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Advice From Chiropractor And Triathlete Dr. Leonard Ershow

By Taylor Smith

Speak about your experience competing in triathlons.

I initially got interested in triathlons in the early 1980s while watching the Ironman World Championships on TV. From that time I always harbored a desire to test myself physically, emotionally, and mentally. It seemed triathlons offered that opportunity. In 1987 I was hit by a car while riding my bike and it changed my ability to run effectively for several years. In 2003 I had the opportunity to work at the Ironman World Championships. The athletes, especially the physically challenged athletes, inspired me so much, I decided to get off my overweight butt and start getting in shape. I chose to use the goal of training for an Ironman.

I was out of shape and overweight. I had no idea how to train. However, I was lucky enough to find a world-class coach while I was at the Ironman in Hawaii who motivated me to get into shape by working out and eating nutritious carb-free food and some health supplements like creatine gummies. That started an incredible journey toward competing in triathlons. I initially started with the idea of just finishing my first triathlon and going from there. I am a type A personality, so that goal shortly fell by the wayside, and actually competing became my goal. For me, competing was a mix of multiple experiences.

Once the race starts all the anticipation, fear and anxiety disappear for me. When I am racing well, I am totally in the moment. I usually experience thoughts like “I can’t believe I am actually doing this” or “What a gorgeous sunrise, the water feels great, I am so lucky.” Those races still contain the moments of physical discomfort, but I am able to focus on the whole experience. There are also races which are more physically and mentally challenging. Those races can feel longer than the actual time registered on the time clock.

The end of a race is always a welcome event. They are almost always accompanied by an experience of accomplishment. The podium finishes are just icing on the cake. If I have trained well, come to the race prepared, execute my race plan and put in the maximal effort I can on that day, I usually feel a strong sense of accomplishment. I also view each race as an opportunity to evaluate my training, nutrition and strategy. So, it becomes part of the process of preparing for the next event. Very much like life.

The triathlon community is very warm and unpretentious. It is not unusual to hang out with both age group athletes and world champions at the after race party. There is an acknowledgement of what it took to both get there and finish. So, it is great to share common experiences of the course and weather at the end of the race. Usually, I feel a sense of wellbeing for several days after the race.

What advice would you give to someone interested in training for their first triathlon?

I would first ask them to define their goals for (1) wanting to do a triathlon and then (2) what they want to accomplish in the triathlon itself. Thirdly, I would tell them to have patience. Many aspiring triathletes come to training in less that optimal conditioning. If that is true, they need to have the patience to get in shape as they train. Everything takes time. (Weight loss, fitness levels, reduced times and learning the specific needs of the sport.) Just navigating how to go through the transitions is a learning experience. I remember my triathlon coach said “I have to train you into shape before I can train you for a triathlon”. That was initially very disconcerting for me because I wanted results right away. It can take several seasons to achieve competitive results in triathlon. As I became fitter, my results improved dramatically. I remember the difference in time from my first Olympic distance triathlon to my second (a period of 2 months) was almost an hour. A lot of that was the build in my fitness over the whole year and part was learning how to be in a triathlon.

I would then suggest they join a Masters Swim Group and if need be, get some swim lessons. Most people do okay with biking and running. As little kids, many learn to ride their bikes. We all run at some point, but not everyone is comfortable in the water. I would also suggest they join a training group for triathlons and glean information from more experienced athletes. If it is feasible and affordable, I would suggest they get a coach. This would help them avoid the pit falls of over training and the coach would also be a wealth of information.

They should also read up on what it takes to train for a triathlon. Joel Friel has written some good basic books on training for triathlon.

What kind of gear is necessary for a first time triathlete?

Traditional triathlons are swimming, biking and running. So at the very least they will need for training:

A good pair of goggles for swimming, swim suit and fins. Swim paddles are optional.

A good, well fitted pair of running shoes, comfortable running clothes that don’t cause abrasions.

A bicycle, bicycle helmet, bicycle pants.

For Racing:

While not absolutely necessary it would be good to get either a pair of tri shorts and top or a tri suit. While it is possible to change your clothes during a triathlon, it is inconvenient. A pair of tri shorts or a tri suit have a pad in them that affords a little more comfort on the bike and can be used in the swim and run both.

