Monday, November 27, 2017

This Off Season, Take the Stairs

This Off-Season, Take the Stairs

Old man winter may seriously cramp your style. Use these other ways to stay in shape.
                                                                                                                                                         (c) Digital Vision.

How you can harness every minute of the day to become a stronger athlete.

by John Post, MD

Years ago I heard the saying, "you're not old until you start using the stairs to get out of the pool." It's one of those things that after a while takes hold in our brains until we come to believe it as fact. True or not, I always leave the water directly from my lane with the old push-up technique. And I'm not what you call young.

Another one I learned in pre-med goes like this: "Take the stairs and add a day to your life." This approach can fit well into a triathlete's world, especially in the off-season, when "real" workouts are decreased.

Famed triathlon coach Joe Friel told me many years ago to look at it as if airport stairs were put there just for me. Since then, rarely have I stepped on a moving sidewalk or escalator at the airport. A third member of the discussion admitted that if he had a layover, he saw the stairs as an opportunity to get stronger. He'd go up and down them like mini hill repeats. When asked if passersby would think him a little off in the head, he'd repeat a line from Michael J. Fox, "what other people think of me is not my concern." And he did get stronger—and faster.

En route to better fitness
So, how do you incorporate this "fitness anywhere" philosophy into everyday life? If you have time between flights when traveling, rather than sit and stare at the TV, find an empty gate and do some push ups, crunches, leg levers, planks, hip thrusts, stretching—you name it. An increasing number of airports have actual gym facilities on site. Why not take advantage of them?

The other side of the coin is rest. More than one of us is chronically short on sleep, and the opportunity to get some unexpected shut-eye in a pod hotel not only feels good but is good for your overall health and well-being. Atlanta, Dallas, and Philadelphia all have these 56-square feet personal spaces complete with pull-out day bed, desk and chair, and in-room workstation.

Make routine do double-duty
Everyday life is full of mini fitness-boosting opportunities, including how far away from the door of the supermarket you park to shunning the elevator in office buildings. Park an extra couple hundred meters from the Safeway front door. Pack those groceries carefully and carry them yourself—no shopping cart—the extra distance to your car. If you don’t live too far from the market put your items in a backpack and jump on your bike.

During my junior year med school clerkships, while training for my first Boston Marathon, I learned the hard way that the hospital’s west wing, where our patients were located, had 16 floors. Before getting our assigned patients, my friend Dennis and I agreed we wouldn't use the elevator. Ever. For the whole six weeks. We were assigned to West Wing 15, on the 15th floor of the hospital. When I crested Heartbreak Hill in Boston I thought about "WW15" and just smiled.
And it can be contagious. I had to smile a few months ago when flying with our sons, both in their mid 20's. We were connecting to another flight on our way to Sequoia National Park, the boys about 10 feet ahead of me. Without even thinking, they chose the stairs over the escalator. In a 2013 article in Runner's World titled "In Defense of Stairs," Alex Hutchinson quotes a Swiss study in which participants were encouraged to take the stairs and after 12 weeks noted an increase in average aerobic fitness of 9.2 percent.

On the commuting front, ask yourself if you can occasionally bike or even run to work? It might be a bit of an organizational challenge the first time, or you might need to get up a few minutes earlier, but I assure you you'll arrive at the office refreshed and with a clear mind.

Home "gym"
It snows where I live. Most of my neighbors have their driveways plowed and the guy with the blade on his pick-up on speed dial. We do not. I’ve always considered the chance to push snow around as a bonus workout. It might even substitute for that bike ride I was supposed to take since 25 mm tires and six inches of snow make for a bad combination. Splitting and stacking firewood, raking leaves, anything you can do at home to expend a few calories works. Did I mention the pull-up bar in the doorway?

Look for opportunities in your daily life to accomplish a task while contributing to your overall fitness at the same time. And when you have a little time between flights, consider poking around in search of an empty gate for a little bonus core work. Channel your inner Michael J. Fox, get in there and start doing pushups. And don't be surprised if others want to join you, the conversation turning to, "so when’s your next triathlon?"

