Tuesday, October 2, 2018 - 17:35

Frustration is something that every athlete battles with in their career. Frustration manifests itself differently with each athlete. For simplicity, I will define two of these types of manifestations (my perspective), which may occur either separately or together, and where, in my opinion, the combination of the two is most common.

The first is an outward manifestation, a mental to physical transference of frustration, where the athlete lashes out at things or others around him.

The second is an inward manifestation, a conscious to subconscious (or vise-versa) transference of frustration, where the athlete battles with feelings of doubt, incompetence, inability, etc., to the detriment of their physical ability to perform and execute on an optimal level.
I have battled with both of these and, more often than not, they occurred in tandem.

When I was younger, I was extremely ambitious, wanted to rise to the top as quickly as possible, and pushed myself to extreme lengths to win at all costs. I was fortunate to have a natural affinity for the sport and I progressed very quickly. I started at age 14 where most start the sport at 8-10 years of age. This, however, was not necessarily an advantage. Having this affinity came with a sort of “entitled” sense of superiority. Combined with the amount of work that I was pouring into training and being a teen in his first year of high school, this made losing maddening.

I would throw masks, get into arguments with coaches, and argue with opponents.

Totally unhealthy.

If I had spent that time productively, instead of wasting it on not being able to manage my frustration, who knows what more I could have accomplished. Unfortunately, we are only human, and everyone deals with their problems in their own way. I would consider this post a success if even 1% of all readers tried to consciously work on dealing with their frustration in a more positive and productive manner.

As I got a bit older and learned from my mistakes, and sometimes the hard way, my frustration became less outwardly physical and manifested itself psychologically. At the time (and now), because I was working so hard at trying to get better, I would get frustrated when I would lose. Instead of throwing things around, I would immediately start to break down every component of my training regimen and try to determine what I was doing wrong. While this may seem like a more productive approach, it can be potentially devastating.

I will begin to explain the reason why this is, but first I will tell you my inspiration for this post.

After recently getting frustrated with myself during a lesson at Lilov FA, my coach Pavel Kutelvas asked me why I was getting so mad. I told him that I should not be missing touches during a lesson, that I was working way too hard to be making mistakes in a simple one-on-one. I explained that if I can not touch properly in a lesson, then how am I supposed to execute in a real bout? Especially overseas, one touch lost could mean the entire match!

He told me (repeatedly, but this last time it finally decided to stick) a few SIMPLE things that have seriously changed my perspective on hard work and subsequent results.

1) If a lesson were easy, if you were to score every touch perfectly, then you would never progress as a fencer. The reason for taking a lesson would be only to maintain, and not to transcend.

2) You are human (Part I): Even the best fencers make mistakes during lessons and lose bouts at competitions.

3) You are human (Part II): We all have good and bad days. Sometimes we simply can not outwardly and physically produce when we can not control what is happening within us internally, biologically, chemically.

My immediate thought when hearing all of this was that it was utter NONSENSE. I obviously am well aware of the law of diminishing returns, especially when considering physical input and output, but was always, and still am, a huge believer in the idea that hard work will always result in success.

However, realizing that my behavior during lessons probably seemed a little childish at times, I tried to consciously think about all of Pavel Kutelvas' comments when practicing.

And what a DIFFERNCE IT MADE.

Think about it as “comfort food” for your brain.

It is a complete waste of time trying to fight LIFE ITSELF and attempting to bend intangibles with sheer will. Pavel is completely right: Sometimes things just don’t work out the way you want them to.

I began to think about fencing and my training schedule, not as some sort of isolated part of my life, but as an ACTUAL part/component of my life. And when you think about life, things do not always work out the way that you want them to! Therefore, the same applies for fencing!

This might seem completely stupid, but it was a very difficult thing for me to grasp. And I am still wrestling with it. But I can definitely work on it. I have already unloaded a tremendous amount of anxiety and pressure by thinking in this way. It is as if someone has finally decided to climb off of my chest.

Therefore, if you are someone that transforms frustration into a physical thing, just stop. It can ruin your career, your relationships, and is generally very unhealthy.

