Friday, July 30, 2010

My "Training" Week... Noodle Arms

My arms hate me right now. Being that I'm "off" most lower-body workouts for a while, and being that I'm obsessed with exercise--yea, I said it--I've done a lot of swimming and upper-body strength training this week. I can do moderate-intensity rowing (can't push off too hard w the knee) and some hip/glut/leg exercises too so it's not completely out of balance.

Anyways, I thought I'd provide a glimpse into this past week -- i.e. what sort of training you can do with a knee injury, or another leg injury for that matter.* It's major mellow in terms of endurance training, but it's enough to make me feel like I'm still doing something:


1. Yoga class
60 min with crazy instructor who puts together some haaaard routines.


1. Masters Swim

6 a.m. "hearty breakfast" of 3,000 yds with some decent pulling sets
2. At-Home Stuff
30 min of yoga, PT exercises, foam rolling

3. Strength Circuit Routine**
10 min functional warmup

The Meat
20 minutes of as many rounds as you can do...
5 "jump" pullups
10 pushups
15 air squats (allowable for me because non-weight-bearing and modified to quarter squats on some rounds)

I did 19 rounds + a warmup round so 100 pullups, 200 pushups and 300 squats. My arms were sore forever. I really thought I wasn't going to be able to do one more pushup toward the end. My legs were unaffected by air squats (i.e. that's not enough to make me sore).

1. Hour Swim
Main set of a lot of 200s, w last 15 min kicking focus, yardage-lost count?

2. Strength Circuit Routine
15 min / four rounds of...
10 knee-2-elbows
15 side leg lifts in side plank position
30 split-leg situps
20 bridges with weight
10 single-leg bridges
10 supermans

3. At-Home Stuff
30 min of yoga/stretching + foam rolling

1. Strength Circuit Routine
10 min functional warmup
500 meter row

The Meat
25 minutes as many rounds as you can of...
10 ea. DB plank row***
20 split-leg situps
10 ea. single-arm shoulder press seated on floor (sitting on floor incorporates a lot of core, hip and leg strength/stability)
250 m row

I did 7.5 rounds and 2,300 m of rowing all together. On sore arms. Ouch.

2. At-Home Stuff
yoga/stretching, PT exercises (including my fav- lateral walks with band), foam rolling

1. Lake Swim (my favorite!)
3,000 m with main set of 2 x 1200
4 x 2 min kicking in place at the end

That's where I'm at now. Over 10k of swimming and rowing alone already. More swimming on tap for this weekend even if my arms are less than stoked on that. They'll just have to suffer along.

I also didn't piss off my knee with any of this stuff, and it feels a lot better than it did last weekend. But don't worry, I'm still not going to go do anything stupid.

*If you have a knee or leg injury, please consult an expert/your doctor before doing any of these exercises or workouts above.

**Strength-circuit routines are meant to be done at high intensities with little or no rest for the full duration. It's all about fitting in as much work as possible.

***DB plank rows = get into plank position and hold dumbbell in each arm. Lift DB bringing elbow up, one arm at a time. Basically it's a bent-over DB row but in plank position so major core activation.

Tuesday, July 27, 2010

Injury update

Good news: Looks like my IT Band is cured. All those original issues are gone.

Bad news: Something is still majorly wrong in my knee. What exactly? Not sure. But we may be on the right track to knowing.

Symptoms: Pain deep in the knee (pretty sure swelling in the joint capsule making it worse); pain that starts on the lateral side and radiates medially; pain on the posterior (back) side. Any knee experts want to guess on what this could be? Read on for our latest diagnosis.

It's sort of like the chicken and the egg. Did my ITB issue cause this knee problem or did the knee problem aggravate/cause ITB issue? When I first got injured, everything was a mess so I can't really say what hurt first. But now this knee thing is getting worse while my ITB is feeling good to go.

I was thinking it might be plica syndrome, which I had in my L knee in 2008. Why? Because if plica happens in one knee, there's a good chance it can happen in the other. It's a weird issue. But some of plica's main symptoms aren't there, like no clicking/popping. And plica usually happens on the medial side.

