Knotted Muscles / Trigger Points

Muscle soreness while training is common and by itself, is really not a big issue. Usually, sore muscles are caused by microscopic tears in muscle fibers. The soreness typically goes away within three days.

But when muscles remain sore for weeks or even months, and the pain is centered in a particular spot, or a "knot" you very well may have a Trigger Point problem. Trigger points are typically found in muscles, tendons and ligaments. Technically, the doctors call this "myofascial pain syndrome."

These are very sore, long lasting aches and sometimes produce sharp electrical-type pains that are often caused by trauma, repetitive strain or pushing beyond any reasonable norm.

I have had a consistent problem in my upper back, in the Trapezoid area. My Trigger Point always flares-up when I do long bike rides, and 100% of the time when I am in the aero position on the Time Trial bike.

Essentially, it is an acutely knotted mass of muscle strands in a very specific spot. The muscle is in a constant and palpable contraction (shortening of the muscle) that will not release and thus results in a taut band and a hard fibrous nodule, lump, or knot. No amount or rubbing or massaging or pressure or anything else will relieve the pain.

Aggressive, deep tissue massage will tend to break up the knot a bit, but typically, there is also a lot of bruising that goes along with the deep tissue massage. Plus, the relief is at best, only temporary and never complete.

I have tried literally every recognized cure for this problem, including:

• sports massage
• deep tissue massage
• heat packs
• electrical stimulation
• chiropractors
• anti-inflammatories
• prescription pain killers
• physical therapy
• electro-magnetic therapy
• weight training
• Lidocaine patches
• Cortisone injections
• Lidocaine injections
• and finally, rest.

Of all these, only one thing worked...rest.

However, since rest is not an option while training for an Ironman, I have been working with a pain management specialist. No oral pain killers or anti-inflammatories have helped whatsoever. So now we are to the point of "wet needling."

The goal is to deactivate the contracted muscle. One option is to paralyze the muscle with Botox, and this would normally be a viable option. However, since my Trigger Point is located in the upper back and shoulder region, I could lose the ability to fully control my shoulder due to the temporary paralysis of the muscle. Odds are low that this would happen, but due to the risk, they don't want to go that route. Instead, we are now trying a wet needling procedure.

Wet needling involves the injection of a mixture of Steroids, Lidocaine and Cortisone directly into the muscle knot. A significant amount of care is taken to precisely identify the muscle strand, and once so identified, a shot of the mixture is injected right into that fiber. Then they move up the fiber ever so slightly and inject the fiber in another spot, and another, and so on.

What they are looking for is for the muscle to start twitching or firing. Once they physically observe the muscle twitching then they know that it is beginning to release from its contracted state.

Today, I went in for this wet needling process. As the four or five injections were made, I could feel the muscle "release" and the doctor was pretty excited when he saw the muscle firing and twitching which was the visual cue he needed to confirm that this process was working.

Three hours later, the spot is still sore, not from the shots, but probably from the excessively-hard rubbing and pressure that I have been constantly applying to this spot over the past few days trying to relieve this knot.

Hopefully in a few days, we will know for sure if this has worked.

Being Tough or Just Stubborn?

It has been said that over 90% of all those training for an Ironman incur at least one injury that requires over a week of recovery. But the whole idea of completing an Ironman is to test one's resolve.

There are very few opportunities in modern life where one can literally test the ultimate limit of one's physical and mental boundaries.

Look at any Ironman event and you'll see athletes who've pushed themselves to the point of collapse, exhaustion, dehydration and even passing out.

In the months leading up to the Ironman event, injuries first start as minor inconveniences. A subtle twitch, a funny feeling, a stiff muscle, an ache that wasn't there before. These are the first signs.

Rarely does one just run down the road and then all of the sudden...SNAP....something rips or tears or breaks. It's far more likely that we will experience an odd sensation, a soreness or a muscle fibre that just sort of seems out of place, is twitching strangely or is aching.

So what to do when this occurs?

The first thing we should do is to slow down. Check it out. Try to figure out what is going on. Massage it a little, walk a little, etc.

But there is a big difference between what we "should do" and what we often end up doing. It's the difference between being smart and being stubborn.

I know I should slow down and figure out what is going on when these things hit. But more often than not, I catch myself saying:

"You want to be an Ironman? Then start acting like an Ironman and pick up the pace. Tough it out. Be strong. Are you going to quit during your Ironman debut like you are quitting right now?"

Tough thoughts to be sure and this stubborness often gets me to ignore the first signs of trouble. To be smart, to ultimately go the full distance, we must pay attention to the very first signs of trouble.

