Bruises That Worry

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Mountains are dirty and full of rocks. That makes them hard on people who are moving at great speeds to complete a course because any misstep can cause a fall.

When you have athletes that are training in mountainous regions, I always remind people that mountains are made of ROCKS.

Yes ROCKS, and rocks can kill people, even nice, cute people. Depending on if you are in a volcanic mountain or other type of mountain, let’s just agree that all mountains are full of rock.

Rocks get caught up in stuff, they also really hurt and always break skin when you fall on them.  Rocks can cause crazy bruises. Bruises are like a scab on the inside, and you will know instantly when you’re about to bruise the living crap out of your leg, because it will turn color quickly.

If it looks like the bruise on a large muscle group is going to be under the size of a fist, as the Trail Driver I really don’t worry that much. But, if it looks like it is more like the size of my hand if it were open (with all fingers) or larger, I’m definitely going to start to worry.

Bruising that instantly turns black is also not a good sign. Bumps that immediately show a raised “nugget” like a head bump means I will pull the athlete from the course.

It is best to remind all athletes of the rules around safety in advance, so they know IN ADVANCE what accidents will pull them off the course. “Please avoid head injuries” is not enough information…

If your athlete gets injured, ask the person to tell you about the fall and the type of impact. Was it jagged or smooth, was it a deeper punch or just a pancake splat?  Weight falls at 2 ½ times its weight, so a 200-pound male is falling at 500 pounds of force and 500 pounds of force on a spleen is never a good plan.

If you are sending them back, have a medic check them in route and make a back-up plan if the pain gets worse. If they puke after a pancake splat, they need to go right to medical, because this is now a trauma sign.

Best option, pay attention to rocks, tell your team to pay attention to rocks, and NEVER, NEVER trust rocks to stay in place. Nothing outsmarts gravity.

Trail well.

 

The Trail Driver – The Spiritually Driven Athlete – Part 2

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Trail Drivers are those who support athletes so that they can do great things. Trail Drivers allow athletes to be better by helping them have resources while they’re doing things that are incredibly physical. Sometimes that’s logistics, a supply vehicle, or encouragement.

This is a two-part post reviewing how to support those athletes that I call “spiritually driven athletes,” those unique athletes that are called by some special circumstances to do something BIG, like doing a long event to raise awareness for a cause.

These are not the average athletes that are just training to do a specific distance. These are athletes that will be on the road over a series of days doing parts of their challenge over a long part of road. The majority of the time they will be their own support, MacGyver to medic, and they are going to have a ton of time in their own mind. Having a ton of time in your own mind can be great for the first 3 to 5 days, but after 30 days it gets a little dreary and weary.

The role of a Trail Driver, even if they are across the country, is also to make sure that they can help that person manage all of the details that it will take to keep them safe on their journey, supported with the items that they need, and pick them up if there is need. A great Trail Driver can help remove obstacles and put resources to that athlete very quickly.

Mapping is your number one tool. Physical maps are needed on journeys over 50 miles. You will need to see, on one piece of paper, the beginning and the end of that journey, and to be able, long-term, to see how far you’ve traveled. You will need to utilize every form of mapping, Geo location, with a smart phone, and Google maps to identify the physical building that they may need to find. “I’ll meet you at the old post office that’s on the corner of Main and First, and it’s right next to a service station so you “I’ll meet you in the small town.” Mapping does something magical, it allows someone to find out where they are, where they’re going and how much time it will take them, especially when their brain isn’t working right.

Put a map printout at the bottom of their rucksack, and one that they can pull out and use all the time. Losing a single piece of paper is probable. Another tip is to set up the “Find My Phone” application so you can actually Geo locate the phone and you don’t have to call that athlete to be able to find them.

Let someone in that town know you’re coming. Call ahead to either an organization that matches the cause, or a city official. They are going to want to know information; the cause, the name and the information about the person, and approximate times to look out for them. Sometimes I do this so when that day comes, people don’t think this is a crazy vagrant that they have to be fearful of, and sometimes it’s just so they can keep an extra eye out to make sure they don’t get hit on a country road. In small towns across America I have found that having something exciting happen, seeing someone with a dream or that is taking on a challenge to do something greater, is worth coming out for!

Texting is still a tool that allows for people to connect. There will be many times where that person may not be eligible to get that text because of cell service, but at some point they will, and will be glad they have it. If it’s been particularly long and lonely on the road, they’ll gladly interface with it.

Food and types of food matter. You are going to need to have that person focus on anti-inflammatory foods. They, over a series of days will have aches in places they never knew could ache. Orange juice or pineapple juice are foods that they should get to know. There are plenty of menus online that will give you simple items that you can add into their food groups to keep the inflammation down.

