Tri-Maine Series - Training & Preparation

Angela Bancroft, Wild Bear Winner

Tri-Maine Athlete Profile: Angela Bancroft

Angela Bancroft was an unlikely winner of the women’s overall at the Wild Bear Sprint Triathlon.

Late last summer, while training for the Lobsterman Triathlon, she fell off her bike while crossing a wet, pot-holed train tracks. She slammed to the ground landing on her shoulder and banging her head. “As soon as I fell, I knew something was really wrong,” recalls Angela. “I pulled myself off the ground and rode home, unable to move my arm. As soon as I got home, I passed out.”

Initially, medical attention focused on the minor concussion she sustained in the fall. The x-ray on her shoulder did not show a break, and she quickly regained some rotation and strength. The problem was that she could not swim. After physical therapy failed to restore function, Angela had an MRI. She was referred to a local surgeon who was pessimistic that Angela – a lifelong swimmer and runner – would be able to resume her pursuit as a triathlete.

“That’s when I started to do some research. I did some digging and found OA,” Angela says, referring to Orthopaedic Associates of Portland, a specialty orthopaedic practice with a focus on sports related injuries. “OA took my desire to get back to competition seriously. They got me in quickly, and gave me a super-thorough evaluation. They respected my goals and aspirations. Dr. Endrizzi was honest with me about what I needed to do, and he was optimistic that I would be able to race again.”

During surgery in early January, OA surgeon Dr. Donald Endrizzi, who specializes in shoulder related injuries, discovered that Angela had a rotator cuff tear that was very difficult to see even using advanced magnetic resonance imaging (MRI). Surgery was scheduled, and Angela began the long road to rehabilitation and recovery.

“The first six weeks were really hard,” says Angela. “My arm was in a sling. I was not allowed to move it at all. I could not drive. I could not run. Mentally and physically, it was tortuous – there were times when I thought I would never race again.”

Angela took her rehabilitation process seriously. Slowly but surely, she regained her strength. In March she was able to start running again. While her aerobic capacity was greatly diminished from lack of training, her fitness came back quickly. She began to ride the bike again in April, and she returned to the pool in late May.

Responding well to rehabilitation and training, Angela set her sites on the Timberman 70.2 half-iron man on August 19. She did not plan to compete in the Wild Bear in late June, but some of her friends were doing it. She felt good in training, and most importantly, there was an open spot.

“Winning was not an objective for the Wild Bear,” relates Angela. “I was there with a few of my friends to have fun and get back into competition. The swim felt great, and my arm did not hurt at all. I came out of the water first in my wave, thrilled that there was no pain. I transitioned quickly and headed off on the bike. I immediately lost my water bottle, but I kept on going. No other women passed me on the bike leg of the race. I was really excited, and I began to think I might be able to win the race. The run felt good, and I passed a few more women. I had an absolute blast doing the race.”

At the close of the race, just before leaving with her family for Connecticut, Angela checked one last time to see if the results had come out. Angela won the Wild Bear women’s overall with a time of 1:18:20.

“I was overwhelmingly surprised and excited by the win. I could not wait to tell OA and my physical therapists about how much I appreciated what they had done for me.”

Watch out for Angela Bancroft. While she may have been an unlikely winner of Wild Bear, she now is a likely favorite for Timberman and Lobsterman later this summer.

Avoiding Anterior Knee Pain (Patella Femoral Syndrome)

By Tim Davoren, ATC

Anterior knee pain or Patello Femoral Syndrome (PFS) is the most common overuse injury suffered by triathletes, cyclists and runners.

Most hard working triathletes are accustomed to enduring some level of pain. A twitch here; an ache there. No big deal. Likewise with interior knee pain, which begins as generalized pain around or under the kneecap. The onset of PFS can be gradual, or sharp and severe. Most of the time athletes experience it, they brush it off and recover. Then the problem gets worse…

Technically, Patello Femoral Syndrome is the mal-tracking of the kneecap in the femoral groove –the “knuckle” of the femur. This misalignment causes stress to the soft tissue around knee, and eventually can even lead to breakdown of the boney surface of the kneecap or the groove.

