Sunday, November 8, 2009

Silverman 2010 & Camp Solitude

Last year I did the swim & bike at Silverman in an effort to recon the course for racing this year. As life would have it, didn't have my life in balance to put the training effort together to race the course like I wanted. So, my brother aka, Johnny Salsa, crazy johnny, quadjranch is racing the half ironman.

His buddy, Greg Petty, is tweeting live from the racecourse today. You can follow on quadjranch on twitter.

Hope everyone is enjoying the fall. I'm up in McCall today with my lovely wife working on Camp Solitude.


Friday, September 11, 2009

Final Gear Selection

There was a few changes prior to race day. The lower picture is the final race day gear in comparison to what I planned to use in the top picture. I will comment on a few things and leave some others for a different post.

My "secret weapon" was the pull buoy carved out to stuff our required gear and fashioned around our waist with a old tube. It worked brilliantly. I was able to store all of my necessary gear in the buoy-the cell phone or GPS unit, whistle and compass fit there without difficulty. I had tied the pull buoy tight enough that it didn't bounce when running at all and with one easy pull would fall into place between my legs for the swim. When I would stand up from the swim, it would pop back into place on its own. Seamless transitions in that regard.

There were a changes with a few items that we were on the fence about. The webbed gloves vs paddles debate literally continued up to race morning. However, the edge was given to the paddles b/c they were faster in my pool TT's and weren't as fatiguing. The fingertip paddles were the ideal size in that they were definitely faster, but not excessively tiresome. I ended the day without any huge issues from them at all. However, they weren't easy to transition and they were a real handicap getting in and out of the water. On the steep climbs immediately out of deep water required a lot of additional strength that I didn't really have. The gloves would have been nice to get that extra grab. My ideal solution would be to have thin neoprene gloves with finger paddles. I would add a carabiner to my tube to allow me to carry them on the long runs.

There are many things I would do different. Poor equipment choice alone cost us 30 minutes...very frustrating. More to come in my race report.

Now recovering and back to work,

Monday, September 7, 2009

Post Race O till O

8th Overall, 10:38

race report to follow.

Saturday, September 5, 2009

O till O Gear Selection

Last fall my brother called me after Jonas Colting had won and wrote his race report on a unique race called O till O. It was intriguing and Erin suggested that we go do the race to celebrate my brother’s 30th Birthday.

So, here we are. We’ve spent the past few months accruing run miles and swim yardage. My largest week included 70 miles of running and 25k of swimming, so nothing astronomical. Despite 5 months of base training, I biomechanically challenged myself that week. Fortunately all is well and we have no injuries to speak of.

One interesting aspect of the race is the lack of formal transition areas. Despite going from swim to run ( and one bike section) 40 times, you keep all of your gear with you every step of the way. People have tried many different solutions for gear, including kick boards, flippers, water-tight bags for shoes, etc. We’ve taken Jonas’ advice and decided to run in our wetsuit and swim with our tennis shoes and avoid any gear changes. This put heightened awareness upon our gear selection. We’ve spent a few sessions testing different combinations. What you see above is my final section, minus my “secret weapon”….I will disclose that after the race, depending on how well it works. A couple of choices you might find interesting…the Blue Seventy webbed gloves will serve dual function in warmth and providing a paddle effect. One of the test sessions I soaked 4 pairs of different shoes and then weighed them…the Zoots won, saving 2 pounds of dead weight. My shoulder hasn’t quite recovered enough to overcome the resistance of a sleeved wetsuit, so I’m going sleeveless. Infinit remains my nutrition of choice…no worries about the right mix of calories, electrolytes and sugary taste. The pic above contains nearly my entire race kit.

Hope the rest of you are enjoying your summer adventures. You can see mine live tomorrow by watching real time GPS updates online.


Friday, August 14, 2009

Poker Pacing II

Poker Pacing 100's

A few years ago, I wrote the basic approach I use to prepare for Ironman run training. I've been toying with a few different sessions that incorporate another key element of efficient running, high cadence, into these workouts.

