Fear of Fat, My Journey To Self Acceptance

Until a few years ago, I was afraid of fat. And fat in two different ways. Fear that eating fat would make me fat, and fear of being fat. Both had a hold on me for over half of my life, quite a long time to let something hold you hostage.

My Fears

My first memories of my fear of being fat were at age 10. I have been a swimmer for almost my entire life, and 10 is when I remember looking at myself in a bathing suit, and realizing that I was bigger than the other swimmers.
(I’m the 6th from the left on the top row)
My arms and legs weren’t as different (well, my shoulders were), but my stomach stuck out and I was so painfully aware of it each time I put on a suit. I would try to suck in my stomach, just to look a bit thinner next to the other swimmers. At 10 I also started to notice what I put in my body, and if my stomach extended out after eating. I would feel bad about myself if when I looked down, my stomach stuck out a little. My parents fed us primarily healthy, non fried, non fast food meals. They did a good job at teaching us about healthy food. But still, I felt fatter then everyone else. I didn’t start to act on my disordered thoughts until later though.

Around age 12, I started to think about how much I should be eating, and starting to categorize food into good and bad categories. I began to associate what I ate and how much I trained in the pool and gym, to how I felt about myself. I wanted to be good, and I wanted to be thin and fast. Growing up in a half Italian family, we had a lot of cookies around the holidays. There were dozens of cookies, all different kinds and they were delicious. Going to my grandparents, I loved cookies and would sneak them and eat them, feeling bad about myself even more. Each time I ate something I deemed “bad,” it was as if I could feel the fat growing in my stomach and thighs.

As the years went on, and I became a better swimmer, I did lean up, but still, to me, my stomach was bigger then everyone else. Why, when I swam 12+ hours a week and spent several hours lifting weights (as a 12-17 year old) did I still have a stomach? I don’t think I was an over-exerciser then, it was truly how much I needed to do to be as good as I wanted. My body and feelings of being fat were something I could never understand, even as I entered college. Swimming at a Division 1 level had always been my dream. Well, the Olympics were actually the dream, but swimming Division 1 was one way to help me get there.

When I entered the program at Miami University, I wasn’t the fastest swimmer on the team, but I wasn’t the slowest either. I was determined to be the best swimmer that I could, no matter the cost. The first year of college was hard. A tough school academically, and a tough coach. Plus as all athletes know, coaches have different styles, and adjusting to a new style is hard. I didn’t have that great of a year and watched as another swimmer did. The coach would call out this person as someone to emulate, and as I watched her, she grew thinner and thinner. She was able to keep swimming, and doing quite well. So, I followed and began eating just a bit less. And then less, and less. Enough to swim, but enough to be noticed that I was thinner, and took it as praise.

Eventually I ate less and less until people started to comment that I was too thin and was made to go to an eating disorder group. The group was probably the worst place for a competitive athlete to be. If someone only ate this much, I was going to eat less. At the time, I knew what I was doing wasn’t great, but it felt good to be thin. And then, feeling like I was being forced to eat, I decided to start throwing up everything put in front of me. It was another challenge. At first, it was just a plate of food, but eventually it grew to where I would buy a loaf of bread, sneak into the bathroom, eat it and throw up. I knew this wasn’t normal, but I believed I would keep the calories out of my body if I could just throw them up. Bread, cookies and cake, all the sugary, terribly processed junk I could eat.

Being bulimic, your body does absorb some calories, and I put on enough weight to appear normal. My secretive binging and purging lasted throughout college. Upon graduation and moving home, I finally decided I didn’t want to spend my life looking into a toilet, a sink, a plastic bag or garbage bag and I sought help. I had been forced to see a counselor in college, but they didn’t really seem to help or care. Maybe because I didn’t want help and I didn’t care. I can’t even remember how I met my counselor in Victor, but thank goodness I did. She changed my life and helped me to see me as a beautiful, good person, no matter my size. I won’t lie and say that from that moment on, I was good to go, no more binging and purging. I had several more set backs. Including one of the real reasons we left Oregon and our business. The stress of not knowing whether we would have enough money to pay the bills and me not having any control over it, sent me into a downward spiral. I did seek treatment, but ultimately, selling our business was the only thing that would have saved me from me.

I believe that everything happens for a reason, whether it be good or bad. When I moved back to Rochester/Victor after college, I was in a bad way with my eating/bulimia. There was another person that helped me to see that I would be able to get through it. As I was just starting out in triathlon back in 2004, I met Mary Eggers, who herself was just starting out as a coach. When we met, she told me that she too had suffered with Bulimia and she had beaten it and look where she was. It was then that I knew I could beat it as well. It would take an additional 8 years but I did.

Meeting my husband also helped show me that I could be loved and thought beautiful by someone other than family.  He met me during a time when I was still bulimic; I was carrying a few extra pounds yet he thought I was beautiful. It was one of the reasons I knew I had a keeper. Here was someone who didn’t know that I used to be much thinner and I used to be a very fast swimmer. He just knew me as a more normal weight and someone who liked to exercise. He doesn’t always understand, as his struggle has been putting on weight, not taking it off. But we’ve been together for 6+ years, and tells me I’m beautiful every day.

