Pilot Study: Mindfulness and Endurance Athletes

Hey there! I'm working on an exciting new research project examining the intersection between psychology & endurance sports - the first step is this survey, which will inform future work that will (hopefully) integrate physiological and training data.

Interested in participating? It takes < 10 minutes to fill out! You can help out further by sharing with fellow athletes, coaches, and clubs. Thanks for your participation!

Pain Perception & The Science of Meditation

Why and how meditation affects pain perception is super interesting - per previous well-controlled studies & oodles of patient self-report, it seems to work well for acute & chronic pain situations (the original 8-week clinical MBSR course was developed at least partially with pain control in mind - go read about it in Jon Kabitt-Zinn's Full Catastrophe Living).

A new study from Fadel Zeidan's group (out of Wake Forest) came out recently in the Journal of Neuroscience - it expands nicely on his previous work looking at mindfulness meditation & pain perception (slides from a talk I gave on previous paper below). Basically, the take-home from their related work in 2011 was that 4 days of mindfulness training reduced pain perception and altered pain-related brain activity, especially in the anterior cingulate cortex & anterior insula.

Brain Mechanisms, Pain Modulation, & Mindfulness Meditation from ataren

A question that we have to consider in any intervention is how much of this effect could actually be placebo. To my mind, for practical purposes it doesn't matter much - a placebo effect is still an effect, and when you're talking about reducing pain, I don't always really care how or why I'm perceiving less pain - just that I am.

But determining how much of a given benefit is due to the "placebo effect" can be important for a number of other reasons. Say we're evaluating an intervention with potential harmful side effects  - if a sham would make me feel just as good and is safer/easier, it would be bad practice to keep using the intervention when there are potential downsides involved. 

Another good reason to figure out whether meditation's efficacy for reducing pain is different from placebo has to do with determining mechanisms. The initial Zeidan study got us started - brain regions associated with pain reduction are also activated by mindfulness meditation during a noxious stimulus. And the whole reason we try these interventions is to be able to apply them, so from here, one might say, "we can use meditation to treat people in pain! Not only do people report that they feel better, it does XYZ to your brain, and a placebo doesn't!" Which would be marvelous. Pain is hard to treat. And importantly, comparison to placebo/sham treatment is still the gold standard for showing that any intervention is worthwhile.

With that in mind, what Zeidan et al. have now done is take 75 healthy, normal people and assign them to 1 of four conditions: 4 days of mindfulness meditation, "sham" meditation (basically, being instructed to sit quietly and "meditate", no mindfulness encouraged), placebo analgesic cream, or nothing (control), with before and after fMRI scans. As in the previous study, they used a painful stimulus (heat), and had people rate both pain intensity and pain unpleasantness (physical and emotional perceptions, respectively). And as before, mindfulness meditation was associated with greater activity in brain areas involved in pain modulation (e.g. orbitofrontal cortex, subgenual ACC, anterior insula).

Here's where things get interesting: all interventions reduced pain (mindfulness, sham meditation,
placebo cream). Compared to sham meditation & placebo, mindfulness meditation produced the biggest reductions in pain intensity (-27%) & unpleasantness (-44%) ratings. And importantly, we can now see that there are different brain mechanisms involved:

- sham meditation: no big diffs in neural activity. but reduced respiratory rate - so perhaps a sympathetic nervous system "calming" effect?

- mindfulness meditation: greater activity in brain areas involved in pain modulation (e.g. orbitofrontal cortex, subgenual ACC, anterior insula) --> greater top-down regulation of pain?

- placebo cream: greater dorsolateral prefrontal cortex activation, less somatosensory cortex activation --> dampened activity in sensory pain processing regions

Ergo, "mindfulness-related pain relief is mechanistically distinct from placebo analgesia".

And mechanistically distinct in ways that have some meaningful larger implications - let's extrapolate a bit. Mindfulness meditation requires you to be cognitively engaged, and we see this in the pattern of brain activity shown here, which suggests greater top-down pain modulation with mindfulness (translation: higher order brain regions are exerting influence over your more primitive sensory processing areas. Better "self control" of pain). Mindfulness was also associated with the greatest reductions in perceived pain intensity and unpleasantness. So greater cognitive engagement = brain better at self-regulation of pain = less pain.

In comparison, slapping on a placebo analgesic cream is fairly passive. That's reflected in the fact that one of the main neural findings (consistent with previous brain imaging studies of placebo meds) is of reduced activity in secondary somatosensory cortex, which is responsible for your bread-and-butter sensory stimulus processing. The placebo did also reduce pain intensity & unpleasantness ratings, albeit to a lesser degree. So, cognitive engagement not required = passive/lower-order brain pathways = not-as-good pain control.

In sum: your mind is a powerful thing - use it. Meditation is one way to train the mind, and may in the process bump up your pain perception threshold...and maybe, by extension, your 40k time trial performance :)

photo credit: Reigh Front Pia via photopin (license)

Stress, Mindfulness, Brain Changes, and Inflammation: Putting the Pieces Together

In my neuroscience research life, I talk a lot about brains, stress, de-stressing, and what happens to your brain and your body under those conditions. Some people are interested in just one aspect...but what I most often hear is, "But Adrienne, how does it all fit together?"

So one day I sat down and scribbled a map of sorts, with lots of lines and arrows and sticky notes on pieces of paper scotch-taped together. My desk looked like something out of A Beautiful Mind, and I was on top of the world when I finished. And also reaching the non-stop work point where I start talking to my house plants. The fruition of that labor is now in a much more readable format, so here's some food for thought:

Ask questions. Send me your wild theories. Fill in any holes.

What am I most interested in now? Adding the effects of physical activity & sympathetic/parasympathetic nervous system balance to the equation. To be continued...

- AT

On Gratitude

Gratitude is a funny thing.

It seems like it should be pretty easy. For months now, I've been writing down 3 good/grateful-for things in a notebook at the end of every day, because science says it makes people happy. Which I believe. It's a simple, effective psychological concept.

Moreso than that, though, I think it's useful as a barometer for how life is going. If I'm struggling to find 3 small good things to write down, maybe I need to reevaluate what I'm doing with my days. When I sit for 15 minutes staring at a blank page, and then write:
" 1. Rebecca sent me a picture of a goat.",
something's not working quite right.

At the risk of sounding like a whiny, ungrateful person in the midst of a post about gratitude, a lot of things really sucked this year. Autoimmune crap flared, meds stopped working, the rear derailleur fell off my road bike while I was riding, the bottom bracket broke on my other bike while I was riding, I cried in my former program director's office because academia sucks people's souls out their noses and I want out, and then I broke 2 ribs.

So I thought of good people instead of good things for a little while.

And then I thought a bunch about how it's not always the people you expect, or the people it "should" be.

There's a 70-something year old dude who started showing up to my Sunday morning spin class. He's rail thin and has some ptosis and left-sided facial droop. Which is otherwise at odds with the RAGBRAI jersey and carbon sole shimanos. He pedaled slowly away in the back, and then stayed and thanked me for the class, and we talked, and he's on round 3 of a rare type of lymphoma with brain mets now. It's keeping him off his bike outside, because of balance issues from the CNS side effects. His oncologist taught me during my first year of med school. So now, every Sunday morning, I sit on a bench outside and talk with this gentleman about how life is really better when you can ride a bike, no matter who you are. And which brand of waffle maker is the best, and the failings of the US healthcare and research systems. Friends in unlikely places.