If you are someone that psychologically suffers from pressures resulting from frustration, please take my advice: work hard and always try to better yourself, but try and keep in mind that many things that you think you are in control of, are ultimately never in your….control.

Think back to my post about consistency. The more you try to make things consistent and steady in your life, you reduce the risk of performing inconsistently. But it does not mean that you will ALWAYS perform consistently.

So: Do not try and overanalyze the reasons for why things aren’t the way you want them to be. Try to divide mistakes into two categories.

1) Mistakes that can be fixed, you make an adjustment, and they start working.

2) Mistakes that can be fixed, you make an adjustment, and they should be working but are not for some reason

Though very broad and even cryptic, I strongly believe the second category to be related to factors beyond our control. Without getting frustrated, and gradually, try to push category 2 problems in category 1, and over time, you can be sure that you are training in a mentally healthy, and physically productive manner.

Cherish and submerge yourself in every training, lesson, and situation, and live in THAT moment. Work as hard as you possibly can in THAT moment. You can always doubt if you are working hard enough. That’s OK because we are human. We are naturally competitive in that way.
But we all know ourselves better than anyone else.

If you are working as hard as you possibly can, you should never have a reason to doubt your ability to succeed. Just don’t let frustration limit your potential.

Push on, my friends!

Alen

P.S. If you would like to donate to my goal of making the 2020 Olympic team, you can do so by clicking the link below. Thank you so much for your help and support!

https://www.gofundme.com/AlenHadzic2020Tokyo

Tuesday, July 10, 2018 - 12:26

The most common question we get from new or potential patients is, "Do you take my insurance?"  We wanted to talk a little about insurance networks, what it means to be "in network," and why we've chosen to stay OUT of insurance networks.

 

Insurance providers have networks in which they contract practitioners to perform services at discounted rates.  To participate in an insurance network, practitioners have to agree to ALL of the insurance company's terms.  Early on at APH we decided that agreeing to the terms set by the insurance companies (whose top priority is their bottom line -- $$$) was not in the best interest of our patients.

 

It's important to note here is that just because we are out of network does not mean that your insurance company won't reimburse for treatment!  It simply means that we don't have a contract with them.  We submit claims to insurance companies on a patient's behalf, just as an in-network provider does.  If you choose, you can also submit payment to us directly and have your insurance reimburse you instead of us.  It's a pretty simple process and we're happy to assist along the way if you have any questions.

 

Here are some of the main reasons we are an out of network facility:

 

1. We’re able to spend more one-on-one time with patients. You guys are important to us and we want to deliver quality services and effective treatment.  Contracted reimbursements from insurance companies are so low that we would need to see multiple patients per hour just to keep the lights on. Our standards for patient care are just too high for that to be an option. At APH you get over a full hour of one-on-one treatment with our professional team. This allows us ample time to do all of our hands-on bodywork.  It also allows us enough time to do therapeutic exercise with you as opposed to just sending you home with a printed handout and letting you do it on your own.

2. We’re able to treat the *entire body* with the all-encompassing All-Pro Method. Insurance companies require a diagnosis code to go along with every treatment code. This means that if you come in with that nagging high hamstring pain, the only thing we’re able to treat is your hamstring because that’s all we have an actual diagnosis code for. All the other contributing factors are left untreated and at APH where we know that "everything is connected," we know that's not effective for getting to the root of the problem.

3. We’re able to utilize all of our awesome modalities. We don't have to worry about what your insurance company deems necessary or billable.  With your doctors at APH, you can decide that for yourself and opt in or out of any treatments you think will work for you.

4. The duration of your treatment plan isn’t dictated by the insurance company. Most insurance plans allow a certain number of visits under your plan. It’s the insurance company, not the patient/doctor team, that decides when the patient’s treatment is complete. Typically this is when the patient is able to resume “normal” activities. But what if your personal goal is to compete in a triathlon, which is well outside of what most insurance companies would deem normal or necessary? On that same note, what if you're feeling great after just 3-4 treatments? An in-network provider might want to keep you coming back unnecessarily to make sure they get all of the visits allowed by your insurance!  And you might even have to pay a copay out of pocket for each visit!  At APH we work with our patients directly to develop treatment plans in line with your personal goals so YOU -- not your insurance company -- can make those decisions.

