Sunday, June 28, 2009

Car Vs Bike - Car Wins, Again

Natascha Badmann, 6 time winner of Ironman Hawaii, seen here exiting T1 minutes before a bike crash on the Queen "K" that would not only take her out of the race but give her training and racing problems for the next year and more."

Recently, there's been a three part article in the local paper about Matt Miller, former swimmer on the UVA team who gave it up for triathlon. While training on the Blue Ridge Parkway in November, he lost control of his bike and slammed into the front of an MG. By a stroke of incredible luck, the car behind the MG was driven by another doc from my hospital, an anesthesiolgist as chance would have it. Matt had broken his jaw in two places, along with every bone in his face, and was drowning in his own blood, until quick action by the doctor opened his airway allowing him to breathe. When taken to the trauma center, his family was told he wouldn't survive. But survive he did with multiple operations, titanium plates on his broken facial bones, a breathing tube in his neck, etc. Surprisingly, he suffered no other major injuries.

His old college coach got him back in the pool recently where he was able to crank out a "pedestrian" 59 second 100! And although he still looks forward to several more operations to put his face back together, he managed a top ten finish in a Philadelphia time trial. Go Matt!!

We take from this that it can happen to anyone...including you and me. So, when you leave home on that solo ride, tell someone where you're going and approximately what time you'll be back. If you have a cell phone, take it with you and turn it on. (I'm quite guilty of having my cell phone with me but always off.

Consider getting a Road ID. This inexpensive ankle strap yields basic identification, emergency contact phone numbers, etc. and mine has my allergy status, medications and my blood type (a good thing for the ER doc if you plant your face into the grill of a classic car. And lastly, anytime there's a close call with a car, try to figure out how you can avoid that next time. The car usually wins! Safe biking to you all and pass this along.

Friday, June 19, 2009

P's and F's of Plantar Faciitis

"Wish I didn't know now what I didn't know then." Bob Seger

They say there's no accounting for taste. This is a shot of my favorite runner in the 2007 Ironman Hawaii Underpants Run. It's done two days before the race to raise money for a local charity and it's plenty of fun. Just don't choose this outfit!

Tips to rid your life of plantar faciitis

As most of you know, many from personal experience, PF is pain on the sole of the foot, usually at the back of the arch and front of the heel. It's usually worse the first few steps you take out of bed in the morning. So, some recommend 1) tracing the alphabet in the air with the toes of your raised foot. 2) Immediately after getting out of bed, step into supportive footwear. Walk on the outside of your foot for the first ten steps. 3) Don't go barefoot or in slippers unless the slippers have arch supports. 4) In your morning shower point the nozzle at your heel and arch and let HOT water soak the injured area for at least a minute or two. 5) Wear arch supports in ALL of your shoes, especially those you wear the most when not exercising. Do not put weight on your feet unless they are properly supported! This is particularly true with your "knock around" shoes. Leave the flip flops in the closet while trying to recover from this serious injury. 6) Again, supportive shoes in the house and don't go barefooted. 7) In the evening and before you run, stretch and massage. The old wall push up, half with the leg straight and the remainder with the knee bent 30 degrees. These may hurt little so go slow and gradually stretch this area. No hurry as this is not the no pain, no gain situation.

Lastly, every evening after you've stretched, apply heat then ice (no more than 10 minutes) to the arch/heel of your sore foot. I've seen people use a frozen water bottle very effectively.

In my practice, if this isn't effective when combined with decreased running, I ask the athlete to back to his trusted shoe guy for a reevaluation of shoes and gait before getting into anything that hurts (like an injection) or costs money (like an orthotic.)

Monday, June 15, 2009

How To Beat The Heat

"...Rocky you met your match. Rocky said Doc it's only a scratch, and I'll be better, I'll be better as soon as I am able." The Beatles

Avoiding heat injury simply takes planning and common sense. Bob Vigorito, esteemed Race Director of the Eagleman Ironman 70.3 told me at the race check in on Saturday that the temperature on the road at last years race was 114 degrees!

So here are a few hot weather tips for Outdoor exercise:

Hydrate properly throughout the day. While running or walking, sip 3-5 ounces of cool water every 15-20 minutes.

