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. 

T1

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. 

T2

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 walk...no jogging...no 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 www.AnkleCenter.com and www.DocOnTheRun.com

SF Tri Run Clinic: Foot Issues

Thanks to everyone from the SF Tri Club who joined us Monday evening for the Run Clinic. This was the second clinic in a series designed by Dino and Katie (our fearless Run Coordinators).

The point of the clinic was to discuss some of the keys to training that might help one avoid injury, particularly those running injuries that can wreck a triathlon season. We talked about running shoe selection, common training errors and barefoot running biomechanics.

There were many great questions from our Peeps. I will be posting those questions here, with answers, for all those who could not make to the Presidio Sports Basement for the clinic.

In fact, here's one now...

Question: What ARE the most common preventable running injuries?

Answer: The most common injuries I see in San Francisco runners and triathletes (that are preventable) are:
1. Stress Fractures
2. Achilles Tendinitis
3. Plantar Plate Injuries
4. Peroneal Tendintis
5. Sesamoiditis

See you out in the water, on the track, or on the road!

Dr. Christopher Segler is an SFTRi Club member, 10-time Ironman Finisher and Sports Medicine Podiatrist. He is Board Certified, American Board of Podiatric Medicine. His practice caters to active runners and triathletes in San Francisco, Berkeley, and Mill Valley. If you have a question about a running injury, you can call him directly at 415-308-0833.

What is The Best Way to Tape a Plantar Plate Sprain In the Ball of the Foot?

The plantar plate is a small ligament that reinforces the bottom of the joint capsule at the ball of the foot. When you sprain this ligament, the ball of the foot can be sore and ache when you walk. One of the best ways to decrease the stress to an injured plantar plate ligament is to tape the foot so that the ligament it stabilized and can heal. This video will show you how to tape the ball of the foot when the plantar plate is sprained or injured.

The first thing you need to do is get the correct type of tape. The very best tape is called Tensoplast (or Elastoplast). It is good because it stretches when you walk. With Tensoplast tape, the toe can flex slightly without getting irritated. You should order one roll of tape that is one inch wide by five yards in length.

Now that you have the right tape, you will cut a piece of tape to the correct length using your hand as a reference. The correct amount will reach from the tip of your finger the base of your palm. Next you will cut that piece of tape into two equal size pieces. Just cut the piece of tape lengthwise splitting it right down the middle. Take one of the two pieces and place it back on the roll to save it for later use. Now you are ready to tape the toe to help the plantar plate heal.

Take the piece of tape and center it on the top of the second toe. You should place the tape between the foot and the last knuckle in the toe. The tape should be right at the base of the toe. Wrap one strand around the toe, pull down slightly to create some tension in the tape and stick the tape across the ball of the foot so that it is in place on the bottom of the foot under the little toe joint.

Now take the other strand and it wrap it around the toe in the opposite direction, pulling down slightly to create some tension in the tape. This strand will cross over the other as you stick the tape across the ball of the foot so that it is in place on the bottom of the foot under the big toe joint.

If placed correctly and looking at the bottom of the foot, the tape will look somewhat like a breast cancer awareness ribbon. With the tape in this position, the pressure on the tape when you walk will keep it secure. There should be just enough tension in the tape that the second toe is pulled downward slightly lower than the third toe. This will decrease the tension on the plantar plate at the bottom of the second toe joint and help it heal.

You should keep the tape on 24 hours a day to protect the plantar plate as the sprain heals. Change the tape if the adhesive wears out and isn’t sticking to the the bottom of the foot. If your skin becomes irritated, discontinue use. Don’t tape the toe if you have an allergy to tape or adhesives. Heal fast, and get back to running!

This instructional video was created by Dr. Christopher Segler who a 10-time Ironman Triathlon finisher. He is also an internationally recognized expert on running injuries and healing foot injuries while running. He is often invited to lecture on the rapid treatment of complicated running injuries to foot surgeons, podiatrists and sports medicine physicians at medical conferences. He practices sports medicine podiatry in San francisco, CA, but also offers remote consultations world-wide. To learn more about the causes and treatment of capsulitis and plantar plate injuries, visit the ball of the foot information page at www.AnkleCenter.com. if you would like to learn about how to get the fastest treatment possible for a plantar plate injury, you can learn more at www.DocOnTheRun.com.

