December 17, 2014 by Ana To Athlete

Pregnancy, Dual-Athlete Households and Ironmums

Yesterday marked a new low point in my Pregnancy: throwing up in the middle of the foodcourt of a very busy shopping centre. Yup, that happened. No warning and obviously no time to run to the bathroom. The running commentary in my head was quite comical, from the “Oh God this is actually happening” moment through to “thank God I actually look pregnant now, not just like some super prolific Bulimic…” (LOL). At 7 months, you’d think one would have stopped throwing up, but apparently this little bubba is a strong one on the hormonal front and having a laugh causing mum lots of embarrassment!

Top 6 female finishers at Ironman Western Australia, 2014…plus Wynne

In other news this week, my new hero Beth Gerdes – Professional Ironman athlete and baby-mumma to 6 month old Wynne – whipped around the Busselton Ironman course in a PB time of 9 hours and change, clocking one of the fastest marathons of the day in under 3 hours….all while dad Luke McKenzie (also a Pro Ironman athlete) and Wynne cheered her on. I’m not going to launch into the politics of Feminism, but I will say that as a member of a dual-athlete household where I am actually the better Ironman athlete of the two of us, this made my heart swell.

I get so sick of people assuming when we go away to Ironman races that I must be the “wife” that goes to dutifully cheer on my husband. And let’s not forget that he doesn’t get out of it scott-free either – the heckling from his mates when I beat him down the finish chute of an Ironman is ridiculous. But I’m lucky enough to have a husband who is both manly enough to not let that phase him, and who is also super proud of my athletic achievements and happy to defend me – like he says, if I’m in front of him then it means I’m having a great day and that makes him happy (he’s beaten me a few times too, but on the current score card I win…..and the last one I beat him on, I had a broken foot for the marathon, so he’s not living that down for a while….!).

Anyway back to Beth and her superhuman effort. I’m not advocating that the mere mortals among us who balance a day job with training loads shoot for the goal of an Ironman PB 6 months post-partum, but this is her career and it’s her “normal”, and I am hugely proud that her partner Luke is so publicly supportive of her getting her career back on track after Wynne’s arrival. They’re not the only example in the Ironman or distance running world either – thank goodness over the last 5 years we are finally starting to see a host of female professional athletes supported by their partners returning to full time sport, with happy healthy little bubbas to cheer them on. I have been a one-woman study nerd in following their blogs through pregnancy and beyond, and have used a lot of their guidance in deciding how much exercise I am happy safely doing throughout my pregnancy, and also in setting a realistic race goal post-partum for myself (which includes an Ironman one year post-baby arrival, not 6 months – I have a business to run and as it’s my first child, and Ironman is a great love but not my source of income, I want to prioritise enjoying my time with the baby and not to feel rushed with the training). If you are interested in more from these amazing ladies, my favourites include of course Beth’s blog (California Training), and the blogs of Clara Peterson, Lauren Fleshman, and Steph Rothstein (the latter two come complete with photos of what REALLY happens to your body after baby….fascinating stuff!).

As for my plans on returning to racing after the baby arrives, I’m finding that once again, reactions of those around me tend to reflect their own insecurities about things. My closest friends and family think it’s great and are super supportive; others are surprised and like to add a snide remark about “focusing on the baby” or “oh well, just see how you go with that” – with an added glint in their eye like they’re really trying to say ‘good luck finding the time/getting your body back to that level/you’re about to lose your whole identity because you’re becoming a “Mum”…..Of course my life is going to change, and I’m so excited about the next chapter with a new person front and centre and the added challenges that come with that. But I also want to set an example for my son or daughter that I am still an amazing, strong, independent woman and an athlete, as well as being a great Mum. Not to mention the travel experiences and awesome family atmosphere at triathlons in this country that our new addition will get to be a part of – seriously unreal!

The stunning Botanical Gardens in Queenstown, NZ.

On a deeper (ED) level, having a big Ironman race looming one year post-partum is also a protective thing for me. It’s long enough that I won’t feel rushed at all with preparation, but not too long in that it might interfere with when we try to fall pregnant with a sibling for this little one. But the biggest factor is it helps me to stay on track with eating and training once the baby is out, which is the “danger zone” of pregnancy for those of us who have had an ED from a relapse perspective. Even though I have maintained a healthy weight for 5 or so years now, I have still found the pregnancy body changes quite confronting, and have fears about the post-partum period. It’s hard to ignore the statistics on relapse rates. But I do know me, and I know that I have beaten the stats to recover after a decade of Ana; I also know how to pull my head out of a relapse phase in the earlier stages and in my case, it’s by focusing on running or triathlon (and in this case, producing breastmilk too) – which means being healthy, not skinny.

