Ironman Ohio 70.3 - The Long Swim

Delaware Lake, Ohio. Morning of the 2018 Ohio Half Ironman. 

Preface

The swim course of the 2018 Ohio Half Ironman was accidentally set .3 miles longer than the standard 1.2 mile Half Ironman course, hence the title. I wrote this short story to inspire those chasing a dream, taking on a challenge or facing fears in this amazing ride we call life. 

The Long Swim 

Success rarely occurs with luck or miracles; it happens with learning, consistent practice and execution - Coach Amy.

Two summers ago, I did not know how to swim. I swam head above the water with T-rex like arm strokes and toes dragging on the bottom like a trawling net capturing used bandaids and hair. One 25 meter lap and I was hanging on the edge of the pool gasping for air. To successfully finish a Half Ironman Triathlon, professional intervention was required. 

Enter Coach Liz Wielding, Josie Palmerin and David Mitchell who patiently transformed my feeble stroke to one with arms that actually lengthen, pull and propel me forward in an efficient way through open water. Oh, it’s far from perfect; some day I want to swim like my peers who seem to hover on the surface and glide effortlessly through the waves. 

Swimming in a triathlon is not JUST about the swim stroke. One has to battle terrifying “monsters” that grab at ankles, swipe off goggles and knock out breathing with a kick to the chest. And the worst of the monsters in the water is Self Doubt.  

When I walked up to the beach to scope out the swim course, I nearly buckled at the knees. It was the circumference of the lake cove I water skied and boated on for over 20 years. I never imagined swimming across it, let alone around it. It did not matter that I swam twice this distance in training. Looking at the distance laid out like this, a dread invaded my head and spread quickly to my heart and stomach! 

I spent the rest of the day and night pressing back the panic with positive self talk, “trust the training”, “chip away at it”, “stay in your bubble” blah blah blah! This worked for a few minutes before Self Doubt crept back in.

In the early hours of race day morning at Delaware State Park, I sat in the car feeling sicker each minute and wondered, “Why I am I doing this? Why put myself through this torture? This isn’t fun. All the sacrifices over the last 6 months just to feel pain, anxiety, unhappy, and literally believe I might die out there? WTH!?"

I looked out at the cars around me and the thousands of bikes set up at T1 (the transition between swim and bike). “Why are there so many people here doing this to themselves? Are we all crazy?” A disembodied Yoda voice interceded, "TRUST THE TRAINING.” I recalled what my triathlete buddies told me, “Enjoy the day. The race is the celebration of all your hard work and training.” With trust in them and my coach, I dragged myself to the swim start. 

When it was time for the spectators to leave the athletes at the start, I clung to my husband David like a child on his first day of preschool. Draped in a throwaway blanket to keep warm, I sulked and waited while my stomach turned increasingly sour. Eventually the stagnent mob of swimmers moved swiftly toward the water and like lemmings, we ran in 4 at a time, every 3 seconds.

Once in the lake and only a few meters out, I stopped in panic, unable to catch my breath. I whirled around to face the shore and back again to the tangle of limbs and churning water and I thought clearly, "I can quit. I can turn back now and it will all go away."

But that kind of relief is temporary. Failure would last and fester for however long it took me to try again. Failure became a greater fear than the fear of the swim itself. I resumed horizontal and took small, quick strokes with frequent breaths and listened to Liz’s coaching advice in my head, "you are trained for THIS. Just another swim. Keep moving forward.” 

In the mayhem of kicking and slapping limbs my goggles were torn off my face and my breath was knocked out with a kick to the chest but I drew upon the memories of training with my son Spencer at the lake where I practiced staying relaxed and in my bubble while he pulled me down, hit and kicked me. Tapping into this past state of success helped me recover until eventually I fell into my practiced stroke: reach, pull, breathe, reach, pull, breathe. 

As I rounded the second turn buoy, I felt a whirling sensation at my finger tips coming from the feet of swimmers in front of me. What’s this? I was gaining on other athlete’s? I began to sight for openings to pass. Before I knew it, the last buoy was in sight and I swam till my knuckles hit the sand. I felt energized exiting the water and was compelled to smile, wave and whoop as I ran up the hill to my bike. 

Ironman 70.3 - Ohio. Coach Amy energized and relieved coming out of the LONG swim. 

Ironman Ohio - 70.3. Swim Stats from Coach Amy's Garmin Forerunner 935. 

Casting a Net Far and Wide with the CoachAmyPT Message

Never in my wildest imagination did I think the CoachAmyPT message would reach the global stage, yet my passion for running free of injury is doing just that through the recently released Garmin Coach training plans. I’m humbled to be in the company of fellow Garmin Coaches Jeff Galloway and Greg McMillan and proud to represent the Kansas City endurance and physical therapy community. It’s especially sweet to be the only female coach on the panel!

