Thinking oustside the Box

For those of us who commit a lot of time to fitness, training and racing, we know injuries can be both physically and mentally debilitating.  We would do almost anything to heal quickly so we can get back on track with our training.  Perhaps the worst injuries are those for which doctors don’t seem to have an answer.  In those instances, we have to stay positive and sometimes think outside of the box.

In July of 2011, I raced my first Ironman with the hopes of qualifying for Kona (which would mean I would have to race another Ironman 9 weeks later).  The race went well in terms of qualifying, but I knew half way into the marathon that something was not right with my left leg.   Weeks after all the soreness in my muscles had faded, I still could not run without pain on the outside of my knee.  The orthopedist deemed it to be IT Band Syndrome and after X-Rays, an MRI and a cortisone shot, he said I could begin to run again to get ready for Kona because I wouldn’t cause it any further damage.  I tried my best to train, but limited my running because the pain was unbearable.    Surprised that I hadn’t improved, 2 weeks before Kona, the doctor suggested and administered a second cortisone shot with the hopes that the persistent inflammation of something would subside.

In October, I raced Kona because it was a chance I might never have again.  Every step of that marathon (with my left leg) was painful, but I ran the whole way and vied to take 6 weeks off from running to finally let my injury heal.  Much to my chagrin, 6 weeks later my knee had not improved.  I cut out cycling and even used a pull buoy in the pool so I wouldn’t kick.   I was essentially only using my legs to walk.  By December, nothing had changed and my doctor ordered another MRI.  I was told the same thing – inflammation from IT Band Syndrome was causing my pain.   I had tried traditional and non-traditional physical therapy, ART from a certified chiropractor and acupuncture. I saw a pain management doctor and rehabilitation specialists.  I even went to the renowned Hospital for Special Surgery (HSS) and was told I had patellao-femoral syndrome which would require the surgeon to saw off my knee cap and realign it with a screw, an operation that would require 9 months of rehab.

Luckily for me, a fellow triathlete who also happens to be a reconstructive surgeon specializing in peripheral nerve surgery offered to help.    I told him I was having pain on the outside of my leg above and below the knee.  At this point, the pain set in about 15 minutes into any run.  He numbed my lateral retinacular nerve and asked me to go for a run.  I laced up my sneakers and took off.  I hadn’t felt that great on a run since before I had raced that first Ironman 7 months earlier.    He explained that he could remove the nerve that was causing my pain because it was a nerve to the knee joint as opposed to a sensory or motor nerve and that he could decompress another nerve to alleviate the pain below my knee.   Intrigued, I called my orthopedist (also a friend) to ask his opinion.  He told me he had never heard of such a thing and so could not advise me on whether or not to proceed.  The chiropractor, the physical therapists and the doctors at HSS advised me against it.  I decided to seek a second opinion with another, cutting edge orthopedist who told me to go for it.

On April 30^th, 2012 I had peripheral nerve surgery.  Dr. Ziv Peled (pelednervesurgery.com) practices in San Francisco so I flew from New York to have the operation.  I flew home the next

day, used crutches for one day and began cycling with no resistance 3 weeks later.  Within 5 weeks, I was swimming and began a return-to-run protocol (a combination of walking and running) a week later.  By August, I raced in my first triathlon.  Not only did my knee feel amazing, but I had the fastest run split of the day!  Less than a year later, I qualified for the Ironman 70.3 World Championships and ran the Boston Marathon with no hint of knee pain.  

Training and racing are a big part of my life and contribute a great deal to my happiness.  Were it not for Dr. Peled, I would likely still be throwing money away seeking various doctors and treatments for what turned out to be a simple solution.  Unfortunately, Dr. Peled has told me that many of his patients come to him only after they’ve tried “everything”.   His specialty is unique and not well-known and therefore, few patients know to seek his help.  The best part is, a simple consultation and nerve block can help Dr. Peled quickly assess whether his procedures will provide a likely solution.

For those suffering from unexplained joint or nerve pain or from “explained” pain that has not responded successfully to more conventional treatment, there is hope.  There is a lot of hope.  Sometimes we just need to think outside the box to get the answers we seek.