When I have a big race goal, I am focussed on being 100% healthy and strong – no nutrition short-cuts, and the focus is off weight and onto performance, which has in the past worked perfectly for me because the better you eat, the better you perform and the happier you are. I fear that if I don’t plan any big races, the focus will too easily slip back to losing all the baby weight or worse, the number on the scale….and it’s a slippery slope from there. On the flipside, I also feel as though if 100% of my focus is on the baby, then I will fall into the trap of having to be the ‘perfect’ Mum, and that’s a dangerous game to play as well – from a postnatal depression point of view.

The weekly baking for work – well fed Physios are happy Physios!

As always, balance is key….. with a side of preparation, and communication: these are things that I have spent many, many hours discussing with my psychologist, husband and to a lesser extent, dietician, in the hope that I can be as prepared as possible and to minimise the overwhelmed and isolated feelings that can come with motherhood. With less than 12 weeks of baby-growing to go, I’m feeling very ready for this next exciting stage of our lives!

Happy Training xo

October 16, 2014 by Ana To Athlete

Sesamoid Update – 1 year on

“At some point you need to stop making a comeback and start running towards who you are meant to be next” – Lauren Fleshman #womanup

Hoorah for beating the odds – once again!

Sesamoid fractures have a pretty serious reputation for not going well. There is little evidence-based research available for treating practitioners on best standard of care, and even when that has managed to be achieved, they tend to be slow to heal and long to recover from.

Being a Physiotherapist and knowing all of this information, I was shaking in my boots a little at what I was staring down the barrel of just over a year ago now. Compound that fear with the knowledge of what I had done to my foot (doing an Ironman on a stress fracture is not something I will ever do again…), along with my history of poor-ish bone density thanks to a decade of Anorexia, and I was pretty much crawling with my tail between my knees into that surgeon’s office and pleading with him to save my life. Ok, dramatic…but running IS my life, my first love, my sanity and makes my soul happy. So NOT running again was simply not an option.

I am happy to say that even with the odds seriously stacked against you, with a great medical team and some serious dedication to a long and conservative rehabilitation process one can come out the other side flying. Once I got to the point where surgery was the only option left – 8 months of conservative treatment already tried and failed – I had to make a choice. I had to put my big-girl panties on and suck up the situation; there was zero time for feeling sorry for myself and about 24 hours a day to dedicate to doing an awesome job of this rehab process. As discussed in previous posts this included everything from sleep to nutrition to Physio – and most importantly, a great medical team: a brilliant sports physician who understands my passion for running as well as my medical history; the best foot and ankle surgeon in Australia; and a sexy Physiotherapist (OK that was my husband so I may be biased….but it probably helped the treatment come along….!!).

Which brings me to the now. My surgeon was clear and stern with me from the start that it would be a 9-month rehab process before running would even begin, and 12 months before my foot would be adapted to what we had done to it: bone grafting the sesamoid plus breaking, elevating and plating the 1st metatarsal (dorsiflexion osteotomy) to take load off the sesamoid underneath it. 8 weeks in plaster non-weight-bearing was followed by another 8 weeks partial weight-bearing in a boot; then a very gradual increase in walking and loading the area. When I was in plaster I was doing a lot of Pilates, strength work and all-importantly, resting and eating well. My arms got pretty buff at this point – crutches plus strength work= guns!! As soon as I was out of plaster I was into the pool. Initially not allowed to deep water run, but I was allowed to swim if I used a pull-bouy and didn’t push off the wall with my right foot. This made me feel about 100% more human just being back in the sun and in the water again, even if it was limited. Towards the end of that 8 weeks in the boot, I was able to start deep water running and freestlye swimming (kicking). Then came the fun part.

The “real” rehab began once I was walking more and out of the boot. My right calf muscle was over 3cm smaller than my left at this point…I had a lot of work to do. Not to mention adapting to my new biomechanics – the first time I stood on my right foot, I felt like I had a marble under my 2nd metatarsal! Now a lot more of my weight would go through that bone rather than the 1st metatarsal/sesamoid complex, and so I had to go slow to allow the bone to adapt – it’s common at this stage to get stress fractures in the 2nd metatarsal if rehab is too aggressive, due to the increased load. I was allowed to start cycling (using carbon-soled bike shoes so the toe doesn’t bend) at this stage.