 

In a nutshell, we care too much about our patients' well-being to be bound to insurance companies' contracts which are profit-focused as opposed to patient-focused.  In many ways, going to an out of network facility can wind up saving you money in both the short and the long term.

 

At APH, YOU are our main priority.

 

Again, just because we are an out of network facility DOES NOT MEAN that you're not covered by your insurance.  Contact your insurance company directly to determine your exact benefits and please reach out to us if you have any questions or issues regarding payment.

 

We have a few treatment packages in the works to streamline the process even more for patients and also to allow those without insurance access to insurance-like pricing.

 
If you have any questions or comments or would like to discuss payment plans or options, please reach out to us directly.

 

 

 

Sunday, May 6, 2018 - 21:36

The answer to "two truths and a lie" is number 3!  Gabriella's favorite yoga pose is actually supta baddha konasana aka bound angle pose!

We're excited to introduce the newest member of APH.  Gabriella is joining us as a yoga therapist and at APH she will be working one-on-one with patients to teach them flows for warm-up, pain in targeted areas, balance, and strength.

Gabriella is a 200hr certified yoga instructor, intuitive Reiki master, and energy expert. She is currently attending Philadelphia College of Osteopathic Medicine to obtain a Master's Degree in acupuncture

Her strong connection to the energy of the Universe and the energy of others makes her a supportive and compassionate yoga instructor as well as a thoughtful and effective healer.

In her own practice, she works to achieve balance with the yin and yang in her own life, and she is excited and passionate about sharing that with her students. She enjoys life most when outdoors in the woods reconnecting with nature. Her passions include hiking, camping, swimming, yoga, and attending music festivals. Her mantra in life is, Be Here Now. 

 

#DrToddSays: Integrate multiple therapies into your treatment plan for optimal results!

Make an appointment for a one-on-one yoga session here!

Monday, April 30, 2018 - 16:34

Dr. Todd recently saw a 13-year-old patient for treatment of patellofemoral tracking disorder.  Her pediatric orthopedist said he sees this disorder 2-3 times per day!  

What exactly is this common condition and what can we do to help treat it at APH?

In simplest terms, patellofemoral tracking disorder is when your kneecap moves out of place when you bend or straighten your leg.  Your kneecap is kind of a “floating” bone that is held out in front of your knee joint by muscles, tendons, and ligaments. When you bend or straighten your leg, the patella glides along a groove in the femur.  In tracking disorder, the patella moves either too far to the outside or inside of your leg, causing pain usually at the front of the knee.

 

So what can we do to help?!

 

The good news about patellofemoral tracking disorder is that it’s treatable with non-invasive techniques.  At APH, we take a multifaceted approach:

  1. Heat -- to increase blood flow to the area

  2. Active Release Techniques (ART) to the muscles, Graston (IASTM) for myofascial release and Therapeutic Exercises (TE) to hold the correct alignment.

  3. Pelvic manipulation -- to correct sacroiliac joint dysfunction, when stretching and TE cannot correct alignment. We work with the  hips, because poor range of motion leads to problems down the kinetic chain (i.e. knee problems)

  4. Therapeutic exercise -- IS CRUCIAL to correct muscle imbalances. For tracking disorder, we work directly with the quads of course, but also with the hip flexors and glutes to help balance and mobility in all muscles and joints.  It may feel silly spending time working on your hips and glutes when you have pain all the way down in your knee, but dysfunctional movements caused by muscle imbalances in your hips and glutes are directly related to your knee joints (and even further down), as illustrated here:

If you are suffering from knee pain that you think could be attributed to Patellofemoral Tracking Disorder, we can help!  Schedule your appointment here and we'll get you back on the right track.  Pun intended, as always :)

 

#DrToddSays: Let me help you get your knees back on track!

Friday, April 13, 2018 - 13:37

Why is Dr. Todd so passionate about the Functional Movement Screen for young athletes that he's offering complimentary screenings for two whole months?