Protein is a tool, not just a trend. Having protein to keep muscles building and repairing themselves is going to be critical. A protein-based final meal is going to be a critical tool and how they will recover over the 10-12 hours of being on the road. Their body will want foods that sustain it during the peak hours of exertion, but in their resting state it is going to need all of the energy can get to repair all of the parts of the body that were stressed during the day.

Focus only on the goal for the day. Be the voice of reason. Every day actually has a goal, and every goal has a time that it is completed. When things are feeling boring, overwhelming, or just plain too much, let them know how far they’ve come, how much further they will get in the day, or give them information that will help them locate and find where they’re supposed to be and when in the days going forward.

Editing the rucksack. If they are on a long journey that is over months, you will need to edit the rucksack, and change out any gear that is no longer functional. If that person is a solo athlete, you can actually send gear to a hotel along the way and have it ready for them. I have found that hotels are incredibly helpful, if the athlete is camping and sleeping outside, even the campsite can traditionally get deliveries.

Invite others to the task. If your athlete is covering a lot of physical terrain it is incredibly helpful to invite people to meet them on that terrain at various times and give those people a task. Can you bring extra water? Pack something and meet them there. Those athletes don’t have to have someone with them all the time, but having someone check in with them daily for even as little as 20 minutes will help them keep their sanity on the journey.

In order for people to do great things, they don’t need just courage, they need thoughtful, consistent and persistent support. For those of you who are that support, I personally thank you for making the world a better place.

Trail Well.

Managing Blood Flow in the Body

redistributionofbloodflow www.learn.sdstate.edu

If you are doing a repetitive sport for hours on end, every athlete will have places on their body where blood will start to pool, and those places will need to get moving so that the body can function at a higher performance long term.  

Commonly affected areas are hands, legs and feet. Blood pooling in these areas will not only change the circulation in the body, but it will also be a ticket to stiffness both that day and the next day. 

It’s helpful to simply put an athlete in a different stretching position that allows gravity to escort the blood to a new place, or rest the athlete in a different position, or have them choose to switch athletic gear. 

A common question to ask is “Are there any areas of your body that are feeling a little numb?”

If this is a seasoned athlete they will naturally move to try to free up that area for movement.  

One of the easiest items to try is to get that athlete in a reclining position and let gravity work on their behalf. 

The body is an efficient tool and usually will redistribute blood within five minutes. 

As always, pay attention to your athletes and give them as many medical alert tools as you can before the event so that they can participate in their own care.

Sharing blogs like this so that they can watch for their own signs of distress is almost like having a race prep meeting! 

Trail well.

Image courtesy of http://www.learn.sdstate.edu

Stress Fractures Are Annoying and Preventable!

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Over the years I have met a ton of endurance athletes, and one thing that they all have in common is their own personal list of annoying injuries. Many people have a war story to go with each injury on that list.

All you have to do is say to an endurance athlete “pulled hammie” and you will watch their whole body scrunch in reaction to how painful that is in real life and how annoying it is to manage the recovery.

Stress fractures not only hurt, but they are traditionally really annoying because it takes so long to heal bones. Hobbling around on crutches, keeping legs elevated, or having an inability to put weight on that region for any athlete is super-duper, big sigh, frustrated kind of annoying.

Taking steps in advance of an endurance event to avoid stress fractures is the “pay attention” advice for the athletes reading this article. This blog series is really focused on the things that happen on the trail and how a support team is going to react to those events, so I will focus on what to do after the injury has occurred.

The chances of a stress fracture for endurance athletes is high, especially for athletes that are pushing their muscles to the very limit. A normal athlete has between a two and 20% chance of having a stress fracture. An endurance athlete will most likely have one at least one in their personal list.

The reason a stress fracture happens is the muscles themselves become too tired to do the work. In order to pick up the impact of the work being performed that the muscles can’t manage, it directs that stress to the bones.

The majority of stress fractures that I have seen on the road really happen in the areas of the feet and the legs.

The athlete will know that they have a fracture because they have a pain that is traditionally getting worse, it will have a lot of swelling, and it may end up with a slight bit of bruising, but it will be first noticeable by pain. You’ll also know it’s a fracture when the pain is reduced as soon as any weight is lifted from the area or it will  immediately start to feel better from rest, and then spurs back as soon as motion or weight is applied to that area.

The hop test- have the athlete hop on the one side where the pain is. A stress fracture will deliver a pinpoint sharp pain.

Your best option is always to STOP-REST-ICE. If you are a trail driver, 100% of the time my advice is to have the athlete pulled off the course, and I will tell you very few athletes want to be pulled from the course. They will endure huge amounts of pain to not leave the course.

My advice to the athlete in a situation like this is to give them as much information as you can about where you think their injury is or where it is heading. Invite them to discontinue what they’re doing if it is causing them pain. In this case if it is a fracture they could actually double the amount of time that they will be unable to perform and be recovering.