The onset of anterior knee pain is generally the combination of factors starting with weakness of the inner quad muscle or Vastus Medialus Obliques (VMO). Tightness or lack of flexibility in hamstrings and the IT Band is also a contributing factor. Likewise, poor orientation of the patella resulting from God-given bone structure contributes to PFS. A greater proportion of woman suffers alignment-related PFS than do men.

Cyclists and runners both have specific issues that result in PFS.

For cyclists:
• The seat height may be too low resulting in a knee angle that is too severe at the bottom of the pedal stroke;
• Pedal/cleat position or angle/width of the cranks may result in pressure on the knee cap;
• Or the saddle position – either forward or aft – may not be set properly also resulting in stress to the knee.

For runners:
• Foot position, specifically the pronation or rolling inward of foot, results in more stress on the knee;
• Terrain is also a factor. Domed roads in particular cause the uphill leg to pronate more to compensate for the leg height differential.
• Similarly, running downhill is a significant stressor on the kneecap due to the eccentric forces on the quad.

The first course of action for triathletes experiencing anterior knee pain is to assess recent changes in training. Consult your training diary to determine which of the many training variables may have changed (volume increase, new equipment, terrain change, etc.). Once identified, discontinue or decrease the specific type of training that may have caused the injury and see if the condition improves. Icing is also an effective technique, although anti-inflammatory medications like ibuprofen are not recommended in large doses if you tend to train through the injury, (exacerbating the condition), small doses for a mild flare up may be helpful.

Of course, the best course of action is to avoid Patello Femoral Syndrome in the first place. This means purchasing the right type of running shoe, obtaining a professional bike fit, proper pre-season strength and stretching, and gradually building volume over time.

If, however, you are sore during a workout or your training is limited by pain, then it's probably time to see a professional.

Treatment for Patello Femoral Syndrome includes the following:
• Strengthening the quads and glutes to control femoral rotation (a strong butt helps control the inward roll of the foot);
• Improving both hamstring and IT Band flexibility (utilizing dynamic warm-up and foam rolling);
• Evaluating foot mechanics (what's happening at the foot and ankle level)
• Obtaining a professional bike fit;
• Assessing your gait mechanics (how you pull your leg forward and push off your foot).

Tim Davoren is the Director of OAPT and clinician at the OAPT clinic. Tim believes firmly in injury prevention has been staffing Certified Athletic Trainers at high schools throughout Southern Maine for 12+ years. Since 2000 he has been the Physical Therapy Instructor in the OA/Maine Medical Center Primary Care Sports Medicine Fellowship Training Program.

Tri-Maine in the News

Tri-Maine and the Tri-Maine Series of Triathlons have been in the news lately as race season kicks into high gear.

The Brunswick Times Record featured a story on Kurt Perham, winner of the Shipbuilders Triathlon, on July 2, 2007. Kurt told readers of this blog how to win a sprint triathlon, and he then went on the win the Wild Bear and Ship Builders. Looks like he can do Olympic distance races as well!

Then on July 8, the Maine Sunday Telegram ran a story entitled Making Strides, which focused on Tri-Maine Productions, Will Thomas and the Tri-Maine Series.

Derivations of this article were picked up on July 9 by WMTW - Triathlons Make Inroads in Maine - and by Fosters - Triathlons Gaining Ground in Maine.

Functional Threshold Power (FTP)

By Thomas Murray, MD

In a previous entry, OA introduced blog readers to the power meter as a relatively new training tool for triathletes and cyclists. This entry focuses upon Functional Threshold Power (FTP) – the basis for training and racing with a power meter.

Simply defined, functional threshold power (FTP) is the maximum average wattage that a cyclist can sustain for a one-hour time trial. As such, FTP is akin to threshold heart rate over a similar period of time, though FTP is more consistently reliable than threshold heart rate. Whereas hydration, fatigue, nervous energy, caffeine levels and daily rhythm changes can affect heart rate, FTP remains a more consistent measure of work output.

Andrew Coggan and Hunter Allen, the authors of the seminal book Training and Racing with a Power Meter, identify several ways to measure FTP. One sure way to establish functional threshold power is to do a one-hour time trial and measure your average wattage over this time period. Given the pain associated with such an effort, the authors have suggested another testing method to determine an accurate estimate of FTP: the 20-minute Critical Power (CP) test.