My brother turned into a really awesome adult. I'm definitely grateful for him. He is a very wise man, but still draws strange 3-legged dogs that look a little bit like hippopotami.

I'm grateful for two of my male runner friends who don't give 2 craps about how smart I am. And take seriously my suggestions to pack up and move someplace where bikes can be ridden outside all year, and where my Vitamin D level will be greater than 30.

I'm grateful for my bff from college, who I haven't seen in 6 years, but who let me know the other day that she was sitting on some steps because life was hard. Because at some point in our first or second year of friendship, one of us just stopped walking and sat down on the staircase in the science building, and it became a thing you did when you were tapped out for a little while. And it's nice to know that you can still long-distance sit on steps with people from time to time.

Then there's the handful of random smart or interesting people who don't even know I'm grateful for them, because sometimes it's just enough to know that there are people out there who are on the same page as you, and if they found a path through life that's not psychopathy-inducing, then you can too.

Finally, I'm grateful for these goats.

Tales of a Recreational Aquabike: Musselman 57.3

Musselman 70.3 was my favorite race in 2014, so I picked it as my A race this season, since that's as good a reason as any.

But my body had other ideas this year, so it became an aquabike, e.g. the two legs of triathlon that I power through to get to the run, aka "a chance to work on my weaknesses."

I made my way up to Geneva, NY after escaping from clinic the day before. At packet pickup, I collected my block of local cheese and a baby tree (which is currently residing on my living room floor since I live in a high-rise condo surrounded by concrete. If anyone has tree-planting suggestions, please let me know. Or owns a large pot that I can borrow in the meantime. Thanks.) After being distracted by a milk crate full of apricots, I remembered I needed my timing chip and all that stuff too.

Since I'm tired of writing traditional race reports and you're probably tired of reading them, this time Imade a bunch of lists instead, since everyone on the internet likes lists:

Swim Swim Swimmin'

Things that were good:

1. No whitecaps in the lake this year. Always a plus.

2. Swimming a pleasant and relaxed 34 minutes and some change, because I'd had to re-frame this as a training day and some extra practice on the course. For future Musselman endeavors, of course.

Things that were bad:

1. Aquabike is the last wave. I'm impatient.

2. Every year I get lost in the canal. I mean, not really lost, because it's a canal. But every time I go around a turn, I get excited that I'm done, and then I'm disappointed. One of these years I should count how many times the canal turns. I'm pretty sure it's only 2 or 3. Not that hard, Adrienne.

Aquabike note: walking all the way back to transition because you can't run takes a long time. You'd think I'd be more successful at getting my wetsuit off with this extended "break". No. See image to the right, and thank you race photographer for immortalizing this moment.

The Bike

What I Thought About:

1. I love you, road bike, but you are much slower than TT bike. Spine, please cooperate so I can be aero again soon. Thanks.

2. Pretend you are in the Tour de France. Pretend you are in the Tour de France. I wonder what is happening in the Tour de France right now?

3. This race is so much better than an Ironman. I wonder where I can plant that tree.

4. While spinning up the Big Hill because I'm a lightweight: QUEEN OF THE MOUNTAIN!!!

5. That caffeine I had this morning should be binding the adenosine receptors in my cingulate and prefrontal cortex right about now. Oh, look, horses!

Songs I Sang in My Head, in order: (further proof that I have no control over what happens in my brain while alone on the road)

1. Vanilla Ice - Ice, Ice Baby. Approximately the first 6 miles.

2. Beyonce - All the Single Ladies. Next 2 or 3 miles.

3. Sisqo - The Thong Song. Unfortunately for nearly 40 miles. I haven't even heard this song in probably 10 years.

Other Things I Did:

1. Made a new friend named Gary.

2. Stopped to pee.

3. Stopped to help a woman who needed a tube.

4. Appreciated the scenery. There are wineries and farm animals. Another perk of not going HAM.

The Finish

After coming off the bike, I still had to wobble through transition, rack my bike, and trek over to the finish line to receive my spiffy bike gear medal. This is all well and good, and is meant to give aquabike athletes (aquabletes?) a quality finisher's experience. However, the reason I am aquabiking is because I'm not doing so well on two feet. So I tacked a good 10 or so leisurely minutes onto my time while I got Lady Vanilla Icecapades (road bike, christened by friend who had too much tequlia) back in place, pondered the meaning of life, and wobbled gingerly (if that's possible) out and around and towards the finish chute. My new friend from the bike course caught up to me by that point. I suggested we hold hands across the finish line. He was a good sport. I hope to see him again next year.

And THAT, ladies and gentlemen, is how you finish a recreational aquabike.

Peace out.

In Which I Swim Across Presque Isle Bay: 2015 Edition

In haiku format:

A long way to swim

through some cold choppy water

for a free towel.

It takes a special talent to identify yourself in wetsuit + cap.

Out of the water.  I beat speedo man.

I dance in my wetsuit sometimes.

In which I swim across the Chesapeake Bay.

The Great Chesapeake Bay Swim is a bucket list event. Why? You get to swim across the bay, between the two giant bridges. You get to fight the tide, swells, and stinging nettles. If you get pulled off course by the current - outside the bridges at any point - you're pulled from competition. Since I like super hard things and I like swimming, I was ready to sign myself right up.

The nice calm shore, and my hat taking a rest.

I posted a qualifying mile swim time and then was lucky enough to get in through the lottery this year. The distance (4.4 miles) wasn't a concern for me, but the current was. I am a Small Person. I do not muscle my way through the ocean, typically. I prefer to float like a butterfly along with the waves, which in actuality probably more closely resembles a drunk octopus in a neon swim cap, but whatever. I get the job done.

We start on the beach, splash into the shallow water and wade out a little ways at the gun. I start swimming before a lot of bigger people because I am short. Mile 1 is a blur of 300 people on top of each other. The first 15 minutes or so are spent swimming out to get between the bridges - the good news is that it's easy to sight, just follow the massive crowd of green caps. In fact, it's easy to sight for pretty much the whole swim. Once I'm between the bridges, things start to thin out a bit, and I am able to settle into a rhythm. The rest of mile 1 is tough but manageable - we were told in the pre-race don't-drown meeting that the tide would pull us to the right, so I focus on staying closer to the left bridge. So far so good.

I take off my wetsuit. Something is funny.

I see the mile 1 buoy at 27 minutes, which is right about where I should be. This makes me happy. Then that current starts getting stronger...and stronger...and so I start swimming at a 45 degree angle to stay in bounds. I curse myself for signing up for this stupid swim. I contemplate how nice that rescue boat over to the right looks. I tell my wimpy brain to shut up, and swim at a 90 degree angle just to be safe. This cycle repeats. After a whoppingly against-the-tide 45 minutes, I see mile 2! I see the magic feed boat! This is comical: there is a motor boat carrying dixie cups of water and vanilla wafers (not celiac friendly) chugging slowly back and forth, with a lot of neon-colored swimmers clinging to the side. I grab a dixie cup from the poor guy on the boat whose job it is to deal with all these insane people trying not to drown, swallow some water since I'm swimming in salt on a hot day, and keep going right away since I float away to the right as soon as I go vertical to drink, and I'm not talented enough to stay upright and drink and not be pulled out to sea by the current all at the same time.

