Taking Advice

A long-time friend was also diagnosed with breast cancer just a short time before me.  Linda is currently undergoing radiation treatments half way around the world in New Zealand. We’ve been communicating online about our experiences, feelings, treatment regimen and the like. This weekend she shared some realizations that have helped her. It was one of those “aha” moments for me.

“. . . . I was PO’ed because this cancer situation altered what I was doing in my life as well as what I ‘wanted’ to be doing . . . .  I needed to look closer at my current surroundings and note others had it far worse than I did. But my BIGGEST problem is/was . . . .  I cannot stand it when someone or something gets in my way of what “I” want to do and cancer was standing right in my way of life….. and there was nothing I could do except alter my norm. . . . “

So, there you go.  Those of you who know me understand how hard it is to accept this new norm on a daily basis.   I do accept it in the big picture but it doesn’t stop me from struggling and wrestling with the day to day details.   Despite some minor discomfort at times I still feel and look 100% heathy. I have had lots and lots of bloodwork done in addition to an echocardiogram, all results are great.  It is reassuring to know I’m starting from the best possible place as far as my condition goes. It is unsettling to know that the assault on my body to get rid of this cancer for good starts tomorrow.  IMG_3084

 

USAT Sprint National Championship 2015 – A Guest Post

Following is a guest post from Gail Warshaw, a friend and long-time member of the Jersey Girls StayStrong Multisport Club.  I loved reading Gail’s Facebook post, and since she doesn’t have a blog I wanted to share and save this for her.

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I’ve had a day to reflect on my experience at the USAT National Sprint Championships. When I got to packet pickup Friday, I looked around at all the very fit people and wondered what I was doing here. I convinced myself that they were doing the Olympic Distance on Saturday, while I was doing the Sprint on Sunday. But I saw plenty of red wrist bands, the color for the Sprint. Antje Hennings was by my side, telling me I’d be fine. We drive the bike course – I thought Lincoln Memorial Drive was the hill – but then we drove on 794 – and the bridge seemed to just keep going up – uh oh. On Saturday, we went back to the race site because I needed to rack my bike in transition the day before the race. There were some unbelievable Tri bikes there but I found my race number spot and racked my road bike. The good news for me and my non-existent sense of direction. My spot was in the second row and there were flags around the perimeter and my bike was across from a white flag so I had my landmarks to find my stuff when I came back from the swim & bike the next day. Race morning came. Antje told me to just think about swimming with my father and cycling with the Jersey Girls. And I asked “and running with you?” She made me laugh & relax telling me for the run, I was on my own. The swim started and I jumped in with the other women for a quick warm up as we swam from the warm up area to the start – nothing warm about it – 65 degrees is colder than it sounds. The gun went off and I started swimming – under the bridge, past the row of orange buoys, around the yellow buoys, keeping more orange buoys on my right and I can see the swim finish arch. Out of the water, up the ramp, and I start the run to transition. I hear Antje call me from where she was volunteering near the swim finish. Hearing her voice means the world to me. I can do this. I find my bike, peel off my wetsuit, get on my bike stuff and I’m off. Partway up the on Lincoln Memorial, the fog rolls in and I really can’t see very well. Oh, well. Top of the hill, turn around, back down and then start up the ramp to 794. Up & up and up. Plus more fog. I know why my nieces, Nancy Komisar and Dina Komisar Schachtely looked a little startled when I described the bike course. I reached the crest and still had gears left. Hurray! Oh wait – there is a turnaround and I need to go back up again. I passed a few women from my swim wave. I wasn’t fast but I just kept pedaling and before I know it, I’m at the bike dismount. Back to transition – bike shoes off – socks & running shoes on. I start to see a few more women from my swim wave. One foot in front of the other – just keep moving. I’m just about at the finish. I can see the finisher arch I had seen at packet pickup. This time, rather than from the distance, I was going to run through it – feeling triumphant. I hear music, and realize they are playing Pharrell’s “Happy”. The understatement of the weekend. I hear Antje call me. I get my FINISHER’s medal and a cold USAT towel. I run over to Antje, shout out “I did it”! And then I burst into tears. I arrived at the race site totally inhibited by the other racers – and we were racked in age groups so all the women around me were in their 60s like me, or late 50s. What a great group athletes. Many had raced in Nationals numerous times. I was a first timer. They were excited for me when they found that out. I was excited for my transition neighbors – some of whom placed in the age group, some achieved PRs, some doubled, doing back to back triathlons, racing both the Olympic and the Sprint. I finished the race toward the bottom of the age group and frankly toward the bottom of all the finishers but faster than I had expected. I finished incredibly proud of myself and my achievement. My sister, Barbara Warshaw Komisar, got to see me finish on the live stream. Thank you Antje, for saying I should register and we would drive out to my sister’s with my bike. As always, when you aren’t doing a duathlon when I do a triathlon, you are with me from the moment I take the first stroke in the water until I take the last step across the finish line. You are my everything and my reason for being.

