimination really help: Pain is often a feedback loop, so cleaning things out can actually lessen the pain itself.

So stay hydrated!  (But not overhydrated: Avoid hyponatremia.)

Preparation #2:
Take a hot soaking bath, with salts if you prefer.  Showers don't count.  Or lay on the heating pad in bed and read a book or watch TV for 20 minutes.  The goal is to relax and increase blood flow to the injured area.

Thorough relaxation and increased blood flow are important to recovery, second only to thorough hydration.

Let's get ready to start fixing things.

Recovery Session Start:
What follows should not cause any pain whatsoever, nor should it make any existing pain worse.  If that happens, stop and go see a Sports MD.
  1. You are hydrated.
  2. The injured area (or the entire body) has been warmed.
  3. Initial stretch: Pull an arm across the chest, over the collar bone.  Put the opposite forearm or hand on the elbow and pull in gently (not at all hard).  Hold the stretch for 5-10 seconds, then switch to the other arm.  Repeat 3 more times (each arm pulled twice).
  4. Final stretch: Hug yourself with both arms, hands on the opposite shoulders (or as close as possible).  Exhale completely, pull in slightly, then inhale fully.  If you don't feel a stretch across your upper back, then curl forward until you do.  Hold your breath and stretch for at least 5 seconds. then slowly exhale and relax. Release the hug, letting the arms gently swing to your side.  Restart the hug so the other arm is on top.  Repeat 3 more times.
You should now feel loose and relaxed across the upper back.  Any pain you may have had should not be any worse, and is hopefully reduced.

This preparation is useful not just before injury recovery sessions, but also before going to bed, or whenever the injury is bothering you.

Let's start working the injury area.

Initial Manipulation - Tennis ball wall roll:
If you experience any pain spikes during what follows, then stop immediately and see a Sports MD.

Gently lean your upper back against a wall, with your knees slightly bent, feet placed just wider than shoulder width.  Place the tennis ball between the middle of your back and the wall, at the level of the injury but not on it. You should be leaning with only just enough pressure to keep the tennis ball from falling to the floor.  Do not press hard against the tennis ball!

Lower your arms to your side.  Relax your upper back, neck, shoulders and arms.

Using your legs, move your back so the tennis ball gently rolls all around the injury.  If the tennis ball can't gently roll over the injury itself because the shoulder blade is in the way, pull the arm on that side across the chest at the collar bone (as done in the initial stretch).  Move the tennis ball in a random motion for 1 minute.

Be sure to always keep your upper back and shoulders relaxed: Do not tense up!  The tennis ball may be uncomfortable, but it should never be painful. Pain defeats the whole intent of the manipulation, and may make the injury worse.

Repeat the same motions on the opposite side.  Be sure to always do this gently, matching what was done on the injured side.

Symmetry is important!  Whatever you do near the injury must be repeated on the other side of the body.  Why?  There are several important reasons, the most obvious of which is that your recovery will be complete when both sides feel equally good!

Take a minute break after the other side is done.  Repeat the preparation stretches if desired.

Repeat the tennis ball roll on each side with slightly increased pressure to improve muscle manipulation, but never to the point of pain or major discomfort.  Then stop: It is important to not over-do any part of an active recovery process.

This may be all you can handle for the first few times.  Stopping early is vastly better than overdoing!

You can have as many initial manipulation sessions per day as you like, so long as you rest, hydrate, heat and stretch before each one.

The tennis ball wall roll is awesome. I also use it on my lower back (QLs), glutes and hip flexor.

Time to get hard-core.

Daily Manipulation - Foam Rolling:
Daily foam rolling is the Fountain of Youth!  Well, at least for muscles.  It should be part of your daily routine, injured or not.  Training or not.  Like food and water.

Athletic injuries seldom occur in isolation.  They typically happen when the entire body is under stress, but one part is either more sensitive or is receiving extra stress (due to misuse or overuse). It is important to treat any localized injury as an injury to the entire body.  Foam rolling is the best way I know to help whole-body recovery (with hot tubs running second).