A little ways into mile 3, the tide calms down some. Oh, it is still there, but after mile 2 it seems pretty nice. But hey look, here are the swells! I'm bobbing along but I much prefer this to strong tide. I count my lucky stars I don't get seasick. I dolphin dive some when a really big one comes. But I'm cruising and singing Beyonce in my head. Woot woot. The swim is my friend again, and let's do this again next year!! Hey look, there's the mile 4 buoy!

I am swimmer, hear me roar.

Silly me, I think I only have about 15 minutes to swim. But I'm still swimming to the left, and the turn buoys you have to go through are allllll the way over on the right, so I tack on some distance...and there's the magic current again. I grumble to myself as I point my body at 45 degrees to get between the buoys...grumble grumble current grumble...pass the turn buoys in style, and am now under the right bridge. You see, when the bridges end, you cut to the right and then a sharp left to shore, ending at Hemingway's Marina. This requires going under the right-hand bridge. Let me tell you, someone installed an endless pool underneath that bridge. On full blast. I am swimming and going nowhere. All the people around me are swimming going nowhere too, so I feel a little better. I do my best impression of the Incredible Hulk and throw all 100lbs of myself forward to try to get past the bridge. I repeat this process approximately 1000 times, and then I am past the bridge. I flop to the left in the direction of shore. My goggles are on the foggy side, or maybe coated with bay dirt, so I can't really tell where the finish is, but I figure swimming towards sand is a good bet. It is slow going still. I'm pretty sure the last 0.4 was more like 0.8 what with all my direction-changing, plus it's taken me as long as my entire 4th mile. Balls. It gets shallow-ish pretty fast and there are people around me standing and trudging in, but I keep swimming because (a) I am Short and (b) I kind of want to finish this swim by swimming and not by water-walking, dammit. Which eventually I do. I am slightly wobbly going across the timing mat, and I think about how I probably have some orthostatic hypotension, and then I think "man, I am a huge nerd." Then I get my wetsuit halfway off because my shoulders are really done with all that nonsense, and I eat oranges and make entertaining poses for the camera.

I eat an orange. 

In sum, this was a super cool, super hard, super awesome swim. I was told by many Chesapeake Bay Swim repeat offenders that this year was particularly tough, which makes me super proud. And super likely to do it again next year. Cheers!

WYASO Team Endurance Weeks 2-3: Cycling Adventures

Racking up steps lately by dragging out another Team Endurance member at the crack of dawn for a few 50 mile rides! Joints are still all swollen but 2 PTs and an orthopod have concluded it won't make them worse...gotta keep moving one day at a time. This weekend, I encountered a badger, a groundhog, 2 rabbits, and 12 chipmunks, which makes for good bike-handling practice. Ryan encountered an oblivious kid zooming down the wrong side of the trail...but we're all still alive, minus some Reynaud's-induced frozen toes (pro tip: if you cycle & have Reynaud's, invest in some toe covers. Oops.) And we've instituted the post-ride selfie:

It's been a rough month and it's great to get outside, even for easy-pace long rides. Methotrexate for the first time after 4 years of success on adalimumab is no walk in the park. A good reminder to be thankful for the basic things, like ADLs, when things are good. Can't wait to hear what the rest of my team has been up to for the past couple weeks. Walk on!

Walk Your AS Off 2015: Team Endurance, Week 1 Reflections

Welcome to the first of several (intended) updates for Team Endurance - Walk Your AS Off - which will occasionally be hijacking my blog for the month of May. Here's a taste of what we've been up to...

There's never a good time to be hurting, but my body has a way of being as untimely as possible. I went out with a bang this time at least, but am going on 3 weeks of joint swelling - and besides needing to do basic life things and return for the last bit of medical school, I have to admit I was concerned about pulling my weight in the WYASO department. As an endurance athlete who normally puts in 15ish hours of training per week, accumulating time moving is not usually something I worry about. Sitting out a couple of planned road races was a downer, but thankfully it turns out swollen ankles do just fine on the bike - so for my part, I logged 110 miles on the trainer in our abbreviated week 1, and let me tell you, my spine is much happier for it. So are all the people who were tired of listening to me complain ;)

More importantly, I got to see some of our awesome teammates step up to the plate at the Pittsburgh Marathon on Sunday. I'm now going to embarrass returning super-stepper Ryan with this picture (sorry, pgh marathon, for stealing your photos). Ryan was pumped to convert his 26.2 miles to 57,000 steps (on Sunday alone!)

Let me tell you a story about Ryan and last year's Pittsburgh marathon. This time I have his permission to embarrass him.

My buddy Ryan also ran last year. He neglected a little something called training, though (in a major way)."I've run a bunch of marathons before, so I'll be fine!" said Ryan.

"Maybe you should drop down to the half marathon," said Adrienne. "The longest run you've done in almost a year was 5 miles. Or you could just run a fall marathon instead."

"Yeah. But it costs money to switch to the half...so I think I'll just try to finish the full." said Ryan. [side note: this man works in Rehab Services at our Sports Medicine Center. In other words, he knows better.]

So I stood around at the finish line for the 6+ hours it took the dummy to jog/walk/crawl/cry through the 26.2 miles he was entirely unprepared to run. Points for perseverance. Negative points for common sense-ness.

But here's the point I'm coming to (see, I'm getting back to WYASO, I promise) - When Ryan and I talked the day after he put his body through quintuple the miles he'd run in a few years, he said something along these lines:

"So I couldn't sleep last night I was in so much musculoskeletal pain. I kept waking up, every muscle in my legs was cramping and burning, and I had to physically use my arms to lift my legs over the side of the bed to get up."

After I kindly pointed out that it was a medical miracle he didn't have a stress fracture in his tibia or fibula and hadn't gone into cardiac arrest at the finish line (sorry buddy, know that was super helpful), what immediately popped out of my mouth was, "Welcome to my world."

I didn't really think much about what I had said, because normally other people don't think too much about it either. I don't expect them to. It's hard for others to conceptualize, and it's easier for me to joke offhandedly about it and let it go. Wry humor is an effective coping strategy that also lets people off the hook. Or, because I can do things like swim, bike and run 70.3 mile long races, or knock out a sub-60min 10 miler, it probably doesn't seem like my AS could possibly be that bad. Heck, when I can do those things, it sometimes doesn't seem that real to me either.

Except this time, Ryan just stopped cold, and said, "Oh my god. Is this what you feel like all the time?"

That was one of the first times I really felt like someone was processing what it was like to be me on a bad day (or week, month, year). That means a lot. I felt like I had just hit upon the untrained-marathon equivalent of spoon theory.

Which brings us back to this past weekend, when Ryan ran the Pittsburgh Marathon in a slightly more trained state and a lot less pain (he says, "It's a lot more fun that way."). He spent some of those 57,000 steps thinking about that conversation we had last year. Those moments are exactly why we walk, and why WYASO is important to me.

BIG shout-outs also to Annie, with a marathon PR on a hot day, and Brie with a whopping 8 minute PR at the 10 mile distance on the other side PA! Log those steps people, and have a great week 2.

Psychological Ramblings: "Hurt" vs. "Injured" in Endurance Athletes

I'm sitting here going on week #3 of grapefruit-sized ankle and talking to a friend on the phone. "But are you just hurt, or are you injured?" she asked.

There is an important distinction between these two concepts - in how we deal with them from both a practical and mental standpoint. Let's start by trying to define what it means to be "hurt" versus "injured".