 

Two words: Personal. Experience.


 

Here's Dr. Todd in his own words:

"I personally have permanent injuries to my back that were sustained from poor technique and guidance as a student athlete. This led to multiple disc herniations in my lumbar spine in my late 30s. If FMS was introduced to me as a young athlete, I would have been a much more efficient athlete and may have never experienced the debilitating injury to my back.

 

In 2010, I hired a Physical Therapist who introduced me to FMS. I was tested and failed miserably, barely getting through the test because of pain and weakness. That was when I realized that traditional rehabilitation treatment was missing something. It was only treating patient symptoms and not the cause of their actual problem. At APH, as we started to take a more global approach to treatment plans, things began to change and patients were getting better more quickly and permanently instead of just feeling better for a brief period. After seeing these results, our patients began to bring in their family members and children. What stood out to us the most is that the KIDS HAD THE SAME ISSUES AS THEIR PARENTS! We began working with kids as young as 6, teaching them how to move correctly. The postural issues were unbelievable! We saw dysfunctional movement patterns in almost every child we saw. These issues are basic and simple to correct before the abnormal movement becomes a significant injury that could impact and limit them from performing their sport.

 

I truly believe if I knew my risks for injuries at an early age, how to prevent them, and how to maintain my body, I would have been a better athlete as a child as well as an adult with less permanent injuries now."

 

Dr. Todd Schragen
D.C., C.C.S.P., ART

 

To book your complimentary FMS, please make an appointment here.

Thursday, April 5, 2018 - 21:02

How many hours a day do you spend on a computer or wireless device?  Be honest! Do you ever have unexplained neck or shoulder pain? If so, you could be suffering from Text Neck!

Text Neck is a newly coined term for a uniquely modern problem that refers to neck and shoulder pain, repeated stress injury, and severe damage to the spine from using phones, iPads, laptops, or any wireless device with poor posture.

With proper posture, we have about 10-12 lbs. of force on our cervical spines.  Every degree we tilt our heads forward to get closer to our screens, we add more force and unnecessary (and unnatural) pressure to our spines.  As most adults these days spend most of their time with some kind of wireless device in hand or working on laptops or desktop computers, Text Neck is becoming increasingly common.

Take a look at this (embarrassing) picture of Julie, APH patient and content creator, that Dr. Todd secretly snapped while she was researching content about (guess what!) proper posture and spine care.  *facepalm*

Not only is this an incredibly unflattering posture, but she's also close to the 60 degree downward angle, putting up to 60 pounds of extra pressure on her cervical spine!

Luckily, with awareness and proper posture, you can keep yourself out of this new epidemic.  A few things you can do to keep your head on straight:

  1. Bring your wireless device to you instead of bringing yourself to your wireless device.  Hold it as close to eye level as possible at all times to avoid that downward tilt.
  2. Put your wireless device away completely.  Obviously this is a lofty goal but try to at least take breaks.  Set timers to remind yourself to go device-free for periods of time.  This is good for sanity and preserving actual human relations as well as Text Neck prevention :)
  3. Make sure your work set-up is ergonomically friendly.  There are a lot of opinions about how to do this, but for Text Neck purposes make sure your chair (or desk if you have a standing workstation) is at a comfortable height so the monitor is at eye level.
  4. If you're already suffering from Text Neck, make an appointment at APH for an individualized treatment plan.

 

For Julie, all it took was one look at that embarrassing candid picture compared to this much more flattering picture to take a more mindful approach toward her wireless device posture.

#DrToddSays: Keep your head on straight!

( #JulieSays: Be mindful of your posture to take more flattering photos! )

 

Thursday, March 29, 2018 - 12:57

Last week we talked about healthy hip joints and this week we’ll help you “get... that... dirt off ya shoulder” (and also keep it off ya shoulder) like Jay-Z.  Side note: After this, we at APH hereby pledge that we won’t make any more corny song references.  Maybe. At least not for a while.