A wetsuit. Most races are wet suit legal and in colder water than a pool. Wearing a wet suit increases buoyancy, which is definitely a plus, especially with newbie triathletes. Wet suits can possibly be borrowed or rented. I would definitely practice with the wetsuit before using it in an event!

What role does nutrition and lifestyle play in injury prevention and training?

They all play a large role in not only injury prevention, but the overall success in training and competing.

Nutrition has three basic components. Basic Nutrition gives you the quality building blocks every day that support your body during its increased demand when training for triathlon. You need protein to build muscle, carbohydrate to burn for quick fuel, fats to support the nutrition demands for distance and extended time events. Often overlooked are the trace minerals that are necessary for proper muscle contraction. An athlete in training probably needs to increase their calories to meet the increased demand of training. It might even be a good idea to consult with a nutritionist to determine a good food plan. For instance, if you are training for a sprint triathlon, you may not want to eat like you are training for an Ironman. There is also pre-training/training/post-training nutrition and pre-event/event/post-event nutrition to optimize training, recovery and performance.

Of course hydration must be included as part of a nutrition plan. Most people are under hydrated on a daily basis. Even minor dehydration can cause fatigue and confusion. However, when training, especially in hot weather, water alone is not sufficient and can be detrimental. When we sweat we lose water, but we also lose electrolytes. Electrolytes are necessary to insure proper muscle contraction. If an athlete is exercising for longer than a half hour they need to replace fluids and electrolytes, especially if they sweat a lot. If they are exercising for a longer period of time, they should consider taking nutrition in the form of a high quality sports drink which combines electrolytes, fluids and a mix of easily digested fuels. The athlete should try different products during their training to see which ones they like and tolerate well. They should never try a new product on race day. This goes for anything from nutrition to equipment. I have too often seen an athlete’s race day ruined by stomach problems, a breakdown of a new piece of equipment, a rash or blister due to an ill-fitting piece of clothing that was never tried or worn before race day.

Good quality sleep is one of the most important factors in progressing in any athletic endeavor. It aids in recovery and can’t be made up. If you like to party and go to bed late, don’t think you can shake if off in the morning and hammer the bike, swim or run.

What do you tell a patient who suffers from pain due to overtraining or overuse?

Unfortunately, most athletes over train. When questioned, athletes often tell me they train at their race pace. If they want to run an 8 minute 5k pace. They go out and run at an 8 minute pace each time they run. That would be an example of racing every day, not training. Training should be modulated in terms of differing distances, times and intensity. One day might be a short run, the next run may focus on strength or speed, a third run would be a recovery run. Then you could put in a long run with a slower pace. If you are training for triathlons, you are usually doing two workouts a day with different disciplines. Imagine utilizing maximal effort with each workout each day?

Overtraining injuries manifest in many ways. One of the first signs is a general sense of fatigue and inability to recover from workouts. Most triathletes feel tired and sore at some time during their training. However, if an athlete feels an increase of tiredness, disturbed sleep patterns, irritability or becomes over emotional, these can be signs of overtraining. They should immediately take a short break, decrease their workout intensity and maybe even stop all together. Then they should slowly resume their workouts and monitor how they feel. We tend to think the more we do in terms of intensity or distance or combined workouts, the stronger/faster we get. Often the opposite is true. Less is more. With overtraining times in training and races get slower, legs feel heavier, moods change. We often get sick more often and then the dreaded physical injury happens. It could be a stress fracture, a sprained ankle, a pulled muscle or in my case a loss of concentration and a bike accident two weeks before the Florida Ironman. I fractured several ribs, bruised my hip and could not race.

What I do with patients who sustain an injury is I first treat the injury. Then I discuss with them the reasons the body broke down. Most are very frustrated, because it usually comes at very inopportune times, like just before a race and they feel they won’t get enough training in. I share with them personal and clinical experiences where injuries which forced rest actually improved the individual’s race results. When an athlete is properly recovered and gets proper rest, they usually perform better when they return from an injury.

What advice would you give to parents of children and teen athletes?

First I would advise them to listen to kids. Let them explore the activities they enjoy. I know there is a lot of pressure to focus on a particular sport at a very early age. I think that is unfortunate. I believe kids should do a variety of activities and sports. The focus on one sport for multiple seasons at a very early age promotes overuse of certain muscle groups and motor patterns that can lead to chronic overuse injuries and an underdevelopment of other patterns and muscle groups.

