Saturday, October 20, 2012

Traumatic Injuries vs Overuse Injures


Sports related injuries can generally be divided into two basic types of injuries, traumatic injuries and overuse injuries. Traumatic injuries, also known as acute injuries, are high energy forces that cause the breaking of bone and tearing of tendons and ligaments instantly. Causes of traumatic type injuries include falling, getting hit by someone or something, or proving something like hurling yourself off some cliff or ramp (you know who you are).
Traumatic injury potential.  Little Cottonwood Canyon, Utah, 2010. 
video
Hmmm..... Beaver Mtn. 2007

Traumatic injury potential. Porcupine Trail, Moab UT 2009.
Overuse injuries present over time. These injuries are more common and occur due to imbalance in the breakdown and remodeling of body tissues. The body is amazing at adapting to the many assaults that we put it through but can only adapt at a certain rate. No matter how hard we want to believe it, the phrase “The body can achieve what the mind can conceive” is only true given the proper amount of time for adaptation. Being able to distinguish between soreness, weakness, and injury will allow an athlete to push him/herself closer to their breaking point and over time raise the breaking point. Common overuse injuries include stress fractures and tendonitis.

Overuse injury potential. Gannett Peak WY, 42 mile car to car, 17hrs. 2010.
Overuse injury potential. Tetons WY, 2010
The most common and often most effective way of treating overuse injuries is to use the PRICE principle and NSAIDs. PRICE stands for Protect, Restrict Activity/Rest, Ice, Compress, and Elevate. Common NSAIDs, meaning non-steroidal anti-inflammatory drugs, include Ibuprofen, Advil, and Naprosyn.
Overuse injuries can be very frustrating because they can take a long time to heal. The best ways to prevent getting an overuse injury are:

·         -Ease into workout regimens. The “Weekend Warrior” mentality of being inactive all week and then going 100% on the weekend puts an individual at the greatest risk for problems.
·         -Correct form. Get instruction on correct form if needed. There are tons of options online on how to do just about anything if you don’t have a mentor or trainer.
·         -Use correct gear. You don’t need to go crazy but a good pair of well fitted shoes goes a long way, and gear is awesome and any excuse to buys some is always a good idea!
·        - Listen to your body. Pain is there for a reason. Be careful about toughing it out. 

If you are not having improvement with the use of PRICE therapy principles and NSAIDs after about 4-6 weeks more intensive diagnostic evaluation should be considered which include x-ray, MRI or bone scan. 


MRI
X-Ray
Bone Scan

Tuesday, October 16, 2012

Dick Collins Firetrail 50


Last New Year’s, Kimber and I sent out a holiday card to family and friends that had a few of our goals to be accomplished over the course of the year. We decided it would be a good way to hold ourselves accountable. One of my goals was to run 50 miles.

The Dick Collins Firetrail 50 mile race fit perfect with 7800ft elevation change that is 100% on trails along the East Bay ridgeline overlooking Oakland and San Francisco.



Training was to schedule until about 3 weeks before race day, when ankle pain convinced me to take 10 days off in an attempt to get it feeling perfect.  When I started running again, feeling good, two days later Kimber decided to give me the flu, sore throat, foggy head and all. So, I started the race with only 16miles on foot and about 60 miles on bike under my belt for the last three weeks. Luckily these three weeks were my tapper, meaning my training was supposed to decrease.  I was taking naps and gargling salt water up until the night before trying to get over being sick!

Start time was 6:30am and check-in before that. There were around 250 participants and we all packed in along the trail getting instructions and encouragement. Some people were decked out with all the latest backpacks, headlamps, arm and leg covers, hand-fitted water bottles and shmansy GPS watches. I kept it semi-simple with my trusty Brooks Pure Grit running shoes, basic running shorts, shirt, my nerdy visor, Suunto watch, MP3 player(loaded with medical lectures) and a phone strapped to my arm in case of emergency. It was chilly and seemed like they would never say “go”.

6:15am check in and number pickup. Stars were still out on the drive over. 