"Hurt" certainly involves pain. Being hurt may shut down more cautious or novice athletes, but with experience (or in those of us who have been missing that self-protective screw from the get-go) - you can train through being hurt. Many people are hurting more often than they are not. I've heard it said many times that no one standing on an Ironman start line (or insert highly-demanding athletic endeavor of choice) has every part of their body feeling 100%. Does that mean everyone's injured? No. Being hurt isn't necessarily dangerous. I'd argue, in fact, that learning to play through hurt has its advantages. It helps you to, within a hopefully-still-physiologically-safe space, build resilience and pain tolerance. If you can to get back on your bike after taking the skin off your knees in a spill, or run on those sore quads even though you know it's not going to be super pleasant, you'll probably (a) feel proud of yourself for sucking it up, (b) teach your brain that it's ok to hurt sometimes, (c) learn to distinguish between pain it's ok to train through (and pain it's not, see below), and (d) develop the all-important grit to keep going when the going gets tough, something you'll be able to call upon in a race situation when that inevitable moment where your mind screams "STOP!!!" comes. Learning to hurt and deal with it is part of the experience of becoming a successful athlete.

But what happens when you cross the line? Worse, what happens when you lose the ability to see - or accept - the difference between hurt and injured?

"Injured" takes you out of commission. Maybe you pushed through something you shouldn't have, or maybe there was some sudden trauma outside of your control. Being injured is, and should be, psychologically much more devastating. Mentally coping with an injury requires a different kind of toughness - the fortitude to make yourself back the heck off and figure out where to go from here. It sucks. But life goes on, and there's no reason that learning to deal with more serious failures of your body can't make you a stronger person, much as learning to hurt can make you stronger.

A lot of it comes down to risk tolerance.

If you play hurt, you're probably incurring not much risk. You may even be developing grit - necessary for success in most tough things. If you play injured, you're dumb (or you're in truly exceptional circumstances, e.g. this is the Olympics, you are planning to retire afterwards, and you have processed and accepted the potential disability that may come of your actions). Perhaps, then, the distinction between hurt and injured could be best reflected by a spectrum of the amount of danger/risk incurred by plowing on in that state. See this handy scale I made:

In all seriousness though, embrace the process. We will hurt, and most of us will get injured at some point. Take the time to learn where that line is for you, and learn how you cope (or don't) when you cross it. And if you pick a half Ironman for your "A" race where there are bears on the course, please ride fast in the other direction.

Wishing you puppies and rainbows, grit, and a bear-free season,

Adrienne

7 Things I Learned from Watching Netflix Documentaries

1. Master your craft, and people will put up with pretty much any craziness from you. (Jiro Dreams of Sushi)

Whether you love sushi or not, it's worth watching this movie just for the beautiful cinematography. If, like me, you're fascinated by others' relentless journeys for perfection, you will also love this movie. When I'm rich and famous, I'm going to Japan and eating here. If I make my reservation now, I should be able to get a table by the time that happens. "Taste octopus that has been massaged for 45 minutes first" is now on my bucket list.

2. Don't put all of your money into a giant house. (The Queen of Versailles)

It is absurd this house these crazy rich people started to build. Then they lost all their money. Whoops. Don't do that, because it's really hard to find someone with that much money to drop on a half-finished 90,000 sq ft miniature city-state. What follows makes for an interesting study in the psychology of the ridiculously wealthy; specifically, what happens when one goes from riches to rags.

3. Dutch people have figured out social support. (Happy)

I've spent enough time working, visiting, and volunteering in nursing homes, from low-level assisted living to locked dementia units. I do not want to be in one. I plan on asking someone to clock me over the head with a frying pan when that's about to happen, assuming I haven't been chased down by a bear while cycling or consumed by a shark during an open water swim by then. But now, I think a better solution might be to move to Denmark. They have their shit figured out. Co-housing communities give people a built-in extended family to look out for them, whether it's single moms struggling financially or elders who need care and company. I'm pretty sure I could live out my life happily demented there. In fact, I might go there now.

4. My (theoretical) kid is not becoming an elite ballet dancer. (First Position)

So much pressure. So many kids beating themselves up, physically and mentally. I identify with and respect the dedication, and I'm all for going after your dream (also, these kids are damn impressive dancers). And I don't want to write a diatribe on the negatives of single-sport specialization at a young age. I just hope that any offspring I manage to spawn will spend a bunch of time trying a lot of different things and having fun. When your prefrontal cortex is fully developed, then you can go hell's bells down the rabbit hole after whatever single-minded pursuit your heart desires. Although by that age, you're probably too old to be a professional ballerina. Sorry.

5. Studying to be a master sommelier is pretty badass. (Somm)

Watching these cats buckle down for days, weeks, and months on end of straight studying, with their ginormous stacks of flashcards, and group venting/stressing sessions was very reminiscent of studying for my boards in medical school. Except having to do it while slightly drunk. Which may have made it a little more fun, but significantly more difficult. Respect. Wine is hard, and like the 600 flashcards worth of microbes and antibiotics I memorized several years ago, you'll probably need to re-learn all new things in 6 months since there was a drought/those microbes are now all resistant to those antibiotics. If I ever find myself at a restaurant that employs a master sommelier, I will tip generously.

6. We all survived. (Mortified Nation)

I loved this movie. I laughed quite a bit and I also cried a few times. Go watch it. In short, people read their adolescent journals, and much hilarity ensues, along with a lot of raw emotion and some scary/sad things. People go through all sorts of crap growing up; for some of us it's standard teenage angst, other people get hit with real life a bit sooner. But you know what? We all survived.
Warning, it will REALLY make you want to go back and read your diary/journal/whatever from your younger years.

7. Being the best at anything involves the same basic principles. (Generation Iron)

No, this is not surprising. But when it becomes evident by watching a movie about bodybuilders, and you see such obvious parallels between this unique, muscle-bound population and endurance athletes, it makes you think. Also, I'm going to stop knocking body builders. Apparently they're not all on steroids, they're stressed and scraping by in an underpaid, under-appreciated sport, scrambling for sponsor support, eating/sleeping/breathing the details, and then it all comes down to how you do on a single day, which may determine whether you can feed your family for the next year or have to abandon your sport. Sound familiar, professional runners/cyclists/triathletes?

Fast Times & Busted Tendons: Credit Union Cherry Blossom 10 Miler Race Report

After a surprisingly good Pittsburgh EQT 10 miler back in the fall (post-3 months of nothing but epic-long-swim training), I was in the market for another go at the distance. It's just long enough for my liking, but short enough to still be able to hammer the whole time. Most importantly, I wanted to see what I could do with a little run training under my belt. That EQT time turned out to be just good enough to allow me to bypass the lottery for DC's iconic Cherry Blossom race, so I snapped up the seeded entry slot and hopped a bus to DC (note to self: sitting on a Megabus for 7 hours the day before your race is really not the best pre-race activity. Even if it only costs $20.)

The backdrop was beautiful, the weather was perfect, and the course was flat and fast as promised. This is a HUGE race, so I was glad for the seeded start - being in a corral right behind the pro men made it easier to get out at the beginning, although I still ended up going an extra ~0.2 miles weaving around people in the first 3 miles (making up for a slightly shortened race course in the process). Over the past 2 months, I've still only done a small handful of progression and specific-endurance interval runs, trying to simultaneously not screw with my triathlon early-season prep training, so I ran by feel rather than obsessing over specific pace goals. I was surprisingly happy to see myself cruising through the first half of the race in the 5:40s-50s; ideally, I had estimated myself in shape for a finish time of anywhere from 59 - 63 minutes. Sub-60 was that stretch goal where I would finally feel like a legit runner again, and I was more than on target. Sub-62 was used as the "elite" entry standard for Pittsburgh's 10 miler last year, so this was really the range I wanted to be in, and I happily had some buffer room now.