The 20-minute Critical Power test is conducted as follows:
• On a trainer or on a relatively flat section of road, warm-up easy for 15-20 minutes;
• Over the next 5 minutes, do five (5) hard 30-second efforts, followed by 30 seconds of soft-pedaling. The purpose of this drill is to open up the blood and oxygen flow and to increase the heart rate prior to the 20-minute effort, so don’t go too hard. Push a wattage you think you can sustain for 10 to 20 minutes.
• Pedal easy for 5-minutes and prepare yourself mentally for the 20-minute test, as it’s going to hurt!
• Start the 20-minute test by selecting a wattage you think you can sustain for the full-20 minutes. The cardinal rule of time trialing applies here: don’t start out too hard. Keep in mind that the best cyclists in the world can only sustain 400-500 watts over a 1-hour period of time, so if you find yourself starting out at 500 watts, you know you are likely going much too hard. It’s best to start out easy for the first two minutes, and then build progressively to a wattage level you think can sustain.
• Hold that level for the first 15 minutes, and then give it your best effort during the final five minutes. (If you find yourself fading in the last five minutes instead of holding steady or building, then you may have gone out too hard. Keep this in mind for your next test).
• Take your average wattage for the 20-minute period of time and multiply by .95.
• Your functional threshold power = 20-minute CP test x .95.

If your average power for the 20-minute test was 210 watts, then your FTP is estimated at 200 watts. If your average was 300 watts, then your FTP is estimated at 285 watts. And so on.

The objective of the triathlete / cyclist is to benchmark and progressively increase functional threshold power over time – peaking for goal events throughout the year. As such FTP not only serves as a benchmark for training zones, but it also can serve as a “cruise control” target to help avoid over or under performing on the bike (see Powermeters: The Latest Training Tool for Triathletes).

Subsequent entries will focus on workouts designed to increase FTP as well as how to use a power meter to determine workout intensity, training stress, training load and race pace.

What would you like to know about racing and training with a power meter?

Dr. Thomas Murray, an avid cyclist, is board certified by the American Board of Orthopaedic Surgeons and an active member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine. He is President of the Maine Society of Orthopaedic Surgeons.

Recovery: Avoid Injury and Overtraining

Many triathletes are familiar with the principal of overload and recovery.

To improve fitness, a triathlete must progressively increase the training load over a period of time followed by a period of recovery or rest. Classic periodization theory suggests three (3) build weeks (2 weeks for older triathletes) followed by a “recovery” week. During the recovery week the volume and intensity of the training is reduced by 20-50% over the previous three-week training block. The recovery week allows the body to rest, to adapt and to prepare for the next three-week block of exercise, which builds upon the previous block. Ideally, each three-week training block applies incrementally more training stress either by increasing the volume over the previous period, increasing the intensity, or both.

As a group of overachievers, triathletes tend to excel at increasing the training load, but often fall short of taking a vital week of recovery to let the body rest and adapt. During the spring and summer months, many triathletes log between 10 and 20 hours per week of training as the days lengthen and the racing season kicks into high gear. If their bodies have not been properly conditioned for the increased load, these triathletes risk injury and overtraining. Amateur triathletes (most of us), in particular, are susceptible to overtraining. The psychology of these athletes tends to be “if I’m not training, then I must be losing fitness.”

An irregular or inconsistent training program can exacerbate the problem, as triathletes who miss a day or two of training tend to overdo it by making up for missed training sessions. Work-related or family related-stress also contributes to the problem. The body does not seem to differentiate between the stress associated with training load and the stress associated with daily living. Rest and recovery is the only effective antidote to stress – training or otherwise.

Coach Kurt Perham, the points leader of the Tri-Maine Series, advises his clients to “train smart and recover hard.” Training smart implies creating and following a training program that establishes a solid aerobic foundation, builds progressively on that foundation and applies volume and intensity gradually at a rate that assures the body is ready for the increased load. “Recover hard” means take time to rest, relax and allow the body to adapt. Triathletes are advised to be as deliberate about their recovery as they are about their active training programs.

OA would like to hear about your recovery techniques. Tell us what you do to assure your body is rested and ready to go for the next training session. In subsequent blog entries, we will share your recovery techniques, along with some suggestions of our own.