Every day is a struggle, I won’t say it isn’t. Logically I know how others eat, but when I look at food, it’s still different. Maybe one day food will just be what gives me energy, instead of something I don’t trust. I’ve worked a lot on trust of myself and trust around food. And I’ve come far, which made this last year very hard being injured. In the past year, I’ve gained about 7 pounds. I’ve cut back on my food intake as I am literally not able to do any exercise but walking now. Still it’s not been enough, and I have to me ok with it. I have to be able to look at myself and say, you’re ok. You’re beautiful. I don’t want a relapse and I haven’t relapsed. Those 7 pounds will come off, I just have to be patient.

And something’s that very important for me to say is, I caused my anorexia/bulimia. It was no one’s fault but my own. I knew what I was doing was not healthy, and at that point, it didn’t matter. This blog wasn’t me asking for sympathy or to get attention. It is just one more piece of my puzzle, of my life that makes me, me. What I’ve gone through makes me who I am today, and makes me a better person and coach.

The Science

Ok, onto the science part of this blog. Like a lot of people, I always thought fat makes you fat. Even after graduating, having taken my nutrition classes, I still thought, fat’s bad. Every gram of fat, is 9 calories. This is unlike carbs and protein, which are 4 calories per gram. So, logically, you think, fat stores twice the calories, cut down in it. In fact, this is the opposite of what we should be doing. The real culprit for most of America is our sugar and processed food intake.

Let me back up and say, some fat is bad. These include hydrogenated oils, trans fats in processed foods, fried food, butter/lard/Crisco. I think most people know this. They don’t think their fried chicken, buttered biscuit and buttered mashed pototoes are healthy. At least I hope they don’t. Good fats are monounsaturated fats and omega 3 fatty acids. These include things like, olive oil, nuts, seeds, avocado and salmon/cold water fish. And yes, they have more calories than carbs or protein, but here is why we need to eat them.

“Good” Fats

• Reduce the risk of heart disease and stroke
• Maintain healthy skin and hair
• Transport fat soluble vitamins
• Reduce hypertension, ADHD
• Reduce depression
• Boost our immune system
• Protects the cellular membranes in our bodies, and help our brain to grow and develop
• Keeps us satiated, and for someone with an eating disorder, helps to keep us away from sugary sweets

The last point was the key one for me. My eating disorder counselor realized that I was eating too many sugary carbohydrates and not enough healthy fat. Once I reduced the amount of sugar in my diet (like those 100 calorie snacks of chocolate covered pretzels) and instead ate one square of 85% dark chocolate, my desire to eat the high sugar food went down.

While in Oregon I befriended a researcher doing additional research. They mapped the human brain and with MRI, and were able to show that when someone who is hooked on sugar, or overweight sees something sugary like cake, a certain part of their brain lights up. When they did the same test on someone addicted to cocaine, sees cocaine, the same part of the brain lit up. Meaning, that eating sugar, does in fact make us crave more sugar. I shouldn’t generalize and say this is true for everyone. This was just one study. But for me, I know this is true. I will continue to eat my good carbohydrates like vegetables, fruits and 100% whole grains. But, cutting down on sugar was key.

So, try to trade out a sugary snack, and in place try

• having more cold water fish like salmon at least 1-2x week
• adding seeds (flax, sunflower, chia, hemp) to things like oatmeal, and smoothies
• hummus with carrots
• olive oil instead of butter
• avocado as a snack

In addition, taking an Omega 3 fatty acid supplement can make sure that you are getting the correct amounts of omega 3’s. Before just going out to buy any supplement, check with your doctor as some omega 3’s have been known to interfere with drugs that affect blood clotting. Whenever you’re thinking of a supplement, a good rule is ask your doctor first. They can check that nothing you are currently taking or eating is harmful when taken together.

My saying that fat’s are ok, is not an acceptance for you to go out and eat as much cheesecake as you wish. You still have to keep your fat in check, preferably for endurance athletes around 30%. Think healthy fats first, but occasional treats like a piece of cheesecake is alright too.

The journey to accept myself and fat in foods isn’t over, but I’ve come a long way. I’ve realized that self acceptance is one tough thing but I’m going to keep working towards it till I get it.

Quinoa with Mushrooms, Leeks and Red Pepper

Since it’s still in the single digits in Baltimore, my body is still craving warm, comfort food. So tonight’s dinner was quinoa with sauteed vegetables. As a health food, quinoa is one of the best. Quinoa has been around for the past 3-4,000 years, primarily used in South America. Based on it’s looks, quinoa looks like a grain. But it’s actually considered to be a pseudo-grain, or a seed. It’s also gluten free, and you can easily substitute it for any recipe that calls for rice. Some other benefits of quinoa are:

• High in protein, and is a complete protein-perfect for vegetarians and vegans
• High in fiber
• High is phosphorus, magnesium and iron
• Quick to prepare, usually taking 15min only

You can mix quinoa with practically any vegetable, or even beans. Instead of rice and beans, try quinoa and beans. Delish. And my rule with meals is, the more veggies you can add, the better. Tonight I used mushrooms, leeks and red pepper. Leeks are not onions, but are similar in flavor. So, if you don’t have leeks on hand, or don’t want to experiment, you can use onions instead. Give them a shot, I think you’ll like them.

The other things that give this dish it’s flavors are garlic and white wine. If you don’t want to use white wine, substitute vegetable broth or chicken broth. To finish off the dish, I threw a handful of chopped walnuts on top. I originally found this recipe in Cooking Light and made modifications to better suit my needs.