Disclaimer: This video is intended to provide general information about sports medicine injuries and self-teatment options. This of course is not (nor is it meant to be) a sufficient substitute for a medical evaluation by a local physician or medical doctor.

Good News for Ironman Arizona Athletes!?!?

This week, the dam that holds the water in man-made Tempe Town Lake burst. That may seem like bad news for a triathlete. Unless you have ever been swimming in that lake.

There is a reason that they don't let people swim in the lake right next to the University campus. The stagnant water is just plain filthy. The first time I went for a dip there was in 2007 at Ironman Arizona. The day before swim practice began I walked up to the edge and saw a two-foot long carp munching on some pond scum.

I asked another athlete about the water quality. He said, "My understanding is that the city has organized a method to fight the stagnation in the lake by allowing 2000 athletes to splash around in the water this weekend." Great.

During the swim I made an effort to leave the water in the Lake. A guy a met at registration was not so lucky. He took in a couple of accidental gulps. That small error led to several bouts of vomiting out on the bike course.

Although I do hope the dam is repaired in time for Ironman Arizona 2010, I have to say that I also hope the unintentional draining of the lake will mean the cleanest water conditions on record for the race. But even if the water looks clean, I plan on keeping my mouth shut during the swim.

Dr. Christopher Segler is a sports medicine podiatrist in San Francisco currently training for Ironman Canada and Ironman Arizona. He makes house calls in the bay area to treat stress fractures, Achilles tendonitis, and other triathlon-related injuries. Learn more at San Francisco's best running injury prevention site.

Ironman 70.3 California Race Report by San Francisco Sports Medicine Podiatrist

On Saturday March 27, 2010 I officially started the triathlon season with my first half Ironman.

The Rohto Ironman 70.3 California in Oceanside, CA is one of the most popular events on the 70.3 circuit and this weekend I got to find out why.

Given that I have competed in many full Ironman distance triathlons (but no half-Ironman events) I really only had three main goals for this race:

1. Finish injury-free! (bad form for a podiatrist to get injured while running)
2. Finish in 5 hours 30 minutes or less.
3. Test the engine and see what I need to do to prepare for the 2010 Ironman season.

PRE-RACE DAY:
Early that morning I went out for the obligatory short ride and transition run. It felt great to loosen up all of the 8-hour car ride stiffness sustained from the drive down from the San Francisco Bay Area. The weather was perfect! I picked up my registration packet and went back to the room to meet Paige and Alex and go for a swim with my favorite 2 year-old.

Because the swim portion takes place in the Oceanside Harbor, athletes are not allowed to swim at the site before race day. No big deal as swimming is swimming and it all looks pretty much the same on race day… arms, legs, and churning confusing.


Because the bulk of the bike leg winds through Camp Pendelton, competitors are not allowed to ride on the bike course. This would be the first race where I would have basically know clue of what to expect on the bike.

I just figured I would treat it like one of my group rides in Marin with my biking buddies in the Bay Area. I usually don’t really know the routes I am being led on when we head somewhere new, so this should feel similar. I’d try to just take it as it comes and pay attention to my heart rate and perceived exertion.

RACE DAY:
We rented a condo right by the harbor which made race morning stress-free as can be. Up at 4:00 a.m., peanut butter and jelly sandwich down, make coffee, shower, get dressed, pump up bike tires, fill aerodrink bottle, gather gear, etc.

It seems like every race lead to some item forgotten in transit to transition, and this was no exception. I had everything meticulously organized. But just as I was headed out of the door I realized it was cold and decided to put on a fleece jacket. In doing so I forgot to put my backpack on again.

So I headed out into the dark and streamed in line with the other 2300 or so athletes heading to transition. I found my spot and racked the bike. When I got ready to lay out my running gear, I realized the conspicuous absence of the back pack.

No big deal as the condo was only about ¼ mile away. I did a warm-up jog back to the condo and grabbed the back pack. Paige, Alex and I then headed back to transition so I could add my towel, running shoes, hat and number belt to the #589 pile in transition.