Written for October 27, 2015

Monday, November 20, 2017

Hydration Evolution: Where Are We Today? Should You Have a Plan?

The good news: all my workout clothes are laying on the driveway asphalt drying in the warm sun.  Now the bad news: I just looked outside and it's raining!  (Surely something like this has happened to you.)

"Custom" race hydration plan.

If you take away from today's blog that there's no single right way to control one's race/training hydration needs that covers all circumstances, you'll get the point.  It's so easy to have some quick, catchy phrase that gets picked up in 140 (or 280) character messages, or quickie soundbite.  Paraphrasing H.L.Mencken, "for every complex problem, there is an answer that is neat, simple and wrong."

Managing fluid, and to a much lesser degree electrolyte requirements, is like solving an equation with ever-changing variables.  But old habits are hard to break.  Let's look at my swim group as a starting point.  It wasn't that many years ago that we were instructed to "drink early and drink often" during work outs.  But that also has been taken to the extreme as even if we're only in the pool for an hour, well over half the group stops after a pull set or 400 of kicking for "needed" re-hydration.  I wonder if I've ever taken a water bottle to the pool and I swim more than most.  Lots more.

This is not a tutorial on all that's known about over-hydration, hyponatremia and death, but suffice it to say that particularly in the marathon community, slower runners on cooler days who consume more fluids than the body requires actually gain weight as the race progresses.  Basically this is a bad idea.  This fluid overload can dilute the body's serum sodium, which in extreme cases, can lead to seizures and death.  On the other side of that same coin, those who champion only allowing the body's thirst regulatory mechanisms to guide replacement can correctly, although perhaps harshly, point out that "you don't usually die from dehydration."

"For any serious athlete who's worked very hard leading up to an event and wants to perform, I would go into that event with a plan."  Asker Jeukendrup  

Understand that Jeukendrup notes that in longer races like the marathon and 70.3 racing, drinking early may be of significant benefit, not waiting till one is thirsty.  In the early part of a race, your gut is still working well enough to absorb fluid and nutrients where later in the event, when you may be more thirsty, the stomach may be a much less willing accomplice.

From an area ultra runner.  "The marathoners/trail-morons that I hang with are almost all in the camp that you need to be drinking long before thirst.  If you actually get thirsty during a race then you're probably already screwed... and you can quote me on that."

The metric that I found and have liked for my training/long runs is 2 ounces a mile.  So over the course of an hour I'll take on 16 ounces of fluid.  I personally think I'm on the lighter end of things and couldn't imagine taking on less fluids especially the other week in Colorado."* (Trans Rockies Run, 20 miles of trail running/day for a week.)

Two very experienced athletes I know, one an Ironman coach for crying out loud, the other an experienced racer with 13-14 IMs on his resume, both Kona veterans (!), ended 140.6 efforts in warm conditions 14 and 17 lbs down...concluding their day as guests of the medical tent.  I put this to noted coach/author Joe Friel who answered:

Yes I certainly agree that what is right got one is not always right for another. But in this area I ask myself how many have died in long endurance events from dehydration. Answer: none. How about from hyperhydration? When we tell a athletes that a 2% loss of BW causes a slowing and tell them to come up with a plan to avoid that you know what happens. Drink lots. No limits. They can't imagine they could deviate from that. Are they stupid? Nope. Last death in a marathon was a doctor.  Given a choice for my client to lose -17lbs or die I'll choose weight loss.

And all of this doesn't even get into the matter of how you come up with a plan. What if race day is cool? Or very hot? What if the wind is blowing hard so I'm on the course an extra 30 min? What if humidity is high? What if it's low? What do I do if having a bad day? What if race start is delayed an hour? How many variables are there that we're asking a mid level retail store manager to come up with? Based on what data?

And this doesn't even get into what this person should drink on their plan. Most are easily sold a bill of goods when it comes to sports drinks. If my favorite athlete uses it then it must be good for me.  My experience has been that the more stuff that is in the drink (sugar, vits, minerals, salt, miracle ingredients) the more likely they are to have a stomach shut down. I believe the safest is water with nutrition (sugar or fat) coming from another source. Hydration is not closely tied to nutrition.