Yeah, proofs. 

Aaaand then things went downhill. The posterior tib and fibula pain that my ortho had looked at just 2 days prior was coming on with a scream and a shout. I contemplated pulling off. But I'm a stubborn idiot, and since two doctors (if you count me) had looked at my MRI and ruled out any bone injury, I continued to talk myself through one mile at a time, watching my pace fall off and feeling frustrated at this lower-leg revolt. Who needs tendons, right? More than anything looking back at this day, I'm not super proud of how I handled myself mentally at this point. I should've made a firm decision when that pain hit that I was either going to stay in the game, stay focused, run my butt off even if I puked from pain at the end, and be prepared to deal with the consequences of that decision, or to just stop.
Instead I ended up in a frustrating mental middle road, where I repeatedly talked myself into and out of running, recognized that I was not fully mentally in it and got mad at myself for that too, wondered why I was doing this to myself vs. wanting that sub-60 finishing time (which I still estimated I could hit even after pain forcing me down to 6:30s the last couple miles), tried to refocus on the very pretty scenery, and just waited for that finish line to come. Which it did, in 59:17 (48th/11,067) and a whole slew of mixed emotions.

I'm so happy with what I accomplished here. Nearly 6 minutes faster than at the EQT (high responder to a little run training right here). Finally self-validation of the "fast runner" that I still am in my head. I needed to know that I could do that still, despite everything. And I'm finally starting to truly believe that I'll be able to continue on this path.

Disappointment at how I handled myself mentally the latter half of the race.

Worry about my peroneal tendons, which were already swelling as I hobbled to the Metro, but also acceptance. I made a conscious decision to keep running on them. My ortho/colleague/surrogate older brother and I both made the best medical decision given the information we had on Friday - which was for me to run - so there's no reason to waste mental resources questioning that. I'm rocking some crutches right now, but that's no one's fault, and the body heals.

Gratitude. It's Ankylosing Spondylitis Awareness month (sign up for Walk Your AS Off!), and I thought about that a lot too while I was struggling - how I would've given anything to be running just a handful of years ago, even through a ton of pain, and it was kind of ridiculous that I was pissed at having to drop off a sub-6 minute mile pace now. Perspective is hard to keep, and it's easy to get greedy.

Similarly, battling ego - how much faster and harder could I have run in those last four miles without that ankle pain? It's hard for me not to wonder that. But there'll be time in the years to come to find that out. Thanks Tim, if you're reading this, for calling me out on this (and for kindly referring to it as "being a perfectionist" rather than ego).

I would love to go back to this race again. I didn't spend enough time being present and enjoying the beauty of the day - we were so lucky to have race day coincide with the actual cherry blossom peak. And I made some wonderful new friends - I stayed the night before with a friend of my little brother's; Michelle and her housemates were above and beyond nice to someone they'd never even met before (nothing like post-race dog therapy, offers of frozen kale for my swelling ankle, and good life conversations to remind you there are good people in the world).

Post-race Washington Monument love.

ROKA SIM Pro Shorts Review

New gear is fun. Especially when you can pay for it in haiku form (thank you, Triathlete Magazine!). Long story short, I am the proud owner of a snazzy pair of ROKA's new-ish SIM Pro shorts. Essentially, they're "wetsuit" shorts meant to help mimic the feel/body position you get with a full wetsuit, without the full wetsuit.

According to Roka's description, the Pro shorts are built like the Maverick wetsuit (which I can't comment on, as I'm still floating around rivers and lakes in the same little QR wetsuit I got for my first-ever tri. An ex-bf even tried to leave it at Musselman last year when I wasn't looking, but they mailed it back to me. It's the wetsuit that won't quit.) But anyways, Pro shorts have the same fancy-shmancy "RS2 technology" (buoyancy and rotation-enabling) and "Yamamoto SCS coating" which creates a "nano coated surface". Nano-what? Whatever. Just envision those water particles sliding off the surface of your neoprene-coated thighs.

I took them for a test-run in the pool first. This is one of the major advantages I can see to these - if you want to practice wetsuit-position prior to an early season race but can't get out in open water, these are pool-safe and you won't overheat in them.

First impression: they're not as floatation-y as I was expecting (not necessarily a bad thing) - compared to a pull buoy, for example, they certainly don't just pop my butt and legs up in the water. If you're expecting to use them in place of a pull buoy, know that you'll still have to kick (at least a little) to maintain proper body position. Which is ideal, again, for mimicking wetsuit use (hopefully you kick a little bit when swimming in a wetsuit). As for rotation, yes, it's a little easier to feel - I know that I over-rotate to my right as my funky left hip drops, and it was slightly easier to sense that and re-tauten my body with floaty shorts on. Cool beans.

Am I faster in them? Not really. In a 500m time trial in the pool, I was ~3 seconds faster (total) with the shorts than without. But if they reduce (a) the energy I would normally be expending to keep my butt up, and (b) drag (see: nano-surface), why wouldn't I be faster? Two reasons:

1. When I flip turn, they take on water, pulling me backwards a bit on my push off the wall. I don't think this is a flaw with the shorts, but rather with how much I (don't) quite fill them out. I'm a tiny person and in the tiniest size (women's xs), but I've still got some room to spare. Size down if this is a concern for you. My guess is it'll be less of an issue in open water, since I don't normally do somersaults to go around buoys.

2. It's easy to get lazy on the kick. Which is partially the purpose, right? But when I normally pool-swim a time trial, I get a decent proportion of my total propulsion from my kick, because my catch still kind of sucks, which is an issue that wonder-shorts can't solve. So leaving me more energy to catch with a dropped elbow isn't really going to speed me up. Mental note to do another 500m test with shorts+super kicking.

Neither of those points negate the potential value I see in using Roka Sims as a training tool. They're a great reminder of what it feels like to swim with some neoprene on your lower body, and would thus be a welcome addition to open-water skills sessions in the pool in particular. They're good for swim days when your legs are just shot. They're good for pull sessions when you don't want to go the full-on buoy route. I've worn them a handful of times in the pool now, and rinsed them with non-pool water afterwards - they still look like new, so durability isn't an issue so far.

I'm gunning to use them in an actual open-water training session (but I'd be gunning to get out in open water butt-naked at this point, after a long fall and winter of staring at the black line) - but I'm pretty sure the water here in western PA is still hypothermia-inducing. Look for an updated open-water test-run report when the icebergs melt!

Are we suffering from “McMindfulness”?

Mindfulness is sexy right now. If you’re even remotely connected to the worlds of psychology, health, fitness, sports, or business, you’re probably being bombarded with messages encouraging you to be more mindful (just take a look at your Twitter feed). On as personal level, I’m pretty happy about this (although not without some significant caveats, hence this article) – when I made the somewhat-unconventional choice of joining a neuroscience lab to study the neural mechanisms underlying mindfulness training 4 years ago for my PhD research, I faced some pushback from a few of my colleagues – wasn't I concerned about being taken seriously as a physician-scientist? Was mindfulness really scientifically and medically relevant, or just fringe pseudo-science? My argument was largely that I was interested in studying the effects of chronic stress and stress reduction on the human brain, and mindfulness-based stress reduction was (and is) a great paradigm for exactly that. Few people will argue with you over whether or not stress is physiologically relevant to health. I’ll still fall back on this strategy (and my interests still do revolve around stress-brain-health pathways), but these days, it’s increasingly trendy to be into mindfulness. There’s a much better understanding that mindfulness entails more than stress-reduction, and its benefits (and neural effects) extend well beyond that scope (e.g. attention, acceptance, non-judgement, affect regulation).