Due to my job being so physical – Physios are pretty much on their feet for 8+ hours a day – it would be another month or two before I could introduce any extra walking outside of work, which was frustrating. This was (mentally) probably the hardest part – not being ‘disabled’ any more, but feeling like you’re not actually working towards running either. My patience paid off and once I was able to walk for exercise, things moved quickly – at 7 months post-op, I was walking 30mins every other day with minimal swelling and less than 2/10 pain (ie. Acceptable pain levels given the surgery I had)….which meant I was allowed to jump on an Alter G treadmill and start running, 2 months ahead of schedule!

My surgeon was very strict with the Alter G protocol to follow. I started with 50% body weight for 20mins at just 10km/hr. This felt easy as my fitness was pretty good by now from the swim/bike/deep water running routine; that was a key part of this stage going so well. Over the next month I built the AlterG sessions up to 40 mins at 70% body weight including intervals, allowing me to build some speed and rhythm in. I had the luxury of having my husband and Physio accompany me and give me feedback on biomechanics and technique – it was like getting used to running on someone else’s foot! It felt very strange. I will be forever grateful to my sports physician for making access to an Alter G so available to me; not everyone has the luxury or the joy of this.

At 8 months I was given the green light to start my road running return program, which was also very conservative…it started with 30 minutes walking with 8 x 1 minute run throughout. But I was the happiest person on the planet! I kept up the Alter G sessions for a few more weeks just for my sanity more than anything else – it was still a novelty and better than drugs being able to push myself again (from a cardiovascular perspective), plus the fitness boost it gave me was invaluable and transferred beautifully onto road running.

I was slowly building week by week and up to running 5-10km, 3-4 times a week when we got pregnant this time around….and so I have maintained that level of running over the last 5 months, and will continue to for as long as I can into the pregnancy (I’m now 5 months along and 4kg up). Ironically, the extra relaxin hormone boost from the pregnancy has allowed me to get my full flexibility back in the foot post-op and so running feels better than ever! This could have taken a year or more to achieve without relaxin. I can honestly say now that I don’t even think about my foot anymore – it feels “normal”, strong and functional.

Of course, I am missing racing immensely – between the surgery and pregnancy, it’s been almost 2 years since I’ve raced an Ironman and I cannot wait to get back to it. I am hoping to do an Ironman about 10-12 months after the baby arrives; it would be nice to go back to Busselton where it all went down in the first place and get some unfinished business out of the way!

What I have learned about Sesamoid Stress/Fractures:

– Get a health care team on board that KNOWS WHAT THEY’RE DOING. Search for someone who has experience with treating sesamoids; if your GP/Sports Doc/Physio/Podiatrist does not, then call around until you find a team that does. Don’t be afraid to ask upfront.
– Use an MRI for diagnosis and follow-up progress scans. XRays are not sensitive enough and bone scans are not specific enough. The cost is worth it to know what you are dealing with.
– You need to be aggressive – from day dot. These are typically not super painful injures (well nowhere near a femur or sacral stress fracture – of which I’ve had both – hence being able to finish an Ironman on it without realising), and so they can be deceiving. But you need to take them very seriously, as hard as this can be early on,
– From the moment of diagnosis you should be in a boot; either partial-weight bearing or full weight-bearing if pain allows – needs to be <2/10 pain at all times.
– Use contrast bathing or ice/heat protocols – 20mins of each, 1-3 times a day, to flush swelling and increase blood nutrients to the area.
– Give it TIME. Prepare to be in the boot for 8-16 weeks. Yikes! I know….but trust me, this option is much better than having to go through surgery. Sesamoids have poor blood flow and don’t heal well, but if you treat them like gold from the start you will give it your best shot at healing conservatively.
– Statistically, following the above protocol, 50% of sesamoids will heal and 50% will not (at 12-16 weeks). It depends where the break is, what the blood flow is like, and how well you rest it during this time.
– If you are a serious athlete, love your sport, or have a job that requires you to be on your feet, think about getting a referral to a very experienced foot surgeon early in the process. They typically take a couple of months to get into, and it doesn’t mean that you will have to have surgery – but if it’s a slow healing fracture, they will give you an all-important educated opinion on your time frames, options and prognosis. You can always cancel the appointment if you’re going well, but it’s hard to get an urgent appointment if and when you do need it so plan ahead!
– If you do need to go ahead with surgery, ask the surgeon how many sesamoid stress fractures they have treated and how they have gone. You want the most experienced surgeon with good long-term outcomes ie. Return to full sport pain-free.
– Avoid removing the bone at all costs. Unless it is completely shattered, a good surgeon should be able to either bone graft, pin or shave off part of the bone to salvage it. A foot without one or both sesamoids is, biomechanically-speaking, a disaster zone for arthritis and injuries and is not very conducive with a future running career!
– Further, if you do need the surgery, plan it well and be prepared for a long haul. Be ready mentally and physically to put in the hard yards from a rehab perspective (exercises, pain and swelling management, and lots of rest…), but even more so be ready to be patient from a psychological perspective. There is no point going through major surgery only to rush it on the other side.
– Be rest assured that with a good surgeon, and an even better rehab protocol (think slow-and-steady), you CAN and WILL return to your old athletic self. It’s possible you may even come back stronger after all the time spent with rehab and core strength work, and in my case, biomechanically improved because he fixed the 1st metatarsal angle at the same time, decreasing my chances of getting the injury again.