With everything in place, just had to wait for the start.


SWIM 1.2 MILES:
The goal for the swim was simple. Relax and swim 1.2 mile in 40 minutes without getting worn out or beaten up.

My swim wave was relatively early and I got to start right at 7:00 am. The cannon went off and away we went. The water was clean, clear and way warmer than San Francisco Bay! It seemed like no time before I was rounding the red turn buoy at the mouth of the harbor. I drafted a little, but mainly tried to stay clear or the flailing arms and kicking feet that surrounded me.

When I got back to the boat ramp, I checked my watch and saw success! Swim time of 39:33, no black eyes, and no one kicked me in the head. I felt great knowing I could get out on the bike without having to extract an impacted earplug (at least this time).

Transition 1:
After the 600 foot long run in a wetsuit, I made it to the bike. Stripped the wetsuit, put on my socks, helmet, Garmin, sunglasses and away I went!

BIKE 56 MILES:
The bike course was great! Lots of gentle rollers, some big long climbs interspersed with plenty of flat stuff where I could get on the gas. I can say with confidence that the course is beautiful as it wind through the Marine Corps base. Big green mountains, wildflowers and blue ocean dominate. There is also the occasional “Tank X-ing” and “Live Fire Zone” signs just to remind you where you are. The soldiers volunteering on the base provided (no surprise) perfect order and execution at the aid stations.

I kept a constant low-stress level on the bike course. I went hard, but easy enough that I knew I could still run the half marathon. After 2 hours 45 minutes and 9 seconds (20.35 mph average) I was back in Oceanside and ready to run.

RUN 13.1 MILES:
The run course is a mostly flat out-and-back two-loop affair. The best part was that it runs along the ocean and passes directly in front of the condo where I could see Paige and Alex waiving and cheering from the balcony.

I really wanted to make sure I finished in under 5:30 total. So after some quick math I knew I could coast in as long as I maintained an average pace of 9:00 per mile for the entire half marathon. I went about 9:30 min/mile pace for the first mile to try get moving and loosen up my legs. Then I started to gradually increase the pace.

About two miles from transition I saw my old motorcycle road-racing partner Fred Provis cheering for me out on the course. Fred is one of those guys who can make anyone feel like a champion. He definitely put a spring in my step. The next few miles felt much better. By the first turn around I knew I would make the finish on target.

By the second lap I was in a comfortable groove. I fought the urge to push the pace knowing that I might invite injury, or blow it and end it walking. Given that I had a goal of getting a qualifying slot for Ironman Arizona (as well as doing Ironman Canada five months from now) I knew I should be sensible and just keep the pace steady.

About a quarter mile from the finish I realized I was still slowly creeping up on another guy in my age group. I had been behind him for about 5 miles. For some reason passing him suddenly seemed important.

Right after I crossed the bridge to the harbor, I kicked it in high gear and shot past him. Confident that I was far ahead, I slowed down. Next thing I knew he flew by on my right as we entered the last 50 feet of the finish shoot. I started chasing him as he peered back at me over his right shoulder.

I was picking up speed as we approached the finish line. Then the poor guy suddenly stood bolt upright, grabbed he right hamstring and started limp-running to the line just ahead of me. When I crossed the line he was holding onto a volunteer with one hand his his hamstring with the other. I patted him on the back and said “You reeeeeeally earned that one!”

My total time was 5:29:42. I made my goal with 18 seconds to spare. And most importantly (unlike the guy in front of me), I was injury free. Best of all, I went to watch the roll down... and secured my Ironman Arizona slot. See you in Tempe in November!

Let the training begin...


Dr. Christopher Segler is an Ironman triathete, marathoner, and an award-winning Sports Medicine Podiatrist in San Francisco. He has written extensively on the subject of podiatric sports medicine and running injury prevention. His San Francisco Podiatry practice focuses on house call appointments for busy professionals and athletes who want to prevent or recover from running injuries. He offers the convenience of podiatry house calls at Bay Area homes and offices so that his clients don’t have to lose time going to the doctor or getting custom orthotics. You can learn more about common running injuries at AnkleCenter.com and Doc On The Run.com.