After dinner, I often like to have a piece of dark chocolate. My favorite is Green and Blacks 85% dark chocolate. I just break off a small chunk, and then you have one chocolate bar for one week. You’re only taking in around 100 calories, but you are getting so many benefits. Dark chocolate for me is anything over 70%. I don’t know what the official percentage has to be, to be considered to be dark, but I like 70%. Dark chocolate is rich in flavanoids and can help lower insulin resistance, regulate your glucose, and lower your body’s inflammation which has been associated with diabetes and heart disease. For me, it also helps me to feel like I am getting a treat, which keeps me satisfied and not craving refined sugar. This positive info is not a free reign to eat as much dark chocolate as you would like. In large quantities, it’s still high in calories and fat.

The strange thing, is every time I have a piece of dark chocolate, I sneeze. It’s every single time. I finally learned what causes this. At first I thought I had an allergy, thank goodness I didn’t! What’s happening is called Autosomal dominant Compelling Helio-Ophthalmic Outburst sysdrome. Or, the acronym is ACHOO. Hysterical. What happens is similar to when someone sneezes when looking at the sun. That’s never happened to me before though. They don’t really understand why this happens, just that ACHOO  affects 18-35%. For me, I’ll just keep a tissue nearby when I eat dark chocolate

Quinoa with Mushrooms, Leeks and Red Pepper (serves 4 as a main serving)

• 2 cups low sodium chicken or vegetable broth
• 1 cup water
• 1.5 cups uncooked quinoa
• Olive oil
• 3 cloves of garlic, minced
• 2 leeks, thinly sliced
• 4 cups of mushrooms thinly sliced, or 2 packages of 8oz mushrooms- I like mixtures of shitake, portabello, button, etc.
• 1 red pepper chopped
• 1/4 cup white wine (always choose a wine that you can drink after, I like semi-dry)
• 1/2 cup chopped walnuts
• Black pepper, salt and parsley to taste

1. 1. In a medium saucepan, heat broth and water until it boils. Stir in quinoa. Cover, reduce heat to low and simmer 15 min or until liquid is absorbed. This might take a few minutes more or less, so check to see that there are “holes” in the quinoa mixture and water is absorbed. When it’s cooked, keep the lid on and set aside
2. Heat a saute pan to medium. Swirl olive oil around the pan and add the garlic and leeks. Cook for 5 minutes until soft.
3. Add red pepper and cook for 3 more minutes
4. Add mushrooms and wine and cook until mushrooms are tender
5. Season veggies with salt, pepper and parsley to taste
6. Place about 1 cup of quinoa in a bowl and top with another cup of mushroom mixture. Top with walnuts

Nutrition:

• 419kcal
• 55g carbohydrate
• 14g fat
• 16g protein
• 8g fiber

Banana Cranberry Muffins (Gluten Free)

We’re in the middle of a snow storm in Baltimore, and it’s the perfect time to bake muffins….Yup, nasty weather calls for comfort food. Muffins can definitely be comfort food. Although, when I bake, they are a healthy comfort food.

If we were in NY, this would seem like a typical day of wind and snow. But because we are in the Mid-Atlantic, all schools, universities and even the government is shut down. Normally Brett has to work at Charm City Run, but they closed early, so a day off for him too. The weatherman is calling for 6-12 inches of snow through tonight. If the wind wasn’t blowing so hard with up to 25mph gusts, it would be a great day to be out. The wind chill makes it feel like it’s in the teens, so just a little chilly. Taking Rogue to the bathroom and for a 20min walk is about it for today.

Since I’m still learning about how to do this whole blogging thing, I have to warn you, all of my recipes will not look that professional. I really do enjoy going to other websites and blogs and marveling in how beautiful their pictures are. They make their food preparation and then the presentation look glamorous. Unfortunately, for right now, you’ll only get basic pictures. Maybe one day I will purchase a nice camera to take beautiful pictures, but for now, it’s my Iphone.

Usually, I am not gluten free. Thankfully I don’t have an allergy, and gluten doesn’t give me any other GI issues. Occasionally however, I like to do mini cleanses, where I take out all potential allergens and re-set my body. Very similarly to the Whole30 nutrition plan. Also, gluten free things tend to be lower in carbohydrates and higher in fiber (not always true though). This recipe doesn’t use coconut flower, but it is one of my favorite flours to use as it’s low in carbohydrates and high in fiber. It’s a bit tricky to bake with though.

So instead, this recipe uses oat flour and almond flour, two other good gluten free flours. When I am trying to do a mini cleanse, I also cut refined sugar out of my diet. So here, I am using stevia, natural applesauce and bananas for added sweetener. It is also low in fat. I think this muffin is a good choice for someone looking for a comfort food, while needing to be gluten free and watching their added sugar intake. If you are not looking to watch your added sugar intake (why aren’t you?) and you are not gluten free, then this muffin might not taste like a traditional muffin (one loaded with fat and sugar). But to me, it is delicious, and won’t make you feel sick after eating it. A smear of sunbutter or nut butter on this would be good too.

