My Darn Back

I finished all of the meds today and my back has stopped getting better.  I am about 80%, I have full range of motion but still have pain when I wake up or sit for too long.  THIS IS SOOOO FRUSTRATING!!..  Unlike other times I have been injured and improvement continues until I reach 100% this is frustrating.  I started gettting better and it just sort of stopped at he beginning of last week.  I am still only biking and swimming because those do not seem to make it any worse and as a matter of fact, biking actually makes it feel better....  weird

So, Dr. M won't be back until next Sunday.  If he doesn't think it will get worse or relapse, I can deal with it, add core work and running back in.  If he thinks my progress will slide I am sure he will want to inject the area directly with anti infammatory meds. Although not very appealing, at this point, I really don't care, I want it to get better and go back to pain free training. 

Ironman Coeur D'Alene is 21 weeks away (tick tock tick tock) I am definately feeling the pressure start to build with each day that passes that I am not able to train the way I feel like I should be training...  In the meantime, I am spending a lot of focused time on the trainer getting high quality workouts in and swimming.  I have also added some Yoga back in not that my friend Tiffany has allowed me to borrow some Yoga videos. 

Probably no more udpates this week unless something significant happens.  Until then, happy training.

Tracy Butler 

Just a quick update

I'm about 1/2 way through my anti-inflamatory meds and they seem to be helping.  I did a 2 hour bike ride yesterday (semi hard effort) and felt better after than before I started.  I did a little strength last night after my daughter's basketball game and I feel pretty good today.  I plan on taking the week off running but focusing on biking, swimming, and introducing some more core strength since that is my journey from back pain. 

Bike ride tonight after the kids go to bed with hopes of continued improvement.

All for now
Tracy

MRI is back well uh.... on my back

Can't remember if I have written about my back issue that I have been dealing with for about 2 months now and I am too lazy to read back through the blog to find out.  In a nutshell, I have messed up my lower back probably trying to do too much too soon in the weight room.  I have had lower back issues off in on in 2010 training for IMAZ but nothing that has kept me from training.  During the race, I had a flare up for the first half of the bike that was terribly painful.  Eventually it worked itself out and I stretched about every 5 to 10 miles and it helped.

Anyway, more recently I have been having problems between S1 and L5, basically this is where your pelvis joings your Lumbar.  Rest helps but as soon as I started feeling better, I would do somthing and have another flare up.  Really frustrating and with IMCDA in June it is something I don't want to mess with.  So, on my coaches advise I made an appointment with Dr. Anthony Margherita in Creve Coeur.  He was the doctor for Tour of Missouri Pro Cycling Race, numerous marathons and other cycling events.  He understands training and working with endurence athletes so I went to see him.

The Appointment:
- I got a feeling I was dealing with the right guy when I heard him and his resident revieiwing my chart out in the hallway.  He made the comment - "This guy is a triathlete, we need to make sure that we consider his training and races in his treatment"  Okay, I felt really good becuase he already understood my psychosis!  After asking me a bunch of questions, what I was training for, when was it, what was I doing now, what causes flare ups etc... He immediately sent me over for a Lumbar X-Ray.  45 minutes later I was back in his office and we were reviewing them.  He didn't see any structural damage but because of my training he stated he "wanted to be aggressive" rather than a shotgun approach.  Do whatever we needed to do to figure this out now and treat it now so I can get back on track in my training cycle. 

The Pre-Diagnosis
- Based on my symptoms he though that I may have a small rupture in my disc.  The way he explained it is that you discs are like Onions and Jelly filled donuts.  The exterior of the desk is layered like an onion and the middle of your disc (the nucleus) contains a "jelly" like substance.  In a rupture, something causes a hole to be blown through all of the layers and the "jelly" leaks out.  In my case, he didn't think I had a violent rupture but instead he thought that I may have a series of tears that have connected creating a path for the nuclear material to leak out.  Any impact like running, jumping etc... causes the leakage.  The nuclear material is highly inflamatory so when it leak it cuases pain and swelling in the muscles in the area along with swelling in the disc creating the pain I am feeling.  Unfortunately the only way to know is MRI.  I am all for dealing with facts to MRI it is.

The MRI
- My first one, it took 30 minutes, it was loud, it was me being jammed in a tube, it was unnerving but reassuring knowing this huge machine would produce the facts so I can get past this.  This was Tuesday Morning for my Doc appointment with Dr. M Tuesday afternoon.

The Results and Plan of Action
- Frist off, the images were amazing.  He stepped through the images working his way down my back until he got to the trouble spot.  Sure enough, the disc in question was protruding to the right side putting pressure on the sciatic nerves that run adjacent to it.  You could actualy see the disc on the nerve.  The great news is no strucutral damage and he felt this was a very treatable issue.