Currently sesamoid injuries are highly misunderstood by the medical profession and usually by athletes as well, but over the next decade I believe there will be huge improvements in understanding and treatment from medical professionals. In the meantime, those of us who have walked this path beforehand can hopefully shed some light, advice and much-needed hope that there is indeed light at the end of the tunnel!

Happy Training

K xoxo

May 8, 2014 by Ana To Athlete

Exercise and Recovery

I’m going to be a little controversial with this post. I’m going to suggest that for a large majority of ED sufferers, recovery would be best done while they maintain their work or school, and for athletes, their training.

Before everyone gets riled up about it, I am not talking about those so severely undernourished that they are at risk of dropping dead from a massive heart attack at any minute, or those with suicidal tendencies….clearly an inpatient program would be best for these patients (at that stage in their recovery, even if those programs for the most part keep people alive but do not really assist in long term recovery and have notoriously high relapse rates….but that’s a post for another day). I am talking about the majority of ED sufferers who are under their individual ideal weight (note I did not say “under BMI 18” – how ridiculous, what about the person with a bigger frame who is still starving but able to maintain a BMI of 21? Are they “less sick”? of course not), are still participating in work or school, and particularly those who are athletes and see that as a part of their identity. I’m talking about the people who are functioning in society, but are significantly affected day to day by their eating disorder – maybe with the accompanying depression, lack of energy and concentration, fatigue, social isolation and the other joyous side effects.

Here’s why. Think about this: What is the biggest challenge in recovery? I would argue that one of the hardest parts about recovery is learning to lose the “ED” identity and to learn who you really are as a person. Only once that has occurred can one begin to truly move on with their lives and to want to nourish their mind and body. Only then do they have a sense of self to take care of – a reason to recover, if you will. For recovering for someone else, or to get out of Inpatient care, or for the sake of a “goal weight”, will never do it. That typically leads quickly back to a relapse and the cycle that entails.

Inpatient care, while necessary to sustain a life on the edge, takes away all the other factors in the patient’s life that will be the foundation of their true identity as they return to health: their job, their hobbies, their social network, and for athletes, their training and usually tightknit support crew – coaches and fellow athletes. Not only does it take those things away, it actually forces the patient to focus 100% of their time and energy on the eating disorder. Their days are spent focusing on food, psychology, analysis, resting, scales, and usually the added bonus of in-house competition between patients on who is the “most sick”. Statistically, success rates aren’t good – the weight is temporarily gained, yes; but in the long term, recovery rates can be as low as 20% for patients who have had an ED for an extended time period. The statistics have not improved even after a few decades of treatment in this way. Why not?