So then I think, crap, I'll probably have to get an MRI to really find out. But with my stupid insurance I have to meet a $3,000 deductible before they'd even consider partially covering an MRI. I'm no where close to meeting that deductible, so paying full tilt for an MRI? Um, would rather not! So that's Plan B - worst case scenario.

Thankfully I saw my ART/chiro today and there's Plan A. He specializes in sports med and knows his shiznit, so we spent a lot of time doing knee tests, and he agreed that I don't have the symptoms of plica syndrome, nor a meniscus injury, ligament tear, etc. But, really, only an MRI could tell for sure. Blah.

Then, during one of the tests, he hit a spot that created the same painful sensation I get during/after running. The spot was my popliteus tendon. It was sort of a eureka moment for us.

As you can see, the popliteus muscle is a short diagonal muscle behind the tibia and knee that comes in contact with the joint capsule, crosses with the hamstrings and gastroc (calf muscle) and attaches on the lateral side of the femur. Popliteus tendonitis is an overuse running injury in many cases, but often hard to diagnose and gets confused with meniscus injuries. Internal rotation, inward rolling of the foot (pronation - I do it) and downhill running can irritate the pop tendon.

Bottom line is: popliteal tendon issues can wreak havoc similar to what I'm going through: causes joint swelling/pain, posterior pain and pain/inflammation of surrounding structures--this type of exacerbated/chronic inflammation is no longer that "good" inflammation I spoke of before. Still, no NSAIDs :)

So that's where I stand now. Plan A is to do nothing except swim and strength train (going easy on lower body) for the next week or two, continue intense treatment on the knee and go from there... holding onto hope that we've found the answer and I can avoid MRIs and surgery.

Saturday, July 24, 2010

What's Goin Onnnn + Bee sting #4

So Ron made a good point in his last comment that my blog is more educational than personal lately. I've kind of been doing that on purpose because my personal life is pretty mellow right now--no epic training, racing or trips to talk about; work is work; nothing new at school. It's nice having a break from my usual 24/7-busy lifestyle. I can enjoy summer and a true offseason. Go surfing on a whim. Noon masters instead of 6 a.m. (although I love getting a 6am'er done). Catch up with random friends I never see. Make my own hours. Have a glass of wine. Never miss the Tour. Get creative in the kitchen. Oh, and I can put more thought into educational-ish blogs :) Plus, given my injured state, I've also dubbed this my "summer of savings" i.e. saving money now to play later -- got kona in october and more big plans for 2011.

The biggest gossip in my life? My last two test runs ended very badly, for a couple reasons. The first, a 25-min treadmill run about a week or so ago, ended abruptly at the onset of pain, and the pain just got worse the rest of the day. But it was 100% gone by the next morning. Go figure. Still demoralizing.

The second "run" was Friday; it was really more of a walk/jog with an unplanned sprint home. We (doc & I) decided to give it more time until I really run again, so I was just out enjoying exercise (if you can call it that) after doing a morning lake swim. The knee was fine every time I jogged, so I was happy.

But then shit hit the fan.

A damn bee landed on my face, so I swatted it away but it somehow landed on my back and stung me near the shoulder blade area. I couldn't see it so couldn't get the stinger out. I sprinted home hoping I'd see someone along the way for help, but no one! About five minutes later, my mom flicked out the stinger, but the damage was done--I took on a lot of venom I think.

I got really hot, itchy and swollen almost immediately. I took a cold shower. No relief (except when scratching my head while washing my hair--fingernails on the scalp never felt so good). Next I tried laying on the floor with ice packs covering my body. Some relief. But redness everywhere. I wasn't sure if I really had a rash/hives or if it was an illusion. Oh, it was a rash (pic doesn't even do it justice), ewwww...

I know I wasn't in anaphylactic shock and didn't feel too terrible so no way was I going to the ER. Toughed it out, and sure enough the rash subsided within a couple hours and I continued on with life as usual.

Now it just feels like I got stabbed in my shoulder blade. Hurts like a mother! Thankfully I've gotten in 10k worth of swimming and rowing this week, so can give the upper body some rest.

And, oh yea, that unplanned 5-min sprint home was no bueno for the knee. For the rest of the day, I couldn't walk without pain. But woke up the next day with no pain at all. Ugh! This injury is tricky and frustrating as hell. It seems like I'm doing everything right for recovery except completely giving up all forms of exercise. Ugh, that would be the worst... I barely do anything as it it these days. I just want this to end!!!