Increasing cadence has significant benefits in reducing the biomechanical load of running. In turn, the increased cadence reduces the risk of overuse injuries. An improvement in this technical aspect alone can reap huge benefits for most runners in regard to recovery and preserving lower extremity health. In addition, it is much easer to increase foot speed and maintain that foot speed for greater duration during training runs and races. Increasing cadence any amount can be beneficial; the goal cadence is 92-94 strides per minute. You can calculate this by counting how many times one foot strikes the ground in 15 seconds and multiply by 4.

After one gets relatively skilled at poker pacing (negatively splitting) workouts, then the next element is to raise cadence. For this 10k workout, I recommend raising your cadence 6-8 foot strikes/minute. The first mile is done at a pace very slow, concentrating on raising the cadence substantially above your comfort zone. This requires moderate concentration...most people feel awkward in running with such a high cadence and slow pace. The goal is to maintain that cadence as you increase the pace 20-30 sec/mile, ending with a pace 30 sec greater thany your open 10k pace.

For example, my last 10k race was a trail run a few weeks back that I finished in 38:55, or around 6:15. So, my workout looked like this:

9:15 120
8:45 124
8:15 128
7:45 134
7:15 138
6:45 144

The goal is raising cadence while maintaining pace. If need be, slow down the pace to accomplish your goals.

Have fun and enjoy the workout.


Sunday, July 26, 2009

6 Week Countdown to Ö till Ö

My big event this year is Ö till Ö, a one day event that takes place on an archipelago off the coast of Stockholm, Sweden. I will be teaming up with my brother, commemorating his 30th birthday.

The challenge should be a good one, as our individual triathlon weaknesses are opposite, but yet both comprise the race. John, in relative terms, has been the slower runner. He has put in a really great running base this year since moving to Boise. We just completed a 3 week block with 54/57/60 miles running. We've included a variety of terrain, including some tough uphill sections in the Boise Foothills. This past week he surged towards the end of one of our 16 mile runs...I was certain he was going to blow up. Instead, he finished strong and was able to carry that effort to the finish.

Swimming has certainly been my "achilles tendon" in the past. After a bigger effort this past year, my swim times significantly improved. I was able to put down one of my faster swims with a good buddy of mine in SoCal, KP, this spring at the end of a 4k swim recording a low 14:xx effort. However, a re-injury of a chronic shoulder issue flared-up and I had a SLAP tear surgically repaired on 3/2/9. Since that time, it has been full-on with recovery and rehab. I was cleared to swim without restrictions at 4 months post-op, but had started kicking and drills a month before that. Though I have a ways to go to get back to sub 14:30, I've made significant gains in my 1000 TT efforts every week.

One of the fun component of the race is the multiple transitions and choosing appropriate gear. We've spent some time trialing some different gear options in some swim-run bricks, but we haven't chosen our final gear. More of that time to come in the upcoming weeks.

One other aspect of the race that is neat is the live tracking of the event. During the race, each team keeps a GPS which can be followed on line to track progress. Pretty cool.

Hope your summer training is going well.
Dr. J

Sunday, July 19, 2009

Stress Fractures

I've been fortunate enough to spend time with a great triathlete and good friend, Kate Bevilaqua the past few months. Fortunate for those of us in Boise, she chose to spend the Northern Hemisphere summer training here. The past several months have been filled with some unfortunate injuries, the most recent a inferior pubic rami stress fracture. With her permission, I've loaded her most recent x-ray on the bottom (right side, bottom of the "O ring" in the pelvis). Recently, I was forwarded another pro triathletes x-ray with a femoral neck stress fracture (upper xray...note the lucency in the superior part of the bone between the ball and the hip). I thought it might be worthwhile discussing the basics of stress fractures. In upcoming posts I will delve a bit further into more detail in the training aspects when returning from healing fractures. The bulk of this article was recently posted on Endurance Corner's Feature article at

Stress fractures are the result of repetitive biomechanical stress to bones which do not recover from that stress. Anyone may develop a stress fracture so long as the involved level of activity produces stress greater than the bone’s ability to resist it. The fracture occurs when repetitive activities produce nonpainful microfractures of bone trabeculi. If the collective stresses remains below a specific threshold (different for each individual) or if the athlete rests between episodes of stress, the microfractures will heal. On the other hand, if the athlete continues the offending activity the microfractures will increase to the point that pain will occur with activity. This is the first symptom of a stress fracture in most individuals, although some athletes may limp without complaining of pain. If the athlete heeds the pain and reduces the stress at this point, the fracture should heal without other treatment. If the athlete continues with the activity, the stress fracture will become more evident clinically and radiographically.