 

We have two sets of ball and socket joints in our bodies -- our hips and our shoulders.  Ball and socket joints can be unstable which is why it’s important to make sure all the surrounding muscles are warmed up and mobile.  The shoulder is made up of your glenohumeral joint, humerus (arm bone), clavicle, and scapula. It’s surrounded by the rotator cuff, which consists of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, and an extensive network of other larger muscles that hold everything together.

This extensive musculature connecting the upper extremities, shoulders, and cervical spine directly and indirectly affects the motion of your entire body -- from throwing a ball, to balancing your body in space, to high-fiving your new Physical Therapist!

 

Here’s a great shoulder warm-up and mobility drill adapted from Lance Ito and passed on to Dr. Todd by his personal PT and good friend Russel Ditchfield.  All of these moves are meant to warm up the rotator cuff muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) and surrounding muscles that support the shoulder joint.

 

Videos 1 and 2: External rotation and abduction with bands.

3 sets x 15 reps each on each side

External rotation and abduction with bands.

 

Video 3: 3x15x3 reps plus 10 second stretch in each position.

 

 

#DrToddSays: Don’t let your shoulders get “dirty”!  Keep them warmed up and stretched.

Wednesday, March 21, 2018 - 11:57

#DrToddSays: Integrate multiple therapies into your treatment plan for optimal results. Meet our new PT!

If you’re coming from Instagram to find out which of the three “facts” is actually a lie, the answer is #2!  

Dr. Joshi is a skilled massage therapist and a Bharatnatyam dance enthusiast but he’s never been a Pilates instructor.

And here’s a little more about APH’s newest member:

Dr. Joshi is a NJ licensed and Board Certified Physical Therapist.

He spent the early years of his career path as a teacher and a massage therapist and enjoyed the opportunities afforded to him by each to empower people in various settings.

He went on to earn his Doctor of Physical Therapy degree at New York Institute of Technology with the hope of continuing to have a positive impact on patients’ lives on a physical and emotional level.  As a physical therapist, he believes in approaching conditions and situations holistically, restoring patients to their prior level of function and improving their quality of life.

Currently, he works in multiple outpatient physical therapy facilities in northern New Jersey providing quality health care for musculoskeletal, orthopedic, and neurological conditions.

With his training in Ayurveda, an ancient Indian science of healing, he provides a comprehensive and collaborative environment to promote overall health and wellness. Due to his eclectic approach, he provides utmost care in the process of rehabilitation by empowering, reviving, restoring, preventing, and educating his patients.

 

He is open and taking new patients for PT at our office in Livingston!  Schedule your appointment today!

 

 

 

 

Thursday, March 8, 2018 - 16:06

It's already March but that doesn't mean we're out of snow storm season in NJ!  Shoveling snow can be a very hazardous activity for your back. Done correctly, though, it can also be a great opportunity for a workout!

Here are some tips to help you avoid throwing your back out while shoveling and cash in on a killer workout instead.

  1. Foam roll first. It’s important to warm up your muscles and joints before any strenuous activity. My personal favorite way to stretch and warm up is by foam rolling. See our video library for foam rolling demos.
  2. Engage your core. Pull your belly button in and your rib cage down to protect your low back.
  3. Bend at your knees. Instead of making your arms and shoulders do all the heavy lifting, engage your legs while moving snow to allow the stronger low body muscles to do some of the work.
  4. Keep your arms and shoulders as close to your body as possible. When engaging the shovel and lifting the snow keep your arms and shoulders as close to your body as possible. They are levers (your torso is the fulcrum) and keeping them close to your body will minimize the effect of the extra weight of the snow.
  5. Take frequent breaks. The cold weather may prevent you from working up a serious sweat but that doesn’t mean your muscles aren’t feeling the heat. Make sure you stay hydrated and if you need to take a break (or call someone with a snowblower), take one!

Below, Dr. Todd demonstrates safe shoveling technique:

DO THIS:         NOT THAT:

 

Keep these tips in mind while shoveling and your arms, shoulders, and back will thank you tomorrow!

 

Enjoy your snow day!