I could talk for a long time about the exciting things going on in health neuroscience re: mindfulness – it rewires brain circuitry involved in attention, emotional processing, executive function, and default mode; it changes the thickness of your cortex and volume of subcortical structures; and we have initial evidence that these brain changes mediate (or are mediated by) endocrine and immune function. This is legitimately cool and highly relevant stuff, potentially with significant implications down the line for treating a variety of mental and somatic pathologies. But what I want to talk about now are some ramifications of the EXPLOSION of media attention to mindfulness in the past year, and things for smart people to keep in mind.

First, mindfulness is now being applied to everything under the sun - a quick perusal of the media would lead you to believe that it's a panacea for anything and everything. As often happens when a complex-ish thing - particularly one that potentially has a lot of benefits - takes off (see: every popular diet ever), we start to look for shortcuts. After all, mindfulness is DIFFICULT. And it takes TIME.  Companies are running crash courses in mindfulness for their employees. We have mindful eating programs for weight loss. You can be mindful on your smartphone in 10 minutes a day. This is where we start to hear the term “McMindfulness” whispered within circles of researchers or experienced practitioners. And yes, while there may be a little bit of snobbery at play there (my meditation is bigger and better than yours), I think the analogy is very apt.

I want to make it clear that I am not against any of these “McMindfulness”-type programs – I think they really can be beneficial (we have studies that show that, too – the attention training aspect helps you at work, more mindful individuals tend to overeat less, etc), and any mindfulness is better than no mindfulness in our increasingly mind-less plugged-in society. We just need to keep in mind, first, the dose-response effect. The concern here is one of expectations – it’s hard to do this type of meditation training for a reason. Like anything else at life, you need to work hard at it to see the major benefits that are reported in the studies, many of which (at least on the neuroscience side) are conducted in experienced mindfulness practitioners with many, many hours of training. Additionally, we know that the specific benefits you get from mindfulness training depend upon one's hours of experience (this is also reflected in the time course of neural changes we see). In novice meditators, practicing mindfulness is still incredibly effortful – you need to go through this effortful struggle for a while (during which time the neural circuitry underlying focused attention is engaged heavily) before it becomes automatic, allowing you to achieve the effortless open monitoring ability you're probably seeking. Many people report huge psychological benefits from regular mindfulness practice, so maybe these mindfulness-lite programs tailored to specific outcomes are a great gateway to more structured, committed practice – that would be great, and time will tell.

The second thing I want you to keep in mind is the quality of the training you’re engaging in. If listening to your 10 minute daily mindfulness script on your phone is what you can do, please, please keep doing it. It is helping something; your amygdala just might not be shrinking quite yet. Similar to my pet peeves about “you’re not a real runner unless you’ve done a marathon” or “you’re not a real triathlete until you’ve done an Ironman” – misguided, frustrating attitudes that I think push people into things before they’re ready, or just for the purpose of checking off a box – you don’t need to do a billion minutes per week of body-scan meditation while sitting in the lotus position in your closet to use or benefit from mindfulness practice. Your 2 head-clearing mindful breaths to hit the re-set button at various points throughout the day, or the breath-focused movement practice that’s already part of your life (yoga, swimming, running, fill in the blank) is just fine. But if you’re doing your 10 minutes on your iphone while also checking Twitter and walking into a fountain, you’re shooting yourself in the foot. It’s like most diets – everyone went paleo/gluten-free/whatever and we saw lots of success stories initially because it was impossible for them to eat crap. Then, we had companies make paleo-cookies, cakes, and bars and now everyone can eat crap again while still on their magic diet. Same will apply to brain training – no shortcuts, quality is key.

Let’s end with some of the things that mindfulness will not do:

(1) Cure your cancer/autoimmune disease/HIV, without appropriate adjuvant medical therapy. Might it have beneficial effects on your immune system and mental health when added to traditional medical treatment? Absolutely, and there are peer-reviewed studies showing this. Am I going to try to mindfulness-away my deadly disease, though? Absolutely not.

(2) Make your business instantly successful.

(3) Make you crap glitter.

My advice? Take the long game. Like anything else that’s worth doing, it requires consistency and time. Stay away from the frenzied hype, and certainly don’t send anyone on the internet $1299 for a life-altering mindfulness potion. Find what works for you; as I've said before, you don’t have to necessarily sit in the corner and meditate to practice mindfulness. Eventually, the rewards will come – and when they do, let me know, because I’d like to scan your brain.

SOAS Racing Team Gear & Discount Code!

This face is because I got a nice big box of SOAS Racing team gear...so happy to be a part of this amazing team of ladies this year! And for cycling and tri shorts that have gotten me through 11 hour trainer rides with zero chafing, which is a miracle if there ever was one. Also, sports bras with pockets. You can tell that women run this company. They also do an amazing job supporting a variety of female athletes, including ultra-ironwomen, off-road Xterra gals, super swimmers, and marathoners.

Swim Form: Part 1

Above-water video shot at the end of mastér's practice this week, swimming an easy, smooth ~1:40/100yd pace.

Comments welcome! For my part, I think I'm seeing my thoracic mobility limitations show up in my shoulder motion, head could come down more, but body position is much improved...what do you think?

Underwater will be the interesting video - on tap for next week...

(switch to HD for clearest view)

The Case Against Music, TV, and Netflix While Training

Yeah, I said it.

I don't wear headphones. I don't put Netflix on while biking in my living room. I hate that blank TV screen right at eye-level on the treadmill.

And I'm someone who has swum in a pool for 4 hours. I sit on the trainer for 2-4 hours at a time regularly (and once, 11 hours, but that's another story). I've done 10-15 mile runs on the treadmill this winter thanks to our persistent negative temperatures and onslaught of ice. And God bless me, I have aquajogged by myself for 2 hours, in a narrow pool lane where you have to turn around every 8 feet.

So why voluntarily do all this without external entertainment? Do I really enjoy self-flagellation that much? (some sarcastic friends might say "yeah, maybe", but that's not the answer this time). Did I do it all so that I could write a blog post about the superiority complex I've developed from being headphones-less? (also no. I don't have a problem with your entertainment - you do you. But here's why you might want to mix it up occasionally.)

The primary reason is that it's mental training. Everyone knows how to physically prepare for competition...some maybe better than others, but particularly at the top, everyone's in great shape come race day. More and more, what separates 1st from 5th isn't that extra tempo run you did, it's how you held up psychologically when the race pain hit, particularly in endurance events.

(1) Most likely, you get to race day, and you're not going to have that distraction. I can pretty much guarantee you won't have Netflix on the course, and many races don't allow headphones either (and even if they're allowed, doesn't it detract from your race experience??)

