Sunday, 23 December 2012

The 12 Turbo Sessions of Christmas

Mrs had a turbo for a while last year, and it was the least domestic-friendly thing I've ever encountered. Loud, pointy, heavy, loud, did I mention loud? It sounded like there was a helicopter in the house, there was no escaping the throbbing roar. We swapped it for some swim sessions with the coach I was working with at the time.

Fast forward 12 months, and given my ITB problem and inability to run for a while (more on that in a moment) I needed to up my cycling and I didn't feel like my low-intensity commute was really cutting the mustard.

Time to look for a turbo trainer again. I googled for "the quietest turbo trainer in the world" and this is what came up:

Elite Crono Fluid Elastogel

I took the plunge and got it from Wiggle.

I asked my coach, Joe Beer (twitter, website), for some turbo sessions and he sent me a set of 12 (actually, a set of 10, but session 9 has three variants). I thought a nice Christmas project to get my legs going around again would be to do one per day, starting today and finishing on January 3rd. Maybe I should have started 3 days ago?

Historically, every time I've announced an intention to do a training block in this blog, something has happened to scupper it. Let's hope I can keep to this one!

With regard to running, well I made the decision to quit running all together until next year. I've been religiously foam rolling, stretching, completing my asymmetrical exercises, and aqua running at Aqua Physio (excellent fun, much more than I was expecting). I still found though that 3x 5km per week was too much, and I didn't feel like I was letting the various exercises I was completing work to the best effect by continually stressing the area by running - it is an overuse injury after all. So I dropped to just 1x 5km parkrun for a couple of weeks, and then a couple of weeks ago after quite some ITB pain after a run I elected to cease running completely until next year. I think it's the right choice, and three weeks off completely, combined with the multiple angles of attack we worked out, I'm hoping to start next year in good shape.

On the plus side, it means I can get a few parkrun volunteer sessions done over the holiday period. I'd urge any parkrunners who find themselves injured to look towards volunteering - particularly if like me you very rarely ever volunteer normally (I think once, ever, until this injury!). It feels good to redress the balance.

Tuesday, 11 December 2012

Follow-up to: Why the insane Heart Rate suddenly?

This is a follow-up to my previous post, Why the insane Heart Rate suddenly? - you should read that first. It's OK, I'll wait...

I've had the same feedback from a couple of people now. Garmin HR sensors take some time to settle when you start using them, either as a result of needing to warm up a bit (get a bit "moist under the strap", as it were) to improve the contact or because of the static caused by a fresh clean dry technical t-shirt.

We've had our first tastes of cold winter air in the UK over the last few weeks. Cold air has a lower capacity to hold moisture, and when it's cold it'll take longer for your body to warm up and start to perspire. As I explained in my last post, I was making an effort to warm up very slowly in Brighton, and it took 20 minutes (twice as long as I've noticed before) for my heart rate measure to come down. I don't cycle in technical t-shirts and by the time I moved onto the brick run example I gave I'll have already been very well warmed up, and therefore no spike was evident. I run with a Garmin Forerunner 910XT.

So the question becomes - did my heart rate ever go up that high in the first place? I'm starting to think that maybe it didn't.

Firstly, thanks to Louise for showing me her Garmin plot featuring exactly the same thing up to a positively humming-birdesque 220bpm! Follow her parkrun and ultra exploits on twitter and on her blog.

2-hour run from Louise, with a phenomenal spike in the first 5 minutes

Finsbury parkrun, again from Louise, with a similarly extreme first 5 minutes

Secondly, thanks to Rob and Sam for their comments on my last post bringing my attention to the moistness/technical t-shirt behaviour.

Finally, thanks to Robbie C who shared the activity from his easy (for some, maybe!) run round Regent's Park which also shows a starting peak, though not quite as pronounced as Louise's or mine form the weekend. His run was on December 7th which was a cold day, so that might explain why it took longer to read accurately and drop down - 20 minutes, about the same as mine.

Run from Robbie C - I wonder if he knows he ran straight past my office twice? :)

I'm going up to Darlington this weekend to visit my Dad and take in a parkrun (I think we can be fairly sure it'll be cold there) - so I'll make sure I moisten my strap properly in advance and I won't wear a technical t-shirt - I have a very warm Nike base layer I can wear, plus a jumper or something.