At some point, the patient needs to learn how to function in society in a healthy way, and for this to happen there needs to be a reason for the patient to want to get better. Want being the key word here. When an athlete-patient is allowed to keep training, albeit at a reduced load, there is an all-important reason for them to put in all the hard yards day to day that go with recovering from an eating disorder. There can be clear goals and rewards: you gain X weight, you get to train X amount. You eat X foods, you get to attend X training sessions. If you don’t, you can attend but you have to sit out and watch. Sure, it’s harder to gain weight while still training. But guess what? Eating like an athlete is hard, full stop. Years on I still find it a challenge day to day. When you train hard, you have to work even harder on fuelling your “machine” (body), and the sooner a patient gets used to that process the sooner they can master it. Secondly, gaining the weight as muscle, bone density and fat via increased food and some continuation of training is much healthier and less traumatic for the patient than gaining fat alone on a resting protocol. Lastly but most importantly, there are three overwhelming psychological benefits to this approach:

1) the motivation-reward system is clear and immediate;

2) the social interaction with teammates and coaches is maintained, which is so important;

3) the patient is nurtured through the process of minimising their ED identity and replacing that empty space with their “healthy athlete identity”. {You can replace “athlete” and “training” with anything else relevant – student and school, physio and work, etc.}

The key to this process is to have a fantastic support team who can facilitate this transition. For me, it was a brilliant Sports Dietician (it was her idea to allow me to keep training – every other rehab program I had entered forced me to rest and spiral into depression), a brilliant Psychologist who specialises in treating athletes with eating disorders, a Coach who was on board with the plan, and a flexible workplace (I was still studying at University but my part-time job as a research assistant allowed me to set my own work hours, so I could go in when my energy levels were highest – early in the morning). For the most part, my dietician set out my goals for the week and my rewards – when and if I could train etc. All the while she communicated with my psychologist, who from the get-go has focussed on establishing my identity as an athlete. As he reminded me recently, I have always done best when we focus on what my body can do (as an athlete), not how it looks. All body fat % and weight measures were taken away from me, and replaced by more relevant measures like time trials and power outputs. And the only way I can get stronger, fitter, faster, and keep up with my teammates? To eat. Simple as that. I know when I skimp, I fall behind, and as a competitive person, that is motivation enough to nourish my body.

The best part is that the system WORKS. And it’s not just a bandaid fix – it works in the long term. To this day, years on from the start of my “recovery”, I still have a crappy day at work, feel “fat” as my go-to coping mechanism, and then know that if I go and do a solid training session, by the time I walk back through that door at the end I am going to be happy with my body and what it can do for me. Nothing to do with how it looks or what it weighs. Simply what it can do. And that’s pretty cool. Add in the extra bonuses of a good training session – fresh air, endorphins, improved fitness, mental clarity, relaxation – and it’s a win-win situation.

I make it sound easy and like the obvious solution, which for me, it was (obvious, not easy!). Nothing else had worked over the decade beforehand. And certainly this system wouldn’t work for everyone either, but for athletes, I would argue that it is the best way to structure treatment. Realistically, there needs to be a change in the way we treat eating disorders in Australia as the current inpatient systems are not working in terms of long-term outcomes and relapse rates. There is no easy answer.

Food for thought anyway.

Happy training xo

April 28, 2014 by Ana To Athlete

The Broken: A Survival Guide Part III

Right now, I am at the point where my foot is essentially 95% healed, and I’m ramping my running back up.

Cue music: “Highway to the Danger Zone”……

You see, this is the magical moment where the bones are healed enough to need adequate loading in order to reach full strength and function. This means running every other day (yippee!!), but crucially it also means having the discipline to not overdo it. And to listen to my body. And put my pride and perfectionism to the side.

This is, in many ways, the hardest part. It’s the part where I have to test my growth over the past 9 months. Have I really become more patient? Stronger? Less perfectionistic? More realistic? Hell, will my body even remember how to run, let alone with decent pace or technique?! And then the toxic seeds of doubt creep in: what will my fellow runners think of me now? What if I’m not good enough? What if I never get back to where I was before I broke my foot? Will I ever beat my husband in an Ironman again?

Of course, it’s highly likely I will come back stronger than before, will continue to kick my husband’s butt in many an Ironman to come, will have learnt a boatload about myself and my body and most importantly, learnt how to train more efficiently and with less risk (cue Britney Spears: Stronger. Yep, I went there). This is my “logical voice” talking. But we all know, that illogical voice is the one that dominates when we have been out of the loop for some time.

Hiking in NZ with my better half

Two weeks ago, I readied myself to go to running squad for the first time in over a year. It’s a super friendly bunch of runners who I have trained with throughout all my Ironmans in the last 5 years. Saturday mornings are usually a sociable 8-12km group run, with coffee afterwards. There is a front pack, of which I’m usually a member, and then there’s everything back to a 5km jog/walk group. In all, we have about 50 people turn up, so it’s not like I would be lonely.

