Category: Health

  • When Pain Isn’t the Price

    When Pain Isn’t the Price

    6 Warning Signs Athletes Shouldn’t Ignore

    Endurance athletes excel at suffering. We train ourselves to hold the pace when our legs burn, to finish the last interval, and to see discomfort as proof that we’re getting stronger. Most of the time, that toughness helps us.

    Sometimes, though, it lets us ignore real warnings for years.

    I know because I did. For almost twenty years, I treated pain as the cost of racing at the pointy end. I added strength work, ate more protein, trained harder, and planned my Advil and Tylenol around my workouts. It turned out I had severe osteoarthritis in my hips. My whole story is on Substack: The Smallest Space, Part 1. This post is the practical side: the warning signs I missed, so you don’t miss them too.

    1. Your recovery doesn’t look like everyone else’s

    Everyone is sore after a race. But if you routinely need help walking, can’t sit comfortably, or feel much worse than your training partners after the same effort, pay attention. Comparing yourself to others is usually a trap. Here it’s useful information.

    2. The pain shows up when you’re not training

    Pain after a hard session is expected. Pain that shows up at rest, wakes you up at night, or shows up on easy days means something has changed. Mine started showing up outside of racing years before I did anything about it.

    3. You need painkillers to train or sleep

    If you have rules for when you can take ibuprofen or acetaminophen so you can get through workouts or sleep, you’re managing symptoms instead of finding the cause. Talk to your doctor about any regular use of pain medication. 

    4. Your world is getting smaller

    This is the sign I most want you to catch, because it creeps up on you. You stop doing strides. You avoid hills. You drop sports that require quick cuts or changes of direction. You slow down and tell yourself it’s age or a training choice. Each change seems reasonable on its own. Together, they’re your body telling you something.

    5. You’re losing range of motion

    If stretching and mobility work stop helping, or a joint feels stuck no matter what you do, something structural may be going on that exercises can’t fix. 

    6. Other people notice before you do

    My friends and family finally had an intervention because I was walking differently. If someone who knows you says you’re limping, guarding, or moving strangely, don’t brush it off. They can see what you’ve gotten used to.

    What to do instead

    • See a sports medicine doctor, not just a therapist. Physical therapy is valuable, but if you aren’t improving, ask about a diagnosis and imaging.
    • Tell the whole story. Be honest about how long it’s been going on, how much medication you’re taking, and everything you’ve quietly given up.
    • Don’t wait for a breaking point.Getting answers earlier gives you more options.
    • Remember that a diagnosis isn’t an ending. My surgeon told me it was a new beginning. Knowing what’s wrong is what lets you get back to the sport you love.

    Toughness is one of an athlete’s best traits. But being tough isn’t the same as ignoring warnings, and the strongest thing you can do is get help.

    I’m a coach, not a doctor. This post shares my experience and is not medical advice. If something on this list sounds familiar, please talk to a qualified healthcare provider.

    Read the full story: The Smallest Space, Part 1: The Cost of the Pointy End

  • Training Now

    What is it like to train as a 58 year old woman?

    I have been in menopause just over a year. I take HRT and am experimenting with low dose Testosterone for a short block. HRT has been incredible at stopping my hot flashes which were occurring every 1-1.5 hours in my sleep. Testosterone is an attempt to help with joint and muscle pain. I haven’t felt much of a difference on it and may discontinue it in the New Year.

    My training now:

    • 90 to 120 minutes of aerobic training a day
    • 60′ of heavy strength training 3-4 days per week

    Typical week:

    • Monday: 90′ Zone 1-2 Cycling/60′ Heavy Upper body
    • Tuesday: 80′ run am/15′ SkiErg pm and either will contain some intensity
    • Wednesday: 90′ – 120′ Easy Run/60′ Heavy Upper body
    • Thursday: 80′ run/15′ SkiErg pm and either will contain some intensity/Heavy Lower Body with some mobility
    • Friday: 90′ Zone 1-2 Cycling/60′ Heavy Upper body
    • Saturday: Long run up to 120′
    • Sunday: 75′-90′ run/Optional afternoon cycling

    My running mileage is 35-50 miles a week depending upon the time of year. I walk 7-10K per day in addition to the steps I get running. Easy to do when your spouse loves to walk.

    My blood tests and blood pressure are excellent. My heart calcium scan was zero and my bone density is off the charts for a woman my age.

    I do take rest days as needed. Rest days happen with travel or if I notice my resting heart rate 5+bpm above normal. I do use HRV as part of the equation but only if there is a trend showing a decline.

    My nutrition includes a lot of protein (at least 100g per day) and almost no alcohol. I focus on eating veggies, fruits, meat and rice. There isn’t anything I will not eat but I tend to avoid anything fried.

    I prioritize sleep but am not obsessive. My sweet spot seems to be 7 hours with a natural wake up. I take a <45′ nap every day around lunch time.

    I was diagnosed a month ago with moderate to severe osteoarthritis and impingement in my hips. It may seem like I buried the lead but this hasn’t made a dramatic difference in my life. Pain is intermittent and low level. If the pain is noticeable, I may take a couple of Tylenol before a run. On days I don’t lift, I will take two Advil to help with sleep if I notice some muscle and joint pain. I am very careful with Advil and I don’t make it a habit.

    My surgeon who is an orthopedic hip preservation specialist was clear that without my training, I would be in a much worse position. I may need a hip replacement at some point but it is also possible that I may not. His advice was to keep doing what I am doing.

    And I am doing! I had a great time running a 13.1 mile race with my daughter in November. Winning may no longer be an option but my love of participation continues. And I plan on participating as long as I can.

    I am already making plans for what my life might look like if I can no longer run. More cycling, Pickleball, SkiErg, ElliptiGO and adding an ARC trainer to my home gym. Motion continues to be lotion.

    No Easy Way!

  • Cancer

    Like most of us, cancer has touched my life in innumerable ways. Fear of it, treatment for it and death. I have been a caretaker, a supportive family member and the grieving.

    Cancer is the reminder that we all die. Sometimes well and often horribly. What amazes me in these many journeys are the physicians. They are very smart, kind and willing to serve you on the journey where you are. And with some prodding, on the journey you should consider to be on.

    I reflect on there doctors do they meet our mortality every day and do their damn jobs in the best way possible. And sometimes, the best way is to help a patient acknowledge the end. I have sat in those conversations multiple times, and it is the most intimate interaction one has with another person. A moment of humanity and finality. We should all be privileged to have those moments.

    I don’t know if I will get cancer and I don’t know that I won’t get cancer. I do know that I will die. Maybe well but probably horribly. I remind myself frequently that today may be my last day. And in doing so, I remind myself to make the most of it. No easy way.