 

Noga Ruttenberg is a certified USA Triathlon and USA Cycling level 3 coach based out of Westchester. Noga is the mother of two children and an elite amateur triathlete.  She writes customized training plans and can be reached at npeled@hotmail.com

Green Juice

Green juice is all the rage these days and rightfully so. It’s a great way to get more veggies and greater diversity into your diet. Just be careful, it can be very addicting. The experts say that drinking green juice is an easier way to digest your vegetables and helps the body absorb them faster, even though you’re extracting most of the fiber from the vegetable. You’re using up less energy to digest food in a liquid form. This gives your digestive system “rest”.
Be careful with adding too much fruit to your green juice. Doing this will raise your blood sugar because your extracting all the fiber. I try to go by the 10% rule. Don’t let your green juice have more than a small piece of fruit in it.
Anti-Diet Method tip: Try drinking something green once a day. If you like smoothies but are not quite ready for full-on green juice, add a handful of spinach to your smoothie. Nervous about green juice? Add a small piece of pineapple to your green juice to sweeten it up a little and then slowly cut back.

Here’s an easy recipe to get you started. This recipe comes from the movie “Fat, sick and nearly dead” by Joe Cross.

4 cups kale leaves
1 cucumber
4 celery stalks
2 green apples
1/2 lemon-peeled
1/2 inch piece ginger (or less to start)
run everything through a juicer and cheers!

Yoga for Althletes

Serious endurance athletes, such as runners, cyclists and triathletes often overlook yoga as an integral part of training.  The truth is yoga will make you a better athlete.   These athletes often lack flexibility in their hips which can lead to injury and prevent peak performance.  Yoga also works on core strength which is critical to any athlete and can help “open” the hips. Spending time stretching and focusing on key areas will help athletes gain more flexibility, strength and balance in the core muscle groups as well as aiding in recovery.   But like all training, frequency and consistency is the key to success. It’s not necessarily how long you do it, but how often.

 

Another key benefit of yoga is that it will make endurance athletes become stronger mentally. The ultimate intent of yoga was to bring mind and body together into a unified whole. The mental portion of yoga allows for better concentration during a competition and a better ability to move beyond the place where a body thinks it can no longer go.  Staying in the poses for longer periods helps focus concentration on tactical positions and movements which is critical in long endurance races.  Yoga’s focus on breathing can help keep an anxious athlete relaxed and focused in training and competition.

 

 

Finally, yoga can also help to prevent injuries. You can benefit by adding a few yoga poses to your training. High volume and endless pounding can often cause injuries so it’s important for an athlete to sometimes redirect her focus on recovery and rebuilding as opposed to the natural breakdown that happens with other workouts. Your next workout is only as good as your last recovery.

The following yoga poses (which can be easily found on the Web) are among the most beneficial for endurance athletes of all types:

Planks are the ultimate core strengtheners while at the same time improving balance.

Lunges help to strengthen quads while stretch hamstrings as well.

Pigeon Fold is a great hip opener which relieves tension and tightness from the hips and piriformis.

IT Band Twist will help stretch the IT band which is one of the most common injuries for runners and triathletes.

Warrior 2 pose can get the quads burning but can allow for a deep stretch in the hip flexor and calf.

 

Crescent Lunge and Dancer’s Pose are great for hip flexor stretches, strength and balance.

 

Eagle is a great pose for shoulders which is beneficial for swimming.

 

Pyramid provides an intense hamstring stretch.

 

Balancing Half Moon provides a key mental and physical challenge.

Downward Dog with Calf Stretch variation is the ultimate hamstring, shoulder and calf stretch.

 

 

 

 

 

Here are some practice tips:

• Move slowly and deliberately into and out of your pose.

• Do not force a stretch! Doing so will only tighten muscles and can result in injury.

• Hold each pose for 5 – 10 breath cycles.

• Focus on full diaphragmatic breathing to open the body and calm the mind.

• Breathe in and out of your nose.

• Add “Yoga” to your training schedule and commit to stretching 10 minutes, 2 – 3

   times per week.

• Most critically, listen to your body.  There should be no pain with yoga.

 

The time you take to add yoga to your training routine can actually save you recovery time, get you back on the race course faster, or spare you time off due to injuries.

Noga Ruttenberg is a certified USA Triathlon and USA Cycling level 3 coach based out of Westchester. Noga is the mother of two children and an elite amateur triathlete.  She writes customized training plans and can be reached at npeled@hotmail.com