McGlone's Kona Return after Achilles Injury Today on NBC

A minor ache in the back of the leg down near the heel may just seem like a minor annoyance at first. But if ignored for too long, Achilles tendonitis can keep you from running and cycling for months.

This is precisely what happened to Ironman 70.3 Champion Samantha McGlone. In 2007, the fiercely competitive former Olympian showed up in Kona and finished second in the Ironman World Championships, just minutes behind Chrissie Wellington. But a year later, she found herself sitting on the sidelines recovering from an Achilles tendon injury. Reportedly she spent about 6 months with no running or cycling at all. She struggled with the problem for nearly a year and a half.

Runners and triathletes are particularly susceptible to Achilles tendon problems. In part, this is because they are so determined to set goals and stay on track with training. But whether you are a marathon runner, an age-group triathlete, or someone chasing an Ironman World Championship, it can be hard to back off just because you have a little pain in the back of the heel.

Achilles tendonitis is really nothing more than inflammation within the Achilles tendon. Usually, the pain and swelling is in an area just above the tendon's attachment to the heel bone. This is an area known to be prone to injury due to decrease blood flow to this part of the tendon.

Inflammation in the Achilles' tendon is usually short lived. However, if you continue to run with Achilles pain, the tendonitis turns into tendonosis. This is what happened to McGlone.

Tendonosis is a degenerative condition where chonic inflammation essentially breaks down the collagen in the Achilles fibers. It gets mushy and weak. Many times surgery is required to clean out the tendon. Physical therapy can help speed healing. But, as Maglone learned, it won't just go away on its own. You have to see a sports medicine focused foot and ankle surgeon to get better.

Fortunately Sam is back in action. And today on NBC, we can all watch her chasing an Ironman World Championship in Kona, Hawaii. Although her recovery has been longer than the Queen K Highway on a hot windy day, she will surely show her fire and determination as she takes on the challenge on the Big Island.



Dr. Christopher Segler is a multiple Ironman Finisher and award winning foot and ankle surgeon. He lives and trains in the San Francisco Bay Area. To learn more about Achilles tendonitis, runner’s heel pain, stress fractures, bunions and other common causes of foot pain, visit http://www.MyRunningDoc.com or http://www.AnkleCenter.com .

Can Runners Heal Heel Pain?

What could be worse than a runner with heel pain? Answer: a runner who has heel pain and can't run. In this excerpt from a video interview with Ironman finisher and award winning podiatrist, Dr Christopher Segler discusses heel pain.





Dr. Christopher Segler is an Ironman Triathlon Finisher and award winning foot doctor specializing in elite athletes. His podiatry sports medicine house calls practice is located in San Francisco, Marin, Oakland and Berkeley. You can register for a FREE membership and will receive the monthly newsletter “Finisher’s Circle,” which provides expert advice on increasing your running efficiency and preventing injuries and foot pain by visiting http://www.AnkleCenter.com .

Posterior Tibial Tendonitis: a Pain in the Arch

When you run, your foot hits the ground, you pronate to absorb impact and then you supinate to push off again. All of this is possible because of a muscle in your leg call the tibialis posterior. This muscle deep in the back of your leg forms a tendon call the posterior tibial tendon that attaches to your foot. It attaches to the navicular bone in the instep of your foot, right at the top of your arch.

In the very simplest of terms, this tendon helps to hold up the arch. It is really much more complex than that, but we won’t bore you with the details. All you really need to know about this is that when you get posterior tibial tendinitis it can quickly progress and become a surgical problem.

The good news for runners is that it one of the things that least frequently affect us. It most often affects people who are middle-aged. It also is often associated with high blood pressure, obesity and diabetes. Not exactly the picture of a runner. Interestingly though, one study showed women get it four times more often than men.

This is one thing to watch out for if you have fleet feet. It seems many who get this problem are already flat-footed long before it starts. Excess pronation (common in people with flat feet) puts tremendous stress on the tendon. Running increases the stress and strain several fold. The result is repetitive overuse that can set the condition off.