PS - Bee stings sustained while exercising = 4...since 2008. Anyone have me beat?

Tuesday, July 20, 2010

Bashing NSAIDs

How many times have you said this to yourself or someone else: Oh, just go pop a couple ibuprofen, aleve or "NSAID of choice" and you'll be pain-free and able to power through that triathlon, marathon, big game, training session or whatever. But are NSAIDs just masking the problem and possibly a) making things worse, b) hindering recovery? Yup.

I've taken my share of NSAIDs throughout my athletic life (also in my college life when hangovers were frequent, but that's another story). Back in my volleyball days I suffered from shoulder tendinitis in my hitting arm--I played outside and R-side hitter--so being the stubborn competitor I was (am), I would take a pill before a game so I could still pound the ball. What did I know? You hear "pain relief," so that's good, right?

As recent as last year, I still occasionally took ibuprofen for triathlon-related things if I was feeling really bad soreness or pain somewhere--it was rare that I'd resort to a pill, but I did a handful of times.

Not anymore. I'm done with NSAIDs. Threw 'em out at the end of last year when I learned more about then, and I have not taken any with this current ITB thing.

The adverse side effects of NSAIDs are not breaking news, but it's funny, you don't hear about the downsides as much of the purported benefits of NSAIDs. Athletes especially should be cautious about these things for many reasons. Here are some:

1. NSAIDs alter and delay healing. They do this by (forgive the big words) blocking the enzyme cyclooxygenase (COX) and, therefore, prostaglandins don't form. Prostaglandins are good because they begin the process of repairing damaged tissue via inflammation, i.e. the natural way of healing (like I discussed on the Prolo blog.) There are three main phases in inflammation, and without all three phases taking place, which takes time, you won't get better and stronger. NSAIDs screw with this multi-phase healing process big time. You may feel better temporarily, but the problem is simply masked or worsened... (#2)

2. NSAIDs cause scar tissue (fibrous). Basically, by interfering with the natural healing process scar tissue is created and remains. Keep in mind, scar tissue is naturally created during inflammation but--when no drugs are involved--that scar tissue will eventually be eliminated and replaced with new, healthy, strong, kick-ass tissue. However, throw NSAIDs in the mix and that can lead to permanent scar tissue. Scar tissue is crap; it's tough, dry, stiff and eventually leads to more problems, such as chronic pain.

As a side note: also guilty for the creation of scar tissue are cortisone shots and, believe it or not, excess icing.

3. NSAIDs can cause GI issues, ulcers, etc. If taking ibuprofen for a race or competition, the last thing you want is it to create GI issues--endurance racing+nutrition is tricky and tough enough on the system as it is! But sure enough NSAIDs can cause major issues if taken in excess or on a regular basis: GI bleeding, nausea, vomiting, ulceration, possibly permanent damage. There are also risks associated with renal and cardiovascular function. Taking the drug once in a blue moon likely won't result in these issues, but, still, be careful.

4. No evidence that they work in treating sports-related injuries. All those recommendations you hear about rehabbing with rest, ice... and NSAIDs. No! Don't do it! (Well, rest--yes!) For the reasons I just mentioned, NSAIDs will not fix your problem. That pill may be a temporary band-aid, but it's a jacked up band-aid on crack that will mess you up and leave you uncured. Yea, you can take a pill or two for pain relief to get through a race vs. taking them with direct intent to cure an injury, but you're better off just toughing it out naturally either way.

Ok. Time to end my NSAID-bashing blog.

One last thing... I hyped up inflammation, but I'm not saying inflammation is always a good thing. When it comes to an acute injury that needs to heal, inflammation is awesome and necessary. But chronic inflammation is very bad and needs to be handled appropriately (not with NSAIDs). In chronic cases, a healthy diet of anti-inflammatory foods, physical activity, sleep, etc are often needed.

Bottom line: when you get an injury or feel pain, don't take a pill. Go au natural and let nature take its course.

Friday, July 16, 2010

Inglewood instead of Sonoma

This summer is definitely not playing out how I expected. It's interesting to say the least. Not boring, that's for sure. Random stuff seems to be popping up every day. Some good. Some bad.