Before we ever get a blister, we always get a "hot spot." This is a hot sensation where the skin is rubbing. We can take a couple of minutes and deal with it right away, or if we are bull-headed, we ignore it, and then pay the price for the next 7 - 10 days as the raw, oozing blister just festers and is re-aggravated with each successive workout!

This is bull-headed and stubborn. Like my brilliant coach, David Warden, tells me, "Keep your eye on the prize."

But the prize is not finishing the workout in record time or toughing it out through an obvious early warning signal, just to "prove" that I have what it takes. The prize is finishing the full Ironman race.

What good does it do to finish the workout at record pace if you must spend the next 3 - 5 days limping around and recovering?

I need to adjust my perspective.

Being an Ironman is not just about being tough and stubborn. An Ironman must also be smart.
Smart about pacing, about nutrition, about rest, about balance.

And smart about paying attention and taking appropriate action at the early warning signs that an injury may be looming.

The Support Network

My wife started this magnetic support system in my Ironman kitchen (yep, our full prep kitchen has been converted and is now set up entirely for powders, potions, GU, gels, nutritional supplements, shake makers, Gatorade G2, etc. The kitchen also has a dishwasher customized to handle all the plastic bike bottles and hydration systems so that none of the caps slip through the grates and get melted in the drying cycle! Of course, the most important part of the kitchen is the Nespresso machine which I absolutely swear by, love and am the world's biggest proponent...they are brilliantly designed and absolutely trouble free for the perfect Espresso with no hassle whatsoever. http://www.nespresso.com/)

The magnetic sign was important because every day I walk by the back prep kitchen on the way to and from the garage, I would see those words of encouragement. My wife had found and arranged those letters to get that sign started and I could feel her support every day.

The importance of a support network cannot be overstated.

The pursuit of the Ironman dream can take an incredible toll not just on the athlete, but also on his or her family, friends and work associates.

I often think of this pursuit as a very selfish endeavor. The time commitment away from one's family is enormous.

Five to Eight-hour workouts on the weekends are now the norm. Plus the time to prepare the bike, nutrition, the actual plan of where I am going, then to upload all the power data, HR data, etc. can take an additional 1 - 2 hours.

Naturally, once the data is input, the research and analytical side kicks-in and I want to study how I did, if I am improving, etc.

My wife has fluctuated from being: amazed, amused, accepting, supportive and understanding. Connor has been terrific and it feels great to have a 15-year old son who is so proud that his Dad is accomplishing these endurance events. There have been many, many times when I have just been way too tired for various workouts, only to have my wife rib me, pressure me or use some kind of reverse-psychology to get me out the door.

Sometimes she'll say, "Yeah, don't work out. You don't need to. You know you are ready." Which of course is effective sarcasm that gets me out the door pronto! Other times she'll say, "Go on. Come on, just get out there and get going." Somehow, she can read me well enough to know which buttons to push.

Connor saved me the night before my first 70.3 in Hawaii. I will never forget it.

I was up at 3:00am pacing the hotel room. I was most worried about the swim. Connor just sensed that I was worried and he got up and came to me and gave me a huge hug (he's now taller than me!) and he said, "Don't worry Dad. You've got this. You've got it!"

Having my son support me like that was priceless.

Another support mechanism is my coach, David Warden. David is one of the world's leading experts on the science behind Triathlon and the world's most effective training methods. He only works with seven people, so I am extremely lucky and grateful to have him on my team! There is this subtle self-created pressure that I do not want to let David down, and I do not want to report that I did not complete all my workouts as scheduled. Knowing that David reviews every workout and all my power and HR data, is enough to get out the door on some days.

My business partner Kevin has been incredibly supportive. I am either arriving late or leaving early, especially during daylight savings time. The extra work often falls onto him, and he never complains. He is also the voice of reason when I tell him how close I was to coming to blows with a crazy driver or a wheel sucker.

When pursuing the Ironman dream, many people must pull together to support you, especially if you are married, have a family or are working full time. The time to get everything done has to come at the expense of something. It's as simple as that. Where do you find an extra 15 - 20 hours a week? You surely cannot cut back on your sleep, as when you are working out this much, you must have the sleep for your body to repair and rebuild.

The time for these workouts comes at the expense of relationships, work, keeping up the house, other hobbies, television or other past times, etc. In my case, the time has come from work, from the elimination of essentially all TV, and in keeping up on things in general.

The pursuit requires one to be exceptionally-well organized and to have systems in place to ensure that things don't start slipping through the cracks, because believe me, they will if you are not careful! That's where your support network can really come in and help.