On extremely hot or humid days try pouring cool water over your head, along your neck and down your spine every half hour during your exercise.

Wear light colored clothing against your skin that wicks/transfers the moisture away from your body.

Stay away from cotton, especially with shirts and socks.

Wear a light colored moisture wicking hat.

Try not to exercise outdoors after 9:00am. The safest time of day to run or walk during the summer is between 5:00 and 7:00 am.

Seek shady routes if you must exercise after 9:00am. Gravel roads are better than blacktop or tracks. Running in the woods is great.

Wear breathable shoes...mesh not leather.

Listen to your body. Feeling nauseated or light headed are distinct warning signs that you may be overheated or dehydrated. Dark yellow urine is also a sign that you're probably dehydrated.

Lastly, I saw a study that came out of Ironman Hawaii several years ago where women were weighed before and after the swim portion of thte race and they'd lost an average of 1.5 lbs...and they were in the water, not running.

Take care, it's a jungle out there.

Sunday, June 7, 2009

Will Varicose Veins Slow You Down?

I don't want to work, I want to bang on the drum all day.
Todd Rundgren

So you've got some vein concerns, eh? Well, they're pretty common. Although some folks seem more prone than others, half of all adults over 50 will have them to some degree. "Very close veins" as some of my patients call them occur as small "spider veins" or the larger "varicose veins." We know that blood in veins only goes one way, back to the heart, but when the little flaps of tissue known as valves, inside the veins, fail they can become enlarged, twisted, swollen and occasionally purple or blue. In the advanced stages they can lead to skin breakdown and infection but early on it's more of an appearance issue. Some folks might complain of an aching pain in their legs, legs becoming easily tired, swelling, darkening of the skin, and even itching or a rash.

In their most advanced stages, VV can lead to blood clots in the deep veins of the leg, always a bad thing as they'll sometimes break off, travel to the lungs, and not infrequently lead to death.

So what do we do? Things that have been shown to help include sunscreen, regular exercise (presumably not an issue in you), weight control, elimination of constricting clothing on legs, groin or waist, support stockings and elevating your legs when you sit. Some choose sclerotherapy, or injection of the veins which can significantly reduce or eliminate the smaller ones. Laser therapy is used in a similar fashion as well being placed inside the vein to shrink it. This is especially effective in the deeper veins. It's done in the doctors office under local anesthesia.

Lastly, ligation (tying off) and stripping (pulling out) in an operating room can be performed for the more involved problems. It's still performed frequently.

In short, most people don't need to do much about them...but complain...but if you need to, there are docs who specialize in vein issues who can evaluate you, define the severity of the problem and give you alternatives that are right for you.

Monday, June 1, 2009

Triathlon Friends - You got 'em

Joke heard while bike riding recently. The husband is late after a ride with his buddies and tells his wife, "You wouldn't believe what happened to me. I was on the way home when this beautiful blond abducted me, took me to her place, and had sex with me over and over." The wife replies, "Dear, you are such a liar. Can't you just tell me that you and your friends rode your bikes an extra 10 miles?"

One of the seldom recognized benefits of triathlon is the easy abundance of adult friendship. One morning last summer, we started our bike group a little early, finished at my house and my wife and I cooked breakfast for the gang. It was lots of fun...and I'm a very good waffle maker. At least my daughter thinks so. When not on bikes, we had the opportunity for extended discussion, jokes and plans for the rest of the summer. Outside of work, many adults have few friends with whom they can share the issues of the day, and I had 8 of them at my breakfast table!

On New Years Day, the group I swim with always does the main set equal to the year, or 2009 meters 1/1/2009. After busting it for 2000 m, we get out by the backstroke flags and scull backwards the last nine meters. Silly? You bet, but it's adults child's play. It's competitive in a way - the girls always win for some reason. But more than that, it provides a sense of relief and camaraderie not found in the working world.

So, if you feel like wearing a costume to the Tuesday evening bike group, or taking a camera to the Sunday long ride group and later having some fun with photo shop, I say go for it. My grandfather used to preach to me over and over again, "keep your friendships in repair." He was right. Although grandfathers usually are.