I'm planning a hard run, so even if there is a peak it should be narrow as I'll warm up quickly. Let's see what happens...

Saturday, 8 December 2012

Why the insane Heart Rate suddenly?

In the last couple of weeks I've found that my heart rate has gone absolutely sky high in the first 10 minutes of a 5km run. I mean, really sky high. I'll start jogging and will feel absolutely fine and  breathing no harder than if I were sat on the sofa, but my HR has hit 170+ BPM, the kind of rate that should mean I'm sprinting, squat-jumping, or absolutely hammering it up a hill on my bike.

This is not normal. At Frimley Lodge parkrun last weekend I hit 190 BPM which is utterly insane given my peak HR is considered to be 192 BPM - I should be at near-maximum output to warrant that, not jogging along looking in alarm at my watch!

Saturday 1st December, Frimley Lodge parkrun

After 10 minutes it drifts down a bit, but is still very high. For jogging round a parkrun in 28 minutes I'd expect to be 125-135 BPM for most of the time.

Initially I suspected this was as a result of the Bulletproof Coffee I'd been having for breakfast - however there is another occurrence, this time in the evening. On Thursday I went for a run when I got home from work, unusually I hadn't cycle commuted so started the run from cold.

A 5km run after work on my local route

Similarly, I set off very slowly and suffered a huge spike in heart rate before it settled somewhat. Still higher than I would normally expect but closer.

This morning Mrs and I took a drive to Brighton & Hove parkrun. I had decided to warmup slowly, and then run at whatever pace was required to keep my heart rate in HR Zone 1, under 152 BPM. During the warmup I walked briskly with a heart rate of around 100 BPM as expected, but as soon as I took the first few slow jogging steps it rocket straight up to over 170 BPM, literally (and I mean literally) within 5-10 seconds. I've never seen anything like it. I stopped jogging after a few steps, and it came down just as quickly. I carried on in this fashion for 15 minutes, gradually able to jog very slowly for slightly longer each time.

Warmup, featuring ridiculous heart rate responses

For the run I decided there was no way I could stay in Zone 1, I'd have to walk round the course! Instead I set off very very slowly, and held a pace keeping my heart rate under observation.

So it did come down, eventually! A big step down after 10 minutes, before finally getting more normal after 20 minutes or so. Note that my speed was relatively constant throughout this variation. Is it all due to not warming up slowly enough?

After a very slow first km my pace was relatively constant

There's an interesting data point from earlier this week. I went for a 5km on my local route earlier in the week, but this time I had cycled home first. My commute home starts in the West End of London, and is therefore very slow for the first 15 minutes, and not much better after that being punctuated as it is by hundreds of sets of traffic lights.

This heart rate plot looks totally normal for a cycle commute, well within HR Zone 1 (under 152 BPM)

I took this as a brick session, meaning I got in, got changed as fast as I could, and ran out immediately. I was still thoroughly warmed up form the bike ride. I wanted to blow out some cobwebs, so this run was harder than many recent runs, and I completed the 5km in a little over 24 minutes. Still a couple of minutes outside my personal best, but fast enough to have to work hard - the upward drifting heart rate during the run validates that I was certainly working hard to maintain pace.

A faster 5km brick run on my local route

This shows that following a 45 minute low to medium intensity bike ride I don't experience the same spike. This graph is exactly how a hard 5km run always used to look, and just what I'd expect to see. No starting spike whatsoever.

So it looks like there are a few options:

  1. Warm up really very very slowly (so slow I can barely even jog!)
  2. Warm up with a bike ride every time I run (potentially impractical), or find some other way to warm up (drills? some squat jumps?)
  3. Warm up with a 15 minute jog ahead of the start of a run and just let any spike happen and pass - or if there's no time to warm up just accept that I have a huge heart rate spike at the outset of a run and jog through it, saving any harder effort for after 8-10 minutes

Maybe this is a side effect of a low carbohydrate and high fat diet? Why is it happening? My suspicion is that as my metabolism and fuelling has changed, there's some trigger which is not yet attuned to this physiological state.

My body goes "Right, get ready to exercise!" and everything plays according to the rules apart from my cardio-vascular system which for some reason thinks it needs to get a record amount of oxygen to my muscles, or the signal to say that it was already delivering enough is suppressed (fat metabolism takes more oxygen, but I wouldn't have thought that alone explains this).