(2) Sure, some studies have shown that listening to certain types of music increases performance. So yeah, ok, you won't have it in your race - but aren't you still reaping the performance adaptations you got from using it to push yourself harder in practice? Interesting question. I honestly don't know. From a purely physiological standpoint, yeah, sure; but you have to wonder how much whatever you're gaining there is counterbalanced by the opportunity to build psychological resilience that you may have sacrificed. There's true value in learning to push and to have it be entirely intrinsically motivated. No one can take that intrinsic ability away from you on race day. They can, however, remove the band on the sidelines and your personal cheerleaders. You want to be able to cope with that.

(3) This is one of the top 2 best ways to learn to be comfortable inside your head. The other is to meditate. Which also has value, but that's a topic for another time. Most of us are really bad at being inside our own heads. A recent-ish study showed that people would rather administer electric shocks to themselves than be alone with their thoughts. The longer your race, the longer the amount of time you're going to be inside your head. That time can be spent in a mental battle, or in a calm but alert, present-centered state conducive to performance. When people talk about flow, this is often what they mean. It's a great feeling.

Now, I'm not saying you need to train in silence, staring at a blank wall (and there's certainly additional value in learning to deal with unanticipated distractors, too). But learn to stay engaged, to stay with your body. Actually experience what it feels like to hurt during a hard interval, to go up a steep hill. Learn what your heart thudding sounds like, pay attention to your breathing. Begin to associate these physical sensations with different effort levels...learn where you break down, physically and mentally, and see how you can use your mind to push that point out. Learn where your mind starts to fight you, and see how you deal with it.

In the past year, I got into long distance open water swimming. 4-5 hours of nothing but murky water to see and your bubbles & breathing to listen to is a lot of intra-head time - part of what prompted this post...

TNF alpha, your brain, inflammatory diseases, and mindfulness: Thoughts provoked by the new study in Pain

A recent study in the journal Pain (found here - if you don't have access & want full text, shoot me a message) provokes some  interesting questions on the relationship between the brain and inflammation, and perhaps what we can do about these things....

In sum, here's what the authors show:

(1) Thinning in somatosensory & motor cortex is associated with pain reduction,
(2) Thinning in insular cortex (a brain area associated with interoception, empathy, emotion regulation, etc) is associated with fatigue reduction 

....In a subject sample of ankylosing spondylitis patients (an autoimmune inflammatory disease) on TNF inhibitors (which block tumor necrosis factor alpha, an inflammatory cytokine with several roles in the body, including inducing inflammatory processes and regulating tumorigenesis - hence the name).

From Wu et al, 2015

This raises all sorts of questions about TNF alpha pathway effects on the brain. First, cortical thinning has generally been characterized as a bad thing (and associated with excess inflammation, not reduction of inflammation), but here, we see positive correlates with self-reported pain and fatigue reduction, which is interesting in and of itself. Keep in mind that this is a patient population, and the first thing I'd like to know is how cortical thickness in these regions compares to healthy control subjects at baseline - perhaps, due to chronic pain and fatigue, we already see thickening of somatosensory and insular cortices in AS patients (entirely plausible since processing these signals recruits these brain areas). So perhaps controlling disease symptoms with anti-TNF therapy is just bringing these people down to a more normal baseline in terms of brain anatomy, alongside the normalization of inflammatory markers (e.g. C-reactive protein, sed rate) that usually occurs with successful anti-TNF treatment. 

But the most interesting thoughts occur when you try and relate these findings to what we know about how we can alter (a) cortical thickness in these regions and (b) the immune system with cognitive training and stress reduction techniques such as mindfulness. 

In separate studies, mindfulness has been shown to (1) reduce the subjective experience of pain (see Zeidan et al, 2012 for a review - including how insula, prefrontal, and somatosensory cortex activity is modulated by meditation during pain), (2) increase cortical thickness in insula and somatosensory cortices, among other areas (Lazar 2005, Grant 2010), and (3) decrease markers of inflammation (including IL-6, TNF, and cortisol). The Grant et al. study even ties (1) and (2) together, associating decreased pain sensitivity in Zen meditators with thicker anterior insula, cingulate, and somatosensory cortex. So...back to the current study, anti-inflammatory treated patients show less pain/fatigue in conjunction with cortical thinning in insula and somatosensory cortices. But if we think we might get similar immunomodulation with mindfulness as we would on an anti-inflammatory drug (disclaimer: not advocating that anyone ditch their necessary meds to just meditate), why are the brain effects the opposite? 

Intriguing question - as I hinted at before, maybe the effects are different when you've already got aberrant neural circuitry and brain structure from chronic pain/inflammation. After all, your body is pretty good at self-correcting when given the tools to do so.

But what would happen if we combined mindfulness meditation and an anti-TNF in someone with an inflammatory condition? Based on the (self-report, non-controlled study) data out there, good things, in terms of symptom improvement. But again, opposite effects in terms of increased/decreased cortical thickness being beneficial are reported separately - which has to make you wonder, if I meditate while on an anti-TNF, am I shooting myself in the foot because the brain effects of one pain-reduction technique counteract the brain effects of another? I'm still guessing no - .we know that normal inflammatory pathways are dysregulated and brain structure is slightly different to begin with under conditions of chronic inflammation, so most likely the underlying neural mechanisms would work differently too. I'd love to see someone run a brain structure/anti-TNF/MBSR triple-arm randomized controlled trial of this. NIH, any takers? 

In sum, this is a perfect example of the simultaneously awesome and maddening thing about cognitive neuroscience - we constantly bump up against things we still don't know. For now, I suppose I'll keep mindfully swimming along and trust that any changes going on in my brain are in my best interest. 

Writing & defending your dissertation, by the numbers

Ever wonder what happens in the last month of a PhD? Yes, I actually tallied all these things as I went along, on a blackboard in my office. Why? Who knows. Much more interesting metrics would've been my salivary cortisol, IL-6, and percent signal change in amygdala activation, but the NIH didn't give me money for that...so here it is:

Words written: 28,168

Last-minute analyses run, "because wouldn't that be interesting?": 92

Doodle polls it took for my committee to agree to be in one place at one time for my defense: 2

Emails sent regarding defense scheduling: 21

Colleagues I called and asked "do you know things about graph theory?": 7

Colleagues who knew things about graph theory: 1

Number of dark chocolate bars utilized as coping mechanism: 18, plus one of those 1 lb solid bricks, which I ate in 3 days

Number of times I googled "dlPFC connectivity" and felt dumb when the first citation that came up was a J Neuro paper authored by...me: 2 (fool me once...yeah)

Number of revise & resubmits for unrelated manuscripts that conveniently also landed on my desk during this time frame: 2

Cups of tea while writing: 84 (thank you, Gryphon's tea shop)

# of times I watched this video of a hamster in a competitive hot dog eating contest: 8

# of times I cried in my boss at the Y's office: 2

# of times Pandora asked me if I was still listening: this one I lost track of. But I highly recommend creating the station "Hip Hop BBQ". What, you don't write well to the tune of "Back That Azz Up?"?

Things I said or typed to people while under varying stages of contemplating life:
"if I was going to be an animal, I'd consider being a moose"
"the blizzard better not delay my chocolate delivery."
"basically I asked everyone I knew if they knew things about graph theory"
"I just realized I have chocolate all over my face."
"I'm just going to turn in this colorful flow chart held together by scotch tape."
"I want to be that alpaca."