When too much stress is placed on this tendon, it can become inflamed. Continued inflammation can weaken the tendon and cause it to stretch out. This can lead to a torn or ruptured tendon with a complete collapse of the arch. Not good.

So how do I know if have posterior tibial tendonitis? One clue that you might be getting this problem is pain from the ankle bone to the arch on the inside of your leg. If it is inflamed and you stand up on your toes on that foot, it will likely hurt much worse. If you stand only on one leg and do this, it will be even more painful. You might even have some swelling around the ankle or arch.

If you notice these symptoms you need to get it checked out by an foot and ankle expert. This is not one of the ice-it-and-will-go-away kind of problems. Neglecting it can (and often does) lead to surgery. It is preventable as well as easily treatable in its early stages. Orthotics can limit the force of pronation and help to decrease the risk of injury to the tendon, especially if you over-pronate or have flat feet. And as always, make sure you are wearing the right type of running shoes for your foot type.


Dr. Christopher Segler is an Ironman Finisher and award winning foot and ankle surgeon specializing in elite athletes. His Bay Area based podiatry practice is Doc On The Run Podiatry House Calls. To learn more about Achilles tendonitis, runner’s heel pain, stress fractures, bunions and other common causes of foot pain, you can register for a FREE membership and copy of his monthly newsletter “Finisher’s Circle” by visiting http://www.AnkleCenter.com .

Os Trigonum Syndrome: A Rare Form of Posterior Ankle Pain

The day that Jessica came into the office she was worried. Not only was she worried, her mother was worried as well. Jessica is a 26-year-old healthy runner with a penchant for training and a high tolerance for pain.

She was in the middle of training for an upcoming marathon. Her mother had noticed her limping about and recommended that she go see somebody. She came in because she was worried about her Achilles’ tendon. She had heard that could be very serious.

I asked her about her training routine. She said that she typically ran 8 miles at a time on a very hilly course area. She felt that this was a good training strategy given that the upcoming marathon would contain a lot of hills. She wanted to make sure that she would be ready. But running up and down all of those hills was aggravating her condition.

She could remember exactly when her pain started. It’d been getting progressively worse. She pointed at the back of her ankle, but it wasn’t right at her Achilles’ tendon where she had the most pain. It was actually deeper in the back of the ankle.

I poked and prodded and couldn’t find any pain or tenderness anywhere around her Achilles’ tendon. However, if I squeeze the back of the ankle, away from the Achilles’ tendon, she had a great deal of pain and tenderness. Next, I put my thumb underneath her big toe. I had her try to push down with her big toe as hard as she could. And when she did, she had the same kind of pain in the back of the ankle.

We took some x-rays and noticed that she had a portion of bone that was not completely fused to the back of her talus bone. This is a condition known as os trigonum syndrome or posterior ankle impingement syndrome.

We got an MRI that reassured us that she had no issues with her Achilles’ tendon or the tendons to go to the big toe area. The flexor hallucis longus (FHL) tendon which pulls the big toe down against the ground when a runner pushes off can sometimes become torn or irritated and have the same type of presentation. But her FHL was fine.

However, not everything was fine. There was a great deal of swelling with in the talus bone (the bone that connects the foot to the ankle), as well as an accessory bone at the back of the talus called the os trigonum. These two pieces of bone in her ankle were connected with some soft tissue attachments which were very irritated.

Os trigonum syndrome is not a common injury. However one study showed that runners who to do a significant amount of downhill running have an 18% chance of acquiring posterior ankle impingement syndrome. And when it does occur, it can be debilitating.

Runners who develop this problem might have no pain at all when walking on level ground. It starts to become painful when they walk on uneven ground. It becomes much worse when they run on hills. This is because the foot needs to point further down (plantarflexion) and the soft tissues can become irritated or even get caught and pinched between the talus and the calcaneus (the heel bone). This causes a great deal of inflammation and pain.

Not only will there be pain, but many will also have swelling and stiffness in the back of the ankle that may extend all the way to the Achilles’ tendon. That is why many patients who think they have Achilles tendinitis might actually have this problem instead.