So, why the insane heart rate suddenly?

Thursday, 6 December 2012

It just got (even more) real

I'm in! I hope you'll be tracking race number 22,280 on the big day!

Confirmation email

So Comrades Marathon entry confirmed, place on the Unogwaja Challenge team confirmed, ITBS feeling like it's on the mend (I'm sticking rigidly to the plan).

Suppose I'd better look into booking some flights!

Sunday, 2 December 2012

Recipe: Pork sausages with Courgette & Cauliflower purée

The purée is lovely, you don't have to have it with sausages, add whatever you like. It may work with a strong fish - it'll need to be able to stand up for itself though. You could add the vegetable stock back in and blend it into a soup. Next time I may add some garlic, or possibly a little chilli. This is definitely a recipe you can (and should) play with.

Per portion, recipe makes two

Ingredients (makes 2 portions)

For my delightfully simple but rewardingly scrumptious sausage with puréed vegetables you'll need roughly the following:

  • Two medium courgettes
  • A chunk of cauliflower
  • Six mushrooms
  • One vegetable stock cube
  • 20g salted butter 
  • Six sausages
  • Salt & pepper to taste


Get the sausages on first, they'll take longest. 35 minutes or so at 175C.

Now the sausages are in, add 250ml of water into a saucepan you have a lid for. Crumble the stock cube into it, drop all the vegetables in, and turn it on. The vegetables half boil and half steam. They'll take 10-15 minutes depending on how coarsely you've cut them. Nudge them about from time to time with a spoon.

When cooked, pour off the stock. Keep it in a bowl in case you need to add it to the purée to thin it out. Add the butter and season lightly. Use a blender with an attachment that isn't going to explode purée all over your kitchen.

Spoon the mixture onto the middle of a plate and place the sausages artistically onto the top. Job done!

The purée was runny enough without needing to add any of the vegetable stock I'd poured off... So we just drank it out of the bowl :)

The plate test

It looks like a success - Mrs virtually licked the plate clean!

Nutrition breakdown

For one portion, recipe makes two

Saturday, 1 December 2012

ITBS: A comprehensive plan of attack!

I put my cards on the table in a recent post regarding my knee pain. With (very) big aspirations for next year I need to go into 2013 fighting fit. So, here's what's been happening with my knee. My problem is a very common condition in endurance athletes so I'm hoping it'll be helpful for some of you - if not now, then in the future. Take note now, and you may even avoid an injury like mine.

First I went to see my GP - this is the right place to start in the majority of cases. She checked for obvious skeletal problems by wiggling my leg around and comparing my knees (it was probably more medical than that). I was anticipating a referral for some physio, but the GP had a good contact who specialises in problems like mine, so he was a good place to start. One referral letter later, and I was off to make an appointment at Wimbledon Parkside Hospital's knee clinic.

Wimbledon Parkside Hospital

A few days later I saw orthopaedic consultant Dr Peter Thompson - his wiry frame gave him away as quite the runner himself. After talking through my history and in particular when I started getting pain, we ran through a series of tests and examinations. He looked at my balance, symmetry, and general skeletal condition. He identified a very minor difference in leg length, left leg fractionally longer than right. Most people have little asymmetries and differences from left to right so there's nothing to worry about there. From everything I said, he said it was clearly identifiable as Iliotibial Band Syndrome (ITBS).

ITBS is an overuse injury. Once it starts it will cause a problem every time you do whatever it is that irritates the condition. With me that's running, and it comes on after 5-7km or thereabouts. Wikipedia's definition is:
ITBS is one of the leading causes of lateral knee pain in runners. The iliotibial band is a superficial thickening of tissue on the outside of the knee, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front while walking. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed.
Dr Thompson advised I get it checked by ultrasound to confirm his suspicions. I've never had an ultrasound before, it's normally a procedure I associate with pregnancy. In advance he said I should run until it hurts to ensure that any condition was clearly identifiable. I popped back a few days later having run 5km the night before, and a further 5km at lunchtime. The ultrasound revealed good news and bad news. The good news was that my knee was not pregnant (it's OK, panic over!). The bad news was that there was clearly a dark patch underneath the IT Band termination. This is the fat pad, and it was inflamed.