Banana Cranberry Muffins- 12 regular muffins

• 1 cup fresh or frozen cranberries thawed
• 2 tbsp stevia
• 2 tbsp water
• 1 cup oat flour
• 1/2 almond flour
• 3/4 tsp baking soda
• 1/4 tsp salt
• 1 tbsp coconut oil or other oil
• 1 tbsp natural applesauce (no added sugar, just natural)
• 1/2 cup stevia
• 1 egg, plus 1 egg white
• 2 tsp vanilla
• 2-3 ripe bananas mashed
• optional-cinnamon, nutmeg, chocolate chips (I usually cut up a 70% chocolate bar), walnuts

1. Heat your oven to 350 degrees. Spray your muffin tins or use muffin liners.
2. In a small saucepan, cook the cranberries, stevia and water on medium high until the cranberries start to break down and pop. After the mixture boils, reduce the heat and cook for around 5 min. It will look a bit like the start of cranberry sauce. If you would like to keep the berries whole, sprinkle the berries with the stevia, and do not add the water and do not cook. Add as is to the batter later.
3. Combine first 4 ingredients- oat flout, almond flour, baking soda, salt
4. Combine next 5 ingredients- coconut oil, applesauce, stevia, vanilla and eggs
5. Gently mix the wet and dry ingredients together. Gently stir in the mashed bananas and the cranberries. If adding additional ingredients like chocolate or nuts, add here as well. Mixture should be lumpy, but thoroughly mixed.
6. Fill muffin tins 3/4 of the way full and bake for around 25 min. I always check sooner, just to make sure they aren’t burning. Plus, everyone’s ovens are just a bit different.
7. Cool on a wire rack and store covered. If not eaten within a few days, I would freeze them for later use

Best Exercise for Weight Loss?

In my last blog, we focused on how food can effect our metabolism, or the thermic effect of food (TEF). That makes up a very small percentage of the calories our bodies burn. Let’s talk about where a larger amount of calories are burned. This is key for anyone trying to lose weight.

Similar to TEF, the thermic effect of exercise is abbreviated as TEE. Any physical activity we do during our activities of daily living (dishes, washing our clothes, etc) will elevate our metabolic rate. Adding exercise on top of that, elevates it even more. How much does it elevate it? For the moderately active person, TEE amounts to about 15-30% of total caloric expenditure (how many calories were burned). For more active individuals like endurance athletes, TEE can account for 60% of our total caloric expenditure.

It turns out, certain sports produce a greater energy expenditure than others. Makes sense right? Cycling, swimming, rowing, running and body building rank higher than volleyball, handball, hockey and gymnastics. The first four of the highest ranking here are for the most part, endurance sports. The lower ranking are more likely team sports, where you are stopping and starting. Arguably the toughest endurance sport in the world, The Tour de France has a caloric breakdown like this:

• 22 days of riding covering over 4000km
• cyclists have a mean energy intake of around 5000+calories
• cyclists have a mean energy expenditure of around 6000+ calories
• the breakdown by macronutrients was 62% carb, 23% fat, 15% protein
• 50% of the total intake was taken on the bike (Saris et al 1989)

Even though the riders are taking in 5000 calories, they are always in an energy deficit. For most of us, even those of us that are considered crazy because we train 10-20 hours a week, this is a high caloric expenditure for one day.

So, how can we maximize our caloric expenditure, or how can we burn more calories in our training?

There are two main ways,  polar opposites from each other.

1. The first is longer, endurance training. And this training doesn’t have a very high rate of perceived exertion. It can be called intense, but just because the exercise is lasting for 60+ min (usually 90min). The intensity is only 60-80% of your Vo2 max, which corresponds to someones endurance or conversation pace.
2. The second way is by doing shorter intervals at a high intensity, closer to 90% of Vo2 max. The other term for this type of exercise is HIIT (high intensity interval training). Examples of this include olympic lifting, tabata, cross fit and others.

Why do these two types of exercise, increase our caloric expenditure? Yes, both types of exercise burn calories while an athlete is doing the particular exercise or sport, but it’s what happens after the exercise is done, that really matters. This is called EPOC, or Excess Post Exercise Oxygen Consumption. EPOC was originally called oxygen debt. Or the amount of oxygen consumed above baseline after exercise. Now, researchers use it to describe several factors that relate to the body returning to homeostasis, where it wants to be. These include replenishing our energy resources, re-oxygenation of the blood, cooling our bodies to normal temperature and returning heart rate and ventilation back to baseline. The total difference in calories burned after exercises with great EPOC range from 51kcal to 127kcal (Haltom et al 1999, Burleson et al 1998). This might not seem like a lot, but over time, can add up. This can be 306-762 extra calories burned if someone is exercising 6x week. And one pound of fat equals 3500 kcal, so you could be looking at losing approximately 1 pound of fat every month just from EPOC.

The goal of anyone trying to lose weight, or be in an energy deficit, should try to either up their exercise to moderate intensity for prolonged periods of 60+ min, or do shorter, more intense interval training. Both will increase you EPOC, and you will be burning more calories for a longer time. In addition to increasing your EPOC for a short window after exercise, a study by Bahr, 1992, showed that either types of exercise listed above, will elicit higher oxygen consumptions for up to 12 hours post exercise. This is even including when the person was resting. In addition, some endurance athletes that do two a day workouts, will chronically have an elevated metabolic rate. Pretty nice to not have to do anything else for 10 hours and you are still burning more calories.

When we as athletes are trying to lose weight, we need to focus on what types of foods we are putting into our bodies, and what types of exercise we are doing. Both can have a big impact on our weight loss. So, I’ll be eating more protein, and when I can exercise again, I’ll be doing more long endurance exercise and short HIIT.

Low Carb Diets for Weight Loss

This month, my IOC (International Olympic Committee) sports nutrition diploma class started. It will take me two years to complete the diploma, and will be even more qualified to give advice to athletes. As I progress through the course, I will bring you the latest in what’s happening in laboratory’s all across the world. In fact, my professors for this year come from Scotland and Australia mainly.

