San Francisco Podiatry Video


Sunday, October 20, 2013

Ironman Lake Tahoe Race Report

Wednesday September 18, 2013

Driving through the mountains on I-80 I heard myself say, “If this wasn’t number 12, there is no way I would be doing this.”

Sitting in my truck with my P3 nestled comfortably in back I was on the way to Lake Tahoe and talking to my friend Henry on the phone. I was trying to explain what I was about to do. And I was having a hard time buying my own reasoning.

Today I was driving from San Francisco to Lake Tahoe simply to drop my bike and gear bag with Megan Lewis and SAG Monkey extraordinaire Nick.  I was then going to drive to Reno where I would spend one night in a casino hotel, only so I could get a little sleep before I had to wake up the next morning to see if I could make it to the very front of the line at athlete registration. Next I would fly to Las Vegas where I would be giving a lecture at a medical conference that afternoon. I would lecture again the next day before flying back and hopefully make it back from Reno to Squaw in time for the dinner and athlete meeting. Then of course, I would do Ironman Lake Tahoe.

Less than a week before I had unpacked my bike.  It had been in the case since I flew back from Ironman Texas in May.  Last week I assembled it and took it to Tam Bikes in order to get new cables and a new chain installed. I hadn’t even had a chance for a test ride yet.

Work and daddy-duties had been so busy that I had only done about 8 bike rides, 5 swims in the pool and 4 runs (of about 3 miles each) in the past 4 months. Pretty hard to argue that I might be ready for what was about to happen.

But as I was explaining to Henry, if I could just finish before midnight, that would be 12 Ironmans and I might finally get a “Legacy Slot” and a chance to stand on the starting line of the Ironman World championships in Kona. 

Seems like that might be worth any dose of suffering.

Thursday September 19, 2013

I woke up at 4:58 AM, 2 min. before my alarm clock was scheduled to sound.  I hobbled out of bed, put on some clothes and went down the casino elevator to find some coffee and breakfast. When I got back to the room I returned some patient e-mails and packed my suitcase. I stopped by the lobby just long enough to drop my key card in the express checkout box and choke on some casino smoke.

And away I went, back to Lake Tahoe.

Less than an hour after packing in the hotel I was in the Squaw Valley parking lot looking for athlete registration. They were still setting up tables and chairs. Goal #1 was accomplished; I was first in line for athlete registration.

This was important as registration was not scheduled to open until 9 AM. My flight from Reno to Las Vegas was at 11 AM. And Reno is about 45-50 minutes from Tahoe.

At 9 AM sharp I was handed a form which I quickly filled out and signed. I made my way through athlete registration, got my timing chip, picked up my transition bags and then ran through the expo tent the buy a visor for my brother-in-law Todd who is currently training for his first Ironman.

I then ran back to my truck and pointed it at the Reno airport. As I was driving I got a text message that my flight had been delayed by 5 hours. Not good. This meant that I would miss my first lecture.  Luckily I was able to call the airline and reschedule for an earlier flight. I would still be in good shape.

A few hours later I landed in Las Vegas and went to the Wynn hotel and casino to check in. Once I got to the room I showered and changed into my suit.  I checked in with the International Foot and Ankle Foundation conference administrators and rechecked my talk to make sure everything was in order.

A couple of hours later I was at the podium lecturing on tarsometatarsal fracture dislocation patterns and how not to miss them. I sat through the closing lectures and 9 PM headed back up to my room to get some sleep.

Friday September 20, 2013

I woke up at 4 AM so that I could review the slides for my next talk.  After a quick review I went down to the exhibit hall floor so that I could spend some time in the DG Instruments booth.  DG instruments currently licenses and markets the surgical instrument which I invented. So I try to spend some time in the booth to see if any surgeons have questions about the instrument, or its use in surgery.

Later that morning I gave a lecture on lateral process fractures of the ankle. I was able to attend a few more lectures before had to fly back to Reno. Unfortunately on my way to the airport I received a message that my flight was delayed.  Switching flights wasn’t going to help.