That's enough. I'm sure you catch my drift on this.


Lastly, when we interviewed the athletes at Hawaii bike inspection last year, one of the questions was “Do you plan to drink to thirst or drink to a plan?”  82% said plan of one form or another.  I’ve always agreed that there’s no need to micro manage one’s fluid intake and that many of us can be quite comfortable more than a little dehydrated.   Maybe it comes back to the, no one plan is right for everyone.  Think about what Joe Friel said, use your head, your experience from trying different ways during training and racing, do what works for you, and err on the side of dehydration.

From Asker Jeukendrup

Hydration requirements

September 15, 2017


Hydration requirements

Drink too little and performance may suffer. Drink too much and there are other risks.
In endurance sports (and most other sports), getting your hydration just right is important. Dehydration is common and may cause performance to suffer. Overhydration, although less common, can be a much more serious issue. Knowing how to hydrate properly will help you achieve peak performance and avoid serious risks.

Why do we sweat?
In order to make sure body temperature stays within acceptable limits and we don’t overheat, we sweat. The higher the exercise intensity (read as higher speed/pace/power output), the more heat is produced and the more we need to sweat to stay cool. In hot conditions, it is even more important because sweating may be the only way we can cool down our bodies. Other factors can affect sweat rate. Sun, high humidity, insulating clothing can all result in increased sweat rate. On the other side, shade, wind and low humidity can aid in cooling and reduce sweat rate.

How much sweat loss is OK?
Sweat loss is usually measured as a percent of our body weight. In very short efforts such as a 5K, sweat rate may be high but time spent exercising (sweating) is short so that total body weight loss will likely be low (less than 2% of body weight). As duration increases and more time is spent sweating, losses can easily reach 2-5% of body weight. 
Research shows that performance can begin to degrade as sweat losses go beyond 2-3%. Guidelines from American College of Sports Medicine and International Institute of Race Medicine (Optimal Hydration) respectively suggest targeting 2% and 2-5% body weight loss. CORE aligns with these guidelines.

Why is dehydration a problem?
When we lose too much sweat we become dehydrated; this reduces blood volume, increases heart rate, and makes it harder maintain our body temperature. It also increases our perceived exertion. All of these reduce our ability to compete and may increase the risk of heat exhaustion and heat stroke.

Why is overhydration a problem?
Drinking too much (overhydration) can lead to a dangerous medical condition called hyponatremia (low serum sodium levels). Early symptoms can include swelling, headaches, vomiting. More serious symptoms include disorientation and seizure. In the worst cases, if not treated, hyponatremia can result in coma and death. The risks of hyponatremia increase significantly with overhydration. If you do not lose weight during your race, you are 7 times more likely suffer hyponatremia.

How do I prevent dehydration and overhydration?
In order to prevent dehydration, it is important to start a race hydrated and maintain proper hydration throughout the race.
Before the race, drink ~500ml during the 2 hours before the start; excess water will be eliminated through urine. You can confirm you are well hydrated by checking that your urine color is pale.
During the race (or training), there are two approaches to hydration.
Drinking to thirst is a recommendation that works fine for the slower athlete: if you are thirsty, drink; if you are not thirsty, don’t drink.
Drinking to a plan can work for everyone, especially if you are going a bit faster, if your race is longer and if you understand your sweat rate. Your planned fluid consumption should always be targeted at a rate that ensures you will not gain wait; a good gauge for this is to consume at or below your sweat rate. If you want to find out how to measure your sweat rate, visit the article Sweat rate calculation.

Pro tips
It is wise to use the early parts of a race when the gastrointestinal tract is working well to absorb both carbohydrate and fluid. Later in the race, even though you may be thirsty, your gut may not absorb as much. Don’t drink excessively, and use common sense. The goal should be to lose a little weight (1-2 kg, 2-4lbs or ~2-3% of body weight) at the finish line.
It is important to note that if bloating occurs and fluids seems to accumulate in the stomach there is no point ingesting more fluids. Reducing your run intensity a bit and giving the stomach some time to pass fluid on to the intestine for absorption will relieve bloating.