Low carbohydrate diets have gone through waves of popularity. There was Atkins, The Zone, the ketone diet, and many more versions. For almost all athletes, this is not the diet for you. Carbohydrates are our most efficient source of fuel, and what we should be focused on. I like my athletes to have diets in the range of 50-65% carb, 20-30% fat, and 15-20% protein. Low carb diets look like 10% carb, 55% protein and 35% fat. Or some variance of those ranges. Protein is not really a fuel source, and only about 4-5% of protein is used for fuel. So, looking up at the ranges above, and knowing that protein isn’t a great fuel source, let me say again, low carb diets are not the best for athletes looking at improving performance.

So, what does the latest research show? That low carb diets, or even lower carb diets, can be instrumental in promoting weight loss. Who am I talking about here, this is a blog for athletes? Well…..It’s people like me. An athlete who is currently injured and unable to exercise. It’s for someone who uses November and December to take off some weight. It’s not for someone swimming, cycling or running 5-20+ hours per week.
Let’s look at some of the data. All calories are not the same. This seems strange, but its true.
First, let’s go through some basic science. Some of this will be simplified, just in case there are some biochemists reading.  What is a Calorie: the amount of thermal energy required to raise one gram of water by 1 degree Celsius. Why does this matter? Everything we do during the day requires our body to produce heat, and we measure how many calories we need to take in, based on how much heat we produce. This is also called metabolic rate, or your Metabolism. We are producing heat, and thus require calories to do things like digest food, create urine, etc. When we digest food, your metabolism will be raised for a certain time period. This is called the Thermic Effect of Food. TEF, typically accounts for 10% of your daily calorie expenditure.Now lets look at how fats, carbs and proteins break down.

• Fats, or lipids, take about 2-3% of heat to breakdown.
• Carbohydrates take about 6-8% of heat to breakdown
• Proteins take about 25-30% of heat to breakdown

So, looking at these numbers, you can see that the more protein you eat, the more heat/energy it will require for your body to break it down, thus you are burning more calories. Also, protein helps with satiety, or keeping you feeling full.

Personally, I could never eat a diet composed of 10% carb to 55% protein. I love fruits and vegetables way too much to be able to cut that far down. I try to eat like a vegetarian, and a large quantity of meat or eggs isn’t appealing. There are other sources of protein, but to be eating 55% protein, you will most likely need to eat some meat. Applying this practically to me, I can choose higher protein foods, to replace higher carb foods. Instead of maybe carrots and humus for a snack, I could have some plain non-fat greek yogurt or low-fat cottage cheese instead. A simple and still healthy switch. My ratio might look like 40/30/30 which is closer to the Zone diet.

Remember, just because high protein food is good for you when losing weight, that does not mean high fat/high protein food is what you should be eating. Things like cheeseburgers and sausage are reserved for special occasions. And for those in heavier periods of endurance exercise, just try to eat at least 20g of high quality protein with every meal.

Another topic for later is, the Thermic Effect of Exercise. This is how with exercise we are raising our metabolism, and how long and how hard we should be going for. More another day.

LSD, a good or bad thing?

It’s that time of year specifically, as a coach, my athletes might start to question me. They have planned out their upcoming triathlon or running season, and they are ready to hit the ground running (literally). And what do  I do as a coach, I slow them down, at least on the run. My approach to cycling and swimming are not quite the same, and I do incorporate a lot more intensity with those. In fact, you could say my running approach to my cycling/swimming approach are polar opposites. And there’s good reason, which I’ll explain more about below.

LSD, or long slow distance has gotten a bad rap in the last few years. I actually don’t even use the term LSD, as when you say it, it sounds like you aren’t working hard, just that you are going slow. And no one wants to go slow. Instead, I use terms like conversation pace, easy pace, aerobic pace, or long run pace. This pace is one that you don’t even need your Garmin for. He’s an example.

Runner 1: Hi……How…..Are…..You……Doing…..

Runner 2: Hi, how are you doing. The weather’s perfect for a run, isn’t it.

Which one seems more like a conversation, runner 2 of course. Runner 1 is having a hard time talking, they are more likely closer to anaerobic pace. So, while running, you don’t even need to look at your watch to know that you are going easy, or at a conversation pace. So, why is it important to go at a conversation pace while running, especially in your base building months.

• You are training your body to more efficient at using fat as a fuel. The more you can rely on fat, the less you need to rely on stored carbohydrates, thus sparing your glycogen (carb) stores for future use.
• You are increasing your body’s number of mitochondria, which is where aerobic metabolism occurs
• You are strengthening your muscles and letting your tendons and ligaments adapt to the added stress. This will help to prevent injuries down the line.
• This will help a runner to be able to handle more monotonous events from a mental standpoint . If you are always doing sprints, intervals, etc. you won’t be able to handle the longer monotonous events.

Another way I like to explain it is, think of your training like a house. Your runs done in an aerobic nature, or conversation pace, are building the foundation of your house. Without a foundation, the house could fall. If someone is running 10-15 miles per week, and they are running intervals, they don’t have enough foundation laid, and they are more likely to get injured. My rule is that in order to begin anything incorporating lactate threshold, a runner needs to have been running 20 miles per week, holding a conversation pace. Another statistic is that, at all times, runners should be doing 75% of their runs at a conversation pace. At 20mpw, 15 will be at a conversation pace, 5 can be at a faster pace. As triathletes, we have less time to run, but I still use the same science. If someone isn’t running 20mpw, adding more miles will not add more benefit, then adding speed.