On the start I tried to just keep the same pace that I would if I were doing a long training run. But my “training run” pace had me passing the majority of the pack. Oh, well…I heard a couple talking before the race that they were going to keep a 13-15min/mile pace or something. Not acceptable. I felt a bit weaker than normal but, all considering, I felt pretty good for the first 26 miles. I got through about 2.5 General Medicine lectures as I ran, preparing for an upcoming exam. At about mile 23 the trail takes a 3 mile decent dropping roughly 1200ft to the turnaround point. I met Kimber and Richard Byler, my pacer, along with my requested two large Baja Blast Mountain Dews and a 5 Layer Bean Burritto from Taco Bell. My legs were pretty destroyed at that point.  I was to schedule, hitting mile 26 at 3hrs 45min.
Richard paced me in our power walk up the ridge line and for the next 11 miles. Aid Stations were available every 3-5miles and I had high times and low times. It helped a lot having someone to talk to and take my mind off the run.


Mile 26.

Me gusta Taco Bell!
Mmmm...5 layer burrito and Baja Blast.



Mile 37.
At 6hrs 20min, mile 37, I met Jeremy Koons and he paced me all the way to the finish.  Things got pretty difficult.  Luckily the majority of the last quarter of the route is downhill. Every slight hill often required me to kick down into power walk mode. At the last aid station (mile 45.5) I was on the verge of passing out swaying and stumbling as I was grabbing food from the huge table of random calories.  I remember being a little nervous when I saw the paramedic watching me, thinking he might pull me or make me stop. My energy sources at the beginning were mainly Gu power gels but near the end I was downing Coca Cola, oranges, grapes, bananas and mini PB&J.  It was hard to gauge how much I should be eating because I didn’t have much of an appetite but knew I needed fuel. It would have been helpful to get my blood work done there on the trail to know exactly what liquids and electrolytes I needed to make me feel good, not that it was an option.

Finish Line!! Mile 50! 
The last 4.5 miles were long. The trail went along Lake Chabot and every little roll was a challenge. I kept looking at my watch knowing that a sub 9hr finish was just within reach. I never told Jeremy how close we were though because I didn’t want him to push me harder than I already was going (I know, weak!).  At about 8hrs 58min I made the last push with all my effort and rounded the corner to the finish gate. 9hr 44sec! Sub 9hrs not to be had. I collapsed on the ground. 

Me and my pacers, Jermey Koons (L), Richard Byler (R)
The rest of the day left me with intermittent cramping of my calves, quads, hamstrings and abdominals.  While we were sitting there by the finish line you could just see the muscles in my legs twitching randomly almost looking like worms in there wiggling around. I got a massage that was excruciatingly painful but seemed to help.  I pounded a whole ton of food but should have stopped before the protein shake. Later that night Kimber described me as “vulnerable” as she helped me take an ice bath after vomiting all of the finish line food into the cammode.  Why do I do these things? Why not?

Their name, Monster Massage, fit them perfect. 

Got a free shirt and jacket out of the deal. Love the swag!
Final race stats:
·         50 miles
·         7800 ft elevation change
·         9hrs 44sec finish time
·         Placed 39th of 254 participants
Thanks Kimber, Richard and Jeremy for being my support crew!!!

**all photos compliments of my beautifully awesome wife Kimber.

Tuesday, October 9, 2012

Goals of this...

As the name implies, the plan for this blog is to create a place where I can share things concerning mountains and feet. For the "mountain" part I plan on sharing the more adventurous and challenging things that I have been up to.  

Like this.
Or this.
The "feet" part will include information pertaining to podiatry and medicine with the hopes that this blog can someday in the future be used as a tool to educate my patients on various foot related topics as well as allow them to get to know my "non-doctor" side. This won't be an issue until May 2014 however, as I won't be graduating until then, assuming everything goes as planned. 

Like this.

Or this.
I'm not sure exactly how this is going to go as this is a project that will require me to constantly be updating it, and spare time isn't really found to often in the life of Nate Hansen. Thanks for reading.