Although this is not the most common running injury we see, it is important to get it treated. Chronic inflammation can lead to pain that interferes with activities ranging from normal walking to running. Anytime you suspect an Achilles tendon injury, it is important to be evaluated.

Even though Jessica did not have an Achilles’ tendon injury she did have an injury which could be treated effectively. In most cases, immobilization and physical therapy can calm it down. In rare cases, surgery is needed to take out the accessory bone and inflamed tissue. In any event, with this type of problem it is never a good idea to stick your head in the sand and foolishly hope you’ll cross the finish line in record time.


Dr. Christopher Segler is an Ironman Triathlon Finisher and award winning foot doctor specializing in elite athletes. His podiatry sports medicine house calls practice is based in San Francisco. You can reach him directly at 415-308-0833. You can register for a FREE membership and will receive the monthly newsletter “Finisher’s Circle,” which provides expert advice on increasing your running efficiency and preventing injuries and foot pain by visiting http://www.AnkleCenter.com .

Training Programs: Your Map To Success

How many miles you have to run in order to finish a marathon? If your answer was a quick 26.2 miles, that’s not exactly correct. The reality is that most people who decide to run a marathon will run hundreds of miles before completing that marathon. The last 26.2 miles makes up a small percentage of the actual mileage in training that goes into completing that event.

Of all of the trainable aspects related to any sporting activity, endurance is the one that an athlete can affect more than any other. On day one, before any training begins, a runner may be able to run a 100 m sprint at 65-70% of his or her potential speed. This same runner on day one might only be able to run about a mile without stopping. However, after a period of months of training, it would certainly be reasonable for this person to run 26.2 miles. This would indicate a 2600% increase in endurance. Those same sort of gains in performance can simply not been made by any human being regarding speed. 

Distance running is for most people a lifestyle change that provides enormous benefits. In order to accomplish any goal in distance running, whether marathon half marathon or 10K, it takes a great deal of training and daily dedication. In order to achieve any goal, particularly one regarding a distance running event, it is critical to have a training program that can be followed consistently. In a sense, a training program is your roadmap to safely completing a given event. 

The goal of any training programs is to get you across the finish line in your desired time. If your goal is to simply complete a marathon, slowly and progressively increase your mileage at a very slow pace and you will eventually be able to run 26.2 miles. The problem with this strategy is that most marathons have cut-off times. This means that you not only need to complete the distance, but must do so within a specific time frame.  If you have a dream of qualifying for the Boston Marathon, this timeframe is much shorter. That means that you will need to train not only for endurance but also for relative speed.

Regardless of the specific training program that you choose, they all combine certain elements. The long run is a staple of distance running training programs.  The definition of a long run is relative. It simply must be long enough to stimulate an increase in endurance. 

This brings up a question that I get from beginning marathon hopefuls.  Why is it not just advantageous to go run 20 or 25 miles on a regular basis and just gradually try to increase speed?  There are both physical and mental reasons why this strategy will fail. First, the amount of muscle and tissue damage that occurs on very long runs is significant. Second, it is very difficult to increase speed while running very long distances. Basically speed and endurance are opposing strengths that cannot be built simultaneously. Third, the overreaching limits to maintaining a goal pace is in the brain. And the brain must be trained as well. 

When you run at a fast pace, particularly for long distances, there are very specific physiologic limiters in play. Your body can only store so much glycogen in its muscle. You also only so much fat burning capacity. Your body also has resistance to muscle damage as well as limitations mechanical inefficiency.  

When any of these specific physiologic limits become reached, your brain takes over. Chemical signals are sent to your brain when you are running low on muscle glycogen. Your brain also makes calculations on physiologic set points such as core body temperature and decreases output when your brain fears injury. Your brain is capable of picking up chemical signals related to muscle damage.   We know that these markers exist in your bloodstream and are actually the ones measured when you have a heart attack. When your brain notices an increase in temperature, or an uncomfortable level of chemical signals related to intense exercise or tissue damage, fatigue sets in, and your brain forces the body to slow down.

This does not mean that you cannot adjust each of these given tolerances that your brain will allow. Through training, your body can become used to a higher set-point of core temperature. Through specific speed work and training your body, your brain can become accustomed to higher levels of chemical markers and tissue damage without fear of injury and without forcing your muscles to shut down. This is why almost all training programs consist of base training/endurance phases, progression phases, and peak phases. 