I will not cover the details of foam rolling here.  There are lots of printable instruction guides and video tutorials available online that can be found by searching for "foam roller tutorial".  Find the one you like best.  This video is pretty good, but the audio has issues.

I am more than willing to guide an informal foam rolling session for any folks wanting one.  Post a request to the TCSD email list and we'll make it happen.

Be sure to roll all of the following areas for two minutes each:
  • calves
  • hamstrings
  • quadriceps
  • ITB (outer thigh)
  • adductors (inner thigh)
  • glutes
  • illiac crest
  • lower back (QLs)
  • spine (do crunch over low and mid spine, and self-hug at upper spine)
  • lats (also great for swim recovery)

If you are new to the foam roller you will likely need to take frequent breaks, so plan to spend an hour getting everything rolled out.  If you are a foam rolling master, you may be able to do all the above in just over half an hour.  If you are rolling for less than 30 minutes there is no way you are doing even a minimally adequate job.

Remember what I said about no machines on the recovery equipment list?  Well, I lied.  There is one machine that has proven to be a near-miracle for me:  The HyperIce Vyper mega-vibrating roller.  It lets me get a full rolling session done in under 20 minutes.

While I highly recommend the Vyper, I do not recommend getting it until after you have become a master with the regular foam roller.  What I said about hurting yourself with machines still holds true: Using the Vyper without first mastering the regular foam roller is like riding a race motorcycle without first knowing how to ride a bicycle.  Truth!

And that's about all I do to recover from Trigger-Point upper back pain.

But what about getting along with it during the day?

Between Recovery Sessions:
That's where the wearable hot/cold packs come in.  I take them to work with me and use them as needed.  Hydrate, do a set of upper back stretches, then apply heat.  If that doesn't help enough, follow with cold.

Now lets talk about how it happened in the first place, and how we can avoid it.

Cause and Prevention:
The fundamental cause is poor riding form.

We ride in either or both of two positions: In road position, leaning on locked arms, or in aero position, leaning on our upper forearms.

Both positions transmit front wheel vibration and impacts directly to the shoulders.

Most of us ride with our shoulders relaxed, with the shoulder blades close together.

This means that shock and vibration goes from the road, up the arms, through the shoulders, and on to the shoulder blades, causing the shoulder blades to lever over, forcing their inner edges to pinch the nerves and muscles in the area against the ribs and spine.

Bingo.  Injury and pain.

Keeping this from happening requires making some changes.

Change #1 (Technique):  Ride with the shoulders neutral (front to back).

Change #2 (Technique, road):  Ride with the elbows slightly bent (never locked).

Change #3 (Equipment, road): Use cushioned bar tape and gloves with gel pads.

Change #4 (Equipment, aero): Ensure the aero bar pads are mounted on cantilevers and/or have multi-layer construction that includes gel.  Be sure to replace old pads before they lose their cushioning performance.

If, like me, you ride a road bike with clip-on aero bars, then all the above will apply.

These changes work together to accomplish two simple goals: 1) Reduce the levels of shock and vibration that reach the shoulders, and 2) keep the shoulder blades away from the spine.

A simple ride-time stretch can help reset the shoulder blade position:  Every 10 minutes or so take a moment to push the upper back as far out as it can go, hold the stretch for 5 seconds, then slowly let it go in far as it can go, and finally reset it to a mid position.  Repeat as often as needed.

Bottom-line, if you are stuck in an injury/heal/re-injury cycle, then you haven't fully addressed the cause.  Worry less about the injury and instead focus on eliminating the causes!


How can I tell if I'm OK to ride?
Elbow planks.  Be sure to always have perfect form!  Keep the knees locked.  No lifting the butt into pike, no dropped/sway back.

Breathe smoothly.  Don't struggle!  Quit before your form breaks.  The best way to exit plank is to drop the knees then push back into Child's Pose.