There are conditions that mimic stress fractures. Some conditions are the result of overuse, such as tendinitis or periostitis (inflammation of the periosteum surrounding the bone) and cause similar symptoms. In fact, these condition are likely an earlier finding along the continuum of overuse injury that leads to a stress fracture. Stress reactions, the term used to distinguish the earliest such findings, are accelerated remodeling with bone marrow or soft tissue inflammatory changes.

Rarely bone lesions can cause similar pain. The most common of these rare lesions is benign condition called an osteoid osteoma. The pain of an osteoid osteoma usually does not increase with activity, however. It will cause pain at times of both activity and inactivity, especially at night. Both lesions will produce periosteal reactive bone and cortical thickening. Even more rarely, certain malignant lesions can cause bone pain. Also rare, an area of subacute or chronic bone infection may simulate a stress fracture.

The diagnosis of a stress fracture can generally be made by the history of progressive pain following increasing training loads, accompanied by point tenderness of the affected bone at the point of the stress fracture. Stress fractures may present for diagnosis and treatment before the plain x-rays are abnormal, because radiographic changes frequently lag behind clinical symptoms by weeks. In individuals with symptoms of a stress fracture with normal radiographs, a bone scan or MRI will confirm the diagnosis. The longer the patient is symptomatic, the more evident the fracture becomes.

Some people more prone to the development of a stress fracture than others. Since stress fractures are the result of excessive stress, and abnormally angulated bones or extremities result in increased stresses delivered to bone, abnormal limb alignment increases the chance of development of a stress fracture. For example, an athlete with a varus deformity of the hindfoot (opposite of a flat foot) will place more stress than normal on the base of the fifth metatarsal, which may result in the development of a stress fracture of the proximal diaphysis of the fifth metatarsal (Jones fracture). Limb length discrepancies are likely risk factors as well. Hormonal abnormalities, specifically in females, increase the risk of stress fractures as well. Though beyond the scope of this article, new information suggests that ammenorrhea, when coupled with chronic energy deficit as the result of inadequate caloric intake and increased exercise, result in an increased combined risk of fracture.

Stress fractures in running athletes occur most commonly in the bones of the lower leg and foot. Their most common location is in the posterior medial aspect of the proximal tibia, but the 2nd metatarsal is also frequently seen. However, fractures of the spine, pelvis, hip, femur, tibia and foot have been reported. Though not well-documented, the location of stress fractures in triathletes is similar to runners, albeit, it seems to occur with a lower incidence.

The treatment of stress fractures is based upon by classifying them as either high-risk or low-risk for complicated outcomes. High-risk stress fractures occur in the superolateral femoral neck, anterior tibial shaft, tarsal navicular, proximal fifth metatarsal, and talar neck. These require immediate attention and often surgery.

Examples of low-risk stress fractures occur in the lateral malleolus, calcaneus, 2nd through 4th metatarsals, and the femoral shaft. The reason to differentiate the two is that the undertreatment of high-risk stress fractures can lead to completion of the fractures with disastrous outcomes. On the other hand, overtreatment of low-risk stress fractures can result in unnecessary deconditioning, prolonged immobilization, and subsequent increased fracture risk.

Daily supplementation with 2,000 Mg of calcium and 800 IU of vitamin D has been shown to decrease the risk of new stress fractures. This should certainly be entertained by those new to the sport or anticipating an increase in training load. If ammenorrheic, your physician will likely recommend an oral contraceptive to normalize hormone levels.

The return to regular training is highly individualized to both athlete and fracture location, but commonly takes 8-12 weeks at minimum. This return to activity should be closely monitored by a physician familiar with endurance sports medicine.

Best of luck with your summer training,
Dr. J

Saturday, March 14, 2009

Stretches for Running

Many of you might recognize the guy is a good buddy, Clas Bjorling. A few years back at an Epic Camp we attended, he shared with me his thoughts on stretching for performance and the prevention of injury. If a guy running 2:42 off the bike and sub 2:30 in an open marathon talks about running improvement, I tend to find utility. Here are my thoughts a few years later after treating myself and others.