If a child or teen is in love with a particular sport, make sure they still develop other motor skills and definitely let them get breaks between seasons.

You are currently a member of the chiropractic team for the semi pro football team, The New Jersey Lions. What type of support do you provide?

Actually, while we are mostly chiropractors who are certified in sports injuries or have Diplomate status in Sports, we are considered the training team and first responders. We render sports injury treatment before and after the game which includes soft tissue manipulation, chiropractic care, stretching and taping (kinesiology and traditional athletic taping). During the game we provide on the field first response to traumatic injuries. We were chosen as the Athletic Training Team of the Year both two years ago and this past season.

Dr. Ira Shapiro, who was the U. S. Olympic Team Chiropractor for both the 2004 and 2006 Olympics was the doctor who organized that team. Dr. Shapiro, Dr. Victor Dolan and I were asked to be the team chiropractors for the new Trenton Freedom. They are a Professional Indoor Football Team which plays out of the Sun Bank Arena in Trenton. We are part of a multidisciplinary team which includes Dr. Peter Wenger, a sports physician and Trenton Orthopedic Group. We supply sports injury and chiropractic treatments at the practices and pre game. During the game, we provide, with Dr. Wenger, on the field first response. It is quite exciting, they actually made the play offs in their first season.

Do these types of injuries differ from those seen in runners and triathletes?

Yes. While they do sustain muscle pulls and ankle sprains like other athletes, they also sustain multiple high impact collisions during a game which predisposes them to injuries similar to motor vehicle accidents. Head injuries, including fractures, neck sprains and concussions are common. Pulled back muscles and low back strains due to twisting and extension are also seen. Extremity injuries due to muscle tears, dislocations, contusions and fractures are often seen. Then of course there are the contusions, cuts and bruises.

Describe the ways in which most people (athletes and non-athletes alike) can benefit from quality chiropractic care.

Chiropractic is based on the premise of bringing the body back into homeostasis or balance. We all live in a gravity-based environment. If our bodies are out of balance, gravity will accentuate that imbalance. Our movement will become inefficient, and we shall begin to compensate and use other muscles and joints to achieve movement instead of the proper muscles and joints. This could develop generalized muscle stiffness which may cause difficulty in movement, soreness, cramps, knots, and more of the like; and with continual lack of physical activity after the age of 30 could come unnerving conditions such as muscle atrophy. While it may come across as difficult to overcome, you could find yourself the appropriate exercises to reverse that stiffness. Take swimming, for example, the freedom of movement in water may not only enable you to regain that balance, but it could also help other areas– breathing difficulties, muscle strengthening, sleep health, cardiovascular health, and several more. With practice, you may develop a love for swimming as it can be looked at as a relaxing activity as well as an intense exercise. This could also open the doors for you to engage in other activities such as Scuba Diving, snorkeling, and freediving. With the benefits of exercises like swimming looming on your horizon, you could have a lot to gain with the help of movement-based activities.

Of course, the body will do anything to compensate so it can continue to move. And on a professional viewpoint, athletes want to move as efficiently as possible to achieve maximal performance. That can be translated to faster times, longer throws, heavier weight lifts and higher jumps. Chiropractic is very popular among our high-level athletes for that very reason. Many are proactive in seeking chiropractic care to maintain that edge. They also know that injury will sideline them. They will lose valuable training time or the ability to compete in an important event.

While non-athletes don’t have the same goals, they still need to function as athletes in their everyday lives. I worked for a chiropractor, Dr. Phil Maffetone when I first got out of chiropractic school. He wrote the book Everyone is an Athlete. If you think about it, we may not be running the 100 meters in the Olympics, but we are in that marathon called life. We run after and play with our kids, work in our backyards, lift and carry our groceries, carry our luggage, swim, and walk up and down stairs. We can do this only with the balance between our nervous system, our muscular system, and our skeletal system. Chiropractic care keeps that neuromuscular and skeletal balance that allows us to function at our best.

For additional information, call 609.921.7071 or visit Ershow Chiropractic Center is located at 915 Commons Way in Princeton, NJ.

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