Friday, January 29, 2010

Ask the Coach Reminder

Free technical shirt and running hat if you submit a triathlon or duathlon related question to coachrich@triforit.com and the question is answered here.

Curious?  Check out our company website at triforit.com.

Thursday, January 28, 2010

Recovery from Swimmer's Shoulder

So you ignored all the advice regarding over training and proper form in the first post regarding swimmer's shoulder and now your shoulder hurts.  Or maybe you followed all the advice and your shoulder still hurts (it happens).  What do you do now?


My first recommendation is that you contact your physician.  If you are in the Twin Cities and don't have a sports med doc, I highly recommend Dr. Amy Stromwall with Summit Orthopedic.  She is a certified sports medicine family physician.  This means she doesn't do surgery but looks for non-surgical remedies.  If you need surgery one of her partners can perform it. She has worked with the U.S. Olympic swim team.  She understands the typical athletes' need to get back out there.  She's treated me for a variety of issues (including shoulder issues).

Prior to getting in to see your doc, you should rest and ice your shoulder.  This means discontinue swimming until your shoulder pain has resolved.  I know, I know . . . you've got a race coming up in X weeks, you can't stop now.  Listen to your body.  The pain is telling you something is wrong.  Pushing ahead now will worsen the problem and could result in surgery.  Missing one race is better than losing a whole season.  Ibuprofen also will help with the pain and inflammation.

So your shoulder has started feeling a bit better from the rest, ice and ibuprofen.  Now what?  Here are some shoulder exercises that can help strengthen your rotator cuff.  If you have a technique issue with your stroke you will need to address that as well.

I am not a physician (although I am married to one - and no she's not Dr. Stromwall).  I am not a physical therapist either.  I am not giving medical advice. These exercises are just typical rotator cuff strengthening exercises, similar to the ones I was given when I had a shoulder issue. 

Isometric Internal Rotation
Stand near the end of outer corner of wall.
Bend elbow to 90-degree angle and keep elbow close to body, lower arm level with floor.
Press palm of hand into wall for 10 seconds. Repeat exercise on other side.

Internal Rotation using Dumbbells
Lie on side.
Hold dumbbell on same side, Bend elbow to 90-degree angle. Keep elbow against body.
Slowly lift dumbbell upward and toward body.
Pause, and return to start.
Repeat 10 times. Repeat exercise on other side.

Internal Rotation using Resistance Band
Attach resistance band to doorknob / wall.
Stand with right side to wall.
Hold resistance band with right hand.
Bend elbow to 90-degree angle, hand facing frontward and elbow close to body.
Slowly rotate hand toward the middle of the body.
Return to starting position.
Repeat 10 times. Repeat exercise on other side

Isometric External Rotation
Stand with side to wall.
Bend elbow to 90-degree angle. Keep elbow close to body.
Press back of hand into wall for 10 seconds. Repeat exercise on other side

External Rotation using Dumbbells
Lie on left side.
With right arm, hold dumbbell next to body, elbow bent 90-degrees.
Slowly lift upward until back of hand faces backward.
Return to starting position.
Repeat 10 times. Repeat exercise on other side

External Rotation using Resistance Band
Attach resistance band to doorknob / wall.
Stand with left side to wall.
Hold resistance band with right hand.
Start with right hand in middle of body, elbow bent 90-degrees.
Slowly stretch band by moving arm outward until back of hand facing backward.
Do one set (10 repetitions) Repeat exercise on other side.

Lateral Raise using Dumbbell
Stand or sit in chair.
With arms at side and thumbs pointed upward, slowly raise arm to the sides but slightly toward the front (at about a 30 degree angle to the front of the body) until almost shoulder level.
Repeat 10 times.

Lying Lateral Raise using Dumbbell
Lie on left side. Hold dumbbell in right hand in, placed in front of thigh, palm facing leg. Keep elbow slightly bent. Raise dumbbell slowly until arm is at 45-degree angle.
Return to starting position.
Repeat 10 times. Repeat exercise on other side.

Lateral Raise with Internal Rotation using Dumbbell
Stand or sit.
With arms at side and thumbs pointed toward ground (shoulders internally rotated), slowly raise arm to the sides but slightly toward the front (at about a 30 degree angle to the front of the body) until almost shoulder level.
Repeat 10 times.

Saturday, January 23, 2010

How's that Resolution Working Out?


Just thought I'd check in and see how your New Year's Resolutions were panning out now that we're hitting the end of January.  Been skipping those workouts already, hitting the M&Ms by the handful (guilty), not getting enough sleep?

It's definitely not too late to start moving in the right direction in 2010.

Challenge yourself!  Pick a race, sign up (lots of them have registration open already) and start training.

If you don't know where to start, shoot an email to coachrich@triforit.com and I'll help you get on track.

Tuesday, January 19, 2010

Ask the Coach - Swimmer's Shoulder Prevention (Recovery to Follow)

Shaun J. from the Twin Cities asks "What's the best plan for recovering from and preventing swimmer's shoulder?"

That's a really timely question as a lot of triathletes are making their way back into the pool after taking some time off.  There's a real temptation to try and pick right up where you left off last season.  "I was swimming 2,500 - 3,000 in my workouts last year so I'll do that again."  Couple the inevitable loss of swim fitness and stroke degradation from the time off and it's a recipe for disaster.  That disaster has a name, and it is swimmer's shoulder.