Once you are stable in plank, do the ride-time stretch mentioned above.  Focus on keeping your shoulders neutral.

Friday, December 16, 2016

Ready to Race!

It's the Friday before my first-ever half-marathon on Sunday, and I've learned a surprising amount during my last week of training.

Let's rewind a bit, to last summer when I finally decided to commit to some real triathlon goals, the first being to do a 70.3, and I chose O'side 70.3 on 1 April 2017.  Given my difficulties with the run, I added an interim goal of a half-marathon race, and I chose the Holiday Half on 18 December 2016.

Initially, my run training had three simple goals:
  1. Become physically able to do two hours running without pain.
  2. Improve my metabolic capacity.
  3. Improve my speed (to spend less time running).
To accomplish these, I initially chose a two-pronged training approach:
  1. Do long, easy runs to build up leg tolerance and contact time.
  2. Do short, hard intervals to build speed and metabolic capacity.
This approach worked really well, permitting me to make major injury-free gains:
  • I regained the 10K speed I had about 8 years ago (yeah, I had really slacked off on the run training).  
  • I became able to run well over an hour with minimal mechanical discomfort (muscles and joints were OK, though I was huffing and puffing like an old horse).
Implicit in this improvement was getting my cadence up to reduce the impact and muscle recruitment associated with each stride.  My running went from "thud, thud, thud" to "tap, tap, tap".

One thing I avoided during this phase was training for a "run-walk" race style.  I freely gave myself permission to walk when needed, but never as a planned part of my race.  Typically, I'd walk for 30-60 seconds at the turn-around point in my run just to be sure I could do it well enough (many injuries occur when returning to run speed after a brief walk).

Last Sunday I finally did my first 10 mile run (two laps around Lake Miramar, 9.8 miles actual).  I intentionally started out easy, and I comfortably held a 10:00 average pace. But about 8 miles in I realized I had some extra gas in the tank, but was unable to pick up my pace!  It seemed my legs had decided they wanted to stay at the 10 minute pace, and they weren't going to change.

It seemed there was no way I could break 2 hours on my race.  A 10 minute run pace (with no walking) means a 2:11 finish.  To break 2 hours I'd need a 9:00 pace, a full minute per mile faster, and I didn't see a last-minute 10% improvement being a realistic expectation.

Since this week has been my taper week, my runs have been shorter, so I decided to see if I could make them faster, to let me do a little more work on both pacing and my metabolic capacity.  I did a 5K Thursday evening with the intent to do the first 1.5 miles as a best-effort sprint, then return at whatever pace seemed sustainable.  Despite some serious fatigue at the end of 1.5 miles, I still averaged a 9 minute average pace for the total distance!

So I'm left with two significant questions: If I start the race at a 9 minute pace, will my legs lock in to it, and will my metabolism support it all the way to the finish?

I think I'm going to go for it, and let myself briefly walk when/if needed.

The main reason for this decision is that this half-marathon and 70.3 are steps toward my goal of doing at least one full-Ironman in my life, preferably before the end of 2017.  Which means my run must enter all-new territory: The only way I'll survive 26 miles after a 120 on the bike will be to run fast and efficient, to get to the finish line before it falls apart either mechanically or metabolically.

I seriously doubt I'll be able to endure more than a 4 hour marathon after a 120 mile ride.  If it's not at least that fast, then it will likely be hours slower.

A 4-hour marathon is roughly a 9 minute pace.  If I can get close to that Sunday, then it should be an achievable marathon goal.

Run speed is my new best friend.

Update: I did 2:13:49, about what my training predicted.  But I hadn't trained on hills, and I beat myself up a bit on the first 4 miles, going way too fast downhill (6:30) and struggling too hard uphill.  By mile 8 I was power-walking up each hill.  So getting this result with all those mistakes tells me I should be able to reach sub-2:00 on a flat course.