At about 9 PM I was picking up my bike and gear bag from Nick. Because Nick is the official Ironman Lake Tahoe SAG Monkey, I said, “I appreciate your help, but certainly hope I don’t see you on Sunday!” 

At about 10 PM I was knocking on the door of the awesome ski cabin arranged by Andrew Muff. I met Dana and Christine who were super nice.  But I was in bed before I met anybody else. 

Saturday September 21, 2013

Shortly after I got up, the rest of the housemates started to trickle through the kitchen. We all had coffee before heading out for breakfast.

At that point, since I had just assembled the bike and had new cables installed, I was still hoping to get to take the bike out for a short test ride. But now it was raining. I was already worried about the cold, so I wasn’t willing to soak my cycling shoes (or anything else) just to verify that the guys at Tam Bikes did a great job. I chose to trust instead.

After breakfast, I went to pick up some last minute supplies and see if I could find some additional layers. Dana and I found a ski shop that had some consignment gear. I found a used medium weight cycling top for $20 that fit just right. I also found some glove liners for $12.  Perfect! $32 worth of insurance to insulate me from the predicted chill.

Back at the cabin I packed my bags and prepped for the gear drop off.  All of this was fast and simple as I have detailed race-day packing lists. I even have pre-packed zip-locks with the proper contents for each of the special needs bags. By packing them in advance, I think (and worry) way less than I used to. 

FYI: I will post my soon-to-be-no-longer-top-secret Ironman Packing List and Tips. (Feel free to swipe and deploy.)  Such a list will significantly decrease your day-before anxiety.

Because it was raining and I had packed all of my cold weather clothes in my transition bags, I was on my way to transition donning a trash bag as outerwear. But better to freeze today, instead of tomorrow. 

Because it was raining today and predicted to be freezing overnight, I had trash bags covering my handlebars and seat. Certainly didn’t want to start the day on a wet saddle or gripping frozen handlebars. 

As I racked my bike I noticed the guy next to me had no bags to cover anything. So I offered, “Hey would you like a couple of bags to cover your seat and bars?”

“Sure! Just one,” he said.

“Why just one.” I asked.

“I just need to cover my drive train to make sure it won’t still be frozen on the first descent.”

That was a thought I really didn’t need to hear.

I wandered off to find Andrew who had finished racking his bike and dropping his swim-to-bike T1 bag. We headed to Squaw to drop our T2 bags and meet the rest of the group from the cabin. I made an emergency sweatshirt purchase at the expo, realizing I that I had nothing warm (other than a wetsuit) to wear to the start.

By the time we got done at Squaw I was completely soaked and freezing cold. I was having a hard time imagining what it was going to be like to get out of Lake Tahoe and hop on a bike when it was this cold.  To make matters worse, as we were driving back to the cabin, it started to snow.

At the cabin I took a hot shower and later sat in the hot tub to warm up. There was ice on the deck and railing. The snow slowed, the stars began to twinkle. It was serene and beautiful. It just wasn’t Ironman weather.

Sunday September 22, 2013
Race Day

I woke up at 3:45 AM. I quickly put on my clothes, grabbed my gear and headed downstairs. Two peanut butter and jelly sandwiches and two cups of coffee later I was ready to go. We left the house of 4:30 AM heading for the squaw Valley parking lot to catch the shuttle buses to the swim start. 

Once I got to transition it was a simple routine. Drop the special-needs bags and put air in the tires. I pealed the trash bags off my bars and seat.  I kept the trash bags to cover my feet.  I had been warned that the sand was going to be extremely cold.  Knowing that my wetsuit was going to be much warmer than my blue jeans, I slipped into my wetsuit, but kept my sweatshirt on.   I heard someone say that it was 25°.

I put the trash bags over my feet and then put my socks back on to help insulate me from the sand when it was time to head down to the start. 

