The oh so silly Comrades season

**These are my OPINIONS and experiences and not of anyone else – please don’t throw all your dirty, smelly shoes at me**

When I first qualified, 5 years ago, this time of year was my absolute worst! The injuries, the stories, the pressure, the complaints, the tears, the “why am I not getting any better”, the trials and tribulations of COMRADES. But now with some experience and after dealing with 5 seasons of this interesting event, I think I have this time of year waxed!

And I couldn’t think of a better time to have posted this than right after the lovely ROUTE TESTER! Which I saw that a lot of you ran way too fast (yes, I saw your run on Strava).

Don’t get me wrong – being able to get a runner to and through Comrades is my absolute goal. I treat every runner with my best ability and I do care, but I’ve had to find a way to keep my own sanity. Flip, I feel like I’ve done 5 Comrades already after dealing with all of you.

So, during this highly stressful time for everyone – runners, therapists, friends and families of runners, I have written this for some light-hearted reading and a laugh and, of course, for me to vent and feel better.

I entered and began training for my first Comrades, which was supposed to be this year. This all came to a screeching halt on the 28^th of December 2017, when my boyfriend and I were involved in a scooter accident in India (of all places). The foot pedal tore through my left foot, destroying my hopes of the “ASIJIKI” dream. Thankfully, it was early days and my meltdown was kept to a minimal.

That was probably the best thing that happened to me, work wise, because the amount of sympathy I have now for Comrades OVERUSE and “stupidity” injuries is 0! Remember, you do all that running and hurt to yourself – SELF INFLICTED! That scooter pedal did not have a right to ruin my 2018 running plans. However, shit happens. I dealt with it and am now over it. Life goes on and Comrades will be there next year. I do care for my runners and always have their best interests at heart. But please, just this once, sympathize with me here.

Comrades is the cause of the most common running overuse injuries that I see. Duhhh – Comrades is an overuse race. Are humans even meant to run that far? “In the caveman days…” some of you might protest, “blah blah blah”, I get it! But really, how much has changed since then? We now run on TAR and in SHOES! Have our bodies changed since the “caveman days”?  Yes! SO much has changed. So, when I very politely tell a patient that what they are suffering from is merely an overuse injury, WHY do they look at me like I didn’t study for 6 years or I haven’t treated over 100 people like them! Comrades = overuse. Overuse of your legs and joints and sometimes heads. Sorry  – bear with me here.

So, I have decided to discuss some of my case “trends” below (no names mentioned and a tad exaggerated) just for a laugh – okay? Please don’t take it too seriously and if you do take offense, swallow it with some of your recovery shake!

“The new to running and now going to do Comrades” runner

This has to be the absolute pearler and why I will start with them first.

George has casually been doing the Park Run for a year now and has recently progressed to a 10km. Now he is ready to take on the Comrades. Yes COMRADES. Maybe the result of a bet, or slight fomo (fear of missing out) from the previous year or he is just transitioning from his immature, party-going 20s and smoothly sliding into his 30s with the “I’m over those days and I’m now going to focus on my health and training” frame of mind.

I respect you George, but you can’t just run away from the club, straight through to the Comrades finish line. That’s like waking up without a hangover after a tequila binge. Hey some people can, about whom you will learn below – “the super humans”.

And why is this not possible? You most probably will pick up the odd ITB, shin splints, patellar tendinitis, Achilles issues. You need to condition yourself to the road and to an Ultra. You have to treat it with the utmost respect. A few very wise, seasoned (plus 20 Comrades) runners have told me that there is an art. You must first condition your body to 5km, 10km and 21km runs, over some time. Get your bones, joints and tendons used to constant pounding on tar. That tar is a horrible thing – transferring most of your running energy straight back up into your legs! Hence my experience with first timers and stress fractures. Your poor bones are trying to heal and recover overnight and you just whack them with a casual 30km the next day.

I could go on, but from my experience with these guys, the best advice I can give is to progress with distance wisely. Be smart and know your limits.

The runners that must keep lifting BRO

Mary, the gym bunny, has to keep lifting whilst training for the Ultimate Human Race. Mary, how do you expect your joints and poor tendons to react after heavy lifting or 50 reps of squats, lunges and burpees X 3, followed by a 10km run the next day, followed by a 15km, followed by more gym, followed by a 30km run on the weekend? (hand to forehead) .

Poor Mary is constantly plagued with tendon issues. And why? Tendons are responsive to load. Too much load, too soon, allows no time for repair and therefore leads to damage and injury to bodily structures. The right amount of load over time, allows tendons to repair and heal and hence no injury – it’s like magic.

The right gyms will get you onto a sports specific program. If you find yourself trying to race through a gym session whilst competing against your lifting buddy, STOP! Trying to force yourself to get through 50 squats and lunges is just wrong! Racing through strength type exercises whilst you are training for Comrades is just WRONG. Comrades is your race, Mary, not the gym. Your strength training should involve slow, controlled, stability exercises. You need to feel your legs burn, not your lungs.

The runners that just weren’t made for Comrades (yes, we are not all made for Comrades)

I used to feel sorry for poor Tom. He ran his first Comrades 2 years ago and is constantly plagued by a knee injury.

The thing is, Tom actually has bad knees. Years of rugby have damaged them. Xrays and even an MRI have proved this. Months of strength training and countless biokineticist sessions will not take the condition/problem away. It may help with pain or strength and stability but the damage is still there. Why Tom wants to go for his third, I have no idea.

You see, I can’t sympathize with Tom any more. I have warned him about permanent damage and the fact that he may have to have a major operation down the line, if he keeps running these long distances. Tom doesn’t care. He will keep wearing those knees down in the hunt for another Comrades medal. That’s fine with me – they not my knees.

My advice to the Toms is – stick to the shorter distances. Comrades  is not worth your limbs. 1 is fine, 2 is ok, 3, you’re on your own buddy! If you think the running is worth the risk then go for it…YOLO!! But just don’t come back crying to me.

I’ve never been injured and now 10/15 years later I’m plagued with injuries

You’ve been lucky, John, and now it has finally all caught up with you. We age – it’s unavoidable. Our bodies change – you’ve done 10 Comrades! Is that not enough? You do the math.

And no, I have no explanation why some can run and run and run, year after year after year with no injury. They are medical miracles. Please don’t compare yourself with those super humans – we are all different.

The mileage and speed befoks

It works for some and not for others. I’m talking about dear Susie. Going for her second Comrades. Back-to-back medal. The down run. She has to impress. Last year she was conservative with her training 60-80kms a week, chilled runs, no injuries. A nice 9.42 for her first. This year she’s upping the mileage and tempo to try crack that sub 9. She’s taking advice from all angles.

She’s been sitting at about 90-110kms a week but is battling with the ever so infamous ITB. But why Susie? Tuesday track, Wednesday 15kms tempo, Thursday hills, Friday 10kms (meant to be slow but caught up at Regents and tempo again). Saturday long run, slightly slower, Sunday 21km Deloitte, meant to be slow but lands up doing a P.B. You may not see the mistake, but I do. A week just like that can destroy your Comrades dream. I have seen it plenty of times.

Why am I seeing runners go from a 30km per week to a 70/80km per week, in just a week? Haibo! Which blogs and people are you following? I’ve also seen a runner go from a 21km to a 42km, just like that. That’s a damn big jump with some nice knee issue on the side.

Susie and her friends also like to compete with each other on the infamous STRAVA. Who’s got the CR (course record) and who can do a P.B? Strava has made me money over the last 2 years – thank you, Strava. But, sorry for you runners! The ability to suss each other out and see who is in top form and who is not, who is training and who is still sleeping, who trains in the rain and who is a fair weather Fanie. Always competing, always chasing, always injured…get my point?

Common sense, people! Remember most of us are amateurs!

The super humans

FRANK! I know you but haven’t actually treated you. I know you don’t go by the book, so please refrain from lashing me with your recipes for success and your very heroic war stories, because I don’t see many people like you, Frank! You are a super human. You don’t get sick or injured or suffer with anything! You will preach, over some beers at your local running club, that you don’t do strength work, you stay away from track, you run in your old faithfuls, you drink beer or chocolate milk after your runs, you have never set foot in a gym. What are stability exercises, even? You, Frank, are a hero; every runner envies you. You go against everything that we professionals have learnt/know. You are like the WELL-seasoned smoker who doesn’t get Cancer. Keep going Frank, keep proving us wrong.

There are many other cases I could discuss…”I arrive in high heels or slops to your session and I have plantar fasciitis”, “I’ve put on 15kgs and am running this year”, “ I don’t have time for gym”, ”I’m giving up my old faithfuls and going to try ____ (2 months before Comrades)”. “Just finished my antibiotics but feel fine now – plan on doing a 25km on the weekend”. “I’ve missed 2 weeks of training because of this injury and need to make up for it”. The list goes on.