I'd be a lying fool if I said I wasn't devastated that I'm not in Sonoma County right now to race Vineman this weekend. I freakin love that race and was so excited to see so many familiar faces. But after this past week, I know everything happens for a reason. Not to mention, I'm still unable to run for more than 20 minutes, so a 70.3 isn't even a question unless I just wanted to throw away all this progress I've made in my recovery. But the good news for me: I get a longer test run this weekend so I'm hoping for the best.

What I meant by saying everything happens for a reason: Both of my grandparents (dad's parents) are going through some major health problems right now. Grandpa made a turn for the worst this week while Grandma was in the hospital. Crazy how it happens at the same time. Our family, especially my mighty dad, has dropped everything to go up there daily, take care of them and be by their side. It's hard to see people who were always so strong become helpless. Btw, yes, they live in Inglewood.... the LA 'hood.

With my grandpa's problem, by Thursday it was either emergency surgery--a very high-risk procedure considering his extremely fragile state--or he didn't have much longer left. Our whole family was there, and we said our "I love yous" and "goodbyes" not knowing if they'd be the last. Then surgery it was.... anxiously waiting... he made it through! He's not out of the woods yet, but he has his life and one less life-threatening problem. Meanwhile, Grandma got released from the hospital and seems pretty dang strong! Go team Prazak! Fighters! We still have a lot of work ahead in helping them, and it feels good to be around.

Point is: I truly believe I was meant to be here this week/weekend; it would have killed me to be having fun in Sonoma, "selfishly" racing and doing my triathlon thing while my family was all gathered around my grandparents. Family first.

I'll get into more of "the good" stuff of this summer next time :)


Tuesday, July 13, 2010

Almonds... raw vs roasted?

I love almonds. Pretty much any variety hits the spot for me. But I was thinking this morning and I remember hearing once that it's best to eat raw almonds instead of roasted or toasted variety. Personally, I choose raw when I can, but I only had roasted in the house today which led me into this issue.

Apparently dry-roasting/toasting almonds can alter their fat content by not only decreasing healthy-fat content (monos) but by turning a portion of the healthy fats into saturated fats. On top of that, I've heard roasting decreases nutrient content. Again, I'm not saying this is 100% fact. I really don't know. But it is word on the street.

Why does this happen: Specifically, roasting almonds at high heat (more than 175 degrees F) changes chemical bonds in the nut causing monosaturated fats break down. Additionally, high heat causes degradation of vitamin B & E content. Roasting at low temps below 175 for a long time can offset these effects, but unless you roast them yourself, who knows what temp they roasted those nuts you bought at the store.

On the flip side, I read that roasting doesn't significantly alter the macro- and micro-nutrient content of nuts at all and the roasted/toasted kind are just as healthy as raw: Fat content (mono, poly, etc) stays the same and the biggest change is a slight loss in water content.

Ughhh.... This is the problem with searching on the Internet. Everyone is an expert and everyone has an opinion... all of which are different.

So: Have you guys heard anything about this? What are your thoughts/opinions? is this crazy talk or does anyone know if there's some validity to this?!

At any rate... I guess dry-roasted or raw almonds are better than choosing an Almond Joy bar, mmm.


Btw: Check out the latest issue of Triathlete Magazine (august) -- I'm in there a couple times :)

Thursday, July 8, 2010

Still No Coffee

Yup. Gave it up. Cold turkey. I was sick of relying on lots of coffee to make it through a day. It was getting bad: 2 cups in the morning (2 mugs, so bigger than the traditional "cup") and at least another big coffee, often an americano, in the afternoon.

I was also waking up groggy every day; unable to snap into it until I had my beloved coffee. Warning, you don't want to "cuddle up" with me before my coffee haha. As the day went on, I think coffee was starting to have the opposite effect on me by making me more tired. Without that afternoon jolt, I became a zombie. Naps were often not possible, but very highly desired. So I was constantly sipping on a coffee throughout the day. Starbucks, or wherever I could get my fix, loved me (emphasis on the -ed).