 

 

Wednesday, May 31, 2017 - 09:04

Tri season is finally here in NJ. I've been eagerly awaiting the opening race of the season and watching results from warmer areas trickle in over thelast several weeks. Last Sunday finally marked the beginning of racing here in NJ with JerseyMan. The lead in to the race had it's ups and downs both mentally and physically. Although I had a solid run build and had been doing strength work throughout the winter months, some unexpected trips in the car made for an extremely tight hamstring and compromised the early season progress. 

Dr. Todd came back into action just in time. I was having trouble bending down without pain in my lower back and upper thigh. My hamstring was so tight that you could actually feel the muscle as just a taut chord. It was not comfortable. I was losing power and it took a little while to get started on runs. Dr. Todd and I worked on it over the course of 3 weeks pretty religiously. We managed to get ahead with a couple double visits in a week. The ART and focused work on the hamstring and down into the compromised calf muscle was brilliant and in short time I was feeling stronger and better. By race day, the tightness that had plagued my workouts was gone. I could come off the bike without any worry of settling in and without any sign of a limp. This was huge. 

Fast forward to race day and I came off the bike in 5/6 place with another strong athlete. Had I not been able to quickly settle into a run, I could have kissed the race goodbye at that point. Instead, we had a constant back and forth duel for the first 4.5 miles before I managed to pass and put away the other runner. In the end, I came about 0.5mi short of catching 4th place but finished with a strong showing of 5th. 

Using techniques and exercises that Dr. Todd has suggested based on my own functional movement screening, I was able to recover quickly from the effort and move forward with the training. Cycling power is at a new all time high and the run pace is beginning to creep to an even lower level. The season looks promising and the hammy is happy. 

ART
Wednesday, April 5, 2017 - 15:37

The View

I had a doctor's appointment last Thursday that prompted me to learn about myself and better articulate what it is that makes me against drugs. I thought I'd share this because I suspect a lot of people have the same view and that it might be helpful for anyone else debating whether to take a pharmaceutical or not.

When the topic comes up, I typically just say "I don't like to take drugs" and that I prefer natural solutions, however, that's an oversimplification of what I really mean, which is that I don't like the things drugs typically stand for. These three things in particular:

1.) They don't solve the root problem, often "slapping a band-aid" on the situation by masking symptoms
2.) They have side effects and it's often a chemical completely foreign to the body
3.) The patient often becomes dependent on the drug (i.e. needing to take it for the rest of their life)
 
If a doctor is recommending that you take a pharmaceutical for a non-immediately-life-threatening condition, pause for a moment, and consider the above three points. If these three things come up as "not applicable" then congrats! You may have found yourself one of those rare drugs that will help you without screwing up the balance that the human body has so miraculously achieved through eons of evolution. Unfortunately, nearly all pharmaceuticals fail to meet all three of these criteria, and that is why I have felt so comfortable saying "I don't like drugs" as a blanket statement.
 
I should take a step back...we should FIRST be considering natural ways to fix things, because then there is no chance of 1, 2, or 3 being applicable. By taking drugs, we introduce risks, whether they be known (like the side effects you see listed on Warning labels), or unknown risks. Former US Secretary of Defense Donald Rumsfeld made famous the phrase "unknown unknowns" in a speech about Iraq in 2002 - there are unknown unknowns when it comes to drugs too, because the body is so incredibly complex that we don't know the full extent of what we are doing to it when we add something unnatural. The body is capable of some amazing things, so before you add something unnatural, we should use food, habits, natural supplements, exercise, etc to fix our problems where possible.
 

A Real Life Example

Mine. It serves as an example, but also an update to those following along in my recovery.
 
That doctor appointment I had last week was with a bone density specialist in Manhattan named Dr. Joseph Lane. The two doctors I've worked with in the past, Dr. Sylvia Hesse (Orthopedic) and Dr. Ruth Johnson (Internist), have both been fantastic, but there are a few questions that they were unable to fully answer:
 
1.) Will my bone density ever be back to normal?
2.) How fast should I expect it to get better?
3.) Is there anything else I can be doing to make it better?
 