Sustained swim-bike-run-lift training hours per week: 15ish, because priorities, and also coping

The acknowledgements section I really wanted to write:

David Smith for chocolate & for being willing to quit and start a goat farm with me if need be, Rebecca Kriepke for sending me that video of the hamster and driving 350 miles on a spare tire to get here, Jenny Dorand for general academia commiseration, Joe Stabile for dragging me out to look at some nice art and reminding me I am a smart person, my little brother for offering to beat up people for me, DJ for all the Irish bacon I ate in addition to the chocolate, my swim coach for letting me unload on him at 5am, and my Tuesday evening cycling class for being only slightly miffed that I was slightly late yesterday because I was defending my dissertation.

Team SOAS 2015

BOOM! That's right, I'm officially announcing that I'm racing for Team SOAS in 2015. Love their gear and so excited to be connected to this awesome network of female athletes across the US (and Australia, Canada, UK...road (plane) trip maybe?)

Aaaand if you're a woman who bikes, runs, or triathlons - check out their awesome and highly functional gear at Soas Racing (especially their tri shorts. Trust me, your butt will thank you). I actually bought my first ever tri kit from them years ago, figuring that if I was going to embarrass myself swim-bike-running for the first time, I might as well look super cool in pink and black polka dots doing it (see below). It worked, and now those polka dots are kicking $@& instead of dropping things on the way out of T2 (well, most of the time).

Trends in Group Cycling Class Attendance from Pre-holidays to Post-New Year: An n=1 Study

Everyone's familiar with the post-New Year's gym rush, and the (assumed) pre-holiday gym slump. I decided it would interesting to quantify things this year, based on my cycling class. I started noting attendance just before Christmas, and tracked through the end of January:

Some interesting observations that aren't apparent from the raw numbers:

1) The initial uptick in attendance in January was indeed from new people - I spent more time than usual fitting people to bikes and explaining gears in that first week. A few of them are still around, but many have disappeared already.

2) Although enthusiastic newbies have, perhaps, abandoned their well-intentioned resolutions by the end of January (see (1)), attendance has been sustained at a high rate. This is primarily due to a gradual increase in both (a) my competitive cyclists & triathletes who intentionally take a Nov/Dec "off-season" and resume serious training by mid-January, and (b) my more regular general-fitness attendees, who report intentionally avoiding the gym in the first two weeks of January because of the newly crowded locker rooms, etc. As one said "we've done this $^&@ before, and I'd rather wait a week or two until everyone's gone again." Somewhat depressing perception of society? Maybe. But relatively accurate.

3) There was an interesting up-tick between Christmas & New Year's on 12/28...as the health-conscious showed up to burn off their Christmas and pre-burn off their New Year's. Or they all just missed me.

Prehab or Rehab? How to Make it to the Starting Line at Your Healthiest This Year

Cross-posted at the PPG Wellness Blog

We’ve all been there. You’ve trained for months. You’ve gotten up in the dark to run your miles while the rest of the world was still asleep. You’ve bought stock in Gu, and your Garmin is your best friend. And yet, with your goal race just a few days away, you’re still nursing a nagging pain in the side of your left knee, your shins are sore, and there’s a twinge in your hip. Maybe you’ve come to accept this as inevitable – and now you’re standing at another starting line firing on less than all four cylinders, hoping for the best, dreaming of the ice packs and ibuprofen that await your finish.

A common misconception is that if you’re a runner, your body has to hurt, and some may even wear it as a badge of pride. But the vast majority of us are desperate to find a solution to our injury woes – after all, just think how much easier, faster, and more pleasurable running would be without that “foot thing”!  Maybe you’ve even followed all the conventional injury wisdom – rest, ice, 10% weekly mileage increases, stopped running altogether – yet you still hurt. The frustration mounts and you feel like you’re stuck in an endless cycle of having to back off your training and start again from scratch. If this sounds familiar to you, it’s not time to throw in the towel yet – there is hope! When you’re ready, commit to the following 3-step plan for more consistent, happier running.

Take a Step Back

The first step is to identify and work on any weaknesses and imbalances – is your right leg much stronger than your left? Nearly everyone is stronger on one side, but if all your aches and pains are on your left, your body may be telling you something. This leads straight into the second, and perhaps most crucial, step: do you even lift, bro? Make a commitment now to the right strength training – a program incorporating single leg strength and core work, including key functional movements your body goes through when running – and do it consistently! Does your opposite hip drop when you try to balance on one leg? Then it’s happening when you run, too, and you’re landing in that wobbly single-leg stance thousands of times every time you hit the road. Things like single leg squats, bridges to work your hamstrings and glutes, lunges, and step-ups are a solid starting ground. Hate the weights? Remind yourself that the time you spend building strength will pay dividends in your ability to run consistently without pain, and consistency leads to PRs.

When looking for imbalances, don’t neglect mobility – while being super flexible isn’t required (or even necessarily desirable) for running performance or health, one mega-tight hip flexor and an opposite tight calf can alter your biomechanics – how your body moves – enough to produce pain and eventually injury. A consistent 5 to 10 minutes a day of dynamic mobility work is better than one long stretching session per week.

While you’re at it, take a look at your running form. Are you running tall, landing with your feet under your body, and at a cadence of at least 170 steps per minute? Go through this quick mental checklist during each and every training session until this technique becomes automatic.

Run Smart, Run Consistent

How have you been approaching your training? Many runners perform every run at the same moderate-to-hard effort – or take this even farther, doing every run like it’s their last! Instead, make sure every run has a specific purpose. Even the best runners in the world do their easy runs minutes per mile slower than their normal training pace. Running intervals on the track? Now it’s time to throw down the hammer. Sit down each week and come up with a plan – which days are your easy recovery days, which day is your tempo run, and which day is speed work? Then hold yourself to those paces. Variety is the spice of life, and the savior for your legs – as well as your race times.

Stop Neglecting Recovery

Ok, so you’re doing the right training at paces and distances appropriate for your fitness level, building some strength, and working consistently on any imbalances and weaknesses you’ve discovered – the last piece of the puzzle is proper recovery. What are you doing when you’re not training? Sleep, proper nutrition, and life stress all affect how fast and to what extent you bounce back from that long run or strength session. Now, most likely you’re not a professional athlete – you have a full-time job, maybe a family and kids, and as much as you’d like to sleep 12 hours a night, it just isn’t feasible. What you can do is sleep better. Limit your exposure to bright light at night, turn off the technology when it’s getting close to bed time, and cut off the caffeine in the afternoon. Aim for more sleep if you can around your key workouts – if you go in physically and mentally fatigued, you’re setting yourself up for injury. Similarly, you don’t need to be a Puritan when it comes to nutrition – but trying to base the majority of your diet around whole, unprocessed foods means less inflammation and a decreased injury risk. Remember to refuel after training with some carbs and protein – find what works for you. Stressed at work or home? While a hard run may sometimes be a great way to blow off steam, psychological stress can also increase fatigue and injury risk – so proceed with caution.

If all signs point to needing to back off your intended workout – a niggling pain, an extra long day at the office, being up with the kids all night – cross training can be a great alternative (and one that should be part of any well-rounded training program). Cycling, swimming, and deep water running keep you moving, build aerobic fitness, and can even help you recover faster than completely taking time off. Running in the water can be a particularly effective workout, as it most closely mimics the demands of running on land – so grab a buddy and hit the pool!

There are no quick fixes, but with time and commitment, implementing these strategies can break the injury cycle and transform you into a healthier runner, one who is finally able to build a consistent training program and hit those times and distances you’ve been chasing. After all, healthy runners are happy runners, and who wouldn’t want to run happy?