So why are cycling and swimming different? When you swim and cycle, you should still have days that you go easy. You can go for a friendly (no drop) ride, an active recovery cycle or swim, or for a casual long open water swim. The same principles apply as above. The main benefit is teaching your body to utilize fat as fuel though.

Cycling and swimming do not need as much adaptation time to build the ligaments and tendons. You have a much smaller risk for injury. You can swim and ride several days a week at intensity. In fact, my athletes do. The only caveat to this is, for novice athletes just starting, injured athletes coming back, or athletes coming back after taking a hiatus. Those athletes will still start with slower base building rides/swims.

For most of us who live in the northern hemisphere, this time of year is cold, snowy or rainy. Most of our training is done inside on the trainer. If we work LSD on the bike now, that means we are spending hours on the bike. And most people can’t handle more than 2, maybe 3 hours on the bike. Then, as spring and summer come, you are meant to pick up your speed on the bike. If your long ride was 2 hours at a relatively easy pace, and 2 hours isn’t long, that means you will need to be building speed and distance. My belief is that, you can safely build speed over the winter, working more anaerobic zones, and then, build into distance come spring. And on top of that, you are going to be faster than before. Swimming is similar in that, you can always be working intensity through intervals in the winter. Come spring, open water will help to increase your endurance, and you will be faster.

I want to mention not everyone coaches the same. There are some programs that teach speed and intensity for all disciplines during the winter and others that teach LSD for all disciplines. Not every way of training works for every single person. You just need to find out what works best for you and give it a try.

Hearty Minestrone Soup

It’s been very cold and snowy the past few weeks here in Baltimore, and now it’s cold and raining. Cold and rain equals soup for me. I’ve made a lot of soup recently, and this time my husband requested a soup with macaroni. Since I am injured, I have been trying to cut down on non fruit and veggie carbs. Since the last soup was only vegetables and beans, this one is vegetables, beans and macaroni. This soup is also packed with healthy carbohydrates, protein, fiber and vitamins with all of the added veggies.  Yummy and warms the body and soul.

Hearty Minestrone Soup (Serves 6)

• Olive Oil- 2 swirls around the pan
• 3 cloves of garlic, minced
• 1 onion chopped
• 2 cups chopped carrots
• 1 cup chopped celery
• 2x 14.5 oz Italian stewed tomatoes
• 1x 14.5 oz can low sodium cannelloni beans
• 1x 14.5 oz can low sodium kidney beans
• 4 cups low sodium chicken or vegetable broth or 2 cups of water and 2 cups of broth (to lessen the sodium)
• 1 cup uncooked whole wheat elbow macaroni
• 2 cups green beans in 2 inch pieces
• 2 cups spinach
• 1/4 cup parmesan cheese divided (use less, or more, as desired)
• Pepper, Italian seasoning to taste

Saute garlic, onion, carrots and celery in olive oil for 5 min on medium heat.
Add cans of stewed tomatoes, broth and macaroni and bring to a boil.
Reduce heat to medium and cook for 15 minutes.
Add the green beans, spinach and 1/8 cup of parmesan and cook for an additional 15 min on low to medium.
If desired, add fresh ground pepper, Italian seasoning and the other 1/8 cup of parmesan cheese

Nutrition:

• 395kcal
• 68g carbohydrate
• 7g fat
• 20g protein
• 13g fiber

Part 2: A lesson in patience and perseverance

*Disclaimer:  This is a blog that deals with the science of racing, training, recovery, etc.  There are pics in this post taken during the procedure where you can see part of my bra strap, and partial glute*

I wish I could start part 2 of this blog with “I’m all healed and ready to go.” I’m not there yet. Hopefully I will be soon though.

I was very nervous for my first meeting with Dr. Ibrahim, what if he couldn’t help me either? But the minute I met him, he said “I think I know what’s going on, and I can help.” Even if he didn’t really, the confidence in what he said was exactly what I needed to hear. He did a quick exam, and wheeled over the ultrasound cart. I pointed to the area that caused the most pain, and he put the sound head (the part that goes on your body) on my hamstring/glute. In about 3 seconds he said, “I see it, you have a torn hamstring that’s pressing on the sciatic nerve.” I couldn’t believe it. In the past year, not one person could give me a definitive diagnosis, and he saw my problem in 3 seconds. I cried with relief. It turns out, MRI’s can miss 30% of all tears. And my tear was in such a position, that it wasn’t visible.

Dr. Ibrahim told me that with his ultra sound, he wanted to do a series of PRP injections. And these injections  would re-start my healing process, and heal the torn hamstring. Let me explain what PRP is, as it’s still mostly unknown. PRP stands for platelet rich plasma. The process goes like this. You have your own blood drawn (I believe it was a 50cc syringe), then the blood is centrifuged for 15min. The centrifuge separates the plasma and red blood cells. The platelet rich plasma is then injected (using an ultrasound to guide, or unguided) into the injury. The injection lasts for only a matter of seconds. It is incredibly painful, almost like bee sting magnified. One other thing about PRP injections. They are not covered by insurance and can range from $300-1500 dollars each. Most people receive 1-3 injections, so it’s not a cheap procedure.