This pursuit can stress work, family and outside friendships. If your critical relationships are not solid and in good standing prior to starting your Ironman training, I would suggest that you really shore-up those relationships and have a candid discussion about the toll your training will likely take on others.

The toll?

• You will be going to bed a lot earlier (I go to bed at 9:00pm; it used to be midnight).
• You will be cranky and possibly short-tempered, especially during your long weeks.
• If you have a short temper before you start this endeavor, it could be magnified by your training.
• You will be sore a lot of the time. You will likely complain about it. At first you will get sympathy, but that won't last long. Too much complaining can begin to grate on people.
• You will likely be going to see the doctor more frequently, and usually to some sort of specialist. I have been to see doctors more in the past 12-months than in the past 20 years combined. (Broken ankle, hip problems that required four visits to an orthopeadic surgeon for x-rays an MRI and evaluations totally over $7,000, knee problems that required thousands of dollars of additional x-rays and evaluations, hernia, IT band problems, knotted up trigger points called 'myofascial pain syndrome' in my upper trapezoid area from the crouched aero position on my TT bike, black toenails, toenails falling off, massively-huge and very deep blisters, a year-long plantar wart problem that required Podiatrist action, plantar fasciitis, hemorrhoids (from bike?), pre-cancerous growths from sun exposure, etc)
• You will be tired and may not be as fun to be around at times.
• You will be pre-occupied and not always "present" or able to give your full and complete attention to your spouse, children, work associates and friends.
• You will definitely be spending a lot of money on equipment, a coach, bikes, travel, race fees, nutritional supplements, bike repairs, race uniforms, books, power meters, HR monitors, body fat scale, GPS watch, an Endless Pool perhaps!, gym fees, association dues, equipment bags, wetsuit, aero helmet, road helmet, custom bike fitting (a must!), race day souvenirs and the list goes on and on. When you spend this much money, one can't really get on a spouse about their spending habits...even if they already have 137 pairs of shoes!
• The list goes on...

So I find that support is very important. Sure I could still finish the full IM without this support because I am just so determined to do so. But I know for an absolute fact that I will finish healthier, faster and happier, knowing that I have so many people who love me and who are pulling for me and have supported me throughout this incredible journey!

Endless Pool: One Year In-Service Review

I have always wanted a pool. Always.

My great friend and cousin in-law, Chris, had a lap pool growing up and for over 30 years I have been talking about that pool! But the problem with a backyard lap pool for a Triathlete is that it is very difficult to build one long enough (25 meters) to get a satisfactory workout.

Then along comes Endless Pools.

Imagine an adjustable flow of water coming straight at you, just like a salmon swimming upstream. The company calls them a "swimming machine" and another way to look at them is sort of like a treadmill, but for swimming. All this in a compact 10' x 7' footprint. Takes up little space, you determine the speed of the water flow, no lines at the local pools or gyms. What could be more perfect!

The only problem is that these pools are extremely expensive. There is no way that I could ever 'cost justify' the incredible extravagance. Sort of like Warren Buffet who calls his Gulfstream IV-SP jet "The Indefensible."

The cost of a basic Endless Pool is listed at about $20K - $25K, but let's talk real numbers, not the advertising hoopla.

In addition to the basic pool package which is assembled on site, either above or below ground, you'll certainly want to add some extras. The electric pool cover alone can be as much as $4,500. But it doesn't stop there. How about a swim mirror to check on your stroke? Got it. How about lights? Yep need those too for swimming late nights and pre-dawn. What about a swim meter to tell you how fast you are going and to record your workout distance? That's a must, and that's extra. Want a swim step so someone can get out of the pool? You'll need to order that as well. How about four hydro-massage jets for a Jacuzzi-like experience? You bet, especially after a long bike ride! I could go on and on regarding the extras.

In my case, I thought I was getting the deal of a lifetime because I was able to locate a pre-owned pool from a private party and verified all the data with Endless Pools. It came with a custom-made $5,000 cover and most of the parts. All this for about $12,000. I saved well over half and was elated.

But let's just look at the REAL numbers:

$12,000 The initial cost of the Pool
$9,000 Installation cost (I got ripped off here; big time!)
$2,000 Prep and pour a new concrete slab
$1,500 Upgraded electrical service to power the massive hydraulic pump
$5,000 New gas pool heater to save on energy costs (My first electric bill was $2,000!!)
$2,500 Build a deck around the pool for a platform and easier access.
$2,000 Cultured stones to face the outside of the pool structure
$1,500 Labor to install the stones
$2,250 Extra parts, new parts, service call on the cover, service call on the electrical
$300 Landscaping around the deck

The total cost is about $38,000 and I am certain that I have left out a lot of things.