Only I chickened out. Why? Because according to my return to run program from my Ortho, I still have to walk 2 minutes for every 8 minutes of running. And, I knew I wouldn’t be able to stop and have the discipline to walk when everyone else was still running. And my pride didn’t want the slower runners to catch up (there I said it. I may be the world’s most competitive person). A week later and I decided to try again. I took off at decent pace with a largish pack, and I did manage to stop and walk when I was supposed to. It was harder than getting through an airport on crutches, I’ll tell you that much. My heart and soul just wanted to keep on running!!

Whether you are getting back into training after an injury or after an eating disorder (or both), the hardest part is often sticking to the plan. I know from coaching beginner run groups that the three aspects of training that “normal” people struggle with most are 1) motivation; 2) fitness; and 3) being able to mentally push themselves. This is not the case for athletes or those of us with the ED birdy on our shoulder. These are some strategies that have helped me over the last couple of months:

1) Front and Centre: How Far You’ve Come (and how quickly it could go wrong). Its human nature to compare yourself to others, and even moreso for uber-competitive athletes like myself. There’s a bunch of people you used to be faster than lapping you around the park. But that’s OK, because they don’t have a metal plate in their reconstructed foot. They haven’t walked every step of that hard road to recovery. When the temptation to push yourself overwhelms you, it’s important to remember how broken you were and how quickly you could return there (ie another stress fracture or overuse injury). Sometimes fear can be a very good motivator! Write it on your hand, stick a photo in your wallet – whatever it takes, a not-so-subtle reminder is key.

2) Plan Ahead: The Insecurity Factor. As a flip side to point 1, remember that we are all humans and we do all have our own story and our own journey. When that little evil voice starts sprouting doubts in your mind, squash the insecurity by fighting back with basic logic. Those runners know what you’ve been through, know what kind of an athlete you are, and really couldn’t care less that you are running slower than you used to. They’re more than likely impressed by your motivation and determination, not judging you for your pace. They’re likely happy just to see you back at squad. Or they may not have even noticed that you’re not as fit as you were (you’d be surprised how remarkably un-observative “normal” people can be, really….you’d be shocked….not everyone can recite what the whole table ate at lunchtime and what times they ran on the track for the last 4 years….that’s a very unique trait!).

3) No Negotiations. Even if you feel like Paula Radcliffe today. Any changes to the plan MUST be pre-approved by your Physio/sports doc ahead of time. As with any rehab program, you have days where you just float like a butterfly….and days you feel like an elephant. Just enjoy the fact that you feel great, cherish every step, and know that if you stick to the plan, it’ll be that much sooner before you get to have another great training session. If that fails, revert to point 1.

4) Focus on how Amazing Your Achievements Are. And celebrate them. Who cares if your old training buddies smashed out 10km in sub-40min pace? YOU just did 36 minutes of quality running, and you had the discipline to stop and walk, and your technique was great, and you are coming back from major foot surgery, and you get to be outdoors in the fresh air running…you get the picture. Gratitude is the best emotion on the planet. Use it to your advantage. Write it in your training diary. You’re doing awesome. Repeat.

5) Enlist a Training Buddy who is on board. Does not have to be of the human breed. If you are going to squad, suss out who is about your pace at the moment or perhaps also coming back from injury. Or grab a friend who is willing to do walk breaks with you. My favourites for this are my husband and my dogs, the three of them are always whinging that I run too fast normally so they are happy for the walk breaks – much happier than I am!

6) Nutrition: ensure that you are adjusting your eating plan for the increased exercise load. You need to be eating for training, recovery AND healing – the triple threat. Bones have a lag time of about 3-4 weeks with increased load, so when increasing run kilometres it is best to have a training week that is about 50% of your normal current load for that week, to let your bones catch up and get stronger. Push over that and you may find another stress fracture. So if you are up to running say 40km a week, on the fourth week, stick to 20km and you can add some walking or cross training. It’s an annoying but foolproof investment, and any running coach on the planet worth their salt will stick to this plan for injury prevention. You’ll actually come out the other side feeling fitter, as your body will have “absorbed” your training up to that point and feel fresh again. Bonus!

