Dr John M

cardiac electrophysiologist, cyclist, learner

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Do I exercise too much?

April 18, 2010 By Dr John

They have the look.  Their faces are chiseled; the cheekbones are easily visible because the body is devoid of fat.  Their eyes speak fatigue.

They are not refugees.

Have they been stricken with a calorie-eating tapeworm?

No.

They are middle-aged physicians conversing in the doctors lounge.  I see them pulling up their scrub bottoms to compare lower legs. Hmm.

Middle age has stricken these two highly intelligent master thinkers with a difficult to control disease. The triathlon disease.  As a younger man, I was once afflicted. Miraculously I was able to conquer it.

The fasciotomy scars from the therapy of lower leg compartment syndrome was the topic of this show and tell.  Compartment syndrome is not mickey mouse.  It is not for the faint-hearted.  It is a gnarly problem, involving internal bleeding into the front of the leg.  The fascia is a really tough sinewy-like layer which encircles muscle and bone.  It is there to support the muscles.

So much running and pounding of the middle age body can precipitate micro-tears in the muscles.  The torn muscle bleeds, but the blood cannot escape the fascial layer, and thus it builds up in the compartment of the leg.  The expansion causes compression of nerves and blood supply to the foot.  Intense pain is a certainty, but worse yet is the possibility of permanent damage to the affected foot.  A fasciotomy is required.  Don’t click on the link unless you have strong stomach.

Turns out that the cause of said compartment syndromes was a 50 mile running race.  That’s right, 50 (five-zero) miles!

“How was the race,” I ask.

“It was really great, except for that searing pain in my shin.

The drill yourself into an inflammatory-storm-disease does not discriminate. It afflicts the highest level of intellectual society, even presumed masters of the obvious can fall prey.

Many correspondences ask how much exercise is too much.  I don’t know for sure, but if it requires slicing a perfectly good leg open, it was too much.

The over-achieving athletic mind continues to impress me.

JMM

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Filed Under: Cycling Stuff, Exercise, inflammation Tagged With: Anterior compartment syndrome, Athletic mind, Over-training, Running Cross Country, Triathlon

On Junior Sports. Think. Balance.

November 16, 2009 By Dr John

Some say unsolicited advice is self serving. Of course it is, but, here in lies the beauty of a blog.

Although our fall campaign of cross racing brings mostly joy, yesterday, Staci and I was troubled by our observations of the junior race.

The race director, Kyle Wingler was nice enough to ask me how we (OVCX) do the juniors. I told him the USCF had decreased the 10-14 race times to 20 min and OVCX was adopting this. Good, 2 laps. The official walks down and reads from the flier printed months ago; the juniors were racing 30. Ian and Gavin are so fast they pushed it to 4 laps. This meant that others of middle school age raced 35-40 minutes. In those last laps I saw many a frustrated, ‘I am not having fun anymore’ face. These faces are the antithesis of how we should build the sport. As a I transition from racer to coach/cheerleader it is painful to see such frustration in the faces of the sport’s future.

As a former CC coach, assistant cross coach and experienced over trained cyclist, I have very strong opinions on the matter of being “drilled out.”

Three very short stories on junior sports…

The story of Emma Brink: Emma is the Sacred heart track/CC star who is always in the C-J. She is Kentucky’s most outstanding runner and is only a sophomore. For the record, she is as good a person as a runner. Staci and I know Emma from St Agnes CC. She happened by my little recruiting booth at registration. I say to her, “Hey Emma, I know you are the star of the volleyball team, but why don’t you come out and run with us when you can.” Well, she did. It was like stealing Lebron James for your intramural BB team. The first year, she split volleyball and CC, the second she decided CC was enough. Why? Only she can say, but I am told that the low key 2 times per week CC practice, popsicles and Staci’s fun games were a relief from the rigors of the volleyball circuit. Imagine, Staci as your full time coach versus the screaming drill sergeant volleyball coach. Tough choice.

It has been a couple of years since St Agnes CC. I met Emma’s mom last year at a CC meet and she thanked Staci and I. I say, Emma runs so well due to her genes. Her mom says yes, but, St Agnes CC introduced running in a low key and fun environment. She started high school wanting to run more. Her mom pointed out that running less in middle school actually helped her high school running. Go figure, less was better?

My tennis story: Many years ago on a rainy Connecticut day I decide to break the boredom. I grab my mom’s tennis racket and starting banging balls off my garage – the clean white garage door. I start noticing these spots each time the wet tennis ball hits the white garage. Hmm, I should probably stop, but there is a rhythm, plus, I’m pretty good. Non, yells from the porch, “Why are you doing that, it’s raining.” The rhythm is intoxicating. I am bored, there is no internet in the 1970’s. As I wanted for little, my parents bought me a racket and I was hooked. I played all the time. More equipment, books, lessons, coach, indoor tennis, (which was really ‘highzuit” in the 70’s) all followed. Sound familiar? As my high school was rural, I was able to play number 1 or 2 singles all four years. Like CX, I was OK, but far from great. Worry, superstition and lost sleep before matches. Sound familiar? In college, reality struck. After a couple of practices at that level, I was done, forever. Haven’t played 3 times in 25 years. Drilled out on tennis am I.

Tuesday night worlds with Will: I am embarrassed to tell this one, but it enlightened me. Will began his riding on our tandem. It was nice. A tandem ride is exhilarating, think, roller coaster. They are fast, Will is light and very easy to pull around. Our rule was, we would finish when he was done. That’s good. There would be accelerations when he wanted to, usually to try and drop his mom. A good rule: never drop your mom!! Then one day I decided to take him on the Tuesday worlds. We roll around the park and he is having a ball in the peloton. We both have good legs. Then it starts. Kaboom. We are drilling it. Hanging on for dear life, both of us burning matches. We answer, we stay in the main group. After the ride, we sit, and I get that famous Will hug and squeeze. He is exhilarated and proud. Good, right? The next day he is sore and drained. “Will, you wanna ride?” I ask. “Nah.” Problem is, I heard that same “nah” for a month or so.

As Bobrow has outlined, the “drill it out-biggest loser,” Lakeside Seahawk, Mockingbird soccer and Turner gymnastics approach is not sustainable.

Don’t believe me? Read a professional coach’s opinion on “training” of a 14 year old. The well known and respected cycling guru, Joel Friel is saying the best thing for kids is to have fun and learn skills.

Some numbers to consider on middle school age racing times…

BMX: 90 seconds
400m Freestyle Swim: 5-6 min
CC Run (3K): 9-13 min.

Why do we crossers have to make are 10-14 year olds race the same time as elite collegiate 10k runners or elite Master CX racers?

Why does the epicenter of cross, Belgium, not even have a national cross championship for under 16 year olds?

If I was your coach, I would say no training, just ride your bike. Trust me, life will provide ample opportunity for “training.”

JMM

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Filed Under: Cycling Stuff, Cyclocross, Reflection Tagged With: Coaching, Juniors, Running Cross Country

John Mandrola, MD

Welcome, Enjoy, Interact. john-mandrola I am a cardiac electrophysiologist practicing in Louisville KY. I am also a husband to a palliative care doctor, a father, a bike racer, and a regular columnist at theHeart.org | Medscape

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