Congratulations, Gail!
Congratulations, Gail!

A Few Of My (LEAST) Favorite Things

A guest post from my friend and fellow Jersey Girls StayStrong Multisport Club member and a physical therapist, Laura Fucci.

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The Jersey Girls Facebook page is often studded with posts regarding injury issues and discussions.   The year since I joined you impressive, inspiring women I haves culled a few of the most frequently debated topics.  I have been a PT for 23 years, specializing in orthopedics and sports medicine  as well as a full body certified Master Active Release Technique practitioner.   I worked the Lake Placid Ironman the last 4 years where I treated countless Iron folk and met many of you Jersey Girls!  A mediocre runner and triathlete since 2003, I also competed in regional and national level powerlifting back in the 80s and 90s.

Moira asked if I would address some common injuries and hopefully dispel some misconceptions.

Let’s start with my least favorite thing: ITB Syndrome

ANATOMY:

The Iliotibial Band is a tough fibrous piece of connective tissue. It originates along the iliathc crest (the boney lip of the side of your hip)  It splits into a superficial and deep layer. The ITB encloses the Tensor fascia Latae and connects with tendons of the the gluteus maximus.

It then inserts laterally on the knee on the femoral epicondyle and crossing the knee joint onto the tibia.

FUNCTION:

Supplies lateral stability to the knee.

WHY DOES IT HURT?

The ITB gets the blame for causing pain in runners and cyclists as well as other athletes. The ITB is wrongfully accused.  It merely does the bidding of the muscles with which it attaches. Dysfunction in your gluteus, TFL hip flexors or even your foot can cause the ITB to be pulled such that it compresses on the richly innervated  and vascularized fat underneath the strands anchoring it to the end of the femur.  There is even debate in the research community that no “bursitis” exists in ITB syndrome as evidence shows lack of bursa in cadavers studys

This leads us to my LEAST FAVORITE THING about ITB Syndrome.

I have patients and athletes who are forever rolling ,grinding and in general punishing their ITB.  The ITB is not composed of contractile tissue, therefore IT CANNOT BE STRETCHED. Stop rolling your ITBs.  It wont help.  If you happen to get your TFL, gluteues maximus and vastus lateralis/ITB junction in there -then you’re achieving a stretch which trickles down to some relief.

HOW DID THIS HAPPEN AND HOW CAN I GET RID OF IT?

In PT we have a saying about the cause of pain: “It is where it ain’t”.  A good evaluation will uncover where the muscle dysfunction might be.  PTs and Chiros can go on for hours discussing  all the possible causes of ITB syndrome.  In the interest of time and space here are just a few:

Lateral muscle tightness of the TFL, gluteus medius or even the quadratus lumborum (along your side attaching to the top of the hip) can cause a pulling on the ITB which in turns pulls lower down the chain to the insertion on the knee. Think of a rope caught in between a tug of war. The losing side here is at the knee.

Hip lateral rotator weakness:   Gluteus Maximus as well as some shorter hip rotators.  PTs are big on getting patients to activate and strengthen their glutes to normalize functional movement and decrease pain.

Hip flexor tightness: In particular is a muscle called the rectus femoris that crosses the hip and inserts on the knee and can contribute to a painful dysfunction

Pes planus or flat foot: Be careful here as not to mistake a stable flat foot with one that really pronates.  This over pronation and pull the tibia into internal rotation and cause pressure on the lateral knee. A good assessment can judge if there is a need for a new running shoes or orthotic

kneeling-hip-flexor-stretch

An Amazing Week – Women For Tri

I’m having a hard time formulating the words to describe the experience at Ironman HQ this past week, as part of the Women for Tri Board of Advisors.