Dr. Lane was quickly able to answer number 1. His answer...my bone density will never be back to normal. The bone loss I've experienced is partially irreversible. If I take the natural route, I can expect to get from -2.0 standard deviations below the mean (where I am now, at the border of osteoporosis) to about -1.7, or -1.5 at best. At that level, he thinks I'd be able to resume normal daily living, but won't be able to train at a high level. Then he went to say that he thinks I could get back to -1.0, but only with drugs.
 
I knew he was going to say that.
 
He's a conventional doctor after all and the pharmaceutical companies have big bucks.
 
But I listened. He said that at -1.0, I would not be back to where I was before this mess (because "there are consequences [for what you've done]"), but that I could train at a high level again as long as I didn't do anything stupid (like have low testosterone or undereat).
 
Trying not to be skeptical, I prompted "so tell me about the drug." And what he said surprised me. He described a drug called Forteo that is almost identical to a hormone that our bodies already produce that prompts your osteoblasts to make bone faster, therefore outpacing your osteoclasts (which break down bone), thereby increasing bone density. I would take it for 2 years and then stop, supposedly keeping the bone density I've gained.
 
Ok, so that meets criteria number 1 because it actually fixes the problem, which is low bone density. It meets number 2 because it's not foreign to the body and has minimal side effects, and it meets number 3 because you don't become dependent on the drug. I didn't expect to seriously be considering any drug, but this one had me thinking.
 
Then the bad news. The drug is extremely expensive and not often covered by insurance. I could get 1-2 months covered, but after that no guarantees, and if I paid for it all out-of-pocket it would cost $3000 per month! That's completely unaffordable and not happening.
 
So then they told me about a second drug called Prolia, which is covered by insurance. It's completely foreign to the body and comes with a host of potentially serious side effects. It checks off numbers 1 and 3, but fails completely to meet number 2. That's out.
 
I went home with a lot to think about. The first thing I had to do was determine the validity of what he was saying with regards to bone loss being (mostly) permanent. I combed through the literature and asked favors of a number of my friends in the medical field to search as well. We found 2-3 case studies of women in their 20s who had lost their bone density due to the Female Athlete Triad, and then restored it using natural methods (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761891/ and https://www.ncbi.nlm.nih.gov/pubmed/16177598), but we didn't find a single case study of a ~30 year old male who has been able to do it.
 
Favor: if anyone knows of any case studies where this has been done, please let me know!
 
Then I had a number of conversations with Lauren, my family, other athletes, friends, researchers and medical professionals, so that I could a.) hear their feedback and b.) have them act as a sounding board for me. To those who have helped me in that way, thank you!
 

My Plan

I never thought I'd say it, but I'm going to take a drug. I'm going to see how much Forteo I can get covered by insurance and take it, even if it's for only 2 months. For those wondering, it's not banned by WADA. After that, I'll maximize the bone density gains I can make naturally and hopefully get to a place where my bone density doesn't affect my life and those around me, including our baby daughter who will born any day now!
 
I continue to reach out to bone density specialists so that I might discover something new to help me, but if Dr. Lane is correct that it's mostly irreversible, then I hope at least my story will convince others to take care of themselves. Check in on your hormone levels (both men and women!) and eat right, before it's too late. If you don't know how to keep your hormone levels strong, I may be able to help: http://www.ironmattbach.com/consultations and if you don't know what "eating right" means, then reach out to Nicci Schock: http://elevatebynicci.com/
 
 
Drugs have their place. Modern medicine has saved countless lives and should continue to be used in emergency situations, in situations where there is no natural fix, and when the drug meets all three of the criteria I outlined. That's my view. What's yours?
 
 
Friday, February 3, 2017 - 10:48

Ugh. It was all going so smoothly, but here I am facing some hefty bumps in the road. My bone density has barely moved, and I've given myself another stress reaction. What happened?!? Here's the scoop:

My health was returning, so I jumped, ran and lifted heavy weights. No problems! It had been 4 months since I had the initial stress reaction and I stopped training, my hormone levels are back to normal, and my hips were feeling fine. No evidence of any bone injury. I had come to believe that my bone density must be coming back nicely, but I wanted to check it out and make sure before ramping up my training more, so I scheduled a DEXA bone scan.

The result: low bone density!