Sunday, November 12, 2017

What Happens When You Flat 3X in an Ironman?

Courtesy of Steve Smith, Kona Podium finisher 2015


"I've raced the iron distance many times and never had a bike related failure," says an area athlete.  But there are a good number of folks who flat for one reason or other, and a couple even flat twice.  But here we see that it's possible to have even more punctures and still wear the mantle of IRONMAN come midnight.

“It was an epic race, but one I hope to never repeat.”  It was with these cryptic words that I agreed to meet Legacy athlete Tim Johnson from St. Louis at the finisher’s banquet the day following the 2015 IRONMAN World Championship in Kona.

Johnson was one of the folks I had the privilege of profiling for before the race so I knew some of what got him to Kona.  As a veteran of a dozen 140.6 mile efforts, he’d raced under many conditions, some pretty awful, and a host of different terrains. “Ever read the magazine know-it-alls who say that this course or that course is may be harder than this one?  Bunk, all bunk.”  This from a gent who’s raced Ironman Lake Placid, IM Wisconsin and the old St. George, Utah course.  “This one (Kona) beats them all.”

It didn’t help, of course, that Johnson was nursing an ailing Achilles and under chiropractic care for a recent flare up of a sore back.  It’s even more sore today.  Here’s why.  This athlete is a real student of the sport.  He knew precisely where to line up for an excellent swim.  A good T1 followed.  It would be the last good thing in his day for the next 15 hours.  He only made mile 4 on the bike before flatting.  Then he flatted at mile 5.  Now out of tubes, you guessed it, he flatted at mile 6.  As he described his pre-race preparation, he sounded pretty thorough with new tires and tubes a couple weeks out, several rides to make sure all was well, etc.

So, following this third flat tire, he waited about 20 minutes for the roving neutral support bike mechs, who also couldn’t explain the etiology of his situation.  They gave him a new tire and tube.  Plus a spare tube for the road so to speak, but unlike so many of us who'd say "This just isn't my day," fold their tent and quit, Tim shrugged, gave out a big sigh, and began to pedal.  He immediately separated the rubber off one of his brake pads!  (Course he did.)

Hard way to start this second wind, or would 4th wind be more appropriate?  But by now, he was basically cooked.  He missed his pre-race predicted bike interval so he had headwinds “about 70% of the time."  You read that right.  The out and back Kona bike course snakes through the rugged Kawaihae region of the island well known for this blowing both ways phenomenon.  It didn’t help this northbound athlete to view the southbound athletes, already having been to the turnaround, “about 1000 miles ahead of me,” he admitted as he trudged north.
Surprisingly, he made the bike cut off, although not by much.  He was spent, mentally exhausted.  He was only able to run only the first few miles of the marathon.  But, now well after dark, he was truly amazed at how beautiful the Hawaiian night sky was, the brightness of the millions of stars.  You might have been able to predict, that he had to walk the majority of the 26 miles saving his small reserve of kindling remaining to actually run the final mile to the finish.  

Cramping badly, Johnson was taken to the medical tent, weighed, and found to be 17 pounds down. Seventeen!  Through all this he still laughed when he told me, “Yes I was at the IRONMAN finish line at midnight.  Receiving my second bag if IV fluids in Medical.  Ha!”

But, as if you couldn't tell already, Tim Johnson is a glass is half full guy.  In spite his misadventures this day, he was still terribly impressed that he, Tim Johnson from Missouri, was able to "watch one of the most glorious sunsets I’d ever seen as the sun plunged into the Pacific. And you know, I’m doing it in Kailua-Kona, Hawaii!”