I dropped my green morning clothes bag and then went onto the beach in search of the 1:30-1:40 swim corral.  Normally (when untrained) I would swim 2.4 miles in about 1 hour 25 min. to an hour and a half.   But I figured with the altitude (and my paltry 30 hours of acclimatization) I would be lucky to make it in 1:40.

Swim 2.4 Miles

By the time the cannon fired and the athletes started filing into the water I was really cold. In fact, I was shivering. It was the first time I have ever been shivering while wearing a wetsuit. I wished that I had brought a neoprene swim cap and booties. 

As my wave started to approach the starting gait, I wandered over toward the fence to discard my socks and trash bags. And then the gods smiled upon me. There in the sand was a size large pair of ScubaPro neoprene booties. I quickly put them on and tucked them under the legs my wetsuit.

I suddenly felt much better and in the water I went. I checked the clock only to make sure the new how much additional time and needed to account for to ensure that I made it in before midnight. It was about 10 min.
As I waded into the water I found it interesting that sixty-something degree water actually feels considerably warmer than twenty-something degree air. But that didn’t last for long. 

There was an eerie fog hanging over the surface of the water that made it nearly impossible to see the buoys. Not being in any particular hurry I was not overly concerned about this. I figure all I had to do was keep moving in the right general direction in order to eventually get there.

I wasn’t swimming particularly hard because I didn’t want to strain anything. After all, I was in no shape to be doing this anyway. But after about 15 minutes I was shivering so much I was actually concerned about my capacity for finishing the swim. So I then decided to try swimming hard for about a quarter of a mile to see if I can get my heart rate up high enough to bring my core temperature up.

Note to self: if not accustomed to altitude, swimming hard at elevation is a bad idea. 

After only 5 or 10 min. of cruising through the pack of swimmers at a brisk pace I started having some mild spasms in my lungs. This quickly subsided when I slowed back down. 

I would just have to be cold.

I’m almost ashamed to say that this was actually the first time I have ever set foot in the water of Lake Tahoe. Probably not a great idea in terms of Ironman preparation but it is the truth.

The thing that I did notice more than anything else is that Lake Tahoe is ridiculously beautiful. It was cold but I was still enjoying it. I could see all the way to the bottom. And every time I took a breath I could see the freshly snowcapped mountains peering through the fog. Physically it was unpleasant. But aesthetically it was wonderful. I would consider it almost a fair trade.

On the 2nd loop I could see better, but I was getting hypothermic. My swimming was simply reduced to watching the buoys drift dry and thinking, “OK #8...I can make it #7.  OK #7...I can make it #6.  OK #6...I can make it #5.”

Soon enough I was out of the water. 1 hour 31 min. Not great, but good enough.

“One down. Two to go!” I thought. 


I came out of the water andf I was thrilled to see the SF try club wetsuits stripping crew. It was really great to see familiar faces. That was when I was no longer curious if I was hypothermic. I knew it. 

The volunteer looked me straight in the face and said, “Can help you get out of your wet suit?” And I just stood there thinking about it. I knew that I had to get out of my wet suit yet I did not want to peel off the neoprene and be exposed to the cold anymore. Fortunately she was smarter than I was and just started helping me out of it.

When I made it into the men's change tent, it was warm, but it appeared as though they were having some sort of Guinness Book of World Records contest to see how many naked men they could shove in a telephone booth. In that respect it was relatively unpleasant. But at least it was warm...

I started to untie my transition bag and realized I was having trouble. I tied the bag like shoelaces so that it's easy to get it undone. But it wouldn't budge. I thought it was that my hands were numb. So then I tried to bite into the cords with my teeth. That was when I realized the entire draw cord had frozen solid into a block of ice.

I ripped the bag open (but was not happy about this). I was worried that would end up losing some of my swim stuff since I couldn't close it back up.