My reaction: "What?!?!? I only gained 9.7% in my spine?!? And I lost 4.0% in my femur!?!? I thought I was on the right track!"

The problem: There are lots of them. First, my expectations weren't set properly. I was under the assumption that I could gain tens of percents in my bone density within a year. My fault. I should have known, by asking my doctors or doing some Googling, that bone density improves really really slowly...to the tune of 10% per year if you're doing well. Second, there is a margin of error of +/- 5% for these tests. Third, the two datapoints, 7 months apart, don't tell the whole story. I was very disappointed at first, but after giving it some thought, talking to my doctors, and looking at the evidence, this is actually a pretty good result. Yes, even the loss of 4% isn't so bad. My first DEXA was done in May 2016, but that probably wasn't my low point. I was injured and had low testosterone, both of which were further hurting my bone density. Further evidence comes from a bone resorption test that I did (it shows how much bone you're breaking down) in late June that showed I was breaking it down pretty quickly. I had another bone resorption test in November that showed a dramatic decrease in the amount of bone I was breaking down. Therefore, the story is likely that my bone density continued downward till a low around July, but then necessarily must have rebounded in order to arrive back at the "nearly unchanged" numbers we see in January 2017. This would suggest that I've actually been progressing since mid-summer, and that I need to just keep doing what I'm doing. Great. So my priorities are: 1.) I'm still susceptible, so don't get a stress fracture 2.) keep hormone levels normal, which is of utmost importance for healthy bones and 3.) keep lifting heavy weights to encourage bone growth

Fastforward three days. I go for a 9 mile run with a few short pickups. It's nothing out of the ordinary as I've been doing pickups recently and have run up to 10.5 miles at a time without issue. Two hours after the run, though, my hip starts aching ever so slightly. It's the same feeling as when I first had the stress reaction. My first thought..."this must just be in my head. I got the disappointing bone density result and bone stress injuries are fresh in my mind. Plus, I've been doing runs like this, and throwing heavy weights around, and jumping and I haven't had any problems, so why would this run-of-the-mill 9 mile run affect me? Are you becoming a hypochondriac? Matt!? Are you!?" Then I ran on Thursday morning, an easy 6 miles. The ever-so-slight achiness returned...hmmm...then I lifted heavy that same day and the achiness moved into the range of undeniability. It felt like soreness deep in my hip area, but only on my right side, the same exact feeling I had back in May 2016. I immediately contacted my doctor to set up an MRI, which I did the very next day. Well I got the result on Tuesday and WHAM! I've got a stress reaction. It's in the same exact spot as before and looks to be approximately the same intensity.

What does this mean? For the short term, it means I won't be running anytime soon, I won't be doing any heavy lifting, and I can't do any hard bike workouts. Chances are slim to none that I will be doing Puerto Rico 70.3 frown. I'm lucky to still be walking without crutches. I can, for now, still bike easy and swim, but if that aggravates it, then I won't be able to do those either. For the longer term, maybe this is God's way of telling me to put this mission aside. "Here, I'm giving you something more important to worry about, a daughter!"

My new priorities: 1.) get ready for the arrival of our little one 2.) heal my stress reaction 3.) maintain hormone levels 4.) restore bone density to levels where I can run without reinjuring myself

I write about this topic so that others will be aware of the health debacle that can occur if you overtrain. So many articles write about overtraining and how it's not good for you, but they don't get into the nitty gritty. What actually happens to your biology? Why does performance suffer? Why do you become more injury prone? Why do you feel tired and why don't you want to have sex?! It's much deeper than "I'm tired from training," and I feel I have a duty to spread that word. I'll be doing a speech on this topic in 2 weeks at a Sports Medicine conference in Greenville, SC, I'm working with a researcher named Dr. David Hooper on a study assessing overtraining in endurance athletes, and I offer consultations to those who are in a hole and need help. To be clear, my point isn't to diminish enthusiasm about training for endurance sports, but just that we need to be smart about it! There is a balance that can be found in each person's life situation that will allow them to fully enjoy triathlon and become better athletes, all while remaining healthy. I encourage you to find your balance!

 

Train happy, train healthy,

-Matt

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