Don’t judge a book by it’s cover

I  just finished a great running book called Eat&Run by Scott Jurek. I learned of the book on this blog – the author was giving some copies away as part of a contest. I didn’t win the book so I went and ordered it and found it to be a great, easy and entertaining read. I highly recommend it to all my vegan runners out there. In this book the author provides some great recipes and I noticed he talked a lot about Ezekiel 4:9 bread. I know…. Some of you reading this might be thinking “really? your just hearing about this?” I have heard of the bread and the brand but I would look  at it and think, this doesn’t look tasty and I really don’t want to spend 5 or 6 bucks on a loaf of bread that looks like cardboard. He was raving about this bread and it seemed to be a staple in his diet. I personally am not a believer in the whole big bagel, lots of pasta for runners. I think carbs are good and important but I go for the brown rice or whole wheat options first. I even eat lentils and brown rice for breakfast if I know I’m going to have a hard workout ahead of me -not a bagel. Lately my go-to breakfast has been a whole wheat english muffin with some all natural peanut butter and jelly followed up with a green smoothie. This works for me for a two-hour workout. The other day I was at the market and went for the Ezekiel 4:9 cinnamon and raisin english muffins. I’m an idiot and should have tried them a looong time ago. They are amaze balls! So yummy and satisfying even my husband and girls eat them! Don’t be like me and get turned off by the their packaging, their look or that fact that they’re in the freezer section. They are one of your healthiest bread options out there, in my opinion.

Black Eyed Peas and Swiss Chard

This recipe is easy to make and taste better than it looks. The original recipe comes from the Post Punk Kitchen. This is a great dish to serve to meat-eaters for Meatless Monday or maybe you’re just trying to cut back on eating meat every single day? Either way it’s a great, tasty and a satisfying dish. It’s also a great way to get a different type of green veggie in! This recipe makes any green taste good!  I didn’t follow the recipe exactly. I used what I had in my kitchen. She serves it with mashed sweet potatoes and apples. I just sliced and baked my sweet potatoes. Kept it quick and simple.

swiss chard

sauteed onions and garlic

pour in vegetable stock

add tomato sauce

liquid smoke

I added a little vegan worcestershire sauce

sweet potatoes

black eyed peas and swiss chard with rice!

1 teaspoon olive oil
1 small onion, diced small
2 cloves garlic, minced
1 bunch kale or collards, rough stems removed, shredded (about 1/2 pound)
1/4 cup water
1/4 teaspoon salt
2 15 oz cans black eyed peas, rinsed and drained
1 cup tomato sauce
1/2 cup veg broth
1 tablespoon hot sauce
1/4 teaspoon liquid smoke

Preheat a 4 quart pot over medium heat. Saute the onion in the oil until translucent, about 5 minutes. Add more olive oil if needed. Add the garlic and saute a minute more. Add the greens, 1/4 cup of vegetable stock and salt. Cover the pot and cook the greens down for about 10 minutes, stirring occasionally. Add black eyed peas, tomato sauce and broth and thoroughly mix. Cover pot and cook for about 5 minutes, stirring occasionally.

Add hot sauce and liquid smoke, then use a potato masher to mash some of the beans, about 1/4 of them, to thicken the sauce. Cook for about 5 more minutes uncovered. Taste for salt and seasoning. You may want to add more hot sauce.

Strength Is My Weakness

There are 3 key elements to endurance racing: Strength, Speed and Endurance.  Most sports require you to be adept at all 3 in order to really excel.  Ball sports also require a lot of hand-eye coordination and ball handling skills. But for the purposes of this blog, I’m only focusing on the fitness aspect of racing/competing.  Most athletes like the cardiovascular stress that comes with aerobic activities and of course aerobic work is critical.  With respect to endurance races such as marathons, triathlons, cycling, open water swimming, etc., endurance is obviously very important.  Speed is less critical but always an element that should be included in training.  What many people fail to realize however, is how important strength and strength training are for ultimate success.  The reason is 3-fold.

First and foremost, strength training increases muscle mass and helps reduce injury.   If you have ever suffered a sports injury, you were probably asked to see a physical therapist to help you in your recovery.  One of the main goals of physical therapy is to improve the muscles surrounding the injured area because when a muscular region is weak, we often make improper functional movements to overcompensate for the weakness ultimately causing an injury.  When our muscles are strong, our functional movements are more likely to be correct, reducing the risk of injury and ultimately increasing our muscular speed.  I write training plans for a number of triathletes and I include strength training twice per week.  Strength training is the most common element of the training plans my athletes ignore.  Not surprisingly, those athletes who don’t strength train are the ones most often injured.

Secondly, strength training is critical in slowing bone density and loss of muscle mass that are a natural part of aging, especially for women.  A typical adult loses about one-half pound of muscle per year after the age of 20, which means you feel less energetic and generally weaker.   Strength training makes all of our movements easier and more enjoyable and it also helps reduce the pain from arthritis and prior injuries.  Women tend to be more prone to osteoporosis than men.  But many women fear weight training because they worry about bulking up.  Strength training for women causes changes in body composition rather than bulky muscle mass. Women don’t have the capacity to build bulky muscles due to their high estrogen levels.