The severity of this addiction hit me when my life slowed down a bit this summer--less training, less school, etc--yet my "need" for coffee was still high. So about two or three (can't remember now) weeks ago, I decided to experiment on myself to see if I'd feel better sans joe. It was worth a shot.

Day 1-3: It was hard not drinking coffee mostly because I mentally desired to drink it, not because I felt physical withdrawal symptoms like headaches. I can be mentally tough even if I smell it brewing in the house.

Day 4-to now: Then it got easy, and I quickly started feeling great--all day! No afternoon sleepiness, no zombie, no urge to nap even on my super busy days, and best of all: no groggy feeling in the morning. I suppose I'm now a delight to be around in the a.m. But I guess you'll have to get the opinions of others for that answer :)

Again, my life isn't very stressful/go-go-go right now (for once!) so I can't say hands down that NO coffee is the only reason I now feel energized all day (no caffeine = energy? sounds backwards). But nevertheless, this change is helping me; my caffeine addiction was very bad.

And all that money I spent on americanos is either being saved or going to the occasional kombucha... but not so much kombucha as of late given the kombucha-has-too-much-alcohol-and-is-off-the-shelves ordeal. I really need to start brewing that stuff.

So that's my coffee story.

D made a good point, though, once I get back to real training, I may need that coffee again :)

Tuesday, July 6, 2010


I've successfully completed a handful of pain-free 10-20 min runs in the last couple weeks. My ART guy keeps warning me that 2-3 miles is my max for a while, even it feels ok.... he threatens with his harsh ART hands, so I listen. But, truthfully, calling it quits after 20 min of running is fine with me because daaaang did I lose my cardio fitness fast! Ouch! And I'm running at about an 8:30 pace. Sort of depressing. But, again, all part of the challenge. On the flip side, I'm noticing some major strength/balance/flexibility gains from all my other working out/rehab stuff. I'm also cycling and swimming a little more, so I'm keeping sane. Noiiice.

One of the treatments I got for my ITB/knee is a little sumthin called prolotherapy. Yes, it's a shot, but, no, it's not some crazy steroid or potentially risky quick-fix injection. It's safe! I'd never heard of prolo until my sports med doc recommended it; he's a kick-butt triathlete whom I trust tons. Did a little research, and I was sold.

So what just is "prolo," as it's called...

First off, prolo is short for proliferation, which means growth/creation. Essentially, a prolo shot repairs damaged or weak tissue (i.e. a ligament, tendon) by creating new, stronger tissue. The shot itself is comprised of a dextrose solution (just sugar water!) and it's administered directly into the damaged area; in my case, the lateral side of my knee at the IT Band.

Once injected, the prolo goes to work almost immediately by causing inflammation. Yes, inflammation, which can actually be a good thing--t's the body's natural wound-healing process; in other words, its way of mobilizing an army of healing agents to a damaged area to do some major repair work. As a result, you see increased swelling from all that "stuff" (trying not to be too sciency) doing it's healing work, not to mention it hurts. But, again, inflammation is our friend here.... it results in the creation of new tissues, mostly collagen, and thus a more robust ligament.

The inflammation can last up to three days and can be quite painful; although, it was less for me. After that, tissue formation and strengthening continues for a while. In the meantime, pain from the injury can decrease rapidly and workouts/activities can resume to some degree... I ran (briefly) about five days after my shot. Three to four weeks after the initial treatment, it's recommended to get another prolo shot, and maybe even a third shot several weeks later depending on the injury repair, pain, etc.

Prolo is also used for chronic pain, arthritis, fibromyalgia, etc. My doctor is one of the few in the OC area who offers it, and he has a lot of success stories associated with prolo. I have yet to read any harmful side effects, so if you know of any, don't tell me.... JK. I'd like to know any opinions/thoughts/stories on this treatment!

Also, fyi: Personally, I'm not going to credit prolo to my recovery (I'm not better yet!), and I don't want to say it's a quick fix because it's not--yes, you can start running again sooner than maybe expected, but no way will you get back to double-digit running mileage within a week. In the end, I think prolo is a safe, helpful element in this whole recovery process, as is good old fashioned hard work in the gym and on the ART table and on the couch resting :)

Here's a link to more prolo resources, with some good sciencey stuff, if you're interested: PROLO