I dried off as much as possible and got into every layer I had packed in my bag. Tri shorts, tri top, arm warmers, compression socks, my new/used cycling top, SFTri windbreaker and glove liners. I put on a fleece hat under my aero helmet, with vent holes taped shut.  

I ran out through transition to find my bike and get going.

Ride 112 Miles

I figure getting on the bike and starting to pedal would help me warm up. I was wrong about that. It wasn’t until I hit the big hills about two hours later that I stopped shivering. 

But all said, it was going well.  I was being conservative, watching the watts and keeping well within the limits that I knew I could sustain.  I just kept telling myself, “All you have to do is NOT do anything stupid and you can make it.”

Near the end of the first loop of the bike course I did something stupid.

I was on the final climb, creeping uphill at about 3 mph. I was only passing the long line of athletes who had given up and traded pedaling for walking. And I was barely going faster than those who were walking their bikes. 

I head my head down, intently focused on pedaling and keeping enough momentum to make it to the top of the climb. Suddenly I heard, “GO SF Tri!, GO SF Tri!” It was a huge crowd of SF Tri members, many of whom were in their Sf TRi colors. Except for Miguel Mendoza...he of course was wearing a Buzz Lightyear costume. 

Miguel ran up next to me and started shouting Go Chris Go!!! You can Do it! GO, GO, GO!!!!!!” 

And so I went...

I upshifted two clicks, stood of the saddle and went as hard as I could. It seemed as though Buzz himself was catapulting me to the top of the hill.  I flew by the long, crawling line of bikes at about 10 or 12 miles per hour.  

I heard some waning cheers as I crested the final hill to start the descent.  As soon as I sat back in the saddle, I felt a sharp pain radiate from my butt cheek at the way to may left knee. I instantly knew I had pulled my hamstring. 

With every rotation of the cranks it felt a sharp twinge. “Way to go idiot!” I said to myself, “You just blew it.” 

I knew my day was over.  There was no aid station on the descent or I would have stopped. While on the descent I started trying to determine the cleanest exit. 

Knowing the course and the extent of road closures I was fairly certain that if I pulled out any time soon I would be waiting for most of the day just to get a trip back to Squaw from the Sag Monkey. 

Since I had nothing to lose, I figured I should just try to make it for the next 10 miles to see if the pain got any worse. It did, but not by much. 

So then I thought I would go another 10 miles to see if it continued to get worse. It didn’t.

When I was on the road approaching Squaw Valley I got passed by one of the pro women. It was Angela Neath on her final loop.  A year ago I attended a workshop and met Angela. That weekend I did a long run with her and her boyfriend. “GOOOOO ANGELA, GOOOOOOO!” I shouted.

Just seeing her inspired me. I thought I could at least finish the bike. As Angela turned left toward the bike finish I continued onto the second bike loop. I realized that if I altered my position just a little, my hamstring didn’t hurt very much. So I just focused on keeping the low-pain position and a high cadence. 

A few hours later, rolling by the lake at the bottom of a short hill I saw “100 MILES” painted on the road. I knew I would finish the bike. This realization was the spark I needed. It grew like a freshly kindled camp fire into the sudden roaring belief that I “might” actually be able to make it through the run, too. But only if I had enough time. 


I stopped at the dismount line and handed my bike to a volunteer. Limping toward the change tent I realized that most of my limp was actually due to my back and neck. The awkward position required to quiet the hamstring had really cramped my back and neck. 

But I know from experience that all of my back and neck issues will relax from running just the opening few miles. I decided that I would head out on the run course. If the only thing I got was to loosen the back and neck, it would be worth it, even if I had to DNF.

Run 26.2 Miles

When I saw the clock I realized I had 6 hours and 28 minutes before midnight. I did the math. 

At Ironman St. George last year a long day of drinking vile “Perform” taught me an unpleasant, buy useful lesson. Even when throwing up 2-3 times per hour, I can walk 4 miles per hour. That means I can walk a marathon in 6 hours and 33 minutes.

