The Road Bach #5 - Set Back

Friday, February 3, 2017 - 10:45

Ugh. It was all going so smoothly, but here I am facing some hefty bumps in the road. My bone density has barely moved, and I've given myself another stress reaction. What happened?!? Here's the scoop:

My health was returning, so I jumped, ran and lifted heavy weights. No problems! It had been 4 months since I had the initial stress reaction and I stopped training, my hormone levels are back to normal, and my hips were feeling fine. No evidence of any bone injury. I had come to believe that my bone density must be coming back nicely, but I wanted to check it out and make sure before ramping up my training more, so I scheduled a DEXA bone scan.

The result: low bone density!

My reaction: "What?!?!? I only gained 9.7% in my spine?!? And I lost 4.0% in my femur!?!? I thought I was on the right track!"

The problem: There are lots of them. First, my expectations weren't set properly. I was under the assumption that I could gain tens of percents in my bone density within a year. My fault. I should have known, by asking my doctors or doing some Googling, that bone density improves really really slowly...to the tune of 10% per year if you're doing well. Second, there is a margin of error of +/- 5% for these tests. Third, the two datapoints, 7 months apart, don't tell the whole story. I was very disappointed at first, but after giving it some thought, talking to my doctors, and looking at the evidence, this is actually a pretty good result. Yes, even the loss of 4% isn't so bad. My first DEXA was done in May 2016, but that probably wasn't my low point. I was injured and had low testosterone, both of which were further hurting my bone density. Further evidence comes from a bone resorption test that I did (it shows how much bone you're breaking down) in late June that showed I was breaking it down pretty quickly. I had another bone resorption test in November that showed a dramatic decrease in the amount of bone I was breaking down. Therefore, the story is likely that my bone density continued downward till a low around July, but then necessarily must have rebounded in order to arrive back at the "nearly unchanged" numbers we see in January 2017. This would suggest that I've actually been progressing since mid-summer, and that I need to just keep doing what I'm doing. Great. So my priorities are: 1.) I'm still susceptible, so don't get a stress fracture 2.) keep hormone levels normal, which is of utmost importance for healthy bones and 3.) keep lifting heavy weights to encourage bone growth

Fastforward three days. I go for a 9 mile run with a few short pickups. It's nothing out of the ordinary as I've been doing pickups recently and have run up to 10.5 miles at a time without issue. Two hours after the run, though, my hip starts aching ever so slightly. It's the same feeling as when I first had the stress reaction. My first thought..."this must just be in my head. I got the disappointing bone density result and bone stress injuries are fresh in my mind. Plus, I've been doing runs like this, and throwing heavy weights around, and jumping and I haven't had any problems, so why would this run-of-the-mill 9 mile run affect me? Are you becoming a hypochondriac? Matt!? Are you!?" Then I ran on Thursday morning, an easy 6 miles. The ever-so-slight achiness returned...hmmm...then I lifted heavy that same day and the achiness moved into the range of undeniability. It felt like soreness deep in my hip area, but only on my right side, the same exact feeling I had back in May 2016. I immediately contacted my doctor to set up an MRI, which I did the very next day. Well I got the result on Tuesday and WHAM! I've got a stress reaction. It's in the same exact spot as before and looks to be approximately the same intensity.

What does this mean? For the short term, it means I won't be running anytime soon, I won't be doing any heavy lifting, and I can't do any hard bike workouts. Chances are slim to none that I will be doing Puerto Rico 70.3 frown. I'm lucky to still be walking without crutches. I can, for now, still bike easy and swim, but if that aggravates it, then I won't be able to do those either. For the longer term, maybe this is God's way of telling me to put this mission aside. "Here, I'm giving you something more important to worry about, a daughter!"

My new priorities: 1.) get ready for the arrival of our little one 2.) heal my stress reaction 3.) maintain hormone levels 4.) restore bone density to levels where I can run without reinjuring myself

I write about this topic so that others will be aware of the health debacle that can occur if you overtrain. So many articles write about overtraining and how it's not good for you, but they don't get into the nitty gritty. What actually happens to your biology? Why does performance suffer? Why do you become more injury prone? Why do you feel tired and why don't you want to have sex?! It's much deeper than "I'm tired from training," and I feel I have a duty to spread that word. I'll be doing a speech on this topic in 2 weeks at a Sports Medicine conference in Greenville, SC, I'm working with a researcher named Dr. David Hooper on a study assessing overtraining in endurance athletes, and I offer consultations to those who are in a hole and need help. To be clear, my point isn't to diminish enthusiasm about training for endurance sports, but just that we need to be smart about it! There is a balance that can be found in each person's life situation that will allow them to fully enjoy triathlon and become better athletes, all while remaining healthy. I encourage you to find your balance!