We have been given an amazing mandate . . . how to grow our sport among women.  This is what I have been trying to do for several years, and the benefits for me and so may others have been more than I can describe.

My experiences since becoming part of this board have not been optimal — there is a rabid group that has been trying to hijack the mission of the board.  I don’t quit, but the constant bombardment at times has made me want to walk away.  My reasons for participating are not self-serving, I have no need to add my name to the record books, to headlines, or to “history”.  I want to grow women’s participation in a sport that has changed so much since I first decide to become a triathlete.  There are equal opportunities today for just as many women to enter any race they want to enter as there is for men.  There is equal access to training — we can swim bike and run as often as anyone else if we chose to.   When we have as many female professional and yes even age group triathletes as men in a race then the percent of women earning spots to Kona will be equal to the men.  It’s a privilege to be earned, not something that is just handed to any of us.

Work for it, and you will grow what you want handed to you now.  And then, you will have earned it.

If we grow the base of women in triathlon then the rest will follow.   And it will mean something, because we earned it on a level playing field.

Some of the board at our first meeting.
Some of the board at our first meeting.

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Just What Do All Those Letters and Certifications Mean, Anyway?

I’ve spent a lot of time, money and energy to earn the certifications that I have (USAT Level One Certified Triathlon Coach, Total Immersion Level Two Certified Coach).  While certifications do not make you an “expert”, education and experience certainly do.  I see lots of people promoting themselves as certified experts in various and sundry fields that are hot topics these days, not the least of which is nutrition.

Since I can only speak to nutrition from the standpoint of what has worked for me, I thought it best for me to ask an expert.  I’d like to thank one of my athletes, Club members and friends for agreeing to be a guest blogger, and I’d like to introduce you to Aimee Crant-Oksa, MS, RDN and the Clinical Nutrition Manager at Centrastate Medical Center.

In an effort to help us all get the best advice and guidance we can, I thought I’d ask Aimee to explain just what “nutrition” is all about.

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“Would you go to an non-credentialed doctor or nurse for medical advice or care?  Why would you do that for nutrition . . .  isn’t what you put into your body important? Think about that the next time you see the word nutritionist . . . where were they trained or what is their background/knowledge base?

There are three distinct nutrition credentials that require scientific training, an internship and college degrees, either bachelor’s (BS) or master’s (MS).

1.  Individuals with the RD or RDN (Registered Dietitian or Registered Dietitian Nutritionist) credential have fulfilled specific requirements, including having earned at least a bachelor’s degree (BS), (about half of RDs hold advanced degrees – MS or PhD), completed a supervised practice program of 900-1200 hours and passed a registration examination — in addition to maintaining continuing education requirements for recertification.

2.  The CNS (certified nutrition specialist) credential involves passing an exam, completing a 1,000 hour internship and obtaining an advanced nutrition degree – MS or higher.

3.  The CCN (certified clinical nutritionist) must obtain a 4 year degree, complete a 900 hour internship, have 50 hours post-graduate study in clinical nutrition, and pass an exam.

There are many less intensive paths ranging from the CNC (certified nutrition consultant) which requires completing only one course and the certified nutritionist (CN) credential which requires a six week course program.

RD/RDN’s learn to translate the science of nutrition into practical tips for your every day healthy living. Registered dietitians draw on their experience to develop a personalized nutrition plan for individuals of all ages. They are able to separate facts from fads and translate nutritional science into information you can use. A registered dietitian can put you on the path to a healthy weight, eating healthfully and reduce your risk of chronic disease.

Some RDNs may call themselves “nutritionists,” but not all nutritionists are registered dietitian nutritionists.  The “RDN” credential is a legally protected title that can only be used by practitioners who are authorized by the Commission on Dietetic Registration of the Academy of Nutrition and Dietetics.  The definition and requirements for the term “nutritionist” vary. Some states have licensure laws that define the range of practice for someone using the designation “nutritionist,” but in other states, virtually anyone can call him- or herself a “nutritionist” regardless of education or training.

So remember the next time you see the term “nutritionist”, don’t forget to ask just what their credentials are.”