Before we get to prevention and recovery, we should probably talk about what swimmer's shoulder is. 



Your shoulder joint is stabilized by a group of small muscles which together are called the rotator cuff.  The long head of the biceps tendon also helps stabilize the shoulder joint.  Swimmer's shoulder is the result of inflammation in these muscles and tendons from overuse. 




The inflammation and resulting shoulder instability can cause impingement (pinching) of the biceps tendon.

This pain is typically felt during the early to mid-pull part of the catch phase of the front crawl.  It can also occur during the adduction phase of the recovery (when the elbow moves away from the body).

Initially it presents as a dull ache during training which goes away after awhile.  Eventually the pain may persist and increase in intensity - impacting the athlete's sleep and non-swimming activities.

Prevention

Like most overuse injuries the best treatment is to avoid getting the malady in the first place.   The two root causes of swimmer's shoulder are increases in training volume and poor technique.   Too rapidly increasing your training volume requires the stabilizing muscles to continue to work in a fatigued state.  As you tire, your stroke technique tends to degrade requiring more strokes/lap which causes additional inflammation.

Avoiding excessive volume increases is the simpler of the root causes to eliminate.  The old standard of increasing no more than 10% per week applies to swim training as well as the bike and run.  This is particularly true when getting back in the water after a break.  Caution is advised.  There's plenty of time before the season starts.  That extra 5x100 with 5 seconds rest isn't going to make your season, but it could push you over the edge into over training and wreck your season.  Using hand paddles or gloves can quickly cause over training type fatigue in your shoulder and should be used judiciously.

Muscle imbalances also increase shoulder instability.  Triathletes are particularly susceptible to developing muscle imbalances since we focus almost exclusively on freestyle.  Maybe we throw in some breast stroke to warm up and cool down.  Adding some backstroke and even "gasp" butterfly will make you a more rounded swimmer and help prevent swimmer's shoulder.  It also will help prevent the dreaded freestyler's hunched posture - which the aero  position on the bike also contributes to.  The backstroke is a particularly effective stroke for catching your breath during a race. 

Poor technique is a harder cause to eliminate - but with proper guidance (dare I say coaching), patience and hard work, your stroke will improve.  Stroke issues that can cause impingement include hand crossing the mid-line of the body upon entry, having your thumb down upon entry, single sided breathing, and inadequate body rotation.

Many swimmers crossover upon entry.  Not only is this an inefficient stroke (it's like putting the brakes on every time your arm enters the water), but it puts greater stress on the shoulder joint.  One trick to avoid the crossover is to think of your arms tracking on parallel lines on each side of the black line on the bottom of the pool.  If you've been crossing over in past and now it feels like you're making the "Y" in YMCA, you're probably doing it right.

A thumb down hand entry causes great shoulder rotation and increases stress on the joint.  Focus on flattening your hand as it knifes into the water on entry.

Most of us have a favored side for breathing.  Some breath exclusively on that side.  This puts your other shoulder at risk as it must work harder balancing and maintaining forward motion while your head is turned.  Bilateral breathing spreads this load between both shoulders.  The best way to become a bilateral breather is to force yourself to breathe on your offside.  One of the drills I do every time I go to the pool is swim some 25s breathing only on my offside.  At first it felt really awkward.  With practice it gradually became more natural.

Body rotation is essential for efficient freestyle.  It utilizes core muscles rather than just pecs and lats to provide propulsion and puts less stress on the shoulder.   One drill to focus on this rotation and proper arm position is the fingertip drag drill.  Keeping your elbow high drag your fingertips along the water during your recovery.  This photo shows proper arm position with good body rotation.
 
In my next entry I'll discuss some recovery/treatment methods for dealing with swimmers' shoulder.

Thanks for the question Shaun!  Your hat is on its way.

Wednesday, January 13, 2010

The Tri Tops are in!


The new Tri For It! Coaching Garneau tri tops are in!  We're pretty excited with how they turned out.  Remember, you get one of these when you sign up for 6 months of coaching.  You also get one in your sixth month of month by month coaching or when you sign up for your second 3 months coaching.

Watch for Team Tri For It! at local triathlons starting this spring.

Tuesday, January 5, 2010

Answering the "What Should I Eat Today?" Question


In addition to asking "What should I do today?", athletes often wonder "What should I eat today?"  At TFI, we strive to answer both of those questions.

What you eat should vary with the duration and intensity of your workout(s) for that day.  There's a reason why you find yourself in the kitchen after a long ride eating everything in sight.  Your body needs fuel to repair itself and replace the energy stores you've used.  As long as you are careful about your choices (no, that whole 4 meat pizza is not a good post ride choice) you no longer need feel guilty about your post ride feeding frenzy.

We prepare macro-nutrient (carbohydrates, protein and fat) guidelines for our athletes taking into account their weight and training load.  Here's an example of one prepared for Coach Rich during the preparation (base) training cycle:



Once you get over the seemingly ridiculously high calorie amounts (one of the few advantages to weighing 100 kg),  you'll notice that only the carbohydrate values change based upon the training volume.   If the intensity or strength workload increased the protein intake would also increase.  These guidelines assume that weight maintenance is one of the athlete's goals.

With their macro-nutrient guidelines, the athlete can modify their food choices and volume to fit the guidelines.  Initially it does take some effort to track the carbs, protein and fat, but eventually it becomes easier.  The athlete begins to think about food as fuel for performance.