High altitude training has been a hot topic for years and it keeps coming up in questions week in and week out. Let’s cut to the chase here: Too many athletes think it’s great to be able to do it—however, 90 percent don’t understand the implications of training at high altitude.
Category Archives: Articles
The Triathlete and Joint Replacement by John Post, MD
The Triathlete and Joint Replacement
“Some day I’ll wish upon a star, and wake up where the clouds are far behind me. Where troubles melt like lemon drops, away above the chimney tops, that’s where you’ll find me.” From, “Somewhere Over the Rainbow” (Or, it could be the unrealistic attitude of the triathlete with lower extremity arthritis when told that a joint replacement is in his/her future.)
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“When I wear these knees out, I’ll just get ‘em replaced and race another ten years.” (Joe Triathlete)
In the words of Johnnie Carson, “Wrong barn breath.”
Looks like, between me and Dr. Dan Kirschner, you’re getting your fill of medical information. Maybe better too much than too little. The first triathlete I ever met doing Iron distance racing with an artificial joint in place was a gent about 35 years old who’d taken a bullet to the knee in Vietnam – and he had no choice. Winston Allen, from Florida, had his knee replaced a couple years ago and has his eye on Kona this fall racing at 81 or 82. A tall order for anyone of that “vintage” even with two knees which came from the original manufacturer. (Too old you’re thinking? Not so. Of the four men in the 80 – 84 year old age group in Kona this year, 3 of 4 finished! Impresses me!)
A replaced weight bearing joint, be it hip or knee, is a reasonable approximation of the original equipment. But to date, we’ve not figured out how to make them last indefinitely. That said, we’re getting better. Current expectations are a product life expectancy of about 20 years depending on in whom the joint gets installed. Consider the different demand loads placed on the prostheses by your average Medicare eligible 65 year old looking for a bridge foursome versus a 50 year old triathlete with premature arthritis and stated expectation of returning to the sport. Continue reading
Are You Ready For The Unexpected by John Post, MD
Are You Ready For The Unexpected
Do you think, when this athlete was topping off the air in his tires his morning, that he thought, “You know, I’m sure glad I’m the the type of racer who never gets penalized…” I wonder if he was prepared for this.
Sunday They carried a man off the race course on a stretcher. I heard that he just collapsed on the run; maybe it was the heat – a low of 80 degrees last night. And the sun came up well before the first athlete was body marked or the transition area opened to further push the mercury toward inferno status… from a racing point of view anyway. You know, one of those days when the heat simply blasts you when it radiates off the asphalt. It’s a good thing most of were wearing hats and could put ice in them at the aid stations. As we watched them load him into the ambulance, we hoped it wasn’t something serious.
Why I don’t advise pounding beers up after making the podium
Australia’s triathlon trio Emma Moffatt, Emma Jackson and Emma Snowsill celebrated a triumphant and history-making ITU Dextro Energy Triathlon World Championship round in Hamburg back in 2011.
It was a great day for a triathlon; my preparation was fantastic, and although there were plenty of learning lessons during the race, I managed to make second place in my age group, winning my first official medal. I probably had half dozen bottles of water after the race, a banana, and several orange slices to help replace lost carbohydrates and electrolytes. Yes, it was a great morning, and I was feeling fine. While there was lots of pizza and beer on hand at the post race expo, I felt completely satisfied with taking care of my body and enjoying the moment.
Road Rash- Limits of Home Care by John Post, MD
Road Rash – Limits of Home Care
“The road is long, with many a winding turn.” The Hollies, 1969
“You want to know what it’s like to crash on one of these bikes? Get in your car, strip down to your underwear, and jump out at 40 miles per hour!” Jonathan Vaughters
There are two groups of riders: those who have crashed and those who will crash. You look at what used to be your skin, red, raw, and painful. Frequently, if you were really lucky, this is just a scrape, a superficial abrasion – a strawberry – like you had falling on the basketball court.
Now what? First, this is why I carry a water bottle – sometimes to drink from but mostly for hygenic reasons…washing off a dog bite or road rash to try to diminsh the chance of infection or leaving a permanent mark on the skin. Once you’re back home, a mild soap and water cleansing goes a long way, cover with a light dressing and bacitracin to keep the skin from drying out, and figure out when your last tetanus shot was (normally given every ten years but if there’s been a “dirty” injury, and it’s been greater than 5 years, get a booster shot). Continue reading
Rehydration by John Post, MD
Rehydration
“Water, water everywhere, and all the boards did shrink. Water, water everywhere, nor any drop to drink.” Rime of the Ancient Mariner
It’s summer. By now your racing fluid plan should be well established. Gone are the days, as pointed out in recent blog, where you’ve ignored your fluid intake as, “It wasn’t that long a workout,” or “It was only a sprint triathlon,” (but it was 86 degrees!)
Although there are a lot of opinions on rehydration efforts out there, the only one that really matters is yours. You’ve calculated your sweat rate (weigh your self right before and right after a few lengthy runs to determine the % lost), read up on hyponatremia (dilution of the blood stream from excessive drinking for the current conditions) and have a general idea of your own needs. So why is it that so many athletes find themselves like camels at the oasis or that they don’t pee for 6 or more hours – despite continued fluid intake – after an event?
Although there are a lot of opinions on rehydration efforts out there, the only one that really matters is yours. You’ve calculated your sweat rate (weigh your self right before and right after a few lengthy runs to determine the % lost), read up on hyponatremia (dilution of the blood stream from excessive drinking for the current conditions) and have a general idea of your own needs. So why is it that so many athletes find themselves like camels at the oasis or that they don’t pee for 6 or more hours – despite continued fluid intake – after an event?