 

Train happy, train healthy,

-Matt

The Road Bach #2 - Emb"racing" Opportunity

Tuesday, August 30, 2016 - 09:00

In a couple of weeks, I'll be "racing" Ironman Santa Cruz 70.3. I won't be racing, but rather "racing" because I won't even be finishing the race and because I'm going to use it as an opportunity to experiment. My doctor hasn't cleared me to run something as far as 13.1 miles yet, so I'm going to do the swim and bike legs and then drop out. While bummed to not be able to complete the race, the cost of still going out there is minimal, I would only be able to get a small fraction of the already-paid expenses back, and I'm excited about the abundant opportunities I've found in the trip to Cali. Here's my thinking:

 

  • Friends - Before I gained full knowledge of my deep health issues, I had arranged to go out to race Santa Cruz 70.3 and stay with a long-time friend of mine from high school, who now lives near there. Instead of focusing so much on the race, I'll have the opportunity to catch up with him and his wife over a few beers (yes, even before the race!) and to go on a 30 mile ride with him (he happens to be a triathlete as well) around Sunnyvale. Another friend moved out west recently and I'll get the opportunity to meet up with her as well (and race against her, though she might kick my butt now!).

 

  • Sponsors - A close contact and friend from Generation UCAN recently moved out to the Bay Area to spread the word out there. The trip will give me the opportunity to do a speaking event with him, or at least to just get together to chat. The weekend also means that I'll meet other triathletes, where my sponsors' names will organically come up in conversation. Finally, I hope to get some pics of me in action in my new tri kit for my newly minted website :-)

 

  • My Experiment - it is an exercise in control and pacing. I plan to start the bike at a wattage that is ~30w below where I think I could ride, then after each 10 mile split, increase my wattage by 10w until the last 6 miles when I'll give it everything I've got (remember, I won't be running!). The reason I want to try this exaggerated negative split approach is because last year I attempted to discover my limits on the bike. I first attempted in training, where I did two "blow-it up brick" workouts involving a ride at 90% of my FTP and then a 6 mile run all-out off the bike with minimal transition time (like a race). In my first attempt, I targeted 90% during the whole ride, but found that because of all the turns, stopsigns, lights, potholes, cars, steep downhills, and other obstacles that litter the roadways, I only hit 84% (263w) - TrainingPeaks file here: http://tpks.ws/RTnuk. I then ran too fast for it to be considered a blow up - TrainingPeaks file here: http://tpks.ws/vUALd. I failed to find my limit, so I tried again the next weekend. This time, I targeted 96% (300w) so that the road obstacles would drag my average down toward the real target of 90%. It worked rather well and I ended up riding at 88% (275w) - TrainingPeaks file here: http://tpks.ws/F929J. I failed again, though, to blow myself up! I ran almost as fast as the week before - TrainingPeaks file here: http://tpks.ws/4L0L9. While I failed to find my limit, I did learn where my limit was not and it gave me a lot of confidence going into Eagleman 70.3. There I had some mechanical issues and ended up having to ride without power, but rode an 8 minute bike leg PR, then ran the 4th fastest run split for a 6th overall finish, and top amateur. These points and more led me to believe I was more durable than ever, and that it was really hard to blow myself up, so in Kona I went for it, and paid the price. I found my limit finally, and unfortunately it was in my A-race on the Big Stage. Upon reflection, I realized that all my best races in life, including those all the way back to high school cross-country and track, happened when I negative split. They happened when I went out conservatively and built into my performance. Many athletes find this to be the case, and I've found that it rings even truer for me than for most. Last year, my M.O. was not to ride steady or build, but to go out hard because I didn't think I could blow myself up. I know what the limit feels like now, so that is why this year, and next (when I hope to be back truly racing and not "racing"), I want to practice the build. Closing strong. Santa Cruz sounds like a good place to start.

 

  • Humbled - Another opportunity this race provides is for me to be humbled. Given that I've only done ~2 endurance workouts per week for over 3 months, it's going get ugly out there. It'll give me a chance to see how so little training and such limited fitness translates into diminished performance.

 

  • Tri Community - Finally, this race gives me a great opportunity to immerse myself in the community that I love, one of camaraderie, commitment and everyone striving to be the best they can be. The vibe at these races is awesome and I'm looking forward to feeling it again!

 

This post served two purposes - 1.) an update and 2.) a perspective you might emb"race" - some things look sour on the surface, like your doc telling you not to run in a race...but spin it another way, and that same limitation can be seen as an opportunity. Have a bum knee and can't run? Hit the pool, take some lessons and bring your swim time down further than you could do while trying to balance all three sports. There are countless examples like that one. What looks negative in your life that you can morph into an opportunity?