Each coach approaches training differently to serve a wide variety of runners’ goals. My background as a physical therapist strongly influences the way I train runners. It’s amazing how well Garmin Coach captures and shares this approach with runners to help them achieve their goals without injury.

The net may be cast far and wide, but there is potential for an even stronger impact on local KC runners. Area runners can reach out to CoachAmyPT for injury prevention, performance enhancement, running biomechanics and treatment for injury. Local runners can join Roadrunners of Kansas City's ongoing group runs for camaraderie and accountability.

Whether in Kansas City, Japan or Australia, my hope is that Garmin Coach users find their own personal running success and, in the process, develop a life-long, healthy relationship with the sport.

For more information about Garmin Coach, visit Garmin Connect. Contact me for more information about physical therapy. Visit Roadrunners of Kansas City for more information about our running club. 

Running Related Research - Female Endurance Athletes Needed!

Coach Amy, in conjunction with Dr. Janice Louden, is conducting a running related research project with the Rockhurst University Physical Therapy doctoral students. Testing began in February and will continue throughout the spring.

Testing takes place at CoachAmyPT clinic and will take only 30 min. It involves non-rigorous testing of stability and mobility. We are looking for more volunteer subjects that meet the following requirements: 

• Over 40 years or under 30 years of age

• Female (not pregnant) 

• Trained for an endurance event in the last year (sprint triathlons are considered an endurance event). 

If you meet the requirements and are interested in contributing to our research efforts, please email amy@coachamypt.com. We'd love to have your help! 

Brain Power: Using Mental Imagery to Boost Recovery from Sports Injury

Visual imagery during a cat nap can boost performance and recovery. 

I was reminded of the power of mental imagery recently when learning to breathe bilaterally (to the right and the left) while swimming. I started out visually rehearsing breathing to both sides as I fell asleep. I dreamt about it over and over again. The next day I hopped into the pool and tried to swim bilaterally for the first time. The first 200 yards were ugly; I swallowed a lot of water, but then I was able to do it!

Research has shown that even without physical practice, mentally playing through activity such as running, biking or swimming can carry over into the physical world. And, when combined with actual training has a significant impact in performance over training alone. 

If mental imagery works to enhance performance, then patients resting from sport could benefit from this practice, along with their other therapies, boosting the success of recovery until return to sport is physically possible. 

So, lay down for a cat nap - close those eyes and begin to imagine your moves. When we believe, great things can happen! 

How to Safely Run in the Snow

There are risks and rewards to running in the snow. Knowing how to do so safely can be enjoyable and beneficial. Snow running provides resistance making it a challenging workout. Because of the increased resistance and uneven surfaces, injury can occur if steps are not taken to accommodate for it. 

To safely run in the snow, slow down pace, shorten stride and decrease planned distance. Consider decreasing the distance by 1/2 to 1/3 of planned mileage depending upon the depth of the snow. For example, a training plan that calls for 10 miles, should drop down to 5-7 miles in snowy conditions.

It is helpful to wear trail shoes or traction cleats such as yaktrax to improve stability with landing and power with push off on the snow. 

Expect your calves and hamstrings to be a bit more sore than usual. Running should never be painful. Pain = STOP. 

If snow is so deep that it requires high knees to clear the feet, consider snowshoeing or cross country skiing instead and skip the run! The hip flexors will be much happier. 

Be attuned to the weather conditions. Did we have a thaw and then a refreeze? This can cause snow to become icy on top or underneath. Running on ice is a no-no. The injury risk is too high for the reward. Consider running on an indoor track or cross training instead. 

Happy snow running! 

Self Pay v.s. Insurance Pay - Understanding the Differences

Differences Between Self pay and Insurance Pay

As of September 1, 2017, CoachAmyPT is officially an in-network provider of Blue Cross Blue Shield (BCBS). This means that patients with physical therapy coverage under BCBS can choose how they pay for services: Self Pay or Insurance. 

This brings us to the topic of the difference between the two choices. First, let us impress upon you that whether you choose Self Pay or Insurance, your care at CoachAmyPT will always be personalized and 1:1 with Coach Amy. That said, it may impact your finances and the logistics of your treatment so we recommend you compare the two and make an informed decision. 

Self Pay

• Treatment plan of care, frequency and duration are determined as a team by Coach Amy and the patient. 

• Cost of evaluation and treatment is known up front. No waiting for EOB's to find out how much you owe. 

• Patient can choose at anytime to have Coach Amy evaluate and treat multiple problem areas without scheduling a separate evaluation or treatment session (e.g. neck and foot).

• Coach Amy is always re-evaluating throughout a patient's treatment, but with Self Pay, monthly re-evaluations will not take place of your treatment time as they do with insurance. 