3 Essential Keys to Training Hard and Avoiding Burnout
Having a good plan is essential to successful triathlon training. But many times in the quest to “get more done” and “improve performance” we often will rationalize some serious mistakes that can be costly. It is important to remember that no matter what condition you find yourself, or stage in your training you may be, there are certain axioms that should be followed. There are three specific ways that you can make sure you are going to progress and more importantly not burn out or become injured.
Head Position In Swimming
Many swimmers (and some coaches) believe that every swimmer should look straight down at the bottom of the pool when they swim, so as to improve their body position. Is this true? Let’s look at some swimmers underwater to find out :
The Star Of The Pool
First up we have double Olympic gold medallist Rebecca Adlington, showing us a mid head position, looking at the bottom of the pool 1-2 meters ahead of her:
As you can see Rebecca sits fantastically high in the water, a body position she can easily achieve despite looking slightly ahead. This is very typical of elite pool swimmers who rarely look straight down or very far forwards.
Key point: The very best pool swimmers in the world tend to use a mid head position, looking slightly ahead.
The Professional Triathlete
Fraser Cartmell is a star of the 70.3 world stage and a great swimmer to boot. Like all elite triathletes, Fraser’s main concern is performing well in open water swims and so he uses a very forward looking head position:
Looking so far forwards helps him navigate effectively and find the toes of other swimmers to draft effectively. Note that he can do this while still maintaining a high body position in the water (despite being super-lean).
Key point: If you have good stroke technique, you can achieve a high body position despite looking forwards and for open water swimming this is a major tactical advantage.
The Buoyant Age Grouper
Marina is an age group swimmer with a naturally high body position in the water, she’s been told to look straight down at the bottom of the pool when she swims but this was very bad advice for her:
By looking straight down she starts to rise up out of the water at the rear:
In a wetsuit, the extra buoyancy exacerbates this problem further, leaving her feeling very unstable. We coached Marina to look a little further forwards, rebalancing her in the water while still maintaining an excellent body position. Looking further forwards also helped her proprioception (body awareness) in front of her head so that she could develop a greater feel for the water during her catch.
The extreme version of this advice is to ask swimmers to ‘swim downhill’, which is a disaster when their natural body position is already very good :
Here Barbara has added huge frontal resistance after being asked to bury her head in the water. Returning to a higher head position and not pressing down with her chest allowed her to immediately swim more efficiently and be much more comfortable doing so.
Key point: For swimmers with a good natural body position, looking straight down harms their swimming. If you feel unbalanced when swimming (or in your wetsuit in open water) try looking further forwards and see if it helps gives you stability.
The Sinky Legged Swimmer
Glen is a former professional Aussie Rules football player and is relatively new to swimming and triathlon. He suffers greatly from low sinking legs in the water:
Much stronger on the bike and run, this athlete is massively held back by the drag from his low lying legs. To improve his body position there are numerous things he can work on in his stroke, such as:
– Removing hand-entry crossovers which cause scissor kicks and drop the legs downwards.
– Exhaling better into the water to remove excess buoyancy from the chest and make him feel more relaxed.
– Keeping his head low and using the bow wave trough when he breathes.
Once he’s worked on these things he can also try a lower head position to help bring his legs up further.
Key point: Looking down can be a useful modification for those with sinky legs. However, it makes navigation and catch development harder so treat it as a last resort by working on other areas of the stroke to improve body position first.
Conclusion
You can see from the examples above that selecting a head position should be an individual thing for individual swimmers – there is no universal head position that is best for everyone.
Try swimming 100m yourself experimenting with your head position, looking in each of the directions below for 25m in turn :
Choose the one that feels best for your stroke and allows you to swim faster and more efficiently, then stick with it. When we try this exercises on our Swim Smooth Clinics we always receive a range of feedback with some swimmers feeling better looking forwards, while others improve when looking downwards, others feel best somewhere in between.
You can repeat this exercise in your wetsuit, you might well find you can look further forwards which can be a great advantage for open water navigation and drafting.
Clavicle Fractures by John Post, MD
Clavicle Fractures
“Oh, somewhere in this favored land the sun is shining bright,
The band is playing somewhere, and somewhere hearts are light,
And somewhere men are laughing, and little children shout;
But there is no joy in Mudville — mighty Casey has struck out.” Casey at the Bat
The band is playing somewhere, and somewhere hearts are light,
And somewhere men are laughing, and little children shout;
But there is no joy in Mudville — mighty Casey has struck out.” Casey at the Bat
The clavicle is the first bone in the body to ossify and among the most commonly fractured, particularly in children. It can be fractured via several mechanisms including the classical fall on an outstretched as well as striking the point of the shoulder. It’s not uncommon to also suffer rib, scapula and/or cervical spine fractures and is seen repeatedly in cyclists. Frequently a patient will tell me they actually heard the bone crack when the fracture occurred. This injury can be confused with an AC separation, a rupture of the ligaments at the end of the clavicle. They’re treated differently.
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Woman in Triathlon. Psychology & Physiology
It’s clear that the number of women athletes in our sport has risen significantly in recent years. In some countries women-only races and race series’ are appearing. And the industry has picked up on this trend with an increasing number of items specifically designed for women from shoes to wetsuits to bikes.
The depth of the elite women’s field also has deepened in the past few years. We have watched as Chrissie Wellington has raised the bar again and again in winning the Ironman World Championships in four of the last five years (she missed one Kona due to illness). Chrissie also has lowered the world record for Iron-women several times, most recently to 8:18, which she did at Challenge Roth in July 2011. As a result, most of Chrissie’s rivals also have stepped up their games, in training and racing. There has been a slew of Sub Nine hour Ironman finishes by women, inspired by what Chrissie has achieved. Continue reading