Endless pools will never quote you how much it is going to cost for everything, but friends, these are the real numbers. Nothing extravagant or unusual here either.

OK, enough about the costs, what about the performance and value?

I love the pool. It has been a great tool and I am a much better swimmer because of this pool. It has operated flawlessly for about one year now. I have not had a single issue or problem and I am very happy and proud of that pool.

It does take a little adjustment to get used to the pool's current. As the current comes from the front of the unit in a smooth, waveless motion, it is also sucked back and down into a grate at the back of the pool; this is the return. So the water is returned to the front where there is a huge propeller safely housed in a solid stainless steel compartment. Totally, 100% safe to be sure. But the thing is that your feet are drawn down a bit by the power of the returning current. The faster the current, the stronger the draw and downward pulling motion on the lower legs. You'll get used to it, and one cool thing is that when you get back into the lake, ocean or community pool, you will not believe how much faster you are going without that pull on your legs; it's an amazing difference. You feel like you are just gliding right along the surface.

I am the first to recognize that it was a crazy and unjustifiable extravagance. Had I known that it would cost about $40,000, I never would have considered it. Never. For that price I could get a lifetime membership to the finest health clubs in the world. But it's done, and I don't regret it at this point.

I am very happy with the pool. I also like the hydro-jets which I can focus on parts of my back that get trashed from riding in the aero position on my Time Trial bike. But the really great thing about the pool is both the convenience as well as the ability to practice at exact pacing. If I want to complete my 2.4 mile Ironman swim leg in 1 hour and 20 minutes, then I know that I have to just set my pace meter to 1.80 mph and that will be the exact pace I will have to swim in the event. I can adjust the speed to whatever I like, although it gets to the point where it is just too fast!

The Endless Pool has also been used as a family hot tub from time to time. We upgraded the heater to an actual swimming pool heater (thus the $5,000 cost!). That allows me to superheat the water in about 2 hours from about 88-degrees where I typically swim, to 101-degrees for a hot tub experience.

The pool holds about 2,500 gallons of water and it is very easy to maintain. Endless Pools sells a kit of some minerals that you install into the filter and replace every six months. This product alone takes care of everything you'll need to do, except for chlorine. I use bromine tablets in a floater for when I am out of town and this has worked perfect to maintain an excellent balance. Caring for the pool is nearly effortless, but whatever effort is required is actually quite fun.

The pool can be installed indoors, outdoors, above ground or below ground. Below ground installations are quite expensive. At the same time, if you just install this 4.5 foot tall "box" on top of an elevated slab, it can be unsightly.

What we did was to pour a solid concrete pad, then build a deck around the front and side of the pool. that allowed for easier access with two stair steps. Then in front of the elevated deck, we planted flowering bushes to soften the whole look. So you see the lawn, then the flowering bushes, then the deck, then just two feet of the stone facing of the pool. This method allowed us to really break-up the massive box and really soften the overall look. I just love the way it all turned out.

The pool is definitely an excellent training device. I won't go as far as to say that it is a must, but it sure is a very convenient, fun and practical piece of exercise equipment that could possibly last a lifetime. And if you move, you simply have an installer come out, unbolt the pool and reassemble it later. All you'll need to do is to buy a replacement liner, which by the way are very attractive.

If you are really interested, I would be happy to send you photos or talk to you about the process and just give you the straight scoop here.

Disaster Strikes!

Due to a series of conference calls, I had to reschedule my morning bike ride to the afternoon. But to save time, I loaded my best bike onto the roof racks of my new BMW 5-series and headed off to work.

The plan was to leave work a bit early and get 2 - 2.5 hours on the Riverbed and be home for dinner by 6:30pm.

All was well and I was feeling good, so after the ride I stopped by my local butcher shop that makes these incredible, citrus-marinated chicken breasts perfect for the BBQ. I was still in my cycling gear and we got talking a great story about fitness, etc. As a lifelong butcher, he enjoys his product to what appears to be an unhealthy level and was very interested in some ideas to improve his health.

As I was thinking about ideas for him on my way back home I was apparently distracted because I drove right into my garage with my most-prized bike still attached to the roof.

The damage was absolutely incredible!

The rack, which had been very firmly attached to the roof, was ripped right off. In the process, however, it gorged massive dents at three points where the rack was attached. As the rack scraped across the roof, metal on metal, the roof was scratched and deeply indented.

The garage door was knocked right off the tracks and was completely inoperable.

The 100% carbon fiber bicycle, thankfully, appears to be OK. The impact was at the handlebars and they took full blow as they were the only contact point on the concrete wall above the garage.