I see (and experience) my share of overuse running injuries. The initial injury can be debilitating, but often the subsequent aches and pains are a result of a cascade effect from the initial injury/overuse/weakness. The offending injury then results in overload of other muscles, and their subsequent tightness.

Often times, treatment is directed at the source of pain. Many times we ignore the initial symptoms and initiate compensatory mechanisms that overload other muscles in an effort to protect the initially weak muscle.

Start with this simple routine...I find it useful for nearly all running related injuries. The emphasis of the flexibility program is directed towards the running core stabilizing muscles that can be tight. Relieving the tightness throughout the all of the running muscles is more effective than isolating the affected muscle alone.

These stretches are commonly found in most Yoga classes. And though typical Yoga classes are great, most of us are too fatigued to participate on a regular basis in the midst of heavy triathlon training. For this reason, I've collected a set of passive stretches that are very restful that you can complete without a lot of additional active work They really work best when you are really fatigued:

childs pose

down dog or bent knee calf stretches, leaning forward on hands

hero or lion pose

fire log pose

half lord of the fishes or sage

reclining big toe pose (use strap)

...sorry for the yoga terms; go to for pics of poses.

Hope this is helpful.

Dr. J

Wednesday, January 21, 2009

Bike Fit, Part II

I changed out the photo from the bike fit, part 1 blog.  I originally couldn't find my 2003 IM Brazil bike pic, which was my first ironman.  I finally found it and posted.  Take a look and compare to above.  Kind of fun.


On to the next step in the evolution of my bike fit. During my time in Boulder, I scheduled a bike fit with the guru at the Boulder Center for Sports Medicine, Andy Pruitt. He, along with Todd Carpenter ran me through their program.

After filling out a basic intake questionnaire, we discussed if I was interested in a performance or problem oriented fit. A performance fit would concentrate on improving power output through position changes. A rough estimate of the aerodynamic profile could be performed as well. The most aerodynamic position in which maximal power output can be obtained is eventually sought. Although comfort is not the primary outcome in this sort of fit, the position must be sustainable for the given distance. If the position is not sustainable, then a less aerodynamic position is used until it can be maintained for the race condition. This position should be measured in a real life situation and compared to the prior position.

In a problem oriented fit, a thorough biomechanical assessment is performed to determine underlying pathology. A physical exam was performed by a frontal and back coronal view to determine obvious pelvic obliquity and truncal imbalance. Flexibility was examined to determine any areas that might prevent a position otherwise prescribed a particular formula (more to come on next post). This included an exam of my neck, back, and lower extremities (hip flexor/hamstrings/ankles). A thorough physical exam, including a strength evaluation, was completed.

I chose the performance fit, as I had been able to ride my current position in a few ironmen with reasonable success (5:09 IM Brazil bike split).

We then headed in to the bike fit studio where my bike was already set up on the trainer by Todd Carpenter. Todd had studied at the Univ. of Colorado and had done some interesting work on aero position vs uncompromised comfort position on the effect of TT performance. In a nutshell, comfort wins.

I completed a baseline power exam on my the position I presented with (top picture). Then we applied the motion monitor markers (little glow balls on my body) and recorded kinematic data. Using this data, we made some adjustments in fit to gain the correct angles and range of motion during the spinning cycle. Adjustments were also made to my cleats to address knee tilt and avoid loss of power generation by movements that were not driving the leg directly into the pedal (tibia straight up and down like a piston as opposed to elliptical motion).

Though I was interested in improving performance, the changes we made were to improve comfort (bottom pic). I raised my handlebars in order to allow the upper back to reduce the amount of cervical lordosis required to look up the road. This, and the cleat positioning, composed the majority of change. We tested the second position with a similar power test, which resulted in a lower heart rate average for the same power output.

All in all, this was a great experience. It confirmed the fit I had tinkered on since my fit with David Greenfield was pretty good. The additions of cleat adjustment was great fine tuning. The biggest take home was that comfort, even for performance, nearly always trumps "intuitive" aero changes. My one disappointment was the inability to test different positions that might have increased power output, in addition to making the one position I had more economical. I may be splitting hairs and there may not be any difference. As you will see in part 3, I think you can take the comfort caveat and still have room for additional power improvements.