The Treatment:
- Heavy doses of oral steroids to get the infamation down.  If Ibuprofin is an anti-inflamatory - this stuff is 1000x that.  I am to take this stuff for 12 days.  I can still bike and swim because that does not affect me believe it or not.  No Running and No impact or core work.  I am to call his office every2 days with a report on if I am getting better.  If this doesn't work, I will then have to get injections.  Think of it as an epidural of sterioids to my spine... SWEEET!  I am on day two...  Keep your fingers crossed.

Moving Forward:
- After this is fixed, his advise is more core work.  Specifically obliques.  He pointed out that everything that I do is in a straight line - road running - straight line - cycling - my feet never get outside my pedals, swimming - limited rotation.  So, the plan once this is done is more core oblique work.  Absolute Fitness here I come.  I will add trail running as well.

When asked if this is a manifestation of the problems I had in 2010 he said most definately.  The fact I have ignored strength for endurance for the past 4 years is coming back to haunt me.  It is what I get for not listening to my coach. 

All for now, have a great week

Tracy

A note to my Tri Coach

Here is an email I sent to my coach following some analysis of two identical rides.  For the non technical out there, please ignore. For those of you that want to read more about this feature in WKO software you can read about it here:  http://support.trainingpeaks.com/trainingpeaks-wko/wko-user-guide/workout-data/quadrant-analysis.aspx

Here is my email to my coach - Jennifer Meyer at Tri Smart Training Systems.  Again, the goal is to improve and do so efficiently so we have emails go back and forth like this to validate her training plan or see where it need tweaked for my specific needs. 

Begin Message:

Since I did the Pierre Marquette climb repeats on Saturday I was curious if what a comparison of the last time I did it would look like. Take this for what it is worth – a neophyte trying to do complex analysis for the first time . In an effort to gauge progress or lack of it I did a quadrant analysis in Training peaks for my peak 60minutes (other below). I don’t know how to send that file to you or I would but this is how interpreted it. Please Please Please point out any errors in my thought process just because I am really new to this. Also, let me know if this is even a little bit helpful. I can see doing this on my “test” rides to look for changes if any since those should be the most alike than any other rides.




Below is my graph the Yellow is my ride on 9/16/2010 basically my peak for IMAZ training (or close to it)

The Red is my ride on Saturday

 Based on what I see, obviously both rides were lower cadence high power output based on 69.4% spent in quadrant II. I am not sure how to analyze the graphs but I can look at the averages.

My normalized power for my ride on 1/7 was approx. 22watts higher than when I did it the first time. My max power was higher as well (although meaning very little). My average HR was lower the first time I did it by 4 BPMS making me think that I was in better aerobic shape then (as I should have been). My higher maximum and higher minimum also make me believe this is the case.

In my rudimentary analysis what I was trying to see are power numbers and how they compare. Based on what I have seen, both files look pretty similar except for a couple of things.

1) I had more time in Q1 on Saturday – High Force and High Cadence which I think is good and ultimately the goal.

2) My raw power numbers are higher for my Peak 60 minutes. Not by a lot but still higher. With it being “strength” time I would hope that strength training will continue to help this. I want to do this workout a few more times to compare to see if my strength training is helping at all.

3) All things being equal, I near where I was in the past. My concern is that I have slipped way below what I was. Based on this very small “POWER” focused sampling it doesn’t appear so which is encouraging. I know I have a long way to go for CDA both in time and fitness however, it is not lost on me how bad of a training year last year.

The other thing that I did was look to see how “fresh” I was for each workout. Obviously this could make a big difference if I was fatigued either day. When looking at WKO my TSB on 9/16 was -24 and on Saturday it was -7 so from a fatigue stand point I was pretty fresh both days ruling that out as a significant factor.

Again, I am just thinking outloud here so please don’t waste any time on a deep dive or anything. I am just trying to make sure that my thinking is sound as I compare this run at IMCDA versus IMAZ. I want to do things smarter and these comparisons are helpful to see if what I am doing is making me a better cyclist (and hopefully runner). I do want to do more comparisons as I do similar workouts.

Thanks for humoring me and reading this. Any thoughts are appreciated but not expected. Below I have done the same thing for other ranges. It looks like I am generating more power across all the ranges looked at below. I will keep adding to this as I do these workouts and see if it keeps improving? I will also email you so that I have a log for the next time I do this (If there is a next time)

Tracy

Peak 30 Minutes

Peak 5 Minutes – You can see this is all climbing with very very little out of quadrant II. This climbes takes about 10 minutes to do.

Thanks and have a great week.

Tracy