There are five basic workouts that are put together in various combinations in order to comprise a training program.  The first is the long run.  This workout has one specific purpose and that is to get your body used to moving over ground for a very long distance.  The progression is very gradual and you should not do more than one long run per week.

The second workout is the quarter-mile repeat. A marathon runner will typically do anywhere from six to 16 repeats, with two minutes rest in between, during one session. The idea with these runs is that by only going one quarter mile at a time, your body gets used to moving at a very quick pace without taxing the lungs. The main focus is increasing the rate of turnover.

Tempo runs are another workout which are crucial to developing stamina.  These workouts are typically shorter in duration, maybe four to eight miles.  They’re also at a faster pace, typically anywhere from 20 to 45 seconds faster than your desired race pace. Tempo runs will make your race pace actually seem easier.  For a marathon runner, they will typically only lasts four to eight miles.

Recovery workouts are one of the elements that are least frequently utilized. They are also crucial. If you are putting in heavy miles there is no such thing as a recovery run. Running puts enormous stress on the legs. If you are running very low mileage, it is possible that running at a slow pace can serve a recovery function.  However, cycling is a much more efficient and effective recovery workout. A side benefit of cycling is that it breaks up the monotony of running. In a sense it will also provide you a mental break from training.

The fifth workout is a rest day and it is also often neglected.  Most training programs include at least one rest day per week.  The definition of a rest day means that you do not train. You do not go hiking, cycling, or perform manual labor. Think lazy. Rest means rest.

The following is a sample training schedule for a beginner half marathon. This schedule assumes that you already have running for a couple of months 2-3 miles a day at least 3 days per week. 

Wk Mon Tues Wed Thurs Fri Sat Sun Total mi 

1 2 mi easy Rest/XT 2-3 mi easy Rest/XT Rest/XT 3 mi long Rest 7-8 mi

2 2 mi easy Rest/XT 3 mi easy Rest/XT Rest/XT 3-4mi long Rest 8-9 mi

3 3 mi easy Rest/XT 3 mi easy Rest/XT Rest/XT 4 mi long  Rest   7 mi

4 3-4mi easy Rest/XT 3-4 mi easy Rest/XT  Rest/XT 4-5 mi long Rest 10-13mi

5 4 mi easy Rest/XT 4 mi tempo Rest/XT Rest/XT 5 mi long Rest 13 mi

6 4 mi easy Rest/XT 4 mi tempo Rest/XT Rest/XT 6 mi long Rest 14 mi

7 4 mi easy Rest/XT 4 mi tempo Rest/XT Rest/XT 7 mi long Rest 15 mi

8 4 mi easy Rest/XT 5 mi tempo Rest/XT Rest/XT 9 mi long Rest 18 mi

9 3 mi easy Rest/XT 6 mi tempo Rest/XT Rest/XT 11 mi long Rest 20 mi

10 3 mi easy Rest/XT 7 mi tempo Rest/XT Rest/XT 7 mi long Rest 17 mi

11 4 mi easy Rest/XT 8 mi tempo Rest/XT Rest/XT 12 mi long    Rest 24 mi

12 4 mi easy Rest/XT 9 mi tempo Rest/XT Rest/XT 8 mi long Rest 21 mi

13 4 mi easy Rest/XT 8 mi tempo Rest/XT Rest/XT 10 mi long Rest 22 mi

14 4 mi easy Rest/XT 8 mi tempo Rest/XT Rest/XT 13 mi long Rest 25 mi

15 3 mi easy Rest/XT 4 mi tempo Rest/XT Rest/XT 6 mi lo ng Rest 13 mi

16 3 mi easy Rest/XT 2 mi tempo Rest/XT Rest/XT Half MarathonRest 18.1 mi

Easy: means run at an easy pace.

Tempo: means run at a pace 20-45 seconds/mile faster than your goal race pace.

Long: runs should be run 1-2 minutes/mile slower than your goal race pace.

Rest/XT: means rest if you bad, cross train if you feel good.