Back to see Dr Thompson and he verified his earlier ITBS diagnosis. He referred me to leading consultant physiotherapist, Ms Claire Robertson, and, following a look at my running style on a treadmill, a consultant orthotist named Gary Gordon (I'm really not a fan of sticking things in your shoes to address bio-mechanical problems, so it should be an interesting conversation!). We discussed if I should continue running, and if so how much. We settled on a rule of no more than three 5km runs per week between now and Christmas, with a slow (10% increase per week) build up if all is OK by then. Great news that I can carry on running a little bit and won't need to drop the parkrun obsession just yet. He also advised a strap to go round my lower thigh, this pushes down hard on the IT Band, lifting it slightly on each side and therefore easing some of the friction. Not a long term solution, but it can provide improved comfort whilst resolving the condition.

Diagram from here showing ITBS alongside PFPS (Patellofemoral Pain Syndrome)

My session with Ms Robertson was well above expectation. She's a keen runner who has suffered with ITBS herself and was eager to talk about my training, races, and injury in depth. Very quickly she identified the root cause.

She had me lie on my side and raise my left leg so my foot was about 18" above my right foot, left leg straight, right bent slightly at the knee for balance. Leaning on my ankle, she told me to resist as she tried to push my legs back together. I couldn't resist at all. She was amazed, apparently I should be able to resist easily, and keep my leg rock solid. We repeated the test with my left knee half bent where I resisted well but she could still move me, and then with my knee fully bent where finally I could resist entirely. I flipped over onto my left side and we repeated the test with my right leg. I was stunned when I could hold her full weight with no effort whatsoever, it didn't feel like she was pushing at all.

This, then, is the root cause of my ITBS. I have a very large imbalance in the strength of a specific area of my gluteal muscles, with the left side demonstrably weaker. This part of the glute helps give stability through the hips as you push off with each running step. Because my hip would drop to one side it was effectively pulling excessively on the top of the IT band, and causing it to become overly tensioned and rub. The rubbing leads to heat, and the defence mechanism for unwanted heat is to bring liquid to the area, and this is the inflammation that was so clear on the ultrasound. It doesn't help that both my IT bands are really tight anyway - a possible side effect of not stretching out after exercise.

The TFL shown here is where I have to focus my efforts (diagram from Wikipedia)

We worked out a comprehensive plan of attack - lots of little things that should help all focussing together. This was my advice, and I aim to follow it meticulously:

One: Avoid running through the pain. It's an overuse injury - there's nothing to be gained by "manning up", and it won't go away - it'll just hurt more, and take longer to recover.

Two: Ice massage after running. Use a single ice cube in a cloth applied directly to the area. You don't need a broad ice bag, it's only a specific point that needs treatment.

Three: Go and have a chat to Rob Turner - he's an expert at rehabilitation training after just this kind of injury and can advise on strength and conditioning.

Four: Go get a sports massage and get them to focus on my left IT band.

Five: Make friends with the foam roller (ouch!) starting with 3 minutes standing (applying pressure with my arms) and building up to 10 minutes of bodyweight twice per day and again before running. Not everyone agrees with this.

One of my cats, Dexter, demonstrating poor foam rolling technique (not for the first time)

Six: ITB stretches, 3x 20 seconds each, twice per day, and always after running. If pain comes on whilst running, can stop and stretch out like this too.

Static standing stretch, leaning on the wall

Seated stretch, when this gets easy twist from the torso to increase

Seven: Static glute exercise, left side only (need to address the imbalance), every other day. Stand on the stairs on left foot with right foot hanging over stair below, use banisters for balance. Slightly bend left knee. Drop right leg from the hip, then pull it up using the outside of the left glute. Stay aligned and don't twist. Start with 3x 12 reps, build up to 3x 20 reps.

Drop the right leg, lift back up from the outside of the glute on the left

Eight: Check out aqua running. This is something my coach has mentioned on many occasions, but I've never looked into it. AquaPhysio Ltd are down the road, so I'll try them out.

Nine: Wear the lower-leg band when running.

Leg strap (complete with foam roller chewing kitten caught in the act once again)

So there we go. I'm due a follow up in January. Let's see how it goes.