Tuesday, November 7, 2017

Lessons From Kona: Bike Tires, What Too Many Athletes Don't Know

Sharing a Condo at the World Championships

Ready for a laugh?  One of downsides of getting up at 3:30 or 4am in a condo of sleepers is wanting to get stuff done without disturbing the others.  So imagine you have your lap top on the kitchen stove, working by the light from the open microwave door.  You’re hungry – get out cereal, milk, etc. and consume same.  Now you’re thirsty and want a glass of same milk.  You reach up into the cabinet, grab a glass, and as you begin pouring the milk, you realize the glass is upside down, and you are spilling milk onto yourself, the floor, the counter, your lap top.  You begin to laugh at yourself, pretty hard actually, for being an idiot, that it never occurred to you that the glass could be anything other than “normal.”  Duh!

Elsie the cow.   Moo!

Kona Pier, source of all needed knowledge

Ready for this?  

On Saturday at the Ironman World Championship I watched an athlete in the pre dawn hours of race morning pump up his tires.  He had deflated them following the antiquated custom of “letting some air out of them so they don’t pop” in the afternoon Hawaiian sun.  He was using his own pump from home not one of the ones supplied by WTC.  But the pump was broken.  Had been broken for a while.  The needle on the gauge was broken off so he chose to pump the tires up until they felt right.  When I discussed this technique with one of the so-called panic mechanics on the pier, a gent who works in a bike store and does this every day, he mentioned, “Once the pressure gets to 90 or 95 psi I can’t tell if it’s 195.  I doubt he can either.”

The basic importance here is the hopeful elimination of race flats.  But, if on race day, with the adrenaline flowing, tires get over (or under) inflated, the athlete is risking not only malfunction and lost time, but an accident should the tire deflate at precisely the wrong time.

A second and somewhat sad observation the mech offered was how “ill prepared and ill equipped” some of the athletes were.  In Kona, not only are you expected to be able to handle routine bike maintenance issues, the eager race volunteers are instructed not to mess with your bike or wheels.  They can hold the bike or pump and the rest is up to the racer.  You’d best be ready.
So many are not when it comes to their own equipment be it tires, tire pressure, valves  clogged with sealant just to name a few.  According to my new friend the mechanic, “These people would have a lot less stress if they’d just take the time to understand how their race wheels work.”   (Think Norman Stadler melt down as defending Kona champion after his second flat in so many hours which lead to his heaving of his not inexpensive bike off the side of the road into the lava fields melt down.)  This much needed and very beneficial experience comes from using race wheels in training such that when an issue arises, the athlete has dealt with it before.

We’re entering the off season.  Why not see if your local bike store offers a 3-4 lesson course on basic bike maintenance.  If not, ask for a private one.  This is what these folks love to do.  When you show interest in their trade they’re usually most enthusiastic about sharing what they know.

Give yourself the gift of knowledge.  You’ll thank yourself one day.

Thursday, November 2, 2017

Don't Get Sick! 9 Tips on Staying Healthy This Winter

There's No Such Thing As Bad Weather, Only Bad Gear

This is a watch phrase of the U.S. Navy SEALs.  They live it and teach it.  Triathletes would do well to listen.  In short, you can train outdoors year round as long as conditions are safe.  We’re talking road surface, not only for you but any automobiles that may venture nearby.  Visibility is also key.   This was sadly learned by our community last year when an unlit runner was killed by a car on a foggy morning just before dawn.  It didn’t help that he was running with his back to the traffic contrary to what most of us do.  You’ll need an accurate idea of the outdoor air temperature, short term weather forecast and a little knowledge of layering clothing.  Chemical hand and toe warmers come in handy on occasion. Reflector vests, strobes, anything that can make you more visible to a car coming around a blind curve also help.  One local runner has a flashing strobe on the top of his head.  Sure it looks kind of goofy, but when he's running down 21 Curves Road across from our home, he has no problem being seen.

Don't Get Sick! 9 Tips

This is a piece I did for Ironman a couple years ago that seems applicable now.

                                                                                                                                                     (c) Jeffrey Hamilton

Keep the flu from derailing your fitness plans this winter by following these smart suggestions.

by John Post, MD 

"Flu Bug Twice as Mean." "Schools on Guard as Flu Deaths Rise." "The Flu Didn’t Take Time Off Over the Holidays."