• Patient is not charged an evaluation fee for each new area of treatment unless it has been a year since their last visit. 

• Patient receives a SUPERBILL at the beginning of each month that can be used for tax purposes or to self submit to an insurance carrier that is out of network. 

• Payment is due at time of service or can be made online when appointment is booked. We accept flex spending and health savings account cards, cash, check, and Visa, Mastercard, Discover, or American Express.

Insurance

• Treatment plan of care, frequency and duration is limited to approval by the insurance company. 

• Benefits for PT vary and are dependent upon the patient's particular plan.

• Depending upon the plan, patients may need to satisfy in-network deductibles and will be responsible for payment of services at insurance rates. Please note that out of pocket charges may exceed CoachAmyPT Self Pay rates. 

• In most cases, a separate evaluation and appointment will be needed for multiple areas of treatment e.g. neck v.s. knee unless these are directly related. 

• Insurance does not cover maintenance and in some cases return to sport or hobby. If this is the case, a patient can choose to continue PT, but will need to switch to Self Pay.

• Every 4 weeks, regardless of frequency of treatment, one PT session will be primarily devoted to re-evaluation and a progress note for each area of treatment. 

• Co-pay is due at the time of service. We accept flex spending and health savings account cards, cash, check, and Visa, Mastercard, Discover, or American Express.

Making the Switch

Want to make the switch from Self Pay to Insurance? We are happy to help! Here are some key points:

1. When you schedule your FIRST insurance covered appointment select NEW Patient Evaluation and Treatment-Blue Cross Blue Shield. You will be prompted to fill out new patient forms including providing a copy of the front and back of your insurance card.

2. If you are currently booked for a follow-up Self Pay visit but want to switch to Insurance you can either go into your account or go to your confirmation email and choose the reschedule button. If this is your first appointment using insurance you need to select NEW Patient Evaluation and Treatment-Blue Cross Blue Shield. Do NOT select PT Treatment-Blue Cross Blue Shield. See # 1. 

3. We are not able to retroactively bill insurance for any previous Self Pay visits. 

We look forward to continuing to provide ALL of our patients with the same level of personalized care with Coach Amy and are excited to open up our practice to include those who wish to pay with insurance. 

Patients are Successfully Filing with Insurance and Receiving Payments

Many CoachAmyPT patients are having success self-filing and receiving reimbursement for services. In April, CoachAmyPT began using Therabill which is an industry standard software program that creates invoices from patients' electronic medical records. Invoices include all the dates, charges, codes etc. that patient's need to submit successfully. Insurance plans vary widely; patients should check with their insurance company to see how they will reimburse for out-of-network services. 

Hammy Strain from Running Sprints Interferes with Gymnast's Mobility

Meet Sid...she is a level six gymnast who strained her hammy in gym class doing sprints for Presidential testing. In two treatments of A.R.T. and some functional exercises (my favorite PT treatment combo) - this chick was back to full, pain free mobility with splits. Go Sid! 

Red's Door County Special: Pre-performance A.R.T. with Coach Amy

We are so excited for all the Red's participating in the Door County Triathlon!

Coach Amy is certified in full body and long tract nerve A.R.T. 

Tuesday, July 11th CoachAmyPT is offering extended hours 6:00-8:30 PM for the Red's Tri Team. Pre-performance session includes a 30 minute race ready A.R.T. to focus on tight tissues, areas with hx of injury and worrisome spots. This is NOT a PT evaluation. If you need that, please schedule a PT Evaluation and Treatment at coachamypt.com > appointments.

$60/session

Steps to secure your spot:

1. email amy@coachamypt.com with name, date of birth, address and phone number to schedule. First come first serve. 6:00, 6:30, 7:00, 7:30, and 8:00 PM. 

2. go to coachamypt.com > appointments and scroll down to required forms. Print, fill out and email or bring along to appointment. You do NOT need to fill out paperwork if you are past or present CoachAmyPT patient.

3. Arrive 5 min early, dressed in clothing you can move in!

Current injured Reds patients of CoachAmyPT are encouraged to keep their regularly scheduled 40 min. appointment that week if possible. 

Water Running during Injury

Photo from http://www.sanctuaryequinerehab.com/pool_treatment.html

If Gavin, a race horse slated to race in today's Kentucky Derby can do it, so can YOU! Water running is one of the best cross training exercises you can do if running is contraindicated. Water provides buoyancy, decreasing load on joints while at the same time providing added resistance. 

Most injuries that require rest from loading of joints will benefit from water running. Those with ligamentous tears of the knee should not water run until cleared by physical therapist or doctor to do so. Those with incisions post surgery should ask their doctor first before entering a pool. 

Ask your PT for specifics on how to water run!