Rest: Rest is best the day after your long run. 

Next is a sample training schedule for an advanced half marathon runner. This schedule assumes that you already have been running for at least a year, have already run at least one half marathon, currently run 4 days a week and can comfortably run 8 miles as long run.  

Wk Mon  Tues Wed Thurs Fri Sat Sun Total mi

1 4 mi easy XT 20 min 3 mi tempo 4 x 400 Rest/XT 3 mi long Rest 11 mi

2 4 mi easy XT 30 min 4 mi tempo 4 x 400 Rest/XT 3-4 mi long Rest 12-13 mi

3 4 mi easy XT 30 min 4 mi tempo 4 x 400 Rest/XT 4 mi long Rest 13 mi

4 4 mi easy XT 40 min 5 mi tempo 6 x 400 Rest/XT 4-5 mi long Rest 14-16 mil

5 5 mi easy XT 30 min 5 mi tempo 4 x 400 Rest/XT 5 mi long Rest 16 mi

6 5 mi easy XT 40 min 6 mi tempo 6 x 400 Rest/XT 6 mi long Rest 18 mi

7 5 mi easy XT 60 min 6 mi tempo 6 x 400 Rest/XT 7 mi long Rest 19 mi

8 5 mi easy XT 60 min 7 mi tempo 6 x 400 Rest/XT 9 mi long Rest 22 mi

9 5 mi easy XT 40 min 8 mi tempo 3 x 1600 Rest/XT 11 mi long Rest 26 mi

10 5 mi easy XT 45 min 6 mi tempo 6 x 400 Rest/XT 7 mi long Rest 19 mi

11 5 mi easy XT 45 min 8 mi tempo 3 x 1600 Rest/XT 12 mi long Rest 27 mi

12 5 mi easy XT 60 min 6 mi tempo 4 x 800 Rest/XT 8 mi long Rest 21 mi

13 5 mi easy XT 60 min 8 mi tempo 6 x 400 Rest/XT 10 mi long Rest 24 mi

14 5 mi easy XT 40 min 8 mi tempo 4 x 1600 Rest/XT 13 mi long Rest 28 mi

15 5 mi easy XT 30 min 5 mi tempo 3 x 800 Rest/XT 6 mi long Rest 18 mi

16 3 mi easy XT 20 min 3 mi tempo Rest Rest Half Marathon Rest 19.1 mi

Easy: means run at an easy pace.

Tempo: means run at a pace 20-45 seconds/mile faster than your goal race pace.

Long: runs should be run 1-2 minutes/mile slower than your goal race pace.

Rest/XT: means rest if you bad, cross train if you feel good.

6 x 400: (Quarter mile repeats) means six separate 400 yard runs 

with 2 minutes rest in between.

Rest: Rest is best the day after your long run. 

Notice that both training schedules include a great deal of rest. There are also weeks where mileage ramps up, then decreases slightly before ramping up again. The difference between the beginner and advanced versions are the quarter mile repeats. Repeats are a great way to increase speed.  They are also a great way to get injured if you have not been running for a year or so. Proceed with caution. The beginner program includes much more rest and less speed work to emphasize the fact that building raw endurance is the primary aim to making sure you can go the distance on race day.

There are virtually thousands of different variations on the themes that we have created here. You can find many different training schedules in books, running magazines and online. The key to finding a race program that works for you is to make sure that the person who designed it shares the same philosophy as you. Some trainers think that you should run the entire race without any rest at all.  Others think that it is a good strategy to walk through the water stations only. There are still other proponents of walk, run programs where you may run four miles and walk one mile throughout the race. 

Regardless of which type of program you choose, sticking to the training s the most important step you can take to making sure that you can have a successful event come race day.

Dr. Christopher Segler is an Ironman Triathlete and award winning foot and ankle surgeon with a podiatry sports medicine practice in Chattanooga. He specializes in running injury prevention, sports medicine and surgical treatment of elite athletes. You can learn more about common causes of foot pain while running as well as sign up for a FREE monthly newsletter with tips to increase your running speed and efficiency at http:www.AnkleCenter.com or http://www.MyRunningDoc.com