Finally, strength training helps you maintain a healthy weight and has been found to improve mood, sleep, balance, heart tissue and glucose control.  Most people know that muscle burns more calories than fat.  The more muscle mass we have, the more calories our bodies burn at rest.   As muscle mass

 increases, metabolism increases, making it easier to maintain a healthy body weight.  If you don’t intentionally rebuild muscle through exercise, every ten years you will need to eat 150-450 fewer calories each day to maintain your current weight.

When I talk about strength training, I don’t mean pumping iron, lifting heavy weights, doing 100s of crunches and bulking up.  Strength training is about training the muscles to function properly when fatigued and to ultimately stay stronger longer so fatigue takes longer to set in.  Here are some tips:

·       Choose strength exercises that are specific to the sport you are doing.  Single leg exercises are best for runners and cyclists since you are utilizing one leg at a time.

·       Begin with light weights to allow your body to learn the correct movements and minimize the risk of injury.

·       Make multi-joint exercises the priority.   For example, squats use three joints: the hip, knee, and ankle.  Knee extensions use only the knee-joint.

·       Use your muscles not momentum to lift the weights.

·       Allow at least 48 hours between strength training sessions and make sure you always have proper alignment and form.

Set aside 30 – 60 minutes two to three times per week and you will be able to reap the benefits mentioned above.  Don’t let strength be your weakness.

Noga Ruttenberg is a certified USA Triathlon and USA Cycling level 3 coach based out of Westchester. Noga is the mother of two children and an elite amateur triathlete.  She writes customized training plans and can be reached at npeled@hotmail.com

Simple Black Beans

I love black beans and so does my 5-year-old, Carolyn! My 2-year-old Lia, however, is not a die-hard bean girl. So I was pleasantly surprised the other night when Carolyn requested black beans with rice and Lia ended up eating a whole bowl (usually she just says “I don’t like beans, sissy does”).  I didn’t do anything fancy – just kept it simple but they really did turn out well. I did not use dry beans this time. I used the whole foods brand that come in a tetra pak (most can goods are lined with PBA).

Black Beans
1 tetra pack organic black beans (15 oz) (do not drain)
1 clove garlic
2 sprigs cilantro
salt to taste

In a blender blend 1 clove garlic, a little less than half the beans with liquid and cilantro for 40 seconds, until it resembles a puree.
In a small saucepan heat on low the remaining of your beans with liquid and then add your pureed mixture heat for a few minutes.
Serve over rice with a side of sauteed onions and peppers!

Vegan Chocolate Shake

The other night after dinner my 5-year-old asked for dessert. I didn’t have much, so she got the old “you can have some fruit” line. She wasn’t buying it and told me to “just make some healthy ice-cream”.  My concoction did not turn out like ice-cream, it was a full-on milkshake. I made it using the vitamix and I’m sure if you added more ice cubes it would be thicker. You could also run it through an ice-cream machine or freeze it in popsicle molds for summer. They would taste just like fudgesicles but healthier and vegan!
Anti-diet method tip: This recipe is much healthier than any store bought frozen dessert or milk shake for that matter but it still has sugar! This is a once in awhile recipe for when you need that chocolate fix.

Vegan Fudgesicle Shake
2 bananas (frozen would be best)
1 cup home-made alomond milk
4 plus tablespoons vegan hot chocolate mix
1 scoop cocoa powder (a little over a tablespoon)
2 pitted dates
1 cup ice (put in last)

I used vitamix and ran it on the dessert cycle twice.

Some Race, Some Participate, All Welcome

I don’t judge.  Not everyone is competitive and not everyone has the same goal.  While we are each unique, we can all be healthy and fit.  Before beginning an exercise regime or training program you have to identify your purpose.  Are you just trying to live a healthier lifestyle?  Are you trying to lose weight?  Are you challenging yourself to complete a race?  If so, do you just want to finish or do you have a time in mind?  It’s very important to know your goals and to allow your goals to evolve.  Because, if you don’t know where you are going, you will end up going nowhere.

My goals have definitely evolved over time.  I have always been competitive but once I was out of college, I continued to exercise only to stay fit.  I had no intentions of competing in races or even entering races.  So how did I stay consistent?  It was helpful that I have a tendency to be OCD.  When I commit to something I care about, I stick with it.  The main thing is showing up – making time in the day to fit in fitness.  I used to wake up at 5 am to get my workout in before work because I never knew when I might get called into a late meeting or when friends might propose a very tempting impromptu get –together.  Exercising first thing in the morning assured me nothing would get in the way.  If waking up early was too difficult to face, I exercised during my lunch hour or went straight to the gym from work before coming home and being tempted by the couch and the refrigerator.