All I can say about those bars is that Zipp makes an incredibly strong handlebar and fantastic wheelsets! The bar is fine, and it appears the bike is fine. However, I do not intend to ride the bike again until it is fully checked out by the shop.

At downhill speeds of over 40 MPH one must be certain that the frame retains full integrity.

In the meantime, I will be getting back on my Cervelo P3C Time Trial bike for the balance of my riding prior to the Full Ironman in Tempe in November 2008. Only about sixty-days now remain until this event!

Now I need to go find a good body shop. It looks like it may be $5,000 - $7,500 worth of damage, but the first estimate was only $1,600. It was so low that I am extremely suspect and will get a few others when I have time.

And while this may be an over-reaction, I am actually considering buying a different kind of car that can accommodate my bicycles and gear in a truck or fold down hatchback type area. I was thinking of the Honda Element which appears to be designed for this kind of activity, although I am not thrilled with the low power or quirky shape.

Lesson learned: If you put a bike on the roof of your car, ALWAYS, 100% of the time, take your garage door opener and put it in your trunk! If you have a door opener integrated into your car's electronics, put a small Post-It over the button to remind yourself!

Carpinteria to Solvang

My mission for the day was to secure the prized Solvang Kringle the moment the bakery opened. The problem was that the bakery opened about 7:00am, and I was about 45 miles away on the other side of the mountain pass.

Well before sunrise, I mounted the Specialized S-Works Roubaix SL and headed north to the tiny Hamlet of Solvang, CA. This would be a challenging ride of just over 90 miles, three hours of which would be in total darkness.

I started slow and easy in order tow warm up and to adjust my night vision. Even though I was wearing three layers of cycling shirts and two pairs of gloves, I was still cold as I climbed up over the coastal mountain pass and through the clouds.

Ever driven your car, at night, through very dense coastal fog? You know what it's like when your high beams hit that fog and you are blinded? Well that was the challenge I faced riding up and over the mountain pass. It was unsettling as I made my ascent, as there is no shoulder for cyclists in many of these steep stretches, and with the fog blinding motorists, I was a bit concerned.

I made it up through the clouds and it was a bright starry night at the top. But then I had to descend back through the clouds again as I moved from Santa Barbara toward Lake Cachuma and the Santa Ynez wine country.

Descending through those clouds, at night, in cold weather was extremely cold. The cold, wet air and the low temperature conspired with my accelerating downhill speed to give me ice cream headaches all the way down (about 4 - 5 miles).

The sun began to rise as I hit the lake and headed the 20 additional miles to Solvang. My mission for the day was to secure the prized Solvang Kringle the moment the bakery opened.

Kringle are hand-rolled from Danish pastry dough that has been rested overnight before preparing and baking. Many layers of the flaky dough are layered, then shaped roughly like a pretzel. Solvang is world famous for this particular pastry and I was going to bring one home as "proof" that I actually made to Solvang despite urgings from some not to attempt the trip due to the lack of a cycling shoulder on the mountain pass.

Well they packaged up that Kringle in 4 large plastic bags, sealed them all and I stuffed this pizza-sized pastry in the front of my jersey. To avoid crushing the delicate puff pastry, I suspended the packaged item with medical tape from the straps of my cycling straps on the long johns. It worked great.

The trip back was much faster because I had plenty of light so I was not so tentative. I was also pushed a bit by a few guys from one of the cycling teams. Solvang was the home city for the Discovery Cycling team for many years and the area is full of cycling lore about Lance Armstrong and his amazing exploits.

I would do this trip again, but next time will continue through the Central Coast wine country, and return via Buellton and the 101 freeway heading south back to Carpinteria.

My First 100+ Mile Bike Workout

This morning I got up very early and headed up the San Gabriel River Trail. I started at the beach and ended up at the snow line in the mountains above Glendora. At mile #52, I was high up in the mountains in the pines, oaks and a wild rushing river. It was fantastic.

The total ride took 6 hours and 45 minutes, including a couple of stops for more water. On the return trip it was so windy that I had to pedal hard even on the downhill sections of the mountain pass because I was riding straight into a ferocious headwind!

I fueled correctly, hydrated consistently and took plenty of Electolytes; I had no issues, no problems and in reality, this ride was not as tough as many others where I was not as fully prepared.

I have a bike race coming up in a few weeks (The 104-mile Tour de Poway in the San Diego area), so this ride today was a good primer.

This was my longest ride ever on a bike, and while I was only averaging about 15 miles per hour, I am happy with the results and still find it hard to imagine that I actually completed over 100 miles on my bike and still got home in time for lunch! That was cool!