I thought to myself, “If you can just run 10 miles, only 10 miles, at 5 mph, you can walk the rest and get in before midnight. 10 miles in 2 hours. On a good day, you can run 13 miles in less than 1 hour and 30 minutes. 10 miles in 2 hours should be a snap. That is the new goal...10 miles in 2 hours. And you won’t have to come back in a year seeking redemption. Instead, you could be in Hawaii!”

I started to run. 

I watched my Garmin making sure to stay exactly on pace...11:30 per mile. This would allow me to walk through the aid stations and still stay on target. 

“Just run 1 mile. Stay on pace. Just run 1 mile.” I kept telling myself.

As I passed the first aid station I realized I was now standing up straight. My neck hurt, but my back was better. “Just 2 miles, run 2 miles.”

As I pushed off to start running again, I felt a sharp jolt in the back of my leg. Burt once I was actually running, it didn’t really hurt. 

Peter and others from the SF Tri club began cheering as I passed by. I was running.  Peter gave me a high-five. 

“Just run 3 miles.”

“Just run 4 miles.”

When I made it to mile 5 the pain in my hamstring was escalating. It was hurting with even the slightest up hill. But I knew I would make it. 

I ran all the way to the turnaround and at mile 11, then I started to walk. And I almost started to cry. 

I couldn’t believe that for 50 miles on the bike I had only thought about the logistics of my impending, unavoidable DNF.  I had even thought of the story I would write on the blog (in place of this one) discussing excuses, ill-preparedness and failure. 

But I had just run eleven miles and would walk to the finish with time to spare. 

Night fell. Cold descended. I reapplied all the layers from the morning bike ride. Used cycling jacket, windbreaker, glove and fleece hat. A volunteer handed me a headlamp. 

I was cold, and it was dark, but I was going to finish.

On the final 3 miles it was foggy and really cold. I was shivering, pretty much the same as when I came out of the Lake early this morning. But I was in motion. The volume of noise increased as I made the final few turns through Squaw Village.

I walked amidst the cheering crowds and I fought back the nearly overwhelming urge to retain my dignity by jogging down the finish chute.  One foolish act was enough. “Just further injury.”

The lights were bright, the cheers were loud and the hands were many that offered a victorious high-five as I walked to the finish. 

As I crossed the line I heard Mike Riley say “Christopher Segler...YOU...ARE...AN IRONMAN!”

And just like that, Ironman #12 was done.  16 hours, 28 minutes and 23 seconds. 

A volunteer wrapped me in a mylar blanket. She asked if I was okay. Someone else said “congratulations” and placed a medal around my neck. I said, “I’m okay, but really, really cold.” My teeth were chattering. 

“We need to get you to medical,” she said.

I nodded. 

Once I got the medical tent, they had a “warming area” where I waited for help. I was cold, tired and really hungry.  I just wanted to go to bed. 

After a few minutes, I stood up and one of the medical personal said, “wait...where are you going?”

“I am going to get my bike and my gear bags. I am going home.”

She replied, “...but, where is your bike tag, where is your family?”

I answered “my bike tag is on my bed at the cabin. I am here by myself.”

In an excited voice she said, “But you are hypothermic, you can’t just walk out of here! You could die just walking across the parking lot!”

I titled my head to one side and said, “Of all the dumb things I do, and all the ways I imagine I might die, walking across the parking lot at Squaw is just not one of them.”

“Thank you. And good night.”

Dr. Christopher Segler is a 12-time Ironman Triathlon Finisher.  His podiatric sports medicine practice caters to athletes who think that there has to be way to stay fit, keep training, yet still heal an injury. He often lectures at medical conferences on the treatment of complicated running injuries, running biomechanics, and subtle fracture patterns of the foot and ankle. Next year he will be volunteering with other SF Tri Club members at Ironman Lake Tahoe. If you have a question about a running injury you can call him directly at 415-308-0833.  You can also learn more about running injuries at and