Monday, September 22, 2008

Restoration and 2009





I’m fully recovered from IM Placid and contemplating my plans for next year. As most can relate, it takes a full year to make a solid effort towards reaching your race goals (in addition to successfully signing up for an M-dot branded race!)



So, I thought I would share my thoughts on how I approached my recovery, planning for next year, and the 1st crucial stage in the process.

***

Following an Ironman, your body has been subjected to significant stress. Injury to your muscles, disruption of your normal hormonal balance, and depression of your immune system occurs. Before training again, ample time is necessary to recover from the event and avoid significant long-standing health issues.



The muscle tissue damage sustained on race day continues for a few days following the event. A period of secondary injury occurs the few days after the race and results in swelling and further cell damage. Evidence of cell damage is seen when laboratory work is performed. From an athlete’s standpoint, we feel sore, swollen, and stiff. This lasts for 2-4 days. After the initial injury phase, our muscle begin to repair themselves. By 7 days, most soreness is gone and muscle flexibility is restored. If one were to test a single effort muscle test, this effort would demonstrate pre-race results by 7 days but in no way indicates full recovery. The recovery during this period is governed by the restoration of calcium balance and the glucose transport system and is largely intact by around 14 days. However, the time required for full muscle recovery varies significantly and depends on several variables, the most important is likely the effect of pre-race training regimen. In any regard, there are studies that show decreased maximum torque and cellular changes as long as 4-6 weeks following the event.



The immune system is impaired and we are susceptible to upper respiratory (URI) and other infections following race day. There are reports of 25% of participants of long endurance events experiencing URI’s in the 2 weeks following the event.



Finally, my mood the few days following the event is quite elevated despite my tired physical state. This generally persists for the first 7-10 days and corresponds to the time when I begin to feel physically recovered. Soon after this time, usually around 3 weeks following the event, I find myself more irritable and a bit depressed.



So, how do I recover? The first few days are compression socks, ice, and gentle massage for the initial and secondary damage days. I use running as my gauge to return to physical activity in order to prevent any overzealous attempt at quick recovery. As this tends to be the most difficult activity to resume, I wait to raise my effort above a steady at any sport until I can run comfortably. My return to sport begins once my initial soreness resolves (usually around 5 days). An easy walk/jog and swim are my first workouts. I then will continue 30 min run/walk sessions for the first 2-3 weeks with an occasional bike and swim. However, I typically don’t feel fully recovered for 5-6 weeks. Until I can run comfortably downhill and assume a baseline run pace at an aerobic effort, I limit my rides to less than 2-3 hours.



***

So, I’m fully recovered according to my criteria. Though not fit, I could sustain extended, hard efforts in any sport. As I plan for the upcoming year, my initial focus will involve returning to a regular base of core strengthing, yoga/stretching, and weakness/injury rehab before attempting a committed return to aerobic base building. This “restorative” phase will allow me to build high frequency volume with less risk for overuse injury.

***

So, my race goals for next year are two-fold. The first is to continue on my quest for a fast(er) ironman run. The second will be to experience racing near the front in a smaller field. For now, I’m considering either a return to IM Brazil or a maiden voyage to my home state IM for the fast run. I need a little more recon to sort that out. For a smaller race, I’m considering the Silverman. The difficult course likely plays in my favor, as aerobic endurance is more a strength than high end speed. I may take the opportunity to preview the course in the upcoming race.



Enjoy your recovery or taper phase if heading to Kona,

J

4 comments:

Moogie said...

Jeff- Wow..I continue to be so impressed by you as I know that your long days and workouts are coupled with 10 12 hours surgeries.It has been great to find a way to stay in touch. You are profoundly missed. Just an update I finished both the rambling rose and the angels..and because I was the last one( and the big girl on the race) in for angels got a special escort by your friend Mick..what a guy. I am excited about this sport and although my goals are much different from yours (ie to be able to run a 5k with no walking and to really pick up on my swim time) I find you post inspirational and filled with food for thought. I have sent slide presentation to thank him and Brett for their incredible kindness-hope some time in the future you wan see it. So glad life is good for you..you deserve it.We will always feel forever lucky to have had your heart and hands treating our three.Laura

Gordo Byrn said...

Hey,

Are you willing to let EC.com use this article for Ironman Recovery?

g

BRFOOT said...

Jeff
I saw on Garmin-Chipoltes website that they have their riders using what we would call SCD's. Of course these are "special" ones for athletes but SCD's nonetheless. Ever tried one? Makes sense but I'm to cheap even to buy the compression socks/TED hose let alone a SCD machine. Just curious.
Bryan

Jeff Shilt, M.D. said...

Laura:

Thanks for the kind response. The opportunity to help out in a small way in comparison to the huge commitment you demonstrate to your kids is the reason "I do what I do". It is fun to watch from afar your progress with triathlon-I hope it provides you as much enjoyment as it does me.

G~man: of course, let me clean up and expand a bit. Lets talk further regarding your thoughts.

Bryan:
Haven't used the SCD's personally. Obviously they are standard in clinical practice and I use them all of the time there. I think there is a role if you need to expedite resolution of the "inflammatory phase" of an event which last 2-4 days following the race. This comes into play for bike stage races and if you were considering a "double" ala Chris McDonald.

For me, the compression socks are fantastic for plane trips prior to and following races. I use them after big days as well. I think they are useful in that regard. As as you know the dirty little secret, you can get them a lot cheaper at your pharmacy as TED hose.

Thanks,
J