As we approach a month before the big day, please put your thinking caps on. Please be smart, it doesn’t take more than a few brain cells. Yes, this Comrades fever envelopes, engulfs and absorbs you into its big, comforting arms. But do NOT let it overwhelm you and brainwash you into thinking that it comes before your body and health. Oh no! 1 year is not worth another 2 years (and sometimes even a lifetime) of plaguing injuries and health issues. It’s not worth permanent damage to your heart, kidneys and joints. It’s not worth your life. Seriously! Those of you who survive on painkillers and anti-inflammatories through your races – take a wave at the heavens. You’ll arrive there sooner than you may think. It’s not worth it. And WHY are you even running if you have to take 4 of those? Next level “stupid”.

Okay – enough of the rant – time for some love. Thank you to my runners (patients) for inspiring me and for keeping me on my toes. Thank you for trusting me and thank you for listening. As much as you stress me out, I still really enjoy the challenge of dealing with, solving and managing your issues. I love your dedication and passion and I can’t wait to see you all cross that line. ASIJIKI everyone!!!

 

HRV and Wearables

Did you know that it is thought that HRV is the only way to measure how our bodies respond to stress unconsciously?

I have a special interest in heart rate/HRV and the data from wearables and smart watches. I’m no cardiovascular specialist but did do some research for a paper I had to write and thought I would simplify it for the purpose of this blog 😊

What is HRV?

Heart rate variability is the variation in time between heart beats i.e. beat to beat fluctuations in the rhythm of the heart. The variation should be constant and is measured in milliseconds. This is regulated by the Autonomic Nervous System (ANS) and can be used as a reliable indicator of our state of health. A higher HRV is associated with “rest and digest” i.e. parasympathetic state and lower HRV with stress or illness. HRV is unique to every individual. HRV can be said to be related to the overall state of the central nervous system. We can’t measure stress or ANS function, so variability gives us a good indication as it is the only figure of measurement available at present.

How is HRV measured?

HRV can be measured with ECG devices and modern computer technology including smart watches and wearables (Garmin, Whoop, Oura Ring).

The best way to determine your normal level is to use a wearable that measures your HRV in a controlled setting, like sleep, and establishes a baseline over a few weeks. This baseline range will never change.

What is a wearable?

Compact electronic and computing devices that can be worn on an individuals’ body. They have empowered individuals to monitor, store, and transfer personal information about health, physical activity, and surrounding such as body temperature, blood pressure, heart rate, calories intake, calories burned, steps counters, sleep pattern, location etc. Examples are, smart watches such as Garmin, Apple Polar, Suunto and other wearables such as the Whoop band or Oura ring. They are very popular amongst active individuals, as many of the latest devices can also help track recovery, fitness and HRV. Giving an indication of the body’s ability to handle further stress (such as being able to increase training load, frequency, or intensity) or whether the body needs more time to recover (sickness, over trained, needing more sleep). Therefore, it is safe to say that athletes may also be able to use their HRV to optimize their training, performance and endurance.

What is a good HRV?

A normal HRV for adults can range anywhere from below 20 to over 200 milliseconds.

HRV and the Nervous System?

The hypothalamus, a small region located above the brain stem, constantly processes information and transmits signals to the rest of the body through the ANS. The signals can either relax or stimulate different functions in your body, including your HRV. HRV is the most effective way of estimating your ANS balance, as it directly impacts your heart’s activity. Therefore, HRV reflects the balance between the parasympathetic nervous system (PNS or rest-and-digest branch) and the sympathetic nervous system (SNS or fight-or-flight branch). By these two being in balance, it helps you to respond to daily stressors and regulate some of your body’s most important systems, including heart rate, respiration, and digestion. PNS regulates your heart to slow down, making room for variability between beats (higher HRV). Your SNS system tells your heart to speed up, limiting space for variability (lower HRV) (5).

• Higher HRV is associated with rest-and-digest, general fitness, and good recovery.
• Lower HRV is associated with fight-or-flight responses, stress, illness, or over training.

What affects HRV and why is it good to check it?

Being aware of your HRV allows you to identify ANS imbalances, it can help you to understand how to respond to stress in a healthier way. It may increase your awareness of your lifestyle habits.  It can detect your reaction to the environment, and your emotions. HRV measurements can also help increase your awareness of how you live and think, and how your behaviour affects your nervous system and bodily functions.

Various medications and substances can influence the autonomic nervous system and, consequently, HRV. For instance, stimulants like caffeine or certain drugs may increase sympathetic activity and reduce HRV. Alcohol also has a massive affect on HRV.

Many athletes tend to have greater degrees of cardiovascular fitness since exercise training improves the heart’s efficiency. Because of this, they also tend to have higher HRVs. However, a higher HRV doesn’t always mean better heart health. For example, arrhythmias, which are potentially serious irregular heartbeats, can cause high HRV.

Generally, a prolonged reduced HRV may be associated with an increased risk of death, arrhythmias, and heart attack.

HRV has also been found to be lower in people who suffer with psychiatric diseases (anxiety disorder, panic attacks, posttraumatic stress disorders, epilepsy, anorexia, borderline personality disorder, and depression).

A single nightly HRV reading can provide insights, like:

• A higher HRV score that reflects a rest day, cool bedroom, or “mindful” low/moderate intensity activities such as hiking or yoga.
• A lower HRV score that results from dehydration, alcohol, late meal or exercise, illness, a high-intensity workout, acute stress, or a hot bedroom.

Exercising is still the best way to improve heart rate variability, and it can pay off in as little as two months. Moderate exercise for 150 minutes a week total should be the goal. Do cardio, resistance training, or HIIT workouts, whatever you love enough to do consistently.

How can you improve your HRV?

• Exercise and proper training. Regular exercise is one of the most effective ways to improve HRV. However, athletes should avoid over training, however, since strenuous exercise lowers HRV in the short term. Therefore, it is important not to put the body under too much strain without allowing it enough time to recuperate.
• Eat healthy food at the right times. While eating a nutritious diet is good for your HRV, it’s also important to keep in mind that having regular eating patterns will also help your circadian rhythm. Not eating 3-4 hours before bedtime can enhance the quality of your sleep by enabling your body to focus on other restorative processes instead of digesting food.
• Stay hydrated. The amount of blood in your body is determined by your level of hydration. So the more liquid in your system, the easier it is for your blood to circulate throughout your body and supply it with oxygen and nutrients. Make it a goal to drink an ounce of water per pound of body weight every day. 
• Avoid alcohol. According to some studies, drinking alcohol can lower HRV by an average of 22 milliseconds the following day, and lingering effects of alcohol in your system may even reduce your HRV for up to 4-5 days.
• Get good, consistent sleep. In addition to getting enough quality sleep, it’s also important to maintain a consistent sleep schedule. Consistent sleep helps you have more REM and deep sleep, thus improving your circadian rhythm and increasing your HRV.
• Be exposed to natural light. Biological processes that regulate sleep-wake times, energy levels, and hormone synthesis are triggered when you are outside in natural sunlight, especially in the morning.
• Take a cold shower. The vagus nerve, which activates the parasympathetic branch of your ANS and controls HRV, is stimulated by exposing your body to low temperatures for brief periods of time (cold showers, ice baths, etc.)
• Breathing exercises. Slow, controlled breathing has been shown to boost HRV and help fight stress, which can decrease HRV. 
• Practice mindfulness. For some people, practicing meditation or other mindfulness techniques can have a positive impact on HRV, helping with relaxation and stress reduction. 

Conclusion:

I have always been fascinated with HRV since suffering with a heart condition at the age of 29. I am 100% tuned in with mine and believe that if more people were too, it could greatly benefit their overall health and wellness. As discussed above, awareness of your HRV can help in so many ways. Predicting illness and over training, indicating recovery, detecting the affect of stress on your nervous system etc. As a health care practitioner, being able to have access to this data when working with a patient could be greatly beneficial. You could track nervous system responses to treatment and also see whether certain lifestyle factors are affecting a patient’s well being, as well as holding them back from reaching their true health and fitness potentials.

It may also be a very useful tool when dealing with pain and therapy response to pain. If a patient is not recovering as you may expect or not responding to treatment, you could look at their HRV (if measured), as a tool to look into their nervous system. As mentioned above, if someone’s nervous system is stressed, it may contribute to delayed healing, therefore a longer recovery time will be needed towards a patient’s function and/or pain.

References on request

A close call

Case presentation of a 27 year old female ultra distance trail runner

I wanted to write this up because I believe it could help other practitioners/athletes and just people in general.  After I had heart issues at 26, I wrote a blog about the events leading up to it and had the most overwhelming feedback. I even had a few athletes send me messages to say they had been for medical check ups after reading it and had “issues” picked up. I think the biggest lesson here is to get to know your body VERY well, to know what is normal and abnormal. Our body is our vehicle, we are sometimes not very tuned in to our own warning lights. Sometimes these may flash for weeks and we still ignore the signs. In athletes, our fitness may be to our detriment as we are very used to being in pain/being tired/fatigued/run down. We are familiar with niggles, low immune systems, and the most scary, we know how to push boundaries and be “hard core”. This can sometimes not serve us very well and I hope by reading below you will learn how important it is to be in tune with your body and to be able to know when to seek help. So thank you to this very considerate runner for allowing me to write up her case, in order to create more awareness and possibly save a life/lives.

A few days before her trip, she had been running in the mountains in Dubai and felt a bit more tired and out of breath than usual, putting it aside to the fact she had taken a 2 week break previous to this particular run.

Fast forward to 2 days before her race in the UK. She developed a cough overnight and took a heap of vitamins and medication. It subsided by the morning of the race. *I would have done exactly the same and I’m sure many others would have too.

Race day. 13^th of May. 103kms, +6000m of elevation. She felt absolutely fine when she started. She took a bad fall on a decent at 20kms and carried on going. The heat had cranked up and at hour 10 she started to feel really flat and dehydrated. At the 50km mark she was overheating, felt nauseas and just plain depleted. At this check point she took her time to eat and get fluids in and then continued to march on.

As night began to creep in, she started coughing again, it got colder and she could feel her chest start to tighten on the climbs, which is a pretty normal feeling when you’re racing an ultra. She put it down to her heavy hydration pack and it already being 16 hours into the race.

At 75kms, she almost pulled the plug as she had started to vomit and could not take in food or water. Those around her egged her on and motivated her to see the race through. This was just before the toughest part of the race, a monster of a climb. *again I would probably pull myself together and just keep going. It’s what endurance athletes do. We are used to “hitting the wall” and being in those “dark places”.

However, this prevented her from eating and drinking for almost 5 hours. Maybe this had been a bad idea?

Eventually, this amazing runner finished at 7am, after 26 hours on the course.

Unfortunately when she returned to the hotel, she started coughing more frequently.

She jumped on a plane back to Dubai the next evening and her cough became worse accompanied now by chest pain.

She took a lateral flow test which showed negative results for Covid.

On the 17^th of May she went to a doctor. After listening to her breathing, she was diagnosed with bronchitis and was sent away with antibiotics and cough medication. *did the doctor do a necessary full case work up?

After another 7 days off running, she tried to run and only managed 2kms as she felt breathless. The running became 200m run/walks, but her breathing got worse. She stopped running completely.

Back to the doctor she went and was told her bronchitis had 80% cleared and she should continue to take her cough medication. She was also told to stay off exercise.

Towards the end of May, this determined runner tried to get back to running again and had mixed responses from her body. Some days she felt good but she still had to stop and walk every few kms and other days she felt in the pits and couldn’t sustain an effort of more than 1 to 2 minutes. “ I kinda just put it down to the fact that the bronchitis had affected my breathing and the breathlessness could stay for a while post bronchitis, so just took it easy with returning to the running”.

During this time I had actually seen her for a chiropractic consultation. She presented with hip pain that she had experienced before her race, she had been diagnosed with a bursitis. She also told me about the bronchitis. She had no respiratory distress and no red flags. I treated her. I ALMOST did a technique on her chest to help her with the coughing but somewhat decided not to. I still don’t know why I didn’t but thank goodness I avoided it. I did however manipulate her thoracic spine as she said it had been tight from the coughing or possibly the heavy hydration pack from the race. At the time I had also been suffering with my breathing and had been to the doctor twice and sent away with an inhaler, corticosteroids and antibiotics. We had been sharing stories and they seemed quite similar.

On the 4^th of June she had her worst run and could only manage 100m. Her heart rate was super high and she felt like she wasn’t recovering. She completely gave up with the running and put more effort in the gym.  “Anything slightly cardio based and my breathing would instantly go out of control (like mountain climbers)”.

On the 10^th of June, back to the doctor she went. She was told nothing was wrong but insisted on an ECG and blood tests just to be sure. The ECG was normal but the bloods were another story.

“I have blood clots on my lungs so they admitted me to the ICU today.” !!!!!!!!!!! The bloods came back with elevated CRP and D-dimer levels. “D-dimer is a protein fragment (small piece) that’s made when a blood clot dissolves in your body. A positive test means the D-dimer level in your body is higher than normal. It suggests you might have a blood clot or blood clotting problems”. She received a call telling her to go straight to the hospital.

In the hospital she was told not to move from her bed as she had a life-threatening condition. Still she was not told what was wrong at the time. She had to sign a consent form to use the toilet at her own risk(basically risk of DEATH), not knowing how serious the situation was. Only after a few days and a chest CT later, she found out that part of her right lung was “dying” and she was probably only 2 days away from a possible heart attack/stroke. She had MULTIPLE pulmonary embolisms, worse being in her right lung.

During the previous few weeks, she had been flying 2X every week between Dubai and Saudi for work. It is honestly a miracle nothing happened.

What is crazy about this whole case it that being a medical professional myself, she did not present at the time with blatant red flags i.e. respiratory distress, chest pain, breathlessness without exertion. I was so cross with myself for treating her. When chatting to her in the hospital, I couldn’t say sorry enough. But then she told me, if we hadn’t have chatted during that consult about her situation, she would have delayed going to the doctor by a few days longer. It’s fascinating how life can play out.

So what caused this? The doctors could not(and still cannot) give her a clear answer. Maybe the dehydration in the race, flying straight after, I said possibly Covid that wasn’t picked up? Oral contraceptive, her fall during the race. Her case is still a mystery.

Regardless, this has been a wake up call for myself and I guess for her.

For me, it cements the reality of not only relying on the opinion of a doctor. To think she was given the all clear. Sometimes your instinct plays a huge role. He diagnosed her with bronchitis and told her she was on the mend. I need to do my own full case work up and approach the patient from my own point of view. Knowing her quite well and also knowing she had seen a doctor previously, I just assumed she was recovering from a chest infection. Case histories are SO important and are often overlooked.

For this runner, maybe knowing when to draw the line and stop. We as endurance athletes know NO limits. We just push and push and push. Sometimes to complete depletion. I’ve done it and landed in BIG trouble. We don’t know life without exercise, it’s our escape, our happy place, our freedom, our sense of belonging. We often know deep inside that we should be taking a break, or sleeping a bit longer or allowing ourselves to get better. But the urge, that drive, that passion seems to cloud our minds. When I had a chat to her she also mentioned a very important point. The concept of “over glamorizing” racing or training when you are unwell, even SICK, recovering from an illness or not in a good way physically. It is honestly nothing to brag about but is seen quite frequently on social media and people seem to praise and glorify this and it comes across as an achievement in itself. Is it really?

This case is a lesson to all and I hope by sharing this story you can think twice the next time you decide to head out for a run feeling like something is just not quite right.

Pre-race Comradions

It’s been a while since I have worked with Comrades runners.

For those of you who have known me for a while, I have been treating Comrades runners since I started my first day of work in Durban, South Africa. To a point that eventually about 50% of my practice were just these okes. From top 20 finishers to 11:59 scramblers. It brought all types of emotions, for me and the runners. I pushed my professional boundaries and they pushed their bodily boundaries. Some experiences etched into my brain, this bunch are, well, interesting.

I have also supported Comrades since I was weeeee years old. It was a family tradition. We would set up on the side of the road, in the dark, my Dad making bacon and egg rolls and my brothers and I drawing on the road in chalk, whilst we waited for the first runners. It was an event of the year that we just couldn’t miss.

Fast forward…I am now in Dubai, 3 and a bit years later. By some universal magnetic force, I have landed up treating a group of them. All South African I may add. I secretly do love it, they add a certain spice to my day that leaves me feeling energized.

Together with my recent experience of training and competing in a full Ironman and a hilarious discussion with a patient (Comrades runner), I have been inspired to write yet another pre-race post, specifically for Comrades. Athletes fascinate me, from wanting to live a healthy, active lifestyle, to risking every physiological fibre to reach a start line.

With the race on the horizon and lots of nerves, jitters and banter going about, I thought it would be time to introduce to you my pre-race favourites.

So, let’s begin with talk-a-lot Tom. This one does not know how to hou bek (shut up). Has to have a say in every conversation even though 99% of the time he’s contradicting himself and not making any real sense. He always chips into conversation and keeps everyone amused. He definitely makes the training sessions more bearable.

Doubting Debra. Man oh man, if only this lady knew the talent she has. She puts in the hard work, she sticks to the plan but that mind of hers plays in a circus before race day. Debra is strong in every training session, she is a wonderful person to train with. She just needs to learn to control those reins before her mind gallops away. Debra IT WILL ALL BE FINE! You’ve got this.

Deviating Dave loves to prove the coach wrong. Never sticking to his pace or race plan and always thinking he has more in the bag and a lot to prove. “Run 60 minutes” = Dave’s run 90 minutes. “5:30 pace” = Dave’s sub 5 min pace. “But I just felt so good”. He’s a coach’s nightmare and a physical therapists dream. You will learn Dave, we all do.

Talented Themba. That annoying one who skips a session here and there, leads a relatively balanced life, sometimes pitches up to sessions with 3 hours sleep and a few pints down his gullet. But yet just smashes those races every time. It’s just.not.fair!!! When he puts in the work and puts down those drinks, he is just unstoppable. PB’s fly. Themba, his name meaning trust/hope/faith and should also mean BLESSED.

I know everything Karel a.k.a Karen. IYKYK. I’m actually a tad afraid to say anything a as I might get shut down VERY quickly. Karel knows a race back to front, inside out. Beginners love him, his fellow running friends actively engage with him in fear. He knows what nutrition is best and at what exact split second you should be taking it. Don’t ever challenge him. I beg you. His coach has won 10 diamond medals in that race before, he has taught Karel very well. “He is the best in the business, trust no one else”. Don’t run in those shoes, the cushioning is terrible. Your training should include more hills. Where’s your protein shake, you should be doing a warm down. I could go on for days.

Silent Sam. Although she may be quiet, this one has the ability to become a weapon of mass destruction. She doesn’t like getting involved in all the hype, but secretly deep down she is fierce and has everything planned down to a T. She means business. Sam is the epitome of float like a butterfly, sting like a bee. She is competitive but mostly with herself. She doesn’t like to commit to racing with anyone because if the race plan fails, hell may break loose. We see you Sam.

Nervous Nigel. Eeeek, the one I don’t really like to be around. This guy releases this jittery energy that spreads like caffeine through your blood after that first coffee of the day. Nigel’s mind is easily manipulated, the Karel’s love him. Changing his mind a million times before the race. This nutrition one day, these shoes another. Hells bells Nigel, just stick to your own plan. And please don’t try anything new on race day, AGAIN.

Together Toby. The HIGHLY organized one. Would wear ear plugs if he could, just to dim out all the nonsense. He stays away from the Nigel’s and Karen’s and focuses on THE race. He has kept to his training plan, has nailed his nutrition in training and is now fully ready to execute his A game. This guy does not partake in pre-race banter, only post-race beers. Instead, he sticks to reading the race information booklet for the 35^th time, examining every meter of elevation that lies ahead. He arrives at the race line, FOCUSSED, sometimes even seen with permanent marker pacing drawn onto his wrist. He is next level.

Introducing my favourite, the lady of the moment. Data Dianne. I love to bait these ones. Hook line and sinker, she always takes it. Data is life. I mean is a run really a run without hitting a cadence of an elite nature, 180 or nothing. Arrives at one of her training sessions without a watch, gets back into her car and drives home…(crickets). Somehow not too concerned with heart rate, even though this is the biggest predictor of fitness or failure. Doesn’t like to calibrate treadmill and watch pace, the watch is always right. Takes that P.B. even though the buildings are known to cause a disruption in GPS frequencies. Technology over biology.

Coach Brian. God’s gift to running. “Those coaches don’t know what they’re doing”. Loves to bad mouth. My way or the highway. Some people love it, I run 100 miles away from it. The Brian’s are quite old school, quite tunnel visioned. Even though research may prove otherwise, according to Brain, his way is best. He has all the experience. This type of coach is quite a pain to deal with, their athletes are militant trained. I don’t dabble with Brian, I may get a grenade thrown my way.

Remember training and racing is not life. It’s part of life, it can make life wonderful and hard at the same time. It’s a journey. It’s what makes us better people. Enjoy it! Stay light in your heart, mind and feet. Good luck Comrades runners!!!

10 years

Let’s get one thing straight. I’m not here for Kona, podium or any records. The Europeans can take that cake. I’ve had my ass handed to me at a world champs before. It ain’t pretty. I would like to get as close to a certain time as I can but shit can happen and we never know how our bodies are going to react on the day. And it’s a long day. We must remain flexible, calm and level headed. We must be prepared for anything. And of course remember the most important thing, we do this for fun! Don’t take yourself too seriously.

I’m also not just here for race day, I’ve been here for the journey. And it’s been a 10 year journey for me to get to this point. And I plan to keep going, although I don’t know about this long Ironman nonsense I’ve just put myself through ha ha! This is the 3rd time I’ve trained for one, lucky number 3 get me to that finish line!!!🤞🏻

I did my first 70.3 in South Africa in 2012 and was set on doing a full IM after this. Luckily my coach at the time(shout out to Justin Hand), was wise enough to hold me back as I was only 24(oh dear now you know my age), with very little experience, endurance and mental capacity for this stuff. I will be eternally grateful for this. Its given me longevity in the sport. I’ve never lost the passion for endurance.

Ķ

After numerous sprint, olympic and 70.3 distance races, an ITU World Champs, 2 marathons, the Two Oceans 56km and a multi stage canoe race with my Dad, I set my sights on 2016 in Port Elizabeth. Which didn’t happen as I contracted the coxsackie virus and a whole host of subsequent health issues. Disappointed was an understatement and depression followed. A long 8 months of absolutely no exercise, can you imagine? I questioned my WHY big time. But also learnt a lot about myself, my belief and support systems.

I finally came right and set my sights on Comrades 2018. Only to be knocked down again(literally) due to being in a motor bike accident in India, which almost cost me my left foot. Road running and triathlon then got the boot, I was over it.  Enter mountain biking and trail running. This taught me real endurance, grit and toughness. Those mountain bike races were the hardest races I’ve ever done.

In 2019, I made the big move to Dubai, triathlon and road biking all up in my face ha ha ha!Then I almost lost my left thumb in the first 5 months, from a cooking accident. I managed to get two 70.3’s done and then started training for Ironman Philippines in 2021, only for it to be cancelled.

I’m spiritual(in a hippy sort of way), I believe the universe sets us on all these paths for a reason. What will be, will be. Life is about living, learning and moving on. I don’t do grudges. As much as I have faced disappointments, I have come back each and every time with a different and better attitude. You have to take responsibility for your own life. You can’t keep blaming the world for every outcome. Moping around helps no one. Get a move on.

Honestly, training for an Ironman is shit. Especially if you have a full time job(nevermind kids). Personally, I don’t think the training is sustainable and healthy(body and mind) if done year after year-the health professional side of me talking. You are always tired, depleted, hungry and grumpy ha ha! And you are lucky if you have friends after it! Hats off to the people that manage to do this but it ain’t for me.

However, it is one heck of a challenge. You learn to push yourself to all types of different limits, emotional, physical, mental and this definitely helps you to face challenges in the big world. It requires consistency. The discipline required is huge. You learn to embrace obstacles and climb mountains. You cry, laugh, scream, swear and grit your teeth through the training sessions. Damn it’s a rollercoaster.

My build up to this race has been in typical Kirsten fashion. Typically the universe wants me to arrive VERY head strong. Plantar fasciitis, allergic bronchiitis, covid, a stomach bug, a groin cyst and a bruised right big toe. It’s been a real fight and I feel like a well seasoned soldier prepared for this Ironman war ha ha ha! 

This race means a whole lot to me, a whole 10 years. What a journey it’s been. Sport has opened up some incredible opportunities for me and I’ve met the best of best people.

I will probably be crying on the start line and all the way on the red carpet(🤞🏻), tears of relief that I’m finally here. It’s really surreal. All this time. All the years of start and finish lines have amounted to this, the one I’ve always secretly wanted.

Thanks Luke for pushing me to enter this when I came over for tea last year, everyone needs a friend like you.

Thanks Dad for being my motivation in life. I only wish to be like you in my 60’s.

Thanks Cav for being my coach and biggest support. For being so understanding and for putting up with my mood swings and grumpy days. For pushing me through my grey areas and over walls. For all the advice and pep talks. It’s been great to share this experience with you. I promise not to bike too hard ha ha!

As my very first triathlon coach Justin Hand said, the training is the hard work and the race is the fun part. Now time to have some fun 🙂

Return to sport post viral infection. Here for the long run!

Many people have had their fair share of “starting again” in their sporting careers.

We are talking about being a few weeks out of competition, months of preparation behind you, at your peak fitness level and then BAM, the curveball. Illness, injury, accidents, unexpected surgery. This is what I’m talking about and I’m sure many of you can relate.

It’s heart breaking. The commitment, dedication, discipline and sacrifices. All seems wasted at the time. You enter what I sometimes call the black hole. You see nowhere out. Your goals crushed, your efforts fruitless, nothing to look forward to, nothing to drive you. You lose all motivation.

Since I just recently had my own experience with covid, I’m going to be talking about “starting again” after a viral infection. I have previously managed to avoid covid and unfortunately AGAIN, a virus nailed me close to another Ironman. Many of you that know me well, would know that in 2016 I was training for my first Ironman in South Africa. 6 weeks out of the race, I was diagnosed with the coxsackie virus and subsequent myocarditis. It was hell. 8 months of hell. So when I tested positive for covid, I had that horrible sinking feeling. Knowing that I have previous cardiac issues and an abnormal heart rhythm, the odds were stacked against me.

HOWEVER I quickly pulled myself together, including my mental state and got to work. Researching, reading, trying to find the best way possible to fight this virus, keeping myself healthy, keeping my heart in check and knowing how and when to get back to training. I started getting messages, “take it easy”, “don’t rush back”, “many people took weeks/months to recover”, “be careful”. Whilst all with good intention, this does play your mind. All I could think of was, I’m still going for this.

As with any injury or post surgery rehabilitation, there is a return to sport protocol. Muscles, joints, tendons, bones and ligaments need time to heal and then time to adapt to the training load again. If not followed, it can lead to weakness/ long term injuries/ permanent damage. The same goes for a viral infection. But what’s more dangerous with a viral infection, is that it can affect your organs and blood, in the case of covid. Clotting has been a huge issue post covid infection, my colleagues have seen a few cases of deep vein thrombosis. The heart, lungs, kidneys and brain also seem to be the organs most affected. When returning to sport the heart needs time to adapt to the cardiovascular load again, otherwise you can cause damage to it. Sudden cardiac death. Ever heard of that? Young, fit, healthy athlete drops dead from a heart attack. Fortunately (and unfortunately), I have been through a near heart attack situation, so I am well aware of this. Also be aware that the period of inactivity before you can begin exercising also causes a degree of detraining and increases the risk for potential musculoskeletal injury, particularly if you resume exercise too fast and aggressively.

The big question is, ARE YOU IN IT FOR THE LONG RUN? Excuse the pun 😊 Looking at the longevity of your sporting career. Or are your goals more important than your body? It’s really tough, I’ve been there! Wanting to get back at it because you’ve put so much work towards a race. However,  I know that I’m definitely and have always been in it for the long run. I want this body to be able to run marathons at 60!

During my time in isolation I read numerous research papers, articles, blogs. I even did my own research with athletes experiences on Instagram. It has been very interesting getting feedback and also quite scary to realize that there is an entire process to go through when returning to sport post covid, that many people including many coaches are not aware of. In fact, this protocol should be used for any virus.

So I thought I’d share what I have learnt, read and been advised, just to make some sense out of it all. The information is confusing and continually changing. It also all depends on the individual, your symptoms and any previous health issues. I’m no medical doctor or specialist. I am using information from medical publications and comparing it to what people have told me and what I’ve seen people doing. Remember this is for mild/moderate cases ONLY!

I have taken the following information from the British Journal of Sports Medicine and the American Medical Society for Sports Medicine.

Illness severity	Defining and common clinical findings
Asymptomatic	Positive COVID-19 test with no symptoms
Minor	Low-grade fever, cough, mild fatigue only, URI symptoms (eg, nasal congestion, sore throat), possibly other symptoms (eg, nausea, vomiting, diarrhea, anosmia, ageusia)
Moderate	Persistent fever (38°C [100.4°F] or higher), persistent fatigue (at least 7 days duration), pneumonia (CXR <50% lung parenchyma involvement), chest pain not associated with cough, activity-limiting dyspnea, orthopnea, edema, palpitations, syncope
Severe	Dyspnea, hypoxia (SpO2 <94% on room air), need for supplemental oxygen, CXR infiltrates involving >50% lung parenchyma, requiring hospitalization for medical treatment
Critical	Respiratory failure (ie, mechanical ventilation, ECLS), shock, multiorgan dysfunction

This figure from the British Journal of Sports Medicine seems to explain it best.

It is suggested that you should increase exercise frequency of exercise first, then duration, and finally intensity. Each parameter should be increased gradually. Increasing training intensity or volume no more than 10 percent per week or every three to five training sessions. This can be modified according to your age, severity of symptoms, pre- existing conditions and pre covid conditioning.

Factors to consider before testing positive:

• Fitness and goals
• Physical conditioning
• The amount of hours spent training per week
• The state of your health (sleep, diet, alcohol, smoking, stress levels)

Some of the factors to monitor after you tested positive

• Resting heart rate. Take this everyday!!
• Symptoms. The progression and regression of them and the time frame.
• Need for medication
• Rate of perceived exertion doing simple tasks. How do you feel showering, walking around/ doing the washing?
• Sleep, stress, fatigue and muscle soreness during the illness
• Mental state. I added this here as I feel it is so important. Are you positive about your recovery, are you telling yourself that you want to feel good again? Being negative and “down in the dumps” can affect your recovery time

Important considerations for deciding to Return to Sport

• It is obviously not recommended to exercise whilst you have symptoms. The duration varies depending on individual factors including severity of your symptoms.
• The recommendations are continually changing. But the current protocol is as follows. The asymptomatic athlete: three days abstinence following positive test. Mild illness: three days abstinence from symptom onset. Moderate illness or cardiopulmonary symptoms: minimum five days abstinence and an advised evaluation prior to return (note that this period has been reduced from 10 days in previous recommendations).
• Before considering starting your return to sport , you must be able to complete activities of daily living and walk 500 m on the flat without excessive fatigue or breathlessness.
• At any stage, if you experience any fatigue, elevated morning heart rate, breathlessness or any other symptoms you must take a day to rest and take a step back in the protocol.
• Athletes with pre-existing conditions and diagnosed with covid should have a medical assessment.
• You must be off all symptom-related treatment before beginning your return to activity. As loss of taste or smell may persist but this is not considered when returning to sport.

Red Flags!!!

●Chest pain or palpitations

●Breathlessness out of proportion to that expected during recovery from exercise

●Findings associated with thrombosis or pulmonary embolism (eg, swollen leg, tachycardia, or dyspnea at rest)

So what was my experience with covid and returning to training with an Ironman looming.

I have been training for a full Ironman. Training between 15-20 hours per week. My symptoms went from sneezing and a very bad post nasal drip to full on fever and muscle/joint pain for 3 days. I have never had pain like this even with the flu. Felt depleted and fatigued for 3 days following this. I still moved, did mobility and breathing work. Throughout having symptoms my heart rate remained low and I had no involvement of my lungs. 6 days after the acute symptoms subsided, 3 days after my fatigue subsided, I did my first indoor bike session. Monitoring my heart rate, had no spikes and no breathlessness. Did not feel fatigued on the day or the day after. The next day I did a gym session and 5km run on the treadmill. The next day another bike, increasing the time by 15 mins. Again, no worrying symptoms. All whilst making sure I increase duration and frequency before intensity. I was very fortunate to be able to return to full training 2 weeks after having covid with the guidance of a sports medicine doctor.

Comments and experience from others

“I literally took it easy on the way back cause my heart rate used to spike with minimal effort, then started increasing effort whenever I felt I can and as days passed by, things are back to normal now. Just didn’t rush, at all”. – triathlete

“I had a mild ish one. Ended up in my lungs. I waited one week when I had it. Then did weights only for the first 5 days. Then on the 6th did a 10km run which felt like my lungs were on fire. But I eased back into it with running and biking”.

“Not a triathlete. But from an avid runner, when I had covid. I took a full week rest. Then 1 week only cycling and on the 3rd week running at 60 to 70% and by 4th week I ran back at full capacity. My wife said I was too conservative 😂. But I wanted to be safe. It’s not like few weeks are gonna make a difference. I’m in it for the long run”. YES YES YES!

“Symptoms were night chills for 4 nights , loss of appetite (not smell or taste) for about a week to varying degrees. returned to training on day 14. started with some easy body weight , gentle bike . 2 weeks back to almost normal”. – cyclist

“I had body ache and fewer for 2 days and then pressure on my chest and dry cough.
Then I read this book and I did exercise 6. I was like new next day. Please check it and let me know what you think. True is that I had very mild symptoms and for hard cases it wouldn’t be that smooth, but it will definitely help. I am 100% sure, because with breathing exercises I improved a lot not only with physical health but also mental”.  https://buteykoclinic.com/wp-content/uploads/2016/07/englishbookvideosp.pdf

“We only had sinus . Lasted 4 days started training 2 days after symptoms were gone . Just monitored HR and reaction to training . Did only one session of about 45 minutes each day for the first week and then built up to longer sessions and double days . Still did lots of resting in between and 😴. Took a few weeks to get back to quality sessions but we didn’t have any complications or set backs . Just used HR as a guide as well as how I felt day to day 😃”- triathlete

“1) I had body aches, headaches and sore throat. Lasted 4-6 days. Sore throat was the last go at about 7-10days
2) from about day 7 I started
3)Started with 30mins low heart rate movement (kept it under 100) I just started on the rower at home. Felt like I needed to move to help speed up recovery which I really think it did. Sweated quite a bit with the first and second one and definitely felt better after.
4) slowly upped intensity and duration over about 2 weeks
5) from 4 weeks I was back to similar volume of training but was still feeling like it took more out of me than before and would reach heart rate percentages earlier in training. I would say by about 2 months I was same if not better than pre covid. I feel like the slow start at base levels and building up slowly over 2 months benefitted my training in the long term and helped with heart rate control and self knowledge.
6) I can recommend starting moving early with low impact and HR” – Crossfit Athlete

“Took me 2 weeks to regain my weight and a month to reach my prior performance levels.”- triathlete

“We had covid. 3days headaches body aches and mild fever. I stayed under 135bpm and walked for 30/45min on day 5/6/7 then cycled from day 10 for 45min zone 2. Kept zone 2 and skipped every 2nd day training until 3weeks”.

“I had mild symptoms last year dec. My symptoms were serve headaches, tiredness, and no energy. I isolated for ten days. And because I didn’t show hectic symptoms I went for a 30km cycle the day after my isolation and it knocked me down for twos day were all I did was sleep. After the two days I tried to go for a slow run and we’ll that end up being a walk. Running took me a while before I could run far. The whole of dec I think my longest run was 6km and very slowly. I used to get tired going up stairs. But I’m January I decide to build up slowly again” .

In conclusion:

• A return to training protocol should be followed post viral infection but should be individualized to the person.
• Intensity should be the last parameter included. So is it safe to return to racing a week or 2 post infection?
• Use your heart rate and post exercise symptoms as a guide when returning to training.
• Always put your body before a race
• See a sports doctor and have a full medical done if you have any concerns or if you have any races lined up after having a virus.

Recommended reads:

• https://bjsm.bmj.com/content/54/19/1174
• https://www.uptodate.com/contents/covid-19-return-to-sport-or-strenuous-activity-following-infection
• For triathletes: https://joefrieltraining.com/covid-and-return-to-training-comments/

The Big Test- a poem written during COVID 19

So life is testing us.

How are you reacting? What lessons are you learning?

Maybe we all need a good reshuffle and clean out. A new perspective. Who are the people that form our foundations? What is the job that drives us? Are we happy in our environment?

We were all warned about those rainy days but hell it’s been pouring for weeks now. Most of us weren’t prepared. Some have huge boats and others just a raft. Sink or swim. Sink or swim.

Don’t fight, just flow.

Slow down

Breathe

Look and not only see…

The children learning to ride

The neighbourhood folk trying to keep fit

The dogs on leads

The birds

The trees and flowers

Feel…

All the emotions, how are they manifesting in the body, tension or pain?

Feel…

Your feet and ankles, your roots.

Your toes as they strike the ground.

Your hips as they work to drive you forward.

Your knees stabilizing.

Your shoulders, are they tense or rounded. Or are you relaxed.

Your hands, clenched or free.

Your head on your shoulders.

How does your body feel and react to movement?

Appreciate…

Your ability to move well

Freedom

Life

Health

Your 5 senses

Slow down. Slow down. Relax your mind, refocus your thoughts, take a real look at what exists beyond your borders and not in your head.

We can’t keep staring into uncertainty, the grey area. We can’t keep fighting this riptide. Don’t get dragged into negativity and despair. Flow, ride the wave, learn the lessons.

Life is testing us

Stay as if you’re leaving….

I finished my last stick of biltong a few days ago, the flood of emotions I cannot begin to explain. A. STICK. OF. BILTONG. Yup! My last tie to home, now swirling around in my stomach.

This may seem a little bit too dramatic but there is a lot more to this. I had just come back to Dubai (or left South Africa), a day before the Rugby World Cup Final. I thought I would be ok but I wasn’t. I watched the final, keeping my eyes on two screens. 1 was the T.V. and the other my cellphone. The vibe inside the bar we were at was dismal compared to what I was witnessing through my cracked Samsung screen. I received pictures and videos from friends and family all over South Africa, this made me feel connected to all the excitement. I felt included in it all. However, as I got back to my apartment and continued to stay glued to my cellphone, the tears started to roll. My closer circle all know that I’m not really an emotional person. For goodness sake, I don’t even cry at weddings. But WOW, the unity, celebration and passion for our Country, all reflected on social media, was incredible. I felt so left out and empty. I felt as if I had betrayed South Africa by leaving. I should have stayed those extra 2 days. I love my country, the people, the smells, the warmth, the beauty the adventure. Why was I feeling this ache in my chest? When I left in March, I was 105% fine. No yearning for what I had left, I had my eyes set on a new adventure in Dubai, new beginnings, new experiences. What made me feel so sad? It took me a few days to process this and here’s the story.

When I moved to Dubai in March 2019, it was a sense of relief. The stress of my job and leaving my patients behind was overwhelming. I was stuck in quite a rut, not progressing much. I was 30 and felt I needed to experience, see and learn more. I wasn’t squeezing enough juice from this sweet fruit called life.

Then at the end of August, in true Kirsten fashion, I almost cut my thumb off and unexpectedly had to return home. I had been in Dubai for 5 months and was coping quite well. Especially having survived most of the hot, dusty, rather dull summer. I was chuffed with myself.

My unfortunate injury gave me 9 weeks at home, in Durban. I wanted to come home to do my rehabilitation, I was familiar with the doctors and specialists and felt more comfortable. My money makers needed the best care. However, I had no idea what I was going to do between my rehab sessions. I tried to apply for courses online (impossible to do manual courses with 1 hand). My brain saw this as a complete waste of time. I needed to do something. Eventually after the struggle of the first 2 weeks, I decided to just go with the flow and enjoy my free time. I don’t think many people get 9 weeks worth of free time, off work and stress and chores…ever! And a huge plus, is that I got to share it with my Cav (who had to come back with me due to Visa and job issues in Dubai).

In those 9 weeks, I felt as if I had reconnected with my country, my roots. Away from work, stress and the general unimportant things that consume so much of our time. We went camping in Lesotho, away from cellphones, electricity, noise and flushable toilets(ha ha). I love Lesotho, there is such a sense of peace about the place and people. You can never beat the stories and problem solving around a fire. We went to the bush(safari) to Imfolozi, I had told Cav that was one thing I had to do. It was top of my list. Even if it was for 1 night. There is something about the bush that speaks to your African soul. The sounds of the creaking trees and wild animals, those earthy animal smells. You can’t get better and you will also always leave with a story. Our poor neighbors were attacked by baboons. Shame I felt so bad but only in Africa right? We did a night in Mtunzini with friends. We cruised up a river in their boat and got to witness the most beautiful sunset, with the natural music of nesting birds in the background. We ventured through Bergville, up Oliviershoek pass, along the Sterkfontein Dam, through the Golden Gate and up to Clarens. It is common (and sometimes quicker) for people to take the N3 but this drive has all the feels. The view of the Northern berg from this pass (on a clear day), is magnificent. On arrival, we experienced an inland storm, which are the best. The smell and sound of the rain and that earthly smell (again), just overwhelms all your senses. I love Clarens, most of the residential roads are still gravel and the houses are old fashioned. Golden Gate is so beautiful, I have been fortunate to run through and over its mountains. We were lucky to see a secretary bird stomping around, searching for prey. We also witnessed the most amazing sunset, surrounded by friends and mountain air at 2200m above sea level.

I also managed to squeeze in a few beach promenade runs within my limits and then beyond my limits when my cast came off (I couldn’t resist). I ran in the rain, I ate a Durban curry, I went to all my favorite coffee shops. I did a park run, I swam in Thompson’s Tidal pool in Ballito and couldn’t believe the amazing fish swimming around. I had lived in Ballito for 18 months and had done this once during that time. I did a few walks, trail runs, I saw fish eagles, snakes and mongeese. I fought monkeys off with a water gun and cleaned dog poop off the Umhlanga promenade with my besty. Swam in the shore break (shorey) with Cav, did a beach walk, caught up with family over goblets of gin and braais. Spent time with my 2 special grannies, supported the Springboks at a restaurant filled with South African magic (the Shed).

They say that things happen for a reason, I’m still not sure of the reason. It certainly wasn’t for me to have a holiday, it came at a very inconvenient time. I was still in my probation period at work and was lucky that they let me come back (I work for good people). After my tears and feeling sorry myself, I came across a post on Facebook. It was quite mean. Attacking all those who have left South Africa, hoping that they felt bad for leaving especially after the Springboks victory and this sudden unity the country was experiencing. I felt angry. Damn I love South Africa. In those 9 weeks I think I did more then most South African’s do in a decade. In the last 7 years with Cav, we have travelled, adventured, raced and experienced most of what this country has to offer. It is INCREDIBLE!  I left to come to Dubai, to further my career and broaden my horizons. I don’t need to go into detail. People are allowed to move on. I am deeply rooted to South Africa, I chat to all my patients about it passionately. I had a sudden urge to write about it as I think more people need to experience what I have. You need to stay in the country as if you were leaving. Do all the mountains, swim in the sea, spend time with your grannies, value your family. Take spontaneous trips away. Don’t get this disease of being too busy, too overwhelmed. Do things that fill your bucket. You are allowed to turn down a baby shower for a trip to the wilderness with your loved one. Those closest to you will understand and still love you.

I said that 2019 would be about me. My Dad has always told me that the most important person in your life is YOU. You have to look after yourself. You are responsible for your own life and your own happiness. Surround yourself with good people, be kind to family and explore more.

I hope that I can inspire people to love our country in the way I do. Not just because of the unity the Rugby World Cup has brought us but because of how beautiful it really is.

That ache in my chest was because of the deep connection I have with home and maybe it took cutting my thumb to re-realize that. I had been so consumed with being busy. With work and with un-important, unnecessary life hacks. When I left in March 2019, I never really said good-bye. This last good-bye, however, was extremely hard. And now I understand why 😊

Riding the wave

All this time. Time in our heads, time on our hands. Feeling guilty about what we should/shouldn’t be doing or what we are currently doing. Being cross at what others are doing/not doing. What others have that we don’t have. Jealousy, anger, confusion, happiness, boredom, content. I’ve overwhelmed my brain so many times! I’m sure many of you are also learning a lot about yourselves and if you’re lucky to be with someone, you’re learning about them too. How our brains work, what ticks us off, what switches us on, what gives us energy and hope. What pushes us into deep dark holes and what helps us out of them. We are all handling this situation in different ways. I’ve finally decided, there is nothing else we can do but ride out this wave. Somedays the wave is like a tsunmani, other days it’s like a foamy, sometimes the waves just come from everywhere and then it may just be a nice wave to ride. We have no idea where the waves are taking us, it’s beyond our control. We can only decide whether to carry on riding it or fight it and us sea dwellers know it is extremely hard to fight waves and currents. Worrying and stressing about what may or may not happen is just causing more stomach churning anxiety. I will ride each wave as it comes daily and try tackle whatever it brings with it.

However, waves can be overwhelming, you may even have dreams of drowning or being stuck on a sinking ship. It has happened to me so many times. Especially now, when we feel as if we have no control of anything. During the early stages of our lockdown, I did this very interesting free online psychology course. I wrote down some points and left it at that. I was so uninspired to learn and be productive. A few weeks ago, I found my notes and actually couldn’t believe the stuff I had listened to but hadn’t processed in my brain. How often does this happen in life! Our brains get too busy to actually realise how important information may be.

There were so many ”pearls of wisdom” on this piece of paper that I thought I would share because I think it can definitely help a few overwhelmed brains out there. It may also help with some wave riding 🙂

• Craving and clinging may lead to suffering. It is so hard to read or hear, but take a step back and reflect. We cling to so many things in life and when they are taken away we suffer, naturally. Hence my many days of introspection. How can I be happy, when things are taken away?

• Start to recognize people and things beyond your scope of thought ie. Old people on a sidewalk, trees, the wind. The taste and texture of food. Are we taking time to eat and enjoy our food or are we mindlessly watching TV whilst gobbling it up. Can we sit outside and listen to the birds or do we get easily distracted?

• If you’re stuck in a negative thought say, “This is not mine, this is not myself and this I am not”. This situation is beyond our control. You cannot do anything to control it. We are all overwhelmed with emotions, feelings and judgement towards others. If it helps you, then great.

• Jealously and anger: don’t think of it as yours. Especially now! Disown it. Dont let these two control your thoughts and behaviour. Social media, especially, may be responsible for cultivating these feelings.

• Thoughts. Those lovely overwhelming brain “things”. Be mindful of your thoughts and not lost in them. Thoughts are like actors, so don’t get pulled into the drama of them. When your feelings are strong, thoughts seem more real. E.g. You are frustrated with your lockdown situation and then you see somone running without a mask or groups of people gathering on the street corner. How strong are your feelings now?

• The hard one. Meditation. A lot of people are trying it, a lot of people don’t have the mental capacity for it, a lot don’t know how to even do it. Sometimes we may do it without even knowing. So in terms of having negative thoughts or feelings and being overwhelmed in waves of thought, I have some advice. Use the RAIN acronym. Recognize the feeling/thought. Allow it to be there. Investigate it, why is it there and associate with those feelings. Note those feelings in your body: tensions burning, restlessness. Is anything that you are feeling associated with cravings or clinging? Remember, “the cat will keep coming to the door if you feed it”. See the thought before identifying with it. Observe it and weaken it. Dont feed it. I have been investigating meditation, so far I believe it is a place in your head that is still, it can be infinity. Meditation has been shown to decrease our reactions to things. I definitely need to include it more into my daily routine.

• Behaviour is an output with regards to all our input. What are you allowing yourself to be consumed in/with during these hard times? Is it social media, is it gossip on your whatsapp groups, is it a certain series on Netflix? How can this all affect our behaviour?

A little something to think about 🙂

Avoiding a running overdose

Dr. Kirsten Evans (M. Tech: Chiropractic) and Tala Elajou (BsC in Biology and Marine Science, Level 3 PT with Active IQ, and Running Coach with UESCA)

• 

  DCIM\100GOPRO\G0190588.JPG

• 

“Endorphins, which are structurally similar to the drug morphine, are considered natural painkillers because they activate opioid receptors in the brain that help minimize discomfort. They can also help bring about feelings of euphoria and general well-being”.

We can only assume that being away from running has been like coming off a drug. Don’t know about any of you but we have certainly missed our endorphin injection. Running is a form of release for many of us, it’s our brief escape from the reality of the world and it can become highly addictive. Unfortunately, much has changed in the world over the past few weeks and many of us haven’t had that luxury of being able to run, we’ve been deprived of our daily/ weekly dose of that happy drug. Some of us have resorted to running around pools and gardens and others through apartment buildings and basements.

• 

  DCIM\118GOPRO\G7573911.JPG

There is now palpable excitement in the air as many countries are beginning to lift their lockdown laws and are starting to open their roads for recreational use. However, most have limited outdoor exercise to certain time constraints. From what we have seen on social media in the past few weeks, runners are hungry for that endorphin rush and are ready to go go go!

I had been limited to my apartment and 24 flights of stairs, which at first seemed like a great challenge and then became boring. Whilst Tala had her garden, which also seemed “runnable”, but she soon realized it wasn’t worth the damage it would possibly cause. The sharp turns and limited space would affect her stride and cadence, aggravate her ITB and result in an overuse of her dominant side which would have caused an imbalance. This resulted in both of us throwing ourselves into running specific “homework”. Strength, control and stability. 

• 

• 

When lockdown started to ease and we were finally allowed to run, I didn’t feel as great as I thought I would. My calves were sore, I felt heavy and I couldn’t engage into a “faster gear”.

Tala explained it well, “That first run, especially, will feel as if it was the first time you’ve ever run. Even though a lot of strength work was done during lockdown, there is no secret to running fitness, you just need to run more and nothing can replace that. HIIT sessions do not replace your aerobic engine for running. However, having not run for 4/5 weeks you can’t magically expect to feel amazing on the first run”. We are both currently managing between 5km-8kms per run. Tala advises a maximum of 40/50kms a week of running.

• 

  DCIM\100GOPRO\G0110349.JPG

• 

It has been very interesting watching people doing their creative home runs during lockdown and now even more interesting watching them coming out of lockdown. Some straight into a 12km, others 15km and we even saw a 22km run. Some very speedy, some very hilly runs. Here’s the thing, a garden 10km is very different from a road 10km. Forces, loading, stride and cadence are all very different. All the extrinsic factors (camber, training surface, corners etc.) are different. Even treadmill running is different from the road, tar is a lot harder and unforgiving.

To save you all from heading in the wrong direction, we thought we would put our heads together and share some of our best recommendations and advice (our pearls of wisdom). I am so fortunate to have Tala share her wisdom. She is a great runner and a fantastic coach, with heaps of experience.

Starting again

Did you know that it only takes 2/3 weeks of “de-loading”, for a tendon to lose strength? 80% of strength is lost in complete immobilization, which luckily a lot of us haven’t been subjected to. De-tensioning of tissue (a reduction in tensile strength) causes a disorganization in collagen thereby the tendon will not be able to handle loads as it did before. It is most likely that many of us, especially those without the luxury of home gyms and treadmills, have “de-loaded” most of the tendons in our bodies. This is why the next few weeks are vital for proper loading, i.e. correct return to running protocols. Balancing frequency, intensity and volume. Balancing hill runs and flat runs. Balancing trail and road. Running puts 2 to 2.5 times your body weight, in force, through your muscles, joints and tendons. Is it wise to get straight back to running 10kms, at your pre lockdown pace? Something to think about. 

• 

According to Tala, when returning to running, it’s the “back to basics” that matter most. Getting back to the time when you didn’t run with a GPS watch (before you even knew what it was), running by feel, which is where “tech naked runs” come in for all Tala’s athletes during their base building phase.

Technology is advancing as it always does. For many numerically obsessed runners, this means there are an ever increasing number of gadgets and websites where their statistical fantasies can play out. This is all very good for those who have the presence of mind to put into perspective the purpose of technology. However, coaches are seeing training loads change and resultant strange behaviours creeping in. Exhibit one, the extra laps of the car park to get an exact distance on the GPS. How many of us are guilty of this?

Tala also made a point that she is witnessing some of the intrinsic joys of running disappear. With carefree meandering around a new course being replaced by a focus on kilometer rates, cadence data, elevation achieved and Strava segment glory.

• 

“My role as coach is to be the circuit breaker for this behavior, remove technology at times, set the expectations and encourage you to run for the sheer joy of running. This will take you back to your initial stage as a novice runner where the running world was a big mystery that lay ahead. Running with this state of mind is healthy and provides a refreshing outlook to those who may be getting too performance (or technology) obsessed. The aim is engagement, continued participation and establishing positive lifestyle choices. So by returning to the basics, maintaining the joy of running and taking part for the right reasons, goes a long way to meet these objectives”.

The month of May is all about easy, low heart rate runs. An easy run is an ideal “running by feel” workout. Why the easy running? Many runners need to learn how it feels to TRULY run easy. Even more so, your easy pace can vary by day, especially during high volume and/or high intensity training periods when you accumulate fatigue in your legs.

Ultimately, easy run pace doesn’t matter. Easy is a relative measure of feel and effort, after all, one runner’s easy pace is another runner’s 5K pace. If you run a pace which you deem slow, you may speed yourself up so much that the physiological stress of the workout alters and then you’re not really getting an easy run, just extra unnecessary fatigue.

To conclude and let’s be honest, most of us really have no idea when our next race will be. So why put that unnecessary pressure on yourself to perform? When will you ever get that chance to focus on your breathing or cadence or form or even the environment around you. Be mindful and present in your runs. Enjoy them.

• 

As Tala put it, “The most damaging aspect to getting into running well, is ego”.

Keep an eye out for our Part 2, in which we will talk about running specific exercises and how to warm up.

Visit Tala’s page http://runwildrunfree.ae/about-tala/ to learn more about what she does.

My privileged Easter cry

We have been in lockdown for 22 days, not complaining, just an indication. I love to write but I have been umming and ahhing about this. Because I’m privileged. I have a roof over my head. I have access to unlimited internet. I have a bicycle trainer. I have access to food delivery and take outs. I’m in lockdown with my loved one. I still am receiving a portion of my salary. Compared to many people out there, I’m extremely fortunate.

But today, I just burst into tears. I woke up to a dull, dusty sky. The weather outside is becoming unpleasantly hot. I couldn’t get my morning sun as the sun was nowhere to be seen. Generally, I was in a rather uncomfortable, negative, depressing mood.

I silently got off the couch, slipped past Cavin on his computer, whilst trying hard to contain this emotional explosion. As I got to the room, the wave hit.  I am not a crier and those close to me know that I’m not a very emotional person (except when it comes to animals). Cavin was wearing his earphones. Literally 4 minutes into my episode he just walked into the room and gave me a hug. How he knew, I have no idea. When he saw my face, he got worried and kept questioning what was wrong. I told him that I felt too bad to talk about it because I’m so privileged and fortunate and lucky and whatever you want to call it.

Yes, we are all in this together, the same boat and yes, a lot of us have had it really bad and some a hell of a lot easier. Being in a first world country, I am very grateful that I have financial and general security. Flip I’m so grateful for everything!

But why the tears. This 3^rd week has been a hard one. I’ve had one or 2 bad days during this lockdown and have kind of just swallowed them up and marched on because we must keep positive and there are people that are in way worse situations.

Shew, the emotions came pouring out today and I had absolutely no control.

I have been putting enormous pressure on myself to be productive during this lockdown. To read, to cook, to learn, to bake, to watch, to interact, to discover, to please. All to make up for what is lacking. I am a person of routine. I love challenges, I love to be pushed. I always have a goal, something to strive for and work hard towards. I love to be put under stress, I work well under pressure. But now all of that has just disappeared. What is my next anything? I can’t envision a thing, not even the future. This is driving me mad. I have never really sat and watched series or spent much time cooking or baking. My time is always consumed with exercise or work.

• 

I’m missing my work because I absolutely love it. I miss the contact and interaction with my patients, I miss making people feel happy and better about themselves and their bodies. I miss using my brain, I miss being challenged with cases. My job is my therapy really. I miss it so very much. And yes, I have tried the online learning and tutorials and it’s just not the same ☹

I miss having a garden, trees, flowers, butterflies, blue skies, green grass. I miss having a dog. Cavin filled one of our containers with some bird seed and put it on our balcony. So we do have some frequent, feathered friends. I miss the sun. Oh my goodness do I miss the sun. Our balcony only gets the sun from sunrise to about 9 30 a.m. We only have a very short space of time to soak up that Vitamin D.

• 

I miss my friends and family. Especially during Easter. Most of us have memories of those Easter family holidays up or down the coast or into the mountains.

You see, I felt bad about feeling sad for all of this. I have been “pep talking” myself. “Kirsten, you have got this. You are a happy, positive person and you have so much to be grateful for. Pull yourself together”. Today I couldn’t. I let myself be sad, I let myself cry. Over the last few days I have been thinking about all the people out there who suffer with anxiety, depression and other mental disorders. Flip it must be hard. My breakdown, in my 1 bedroom apartment in Dubai, feeling like the walls were closing in and dark rolling clouds were enveloping me from all directions. That’s what some of you feel like daily. And now you have this lockdown to deal with. I seriously cannot imagine what it must be like and I really hope you are all finding ways to get through this.

• 

• 

Which gets me to this point. If you want to bake, workout, puzzle, cook, do your zoom catch ups, whatever helps you through this process. DO IT! Don’t feel bad about it. I have not baked this much in my life. Crunchies, fudge and yes, banana bread. But how good is that banana bread, especially warm out the oven. It’s keeping me sane! Post it on social media, it’s great to see people trying new things, it’s great to see people connecting, people keeping healthy. People playing with their kids, dressing up, having fun. It sure as hell helps me! Flip, aren’t you just sick and tired of seeing videos, posts and facts about the C virus. Your happy posts actually bring light into this dark situation. And those people that complain about it, honestly, keep your negativity to yourselves. If you have something nasty to say, don’t say it at all. Especially during these hard times. We shouldn’t have to feel bad about how we are all individually handling this situation. If your day consists of sitting on your couch, scrolling through social media and Netflix, then do it! No one is making you feel bad about that.

• 

• 

This is not me complaining, I just want people to know that it is ok to feel sad, even if you are from a position of privilege or you are usually a happy go lucky like me. It is ok to wake up and feel empty. If one day you just feel like watching series and drinking tea, don’t feel bad about it. If you want to take out all your frustration on your indoor trainer/ treadmill or whilst doing laps around your pool (so lucky), GO FOR IT! Just be careful and mindful of doing damage to your bodies (the chiropractor in me speaking).

Happy Easter everyone 😊 Squeeze your family members extra tight, give your dogs or cats plenty loves, enjoy your delicious food and chocolate eggs. Enjoy your gardens and pools and the sun, oh the sun. But also think of the less fortunate. To those without jobs, to the homeless, to the people having drug withdrawals, to those having to live with assholes or people who abuse, to those whose businesses are hanging on by the thread, to the people with mental disorders. And most impotantly, the health workers who are risking their lives and those who are fighting this terrible virus. If you are in a position to help, please do. Especially if you can financially. This is a time of sharing and caring.

And remember, it’s ok to cry, even if you are privileged. Don’t feel bad like I did (I still do!). We’re all human and experience these strange human feelings called emotions. This whole situation is very strange. Flip. If anyone has any venting to do, send my way. I’m a good listener. Also, any advice on what else to do, would love some suggestions. Just not a home marathon because I live in a one bedroom apartment 😊 ha ha! Stay safe.

• 

•