Tuesday, January 13, 2009

Evolution of my Bike Fit-Part 1

I thought it would be interesting to talk about the evolution of my bike fit as I start tinkering with my fit, as I usually do early in the season. It is a lengthy conversation and I will break it into 2 parts. The second will include some of my current thoughts on bike fit. Enjoy!

My first bike purchase was one that I bought one night while on call during my fellowship. I was waiting for a patient to be brought to the OR from the ER and was leafing through a cycling catalogue and came upon closeout deal on a Fuji Aloha. I was prompted to close the deal quickly as some of the Vanderbilt residents were going to do a triathlon and I wanted to do it as well. I’d never owned a bike and certainly knew nothing about an appropriate bike fit.

Typical for most closeout deals, there were only a few sizes left. The online operator convinced me that I would be fine with one of the remaining frame sizes, so I went with it. Nine frames, 3 cycling shop fits, one custom 3D fit and 9 ironman later, my expectations from a bike has evolved and is quite different than where I started. My bike needs started with concerns about comfort, skipped to looking good, moved on to desire to go fast and has now returned full circle to comfort.

How I would define comfort has changed as well. My early rides were simply limited by perineal (crotch) comfort. I suspect my early discomfort was simply a process of learning to ride and finding a position that accommodated the particulars of my build and flexibility. These early fits however, were the result of my own fiddling and left a tremendous room for improvement. I went from a bike too large to one that was too small, before abandoning TT bikes for a road bike.

With help from Ken’s Bike Shop, I was finally able to ride comfortably. I was able to finally spend more time on my bike by 2002 and I actually logged some consistent miles for the first time riding consistently 3 times/week. When it became spring time and triathlon season, I slapped a pair of aerobars on the bike and rode on. This set up served me reasonably well and I finished my first IM in Brazil in the following year.

By this time, I began getting more serious about triathlon and wanted to look like on of the guys on the cool TT bikes. After a bit of research I decided to go visit David Greenfield at Elite Bicyles in Philadelphia. After receiving the best customer service during a bike fit I’ve ever experienced (and a day in the life with Richie and the gang is a story I will never forget), I decided to purchase a Razor. His attention to detail during my fit to accommodate my flexibility (or lack thereof), yet reach a reasonably aero position was greatly appreciated. Through a combination of increased training volume, improved comfort and aerodynamics, and inspiration from my cool new bike I was able to return to IM Brazil 2 years later in 2005 and improve my bike time nearly 20 minutes, gaining my first Kona slot along the way.

Sunday, January 4, 2009

Winter Big Day Training

I have to admit that the past few years I've been envious of the Northern athletes that spent the off-season cross training by doing winter sports.  After our move to Boise, the Shilt household has been anxiously awaiting the first big snowfall to hit Bogus Basin.  Fortunately, we haven't been disappointed.  I was able to have my first Winter Big Day Training that included an hour swim, hour run, then 2 hours of skate skiing...well sort of.   Fortunately Erin was kind enough to circle back and give me a few tips & there were a few brief moments of Eureka! Needless to say, I don't think anyone attending Liberec in a month has anything to worry about.
A couple of things you might be interested in.

The first is that Gordo has re-invented his website.  The new site, Endurance Corner, is comprised of two components.  The basic platform, free to all, is comprised of all the articles and blogposts that he has authored over the past 10 years.  Also included are Alan Couzens's insightful blogs and the podcasts that Gordo and Justin Daerr have put together.  

There is a subscription component as well.  This will include unlimited access to Gordo and the rest of the Endurance Corner team on his forum and a customized coaching plan. 
The final note is about the last few remaining spots at our spring training camp in Tucson.  The training was outstanding last year and you can expect the same this year.  Unique this year will be daily lectures and case reports on Medicine and Endurance Sports.  For those in the health care field, you may be able to deduct a portion of the camp as a business expense.  (Of course, you should consult with your tax professional for your particular situation before making any tax or legal decisions!!!).  For those in the coaching business, there will be USAT coaching credits available as well.

I hope all is well and everyone is enjoying the new year as much as we are.