When my college friends asked me to run a marathon with them (2 years after graduation), my first thought was – no way!  I had no interest initially but I had been running several days per week for fitness and it had been a couple of years since I raced (I had been a swimmer so I actually had never raced on land).  One day while on the treadmill at the gym, I challenged myself to run 10 miles instead of the usual 6.  As a coach, this is not an advisable strategy as you should build mileage slowly over time.  But at 24 years of age and having been an athlete my whole life, the idea didn’t seem too far-fetched.  I decided if I could run that 10 miles comfortably, I would run the marathon with my friends.  Three months later I was there at the starting line with them just hoping to finish.  I ran most of the way, walked the hills, and cursed myself by mile 22.  But I crossed the finish line with a huge smile.   I had set my sights on participating and I did just that.  Going the distance was all I cared about.  While I never considered myself to be a runner, I really enjoyed the challenge and I realized in the training that having a race goal gave another dimension to my exercise routine.    The motivation of running a marathon (and sometimes the fear of not finishing) helped me stay on track.

As the years ticked by, I continued to enter half-marathons and 10ks with the goal of staying fit and having fun.  I never cared about my time or my place.  Until one day I did.  When I started racing triathlons in my mid-30s, I no longer just wanted to participate.  I wanted to race.  That’s a whole different mentality with its own set of goals and challenges.  Knowing little about triathlons, I would study race results to try and determine what times I needed for each of the swim, bike and run in order to place in the top 3 in my age group.  Then I would structure my training so that I could achieve those times.   Staying on track was even easier because I had concrete marks I needed to hit.  I eventually hired a coach who taught me about interval training, quality days versus recovery days and heart rate

zones.  I learned how to truly push my body to its limits and I approached each starting line with a new goal – to finish with an empty tank. I had to give it all I had in order to see the fruits of my labor – there would be no time to walk the hills.  These races were totally different than that first marathon – they felt different, they mandated a different kind of planning and success required more than just crossing the finish line with a smile.  But the satisfaction of having a goal and accomplishing it was the same.

Today, I still care about my results and I show up to race.  But I appreciate those who come to participate for the fun or just to stay fit.  Everyone has a different goal, a different perspective and a different purpose for what they choose to do.  Some people choose to exercise for fitness.  Some choose to race for fun and some choose to truly compete.  The wonderful thing is that all are welcome at the gym and on the starting line. Whether you want to race or just participate, all that matters is that you know your goal and that you show up.

Noga Ruttenberg is a certified USA Triathlon and USA Cycling level 3 coach based out of Westchester. Noga is the mother of two children and an elite amateur triathlete.  She writes customized training plans and can be reached at npeled@hotmail.com

Who would have thought?

My husband loves brussel sprouts and would always ask me to make them around the holidays. I was never really crazy about them – not sure why. I guess I just always assumed by the look of them that I wouldn’t like them. Well, we all know what happens when you assume…. shame on me. These little cabbage like veggies are delicious and I can’t get enough. If you see them in a grocery store on their stalks like this, don’t be intimidated – this is how they grow. You just pick them off the stalk and wash and prepare them any way you like. They are super easy to cook. You can add them to a stir fry or roast them or even throw them in a frying pan with a little olive oil and balsamic vinegar and you have a great side dish. Brussel sprouts are loaded with Vitamin C and K so if you feel like you might be coming down with something, give them a try – Or if you’re a runner, Vitamin K is great for the bones! Either way promise me you’ll give them a chance. Here’s an easy recipe for you. I made them the other night this way and they were a big hit in my house!

Roasted Brussel Sprout with Pine Nuts
1 1/2 cups brussel sprouts, washed and cut in half
2 tablespoons extra virgin olive oil
2 teaspoon garlic powder
salt and pepper to taste
a little parmesan cheese would be good as well (vegans can skip that)
1/2 cup pine nuts

Directions
Pre heat oven to 400.
Wash and chop your brussel sprouts.
Place on a roasting pan and mix with olive oil s/p and garlic powder and cheese if using.
Bake for 25 mins.
In a dry pan toast pine nuts. stand by the pan, they can burn fast,
add to brussel sprouts when done. add a little more oil if needed.

I served them over whole wheat couscous and it was really good and filling. sautéed shallots would be a nice addition to them as well.