After the injection, you are good to go home and resume normal activities of daily living, not exercise just yet. I have received two PRP injections from Dr. Ibrahim, the second one this past Tuesday the 7th. I am approximately 48 hours post injection, and they pain is moderate. After my first injection, I felt fairly good for the first 24 hours. By 48 hours I would barely walk. And for the first two weeks post injection, I had trouble walking, sitting, driving and sleeping. In fact, after my first injection in December, I was supposed to do an event in Fredericksburg, VA. With traffic, it’s approximately a 3 hour drive. About one hour in, the pain was so intense that I was having trouble driving as I couldn’t see clearly! I had to pull over, stand for a bit, then drive home. If you decide to get a PRP injection, make sure the first week post injection, you don’t have to drive for an extended period of time, or have to sit for a lengthy time without standing. Remember, they will inject a large amount of fluid back into an injured area, causing more swelling and initial pain to the injury. This was my case at least. I did read another athlete’s blog that said after the first week they started exercising again. That is definitely not the same for me.

So here I am approximately two days post 2nd injection. I’m not sure if I will need a third injection, but if I do, I will get it. I have spent thousands of dollars on medical bills this past year, but if the PRP injections work, then it is worth it. If you have an injury, but maybe it’s not as severe, or maybe you just can’t swing the cost of PRP, there is another procedure called prolotherapy. Prolotherapy is also used to regenerate and heal tissues, tendons and ligaments. Typically, a dextrose, or sugar solution is injected into the body, rather than your own blood. These procedures are much less expensive, and I have heard good things about them too. Dr. Ibrahim also does prolotherapy, and other non surgical procedures. I have met many sports doctors in the past 15 years, and by far, Dr. Ibrahim tops them all. Not only does he sit at your level (not standing over you or across the room), he listens with compassion. He didn’t have to, but he heard the desperation in my voice and got me an appointment much sooner than his secretary had said. And because he is so good, his schedule is crazy. He also asks his secretary to fit me in, no matter what. I am not a Washington Redskins player, or DC United soccer player, I am just a triathlete who wants to race again. If you are injured and find yourself in the DC area, he is the first person I would see.

If after the 2nd injection, my hamstring is healed, I will be able to start exercising in February. I am trying to not get anxious about this, but I am so ready to begin again. This year, when I can begin again, I will focus on my overall strength. And by strength, I mean small stabilizer muscles and core, then what you would think of traditional strength. Then, once I know I am strong enough, I will begin training again. I hope to be able to do some 5ks and 10ks, and sprint and olympic tri’s. It will be a long cry from IM or Leadman 250, but at least I will be training and racing again. I might be much slower than I was, and it might take the next year to rebuild my endurance and speed, but that’s ok, I can and will do it.

Part 1: A lesson in patience and perseverance

The past year I’ve kept my hamstring injury a secret from most people. Even those close to me didn’t know how much pain I was in and how much I was suffering emotionally. This blog post feels like a bit like therapy in the fact that all of my negative emotions regarding the injury have been bottled in for so long, and this feels like a release.

Before I start my story, I want to say, that there are so many terrible things in the world today. I have a wonderful family that cares about me, a good job that pays my bills, a warm house to live in, and for the most part, I am physically fine. When I think that I could have cancer, or be out on the streets, or any number of other terrible things, my problem seems trivial. But, I am an athlete. I define myself in many ways–wife, doggy-mother, someone who loves to cook, but being an athlete is right up near the top. When you aren’t able to do what you love, what you feel makes you, you, it’s hard. And when it goes on for months and eventually beyond a year, with doctors telling you that you are a medical mystery and can’t be helped, it feels like your world is collapsing.

I love to bike, and I love to work hard on the bike. One afternoon I was doing a threshold workout (near 100% of max) and I felt this strange sharp pain in my glute area. I immediately soft pedaled and stopped. I thought I had strained my hamstring as I had warmup up properly, done several gradual builds to 100% of my power, and then started the workout. What else could it be, I was properly prepared?  At home I iced, took advil, and took several days off of intense exercise.

Being an injury prone athlete, I spoke with a PT friend who said, yes you strained it, take a few days off. It seemed to get better with the rest and ice, but the pain never really went away. At this time, I was in the middle of selling my triathlon shop in Oregon, and moving across country to start my PowerBar job. So, training took a back seat and I figured the strain would heal and when I was settled in the Mid-Atlantic, I would be good to go. Unfortunately, that wasn’t the case.

Waiting 90 days for my insurance to kick in was tough. So, I went and did some ART (Active Release) as it wasn’t covered by insurance anyway. It didn’t seem to help either. Then, I tried acupuncture. Interesting, but also no help. Then, it was massage and Graston. Still no relief. Thankfully, my insurance began, and I contacted a PT that was recommended. I thought, this is it, I am going to be healed and back to working out. He was nice, and immediately gave me a diagnosis of ischial tuberosity bursitis. I spent several weeks treating that with dry needling, massage and Graston. Things weren’t getting better, so his colleague said she thought it was an adductor strain. After several weeks of that, they decided it was no, back to ischial tuberosity bursitis.

Then came the diagnosis of high hamstring tendonopathy. Then, it was a QL issue in my back. By this time, the pain had gotten worse, and migrated down my leg. It felt like someone was stabbing me in the butt, and then shooting a pain down my leg…constantly. So, then it was an MRI to rule out a spinal issue. Then, it was another MRI to look at my hip. 3 more doctors and PT’s later, plus a cortisone shot, I was in the same place, only worse.