Because this type of pain can often look like many other things that are not as critical, like shin splints, you really need to pay attention to the swelling, and how the pain changes when the area has weight taken off of it. When you have pain that is in the muscle tissues, it will start off REALLY screaming. If it is a bone pain, it will get progressively more painful as they move.

There are many athletes that will choose to continue on and bull their way through a stress fracture just to meet those goals. For those crazies, try to wrap the area tightly, give ibuprofen and a sturdy warning. That is all I can offer that will be accepted.

I will leave you with an odd fact, and that is if your athlete was also an athlete as a child, orthopedically they are less likely to get a stress fracture as an adult. And that has to do with the placement of the hip being different in athletic development of children.

Here is that random fact link.

Trail well.

Elevation Burns

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When you are trail driving in areas that have high elevation and a lot of sun you’ll want to watch out for elevation burning.

It is also called sun poisoning, but it’s where you see (usually on the arms of an athlete) what looks like sunburn but has teeny white dots in it. Those white dots will be right underneath the skin and may have a little bit of topographical texture to them. Traditionally I see this in higher elevations, but it means that the athlete needs immediate complete sunblock and burn treatment.

I have a tool that I use that is in a tube form called “Rescue Remedy.” It is available at Whole Foods everywhere, or multiple places online. It is a homeopathic treatment that is especially good for burns. If you are taking notes, buy some and keep it in your medic kit at home for burns that happen on the stove. I am not kidding, this stuff is magic!

You want to slather it on that burn as soon as you see it and let it do its job. It will be the difference between blistering and not blistering.

If you have Rescue Remedy, I would apply it immediately and let it soak into that skin as many times as it can. The first application will melt into the skin. You want to apply it until it doesn’t immediately melt anymore and it’s got a white top finish. As soon as that slow sinking white top layer gets melted in (it may take about a minute) then you want to apply sunblock over that.

That should do the trick for the rest of the day, unless they are sweating off their sun block. Be very gentle when touching this area and remind them to not scratch. Scratching will make those white bumps that are actually a kind of blister pop up to the top.

Trail well.

Pulling Athletes Off the Course

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For endurance athletes and teams that are putting themselves in conditions that are personally and medically pushing boundaries, the last thing they will want is to be pulled off the course.

One of the things that I remind all trail drivers when they are servicing endurance athletes is that if it looks painful to you it’s probably not painful enough for that athlete to quit. They are out there to push their limits to places that most people would not consider.

You are there to make sure that they come out alive. And I mean that literally.

For these athletes, before we even set foot on the trail, we come up with a code word or someway in advance to agree when they have lost their mind, or when they are medically unable to continue.

There also has to be an agreement in advance that they will trust you that when you “call it” that they have to stop. And you will have to trust that athlete to know what their personal boundary is and that they can recognize it when they need to pull out. During that agreement time I will usually give a list of items that will make me immediately pull them from the course and those are traditionally the signs of a heart attack, stoke, or medical emergency.

Many times simply resting, or managing water, or a nutrient review will give that athlete enough to continue forward. I never threaten to pull someone from the course, I only invite the idea of rest so they don’t have to get pulled from the course.  I also, during times of complete fatigue, give them a time limit that tells them when I will be managing their health check points. “If you’re still listing sideways  or unable to keep your balance I need you to just sit down and I’ll come get you. I will be watching you in three minute intervals.”

What that simple piece of information does for the athlete is it also lets them know within three minutes if they’re getting better. That sometimes is all the help they need to keep going forward.  It only takes about three minutes for food, hydration, or rest to start working for that athlete.

It also gives you a short enough time for the athlete to work out in their head that we have to go for medical.

Trail well.

 

The Mind is Medicine

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I was talking to an athlete and asking him how they get through extreme events when suffering with pain.

What I got back was something I hadn’t expected – the use of imaginary medicine!

The athlete had a mind technique that is really quite good, and I’m going to share it with all of you. They prepare an imaginary stash of mental painkiller that is located in their body and that does not run out. When they feel pain they start to identify if they need their body to send pain killer to that area. And then they just start imagining pain killer from their body being sent to that area.

Sometimes they imagine a few drops, sometimes it’s multiple doses over miles.

“Does that work?” I ask in astonishment. The response I got back was a gigantic smile and a YES head shake.

What I love about this technique is it gives the mind a chance to check in with the body and work together to get through extreme circumstances. It also helps the body know that this pain does not have to stay, it’s been noticed and it should settle down because much more will be required.

Using mind techniques to manage pain has been used for millennia. Using the power of the body and mind connection is a quick tool that every athlete can take with them, wherever they go.

When you are pushing your body to new limits it IS a brain game, and having as many tools as you can to use when you need them is not just a good idea,  it is sometimes the only way to finish.

Plus in this case there’s no prescription refill needed, it never runs out!

If you have other mind tricks to manage pain while on the trail please leave them in the comments section so everyone can pick them up.

Trail well.