Newspaper headlines squawk loudly concerning this year's flu epidemic and experts are predicting more to come. In fact, you probably know of a few people who've already had it this year—if you haven't contracted it yet yourself.

Although the typical flu (influenza) season runs from October until the end of March, peaking at the end of January, we’ve already seen more people take ill this year than in an entire normal season. This means that in your community there's currently a lot of flue activity—making it even more crucial to take precautions.

What is the flu?
The flu is a highly contagious virus which produces symptoms of fever and chills, sore throat, body aches and headaches, and coughs. Symptoms usually arise one to three days after being exposed. The good news, if any, is that it usually lasts under a week (although complications have been seen in some, necessitating medical care or even hospitalization).

If you’ve encountered someone with the flu, or may be concerned that you have some of the symptoms listed above, call your medical provider for further guidance. This is particularly true if you have a fever.
If you do have the flu, generally speaking it’s recommended that you stay home and avoid work, school, and yes, exercising/training, until you’ve been without a fever for 24 hours.

How do I protect myself?
Even if you've heard that this year’s flu vaccine doesn't include the current strain, a vaccination is still strongly recommended by the CDC. The vaccine for each year is made up of strains of virus present in the world that year. Even though the current strain is not in the current vaccine, it’s still about 50 percent effective in protecting you—far better than no protection at all.
Flu shots are recommended for everyone over the age of six months, especially anyone considered at high risk of serious flu-related complication. Try to avoid those who are sick and consider wearing a mask if you can’t. Then wash your hands and avoid touching your face. Again, if you are sick, please stay home to prevent spreading the disease.

Fitness and the flu
Here's the biggie for us exercise addicts. What do we do when conditioned to train virtually every day? The answer is simpler than you might think.
If all you have is a cold, you may not need to back off at all. Test yourself, see what makes sense for you as an individual, and then do what you can do. If you can’t do something, don’t. But if your illness includes a fever, a goose egg goes in the log book that day. Exercise raises your internal body temperature, which if already elevated from the illness, could make you a lot sicker. Some doctors list 101 degrees Fahrenheit as a reasonable cut-off, but more often you hear 100. Should you make it to the gym while ill, exercise consideration for others by wiping off everything that you touch. One benefit that a fit lifestyle will bring is likely getting over illness more speedily than our non-fit brethren.

Step 1: See your doctor
Almost all primary care clinics can do a quick test to see if you have the flu. It only takes 15 minutes and they can also look for pneumonia or other viral illness. (As a viral illness, flu is not susceptible to antibiotics.) However, other treatment options may be recommended, possibly including anti-viral medications, Tylenol or ibuprofen to lessen the fever and body aches. Drink plenty of fluids and get plenty of rest.

Step 2: The emergency room 
If you do contract the flu know that most patients get over it with rest and time. Some, however, would fare better with emergency treatment. There are no hard and fast rules about when to seek care but, if in doubt, call your doctor and make the decision together. If your doctor feels that the symptoms warrant, you should go to the hospital. In other words, just as you would for any other illness, unless you are experiencing an acute life threatening situation, call your family physician. 
9 steps to staying healthy this winter
In summary, here's how an athlete eying the 2017 competitive season, or just simply with ambitious personal fitness goals, should approach this highly contagious time of year.

1. Get a flu shot. If you’re "allergic" to shots, get the flu vaccine nasal spray.
2. Try to avoid direct contact with people who are ill, whether or not they have flu.
3. If you have to go to a doctor’s office, don’t touch anything. Especially the magazines. (This is from my own doctor's wife.) Bring your own reading material. 
4. Clean your hands frequently. Try not to touch your mouth, nose or face.
5. If you do have to be around those who are ill, consider wearing a mask.
6. Should come down with the flu, cover your mouth and nose with a tissue when sneezing.
7. If you get the flu, stay home! 
8. A fever means no exercise, but a simple cold may just mean some modifications to  changes.
9. Lastly, the CDC has a wealth of flu related info. Visit them at

   Originally from: