Fractured 5th Metatarsal experience

Greetings all,

Over Christmas I managed to snap my 5th Metatarsal in a Snowboarding accident. The accident happened just before NYE in Chamonix and resulted in this pretty mess
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It matters not how I did it which was far more rubbish than you might imagine, but more to the point how long it’s taken me to recover and I wish to offer up my advice to anyone as unfortunate as myself to experience such a rubbish and debilitating break in their foot.

To give you some perspective about my physical state, I’m a keen gym go-er and keen cyclist. I was training for the Caledonia eTape until the injury and was in Base 2 of my training working up to 12 hours or more on the bike at that point. Being very active and training around 2 hours a day, 6 days a week meant that this injury presented me with some pretty big challenges physically and mentally.

6 days after the fracture I had the foot operated on by Eoin Baldwin who did a fantastic job in re-attaching the splintered bones with two fixing screws. That was the complicated bit out of the way, the rest was down to me and my body’s healing process.

In Jan ’12 it was pretty cold in the UK, no more than normal, but still, cold. After getting up in the morning I had real trouble keeping my foot warm in the bootie cast that I had on. It was far from painful and I stopped taking the codeine based painkillers 1 day after the Op. It simply wasn’t hurting enough for me to want to take them.

Sadly, 2 days after the Op, I came down with the Flu which was kindly given to me by one of my holiday buddies. That was horrid, being club footed and Flu’d up all at the same time was one of the most rotten feelings ever. 4 days later I was starting to feel human (albeit club footed) again.

No-mans land ensued. I was signed off from work but still completely mentally able. 12 days after the Op, I returned to work – a couple of days earlier than recommended, but I was going nuts and had a lot of work on. I struggled after the journey to work to keep the foot warm still. After a 07:30 get up, by 10am my foot would be uncomfortably cold and I’d try my best but would fail in trying to warm the thing up until I got home and had a bath with one foot hanging out the side.

As soon as I was back to work, I was back at the gym too. I’ve read elsewhere that other people have completely avoided all exercise to ‘let the body do the healing process’. I honestly disagree with that. This implies that they think their body can only do one thing at once, or it takes power away from the healing process by your body doing anything else. For example your body has 100% of ‘healing power’ and by doing Strength Training on your remaining functional parts of your body, you are detracting from that 100% ‘healing power’ by diverting some of that healing toward the applied stresses of Strength Training.
Assuming you are eating ‘well’ taking into account you are what you eat and you’re eating ‘enough’ which I think would be easy if you’re doing Strength Training with limitations i.e. your lower body is out of action thanks to an injury like this then for me there is no reason to lay back and sit still for months waiting for a bone to fuse.

I’ve ranted briefly on this as I had ALOT of arguments with people telling me I shouldn’t be going to the gym whilst I had the injury. Notably, none of these people were people who, without being harsh, were people that ate ‘well’ or had a good physique or good relationship with food or exercise so their advice fell on ears which were not tuned in to their concern.

I will stress though that you should not attempt any lower leg exercises. I did.
Leg Extensions using the Leg Extension machine were the only exercise I felt comfortable using both my legs so as not to train only one leg and cause imbalance.
I suggest you avoid these too as although there’s no direct stress on the foot in any shape or form, after my news which I’ll talk about in a moment, I suggest disengaging your temptation to use your lower body at all for the time being.

Some 20+ days after the Op, I visited the Hospital for a follow up x-ray only to have the Surgeon stand in front of the light box and utter ‘Oh’. That short noise was the last thing in the world I wanted to hear.

 

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That ‘Oh’ was the realisation that somehow I’d managed to pull the repair apart so the two fixating screws were although aligned but holding the bone with quite a degree of separation again.

It was one of the worst things I’ve ever heard and was very very upset and depressed for a couple of days.
Because the up down and side to side alignment was actually okay meaning the functional operation of the foot was looking okay, the decision was to leave it be for a while and see how it was looking in another 2 weeks. Now, just to mention here, there was expected to be some fusing already, which there wasn’t either because I’d split it or simply it hadn’t started.
The problem with the 5th metatarsal is it’s a small bone, it’s also about as far away from your heart as you can get in your body, and is on the outside of your foot with a relatively small amount of blood flow.
These are all facts that worked against me.

This leads to my first piece of advice.
KEEP YOUR FOOT VERY WARM! Never let the foot go cold.
Cold = No blood flow. No blood flow = No healing.
Do whatever you have to do to keep your foot warm at all times. This includes your Thigh and Lower Leg as they’ll be supplying the blood to your foot. Long Johns, super big socks and over sized slippers are all good things. In emergency perhaps some chemically activated hand warmers stuffed into your foot may help. Make this your personal priority.

My second piece of advice
Do nothing that puts your foot under any pressure until your surgeon advises you otherwise
I cannot state how important this is.
Getting up out of bed puts pressure on your trailing foot, be careful! Getting up from being one legged in front of the fridge and unknowingly the supporting (broken) foot that’s out behind you is put under top side pressure to help with the one legged get up.
Falling over, which I did too many times and hated every one.
Not using any lower leg gym equipment, no matter what muscles you think you are aren’t working. It simply isn’t worth the risk or a re-op or a situation like mine with a mis-aligned bone.
I cannot state how difficult it is to exist with only one foot on the ground for months at a time.
I cannot explicitly state which moment cause my repair to separate. There were plenty (too many) moments including the falls which put far too much pressure on my foot and it could have been any of them.

Lastly, Do Exercise!
Do Upper Body strength training. Unless you have one of those upper body cycling things you’re not going to be able to do any cardio, so simply engaging your upper body will stop you going nuts and keep some resemblance of your physique.

After three months I’m out of casts and actively load bearing without crutches now, but I’m awaiting my next x-ray to see the state of the repair and will update this post when I have that aswell as thoughts on muscle loss and diet during that recovery period.
In the meantime. Good luck if you’re going through this too!

Ciao! x

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Lactate Threshold Test for Power

    Combined data from TrainingPeaks.com and Joe Friel’s TrainingBible.com sites:-
    1 Hours worth of time on the bike – static trainer/turbo/wattbike preferred.
    How the hour shapes up:
      1-15mins = warm-up pace

 

      15-20mins = time trial pace

 

      20-25mins = spin easy

 

      25-35mins = time trial pace keeping a little in reserve

 

      35-55mins = time trial pace

 

    55-60mins = cool down
    Description of the hour:
      Execute 25 minutes of warm up to prep for the test.

 

    During warm up, get in 1 x 5 min all out Time Trial effort after 15minutes, then spin easy until you get in the full 25 minutes. It’s important that in each month in which you test, your warm-up is the same. Do this test somewhere that you can come back and re-test each month.
      After 15mins of warm up pace, activate with one 5 mins effort of time trial pace, then return to warm up pace for another 5mins.

 

    Once warmed up and ready to go immediately start the test. The key to this test is pacing. Almost everyone starts at too great an intensity and then fades in the last few minutes. It’s not unusual to hear of athletes failing to finish the test the first time because of starting out too fast. Tell yourself you’ll hold back just a little the first 10 minutes and continually remind yourself of this once the test begins. At exactly ten minutes into the test (35mins total) click the lap button on your heart rate monitor. Then when the test ends at 55mins in, click the stop button. You now will have three heart rate ­data points captured on your heart rate monitor—average heart rate for the first ten minutes (25-35), average for the last twenty minutes (35-55), and average for the entire thirty minutes (25-55). The one we are interested in is your average for the last twenty minutes. This a good estimate of your anaerobic threshold heart rate.
    Bike Heart Rate Zones – using the resulting data from the test.
      Zone 1 Less than 81% of LTHR

 

      Zone 2 81% to 89% of LTHR

 

      Zone 3 90% to 93% of LTHR

 

      Zone 4 94% to 99% of LTHR

 

      Zone 5a 100% to 102% of LTHR

 

      Zone 5b 103% to 106% of LTHR

 

    Zone 5c More than 106% of LTHR

 

Great iPhone App

I’ve gotta plug my latest workout buddy.. Flex Workout App from the App Store.

It’s a great flexible, customisable application that really really fits for what I’ve done so far in all my routines.
The pre-entered exercises are excellent and describe most of the exercises you’re likely to come across during your workouts, with the option to add your own custom exercises and modify your workouts on the fly even if for no sillier reason than there’s no chance you’re going to get on the machine or equipment you need for that set because it’s busy!

One of the two App’s I’ve ever bought for my iPhone and I love it.

http://flexworkoutlog.com/index.html

Big up Mr/Mrs Flex developer!

On switching Sports Nutrition supplements

I’ve recently been back onto a months worth of Maximuscle Cyclone to help increase lean mass. It’s results aren’t as clear as perhaps I’d hoped, though I’m stronger and heavier than I’ve ever been so it can’t exactly have been doing any harm.

Thing is I really wanted to do two things whilst continuing to supplement my diet with sports nutrition products.

Firstly, I wanted to reduce the total protein intake from supplementation, and increase my real food intake, subsequently increasing ratio of calorie and protein totals from real food instead.

Secondly I wanted to get away from such large doses of Creatine which are present in Cyclone.

My reasons are as follows:-

Although it’s generally accepted that protein requirements are increased amongst weightlifters and athletes, the extent to which they are increased is subject to continuing debate. Excessive protein intake (more than 3g/kg bw/day) may have various negative effects on the body including kidney damage, increased blood lipoprotein levels (which have been associated with the development of arteriosclerosis and dehydration).
One potential problem with the habitual consumption of a high protein diet is that the enzymes involved in protein breakdown may be up-regulated. This in effect means that you become dependant on a high protein diet to maintain muscle mass.

Creatine, although proved to increase strength, power and body mass of between 1 -2KG, the weight gain is mostly lean tissue in the form of retained water and I’ve no interest in relying on Creatine intake to maintain muscle size and strength for sustained periods, for cost and convenience reasons mostly.

My change in mind resulted in purchasing Promax Extreme and Recovermax to replace the standard 2 shakes a day of Cyclone.

Recovermax is a 3:1 Carbs protein recovery drink with 1g of Creatine which I consider fine compared to the 10g of Creatine per day I was receiving with Cyclone. I can use Recovermax the moment I finish my workout and get those Carbs, Protein and few other ‘performance nutrients’ which I’m not so bothered about in the tank as soon as possible.
The claims are that Recovermax will make a difference to my rate of recovery and that will be an advantage to me if it’s true as I’m training 5-6 days a week.

The decision to use Promax Extreme was as a night time drink with milk. Promax is recommended to be taken with 200ml fluids so that’s not an uncomfortable amount just before bedtime unlike the 400ml needed for cyclone, and taking it with milk will mean the slower dietary amino acid absorption in casein will benefit overnight repairs and muscle building whilst I’m out of action. It’s also only 24g of supplemented protein and 1.6g of Creatine per shake.

As a result my total supplemented Protein and Creatine end up as

Protein: 40g down from 60g, out of a recommended daily total of 116-124g per day.
Creatine : 2.6g reduced down from 10g

Obviously I don’t want to lose any size and weight so I’m going to eat another meal or two a day to compensate for this change, but I think it’s the right way to go for now and I’ll report on my experiences with this model in the coming months.

Paul

On Protein Supplementation

Here’s to those of you nailing 10’s or even 100’s of pounds/dollars on Sports Nutrition out there.. Have a read of this.

  • 3g’s or more per kilo of body weight a day of protein is really quite BAD for you (Arteriosclerosis & Kidney Problems).
  • Generous and continuous Protein Supplementation leaves your body assuming that that much protein is always available in the diet, subsequently when you stop supplementation, muscle loss ocurrs due to the body not accounting for the fact it has to work again to extract protein efficently from food in it’s naturally ocurring amounts. (Nice way of you continuing to buy vendors products for fear of muscle loss eh!?)
  • It seems accepted that 1.6/1.7g’s per kilo of body weight a day is all enthusiastic gym goers and general atheletes need to ensure you are fuelling hypertrophy to it’s fullest extent.
  • When increasing calorific intake, the proportion of those Calories made up of Protein increases in a linear fashion. So anyone ‘eating well’ using  a wholefood/non refined food lifestyle can see that if you add up the protein intake from a 4000kcal a day intake will more than easily fulfil the daily requirements of Protein.
  • Protein Supplements seem useful in THREE very specific siuations.
    1. Timing, ensuring you get the Protein to the muscle in a timely manner, before and/or immediately after exercise.
    2. Convenenience, Not many people carry round snacks containing a rapidly absorbed protein compound they can get in them within 30 mins for finishing exercise.
    3. Elite Atheletes being trained by people very much more experienced and clever than me. I’m talking Pro Atheletes here, the sort of people that are putting in the amount of training hours a day equivalent to the hours I pilot my desk a day (lucky bastards).
  • As a result of knowing you’re receiving the correct amount of Protein from a good lifestyle, THE most IMPORTANT thing in attempting to support Hypertrophy is total Calorific intake. Getting in around 20% more than you estimate you need to support your weight on a maintenance basis is where you should start and you should expect to see gains of  0.5 – 1kg of lean weight a month. Much more or less than this and you should adjust your intake accordingly.

I hope this condensed snippet of information is useful to some of you washed up meatheads out there!

Arteriosclerosis

To quote Stefano De Benedetti on Big Mountain Skiing

“In the perfect moment, I was so concentrated. There was no space for other thoughts. When you want to make a turn and you are at the top of a steep vertical wall. I mean when you are in the situation that if you fall you die, everything changes. You think very much about turning. You think very much about where to turn, and you do all this in a very special way. You act like a different person, you act with All yourself. You are making a completely different experience and in some way you are discovering yourself.
This is the magic of the mountain. You can accept to die for this, you don’t want to die, but to live so close to the possibility of dying you understand what is really important, and what is not. And this makes you a better person. It’s probably the highest moment of my life, because in the perfect moment I was, or I felt to be, a little superman.”

Amen brother, Amen.

Thoughts on building muscle mass

It’s dawned on me recently that there’s a reason that people use the Bulk and Cut method to get muscle mass on board.

I’ve been trying with little success to put on lean and only lean size on for a long time and it really doesn’t work. I’m a hard gainer anyways, meaning my bodytype is Ectomorphic, slim wrists and ankles being a common indictator and eating what I thought was ‘just enough’ to cover putting weight on has never really worked.

Now I’ve recently started what is best described as a bulking routine, although I’m not eating MUCH more than I was I’m burning significantly less during the day as I’m not running 10k every lunchtime which is a good 700kcals kept back. Yeah I’m still doing something, like a 5k or a gym session of sorts for ancillary exercises like core, stretching and all the little ones you tend to miss which work your supprting muscles, but I’m concentrating much more on the compound exercises in the evening and I’m noticing good gains in strength and muscle tone in as little as 2 weeks.

Remembering I AM knocking back Creatine at the moment and I know that can retain water quite a bit, but I’m off that this week and back onto straight Protein supplements and will cycle the Creatine BiMonthly to give my organs a break from the plethora of Chemicals that come in Cyclone.

So here’s for another month or two of the bulk routine and I’ll get on/back on the cut routine come April and see where we’ve got to. 12st with any luck!