Update: Bad News, and more Bad News

Wednesday, June 8, 2016 - 14:30

I received this custom Tri Kit in the mail a couple of days ago. I LOVE IT! and can't wait to race in it, but yesterday I learned that I will not be racing Ironman Lake Placid. Many of you may have noticed that I did not race Raleigh 70.3 last weekend. I won't be racing Eagleman 70.3 this upcoming weekend either. My season is up in flames and I'm working on accepting the facts of my situation and choosing the best path forward.

As any of you who have listened to the podcast series about my journey to "go pro" on Endurance Planet will know, it started with what I thought was inflammation in my hip, but I've discovered that it's much more than that. The "hip" injury is actually a stress reaction in my right femoral head where it meets the femoral neck, according to an MRI I had done a couple of weeks ago. The good news is that it's not a stress fracture, but only a stress reaction, because I was smart enough to stop running on it when the pain appeared. The bad news is that the stress reaction is in a bad place, a place of tension, where weight that I apply to that leg tends to put more strain on the affected area which makes it susceptible to reinjury. In fact, if I continue to aggravate the area, I could actually kill the bone. I was put on crutches and immediately knew I would not be racing Raleigh 70.3 or Eagleman 70.3. I won't be running anytime soon, can only do light cycling, and can swim but can't push off the wall. In my meeting with Dr. Sylvia Hesse, a fantastic orthopedic doctor in Manhattan, I mentioned that I've had issues with low testosterone due to overtraining. Hmmmm...are the two linked?? I hadn't thought to ask that question, but Dr. Hesse did. She had me do a bone scan and the results were terrifying. I have osteopenia in my hips and osteoporosis in my spine. To summarize...Overtraining led to low testosterone, which over prolonged periods can lead to low bone density, which led to the stress reaction I have today. I'm a mess.

Yesterday, at a follow-up meeting with Dr. Hesse, she assessed my progress and didn't like it. I still have a subtle dull ache in my hip area on the right side, indicating that I'm still injured. I had been on crutches for 2 1/2 weeks already, but was told that I will be on them for another 2 weeks. I also won't be able to race Ironman Lake Placid. The risk is too high that I will reinjure myself, or even cause another injury somewhere else due to my low bone density. My health is the priority so I will be focusing on restoring it for the rest of 2016, and though the racing season is up in flames, I may be able to take a page out of the phoenix's book and rise from the ashes next year.

I will continue to blog and speak about the health issues - I want you all to know of the problems that endurance training can cause so you can be careful in your own training approach. Stay tuned for my blog about low testosterone, why it happens, and what you can (naturally) do about it. I'll use my own story as a case study so that you might prevent or repair your own issues with low testosterone. It's more common than you think.

Until I can get back to health again, the Tri Kit will hang in my room waiting for me to return.

Be healthy, and train happy.

Training Update Mid-February 2016

Wednesday, February 17, 2016 - 15:15

I'm finally firing on all cylinders! After having a bit of a rough start to 2016 due to little injuries pestering me like mosquitoes, and the lingering of my Achilles problem from last year, I'm now back in the groove. The patience I wrote about a couple of weeks ago is paying off as the injuries have subsided and I feel more resilient and injury-free than I've been since mid last season. Here is an example of what my training looks like nowadays:

Monday AM - Ride shorter, more intense intervals on the CompuTrainer at Tailwind Endurance for 1hr 15min. Do 30min of stability and plyometrics off the bike

Monday PM - OFF, maybe a massage

 

Tuesday AM - Run around 10 miles with Fartlek intervals in Summit, NJ

Tuesday PM - Swim a coach-prescribed set, around 1hr 15min at John Jay College in NYC

 

Wednesday AM - Ride longer intervals on the CompuTrainer at Tailwind Endurance for 1hr 30min. Do 15min of core work off the bike

Wednesday PM - See Doctor Todd for treatment

 

Thursday AM - OFF

Thursday midday - See Josh Grahlman in NYC for treatment and 1hr of strength conditioning

Thursday PM - Run around 10 miles with longer intervals on the West Side Highway path and Central Park in NYC

 

Friday AM - Run to the pool and Swim at Hoboken Masters for 1hr 15min

Friday PM - Spin an easy 1hr 15min at Tailwind Endurance, then roll, stretch, do yoga, or whatever else I find to be therapeutic and recovery-based

 

Saturday - "Long" Ride of 2hrs on the trainer, mainly drill, endurance and tempo-based, with a short run (~15min) off the bike

 

Sunday - "Long" Run of around 14 miles then Swim 2hrs at Berkeley Aquatics

 

That's 3 main runs, 3 swims, 4 rides, and 3 strength sessions per week totaling around 15 hours of training. My coach and I have found this to be a good balance of training that allows for enough recovery, and for me to always feel like I have "extra bandwidth" in my schedule (very important!). On Mondays, Wednesdays, and Fridays, I'm up before 5am so my wife and I are like old people because we go to bed at 9:30pm every night! Keep in mind, the above schedule is just one week during the base phase of training. Each week is a bit (or a lot) different depending on the time of the season, whether it's a "down week" or not, or whether I have life events that step in to remind me to be a "normal" person every once in a while. Consistency is king, but there should be some ebbing and flowing in your training too.