When a doctor tells you that they have done everything they can to help you, that they’ve reached the end of what medical science can diagnose, it feels like your world is caving in on you. At least it did to me. How could no athlete have suffered a similar injury and recovered? I was just an athlete in pain, right? So, I reached out for help again and was referred to another orthopedist. He and his colleague both spent several weeks doing tests, and once again another MRI. All the MRI’s were clear, but I was still in so much pain. So, then I was referred to a nerve specialist who believed I had a damaged nerve. We did nerve gliding exercises and yes, they did help. But, maybe only 20%. During this entire time (up to 9 months at this point), I was only able to walk for exercise. And not a fast walk, that was too excruciating. And I’m sure you’re thinking, you’re a swimmer, why didn’t you swim. I couldn’t kick as that hurt too much. So, then I pulled, but that holding the pull buoy between my legs engaged the hamstring and hurt. So then, I just dragged my feet behind me as I swam. And eventually, the doctors told me to just stop that too.

The next doctor I was referred to said surgery. But, it would be exploratory surgery as they still didn’t know what was wrong. That doctor thought piriformis tear. Surgery just as a way to look inside didn’t seem like a smart idea.

I think the desperation showed on my face. Every doctor I talked to gave me a bit of hope, then failed to provide any relief. After the first few doctors, I didn’t want to give up hope, but I didn’t want to put myself emotionally out there to be told that no, they didn’t know what was wrong. That was the pattern for a year. I hope this doesn’t sound like complaining as I don’t mean it as such. But, I almost had to take a hiatus from Facebook. Every time someone posted about a great workout, a great race, I felt like someone had punched me. If only I could have known what was wrong, I could have made my plan to heal. With every new doctor, my hopes faded just a bit. I know life isn’t fair, and everyone has battles they have to endure, yet I didn’t care. I just wanted to be better. To know what it felt like to run, to jump, even to do burpees. One year of nothing other than walking is incredibly hard. I kept trying to tell myself, that at least I could walk. But, that didn’t really help, I was really just feeling sorry for myself.

My stress relief has always been exercise. And without exercise I had no outlet. It made me hard to live with, as I couldn’t show my fear, frustration, anxiety or hopelessness to anyone at work or relieve it through exercise. My job is putting on events, races and clinics with PowerBar. I believe I did just over 100 events last year. Part of my job is working out and racing with my stores. I had to explain, week after week that I was injured and didn’t know what was wrong, so I couldn’t participate. That grew old very fast. I made all sorts of promises to God if I could just get better. I know how crazy that sounds; I am not dying. I can still function almost like everyone else and I shouldn’t be so dramatic. But being at the end of my rope, I would have tried anything. ANYTHING.

And just as I thought, I am never getting back to the old me, I was told about one last doctor who might be able to help. His name was Dr. Victor Ibrahim, and was located in DC. His specialty was ultra sound guided PRP (platelet rich plasma) injections.  Thankfully, I managed to get an appointment even though he can have up to a 4 month wait.

And I’ll stop there. Part 2, will continue tomorrow, with pictures!

Why Fueled and Focused?

Being fueled and focused are two things every athlete needs for success.

Fuel: what our bodies need to power ourselves through workouts and races. Think of your body as a machine or a car. You need to fuel it with gas in order for it to go. And when it gets low on fuel/gas, or empty, it will slow down and eventually stop. Our bodies are the same way. We need to give ourselves fuel (mainly carbohydrates & fats) in order for our bodies to continue to run and run well.

Fuel for your body is both your everyday nutrition, and your sports nutrition. If you eat a terrible diet during the day, you aren’t providing  your body with optimum fuel. You might start a workout feeling sluggish, or feel like you’re dragging throughout the day. If you focus on what you are consuming during the day, then you will start your workouts and races primed for success.

I’m going to have a lot of suggestions for you on good nutrition, but my first one will be to clean up the “junk” in your everyday diet. Look in your cupboards and fridge. How many things are highly processed? If you can swap one thing during the day for a whole food/vegetable, you are on the right track. Let’s say you grab a bag of chips, pretzels or cookies during the work day, instead, put those down and grab an apple, pear or carrots with hummus. Instead of the higher calories, saturated fat, added sugar and low vitamins, you are getting lower calories, lower saturated fat, natural sugar, higher fiber and more vitamins. The popular Whole 30 diet is a good example of how to clean up your diet. Mary Eggers is blogging about her Whole 30 journey if you need some encouragement and recipes. Click here to follow her. If you aren’t ready to take that big of a leap, just start with one thing at a time.

Focus: having a clear, defined path to achieve success.

“A goal without a plan is just a wish”- Saint-Exupery. 

There is a athletic curve that goes something like this. A beginner athlete often lacks focus. They just need to get out and do their desired sport and they will get better. This is like a runner or triathlete that is just starting off. They don’t have a focused plan, they just go out and swim, bike and run. At first, they will get better. Then, once they have mastered some success, they plateau. In order for them to get better, they need a structured plan, often given by a coach or following an online program. Then, they will continue to achieve, until they plateau, then the plan with need to change again.

So, how do you go about creating a focused plan of attack and setting the goals to get there. In my opinion, a goal needs to be three things. Realistic, Measureable and Personal. I would love to be an Olympic triathlete, but is this realistic. Unfortunately no. Or, I want to be a fast runner. That might be realistic, but is it measurable. What’s fast? I want to beat my husband in our next tri. Is that about me or more about beating him?

So, how about some goals like this.

I would like to better my PR at the half iron distance from a 5:45, to a 5:30. This is realistic, measurable and about me.

Once you have come up with several goals for the season (3-4 is a good start) and you have made sure they qualify based on the three rules, you are ready to plan your attack. But that is another topic.