My swimming is just coming back into form after a month off due to some arm injuries (rookie mistakes), and my running is also just coming back after many torturous months of Achilles pain after Kona last year. Fortunately, I've been able to devote the extra energy to my cycling and strength work. I did an FTP test a few weeks ago (303w FTP) and am close to where I was the last time I tested back in March of last year (312w FTP). Normally, I dread FTP tests because they're so brutal! But this next one I'm kind of looking forward to because I want to see if I can exceed where I was last year in March, in February.

I just did my first Masters Swim meet ever! I swam the 100IM, 100 backstroke, the 50 backstroke as part of a 200 medley relay, the 200 free and the 50 free as part of the 200 free relay. I had a blast! I swam faster than expected given how little swimming I've done. You can see my Facebook page for more of a recap.

I'm also going to the wind tunnel next month! I'm stoked to see what kind of "free speed" I might find in that expensive hurricane chamber...

Even with all of this training, I still manage to do almost all of it alongside training partners - I love training with people! If anything here piques your interest, message me on Facebook or email me at matthew.j.bach@gmail.com, and maybe we can get together for a training session. Always happy to answer questions too!

Happy Training!

 

Patience

Tuesday, February 2, 2016 - 16:30

Patience is something that many preach, yet few have. Disclaimer: I'm going to preach it here, but don't always have it either!

It's so tough to be patient when you're injured because you just want to be doing what you love and be able to get better at it. Back in 2011, I had Achilles issues, then crashed my bike and had two sprained MCLs that resulted in knee pain. It was chronic. Months and months went by, I worked with two physical therapists and didn't see improvement. All the while, I was training through the pain because "it's the middle of the Tri season!" and "the NYC Marathon is just weeks away!" Big...patience...failure.

After 2 1/2 years of debilitating chronic knee and Achilles pain, I decided enough is enough. I devoted myself to getting better, working with a great physical therapist near my work in NYC named Josh Grahlman (who I still work with in addition to Dr. Todd - that's how much I value Chiropractic and Physical Therapy!). I did the assigned strength work religiously (mainly working on my glutes) and got treatment 2-3 times per week. At first, there were no noticeable results. I was frustrated but succeeded in remaining patient and diligent. Then after 3 months or so, all of a sudden the pain started going away and I could run without being laid up for days! Since then, I've been adamant about keeping a strength program part of my training regimen, and it has allowed me to train consistently for nearly 3 years now. The patience paid off.

Here I am again, having my patience tested. I've had a rough start to the year as I learned that the Achilles inflammation I suffered during Kona was not just inflammation but a partial tear. I tried running a few weeks after Kona and the pain was really bad, so I decided to lay off of it for a while and continue to have it treated by Dr. Todd. While I was eager to start up again, I remained patient by telling myself "you have a long season coming up but no races in the near future. TAKE IT EASY and use the opportunity to swim, bike and do strength work." I got back in the gym, and promptly failed to be patient, biting off more than I could chew with a workout that I have done before but not after months away from the gym. I have an impinged nerve and some angry tendons in my biceps and left arm from my neck down to my finger. Not good! What a rookie mistake I made! Now I'm trying to be patient again with my recovery. I was on a roll in the pool, swimming PRs and lots of yards, but then this happened and now I've gone three weeks without swimming more than a couple thousand yards total. Frustrating! But as I've learned, it's necessary for me to be patient now and heal up. The patience is bearing fruit though, as I'm nearly firing on all cylinders again. Just another week or two I hope!

Be patient! When you sustain chronic or acute injuries and let them linger, they are more likely to return later on. Nip them in the bud before they get too bad.

Question: when is it too bad?

It's hard to tell! You must either rely on the advice of others (ideal but difficult) or rely on your own hard-earned experience (not ideal because usually you get that experience only after making the mistakes yourself!) to know when a little niggle is a threat. I've always said "if I stopped training after every niggle, I'd never be training!" and while that's partly true, you must understand your own body and when you need to back off. I learned about my body the hard way in many cases, but am proud that I've also learned from other's mistakes and have heeded their wisdom. It's prevented me from sustaining even more injuries along the way, and recovery is tough. It requires patience!

Goosfraba :-)

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