7) Get a Hero or Two. Professional Triathlete Jesse Thomas actually broke his foot during Wildflower triathlon 2013 and subsequently had surgery about a month before I did the exact same thing. He has blogged about his rehab, the highs and lows, and I have found it hugely helpful following his progress along the way. His wife Lauren Fleshman is also a great role model and her blogs are highly entertaining for any athlete who has faced injury or childbirth and beyond. As a side note – be wary of Ironman athletes claiming to be recovered from their eating disorders. There are a lot of them around who hide behind “Ironman/triathlon” as their excuse to continue with disordered eating patterns. Chrissie Wellington’s book “A Life Without Limits” is probably one of the worst so don’t go there if you are still recovering. Same goes for any running or ultraendurance bio if you are recovering from a running injury – it’s like motivation on steroids to go do something really stupid!

I hope that helps! The journey back to health can be a long and lonely one, especially once you get towards the end and on the surface everything looks fine. Stay strong and remember how far you have come. Most importantly, reward your body for the amazing job it has done by nourishing it and letting it bloom into its full potential. It will serve you very well if you treat it right.

Happy Training xo

February 13, 2014 by Ana To Athlete

Insecurities

“Step out the front door like a ghost into the fog
Where no one notices the contrast of white on white

And in between the moon and you, angels get a better view
Of the crumbling difference between wrong and right

Well, I walk in the air between the rain
Through myself and back again
Where? I don’t know”

– Round Here, Counting Crows

Please read the following scenarios and choose the most correct answer:

1) You are an elite female triathlete with the following stats to your name: two sub-9hour Ironman finishes, <12% body fat and arguably one of the fittest bodies on the planet. When asked your weight in an interview, would you:

a. Tell the truth – your body is a weapon, your job, and a beautiful machine and you are proud of it!
b. Take off 5kgs from the true amount; you think you are ‘heavy’ with the muscle on your frame and your height.
c. Refuse to answer.

2) You are an athlete who has had an eating disorder in the past, you are now recovered but do not know your weight. You haven’t been able to run for 6 months due to injury, but have the chance to run on an Alter G treadmill that your sports doctor has arranged. In order to use it, you and your doctor will find out your weight. Do you:

a. Get on it – to hell with my weight I am desperate to run!
b. Agree to use it as long as you don’t need to find out the weight, then proceed to have a meltdown about it anyway, fearing that your doctor will think you’re the most obese athlete on the planet;
c. Gracefully decline. You are desperate to run, but the trauma of going through being weighed is just too much.

What would you do?

WA Ironman 2009

Impossible scenarios like this face us day in, day out, when we have the tracks of a previous ED in our scar tissue. We may be doing well for the majority of life’s intricacies, but there will always be situations like the above that will either get our blood boiling, or mentally challenge us more than is desirable (I don’t think it’s considered “normal” to have a panic attack at the thought of someone else knowing your weight….).
The first scenario makes me so furious that it sends me searching for my soapbox – in fact, I did send a huge ranting email to my good friend and doctor about the exact situation. I have been in the fortunate scenario to be on a squad alongside professional Ironman athletes for the last few years, and some of the best female triathletes on the planet to that end. Our head coach boasted more sub-9hour females on his squad than any other coach worldwide. It has been incredibly insightful and for the most part beneficial for me to be able to access their wealth of experience and knowledge and to apply that to my own racing and training.

But it doesn’t come without some serious eye-opening of the bad kind. Over the years, as you get more “well”, your triggers become so much more obvious. Racing has always been one of my biggest triggers – lining up on the start line in little more than some loud flimsy lycra is one thing; having that then photographed and marketed back to you in the eschewing weeks is truly disconcerting. No-one looks good in lycra, just putting it out there. The males who don’t have eating disorders love the race photos because they look so buff and muscly; the females – ED or otherwise – hate the photos for the same reason. I continue to race because for the most part it heals my soul. I’m good at it, and so it builds my self-esteem and creates an identity other than “anorexic”; in short, the risk-reward ratio is in the right place for me.

What I have learnt, however, is that disordered eating is rife among these professional women. They are not immune to the pressures; in fact, they feel it more than most.

Which disgusts me. Here you have 5 of the fastest, fittest, most incredible female athletes on the planet, all with bodies which would make any human proud. Their bodies are their livelihood, and to that end are serving them very well. Their self-confidence should be oozing; success is practically their middle name. And yet, they feel the need to lie about their weights, ashamed by the number on the scale.

What does that mean for the rest of us?

What message does that send?

Fast forward to scenario II, where I get this amazing opportunity to start my return to run training 3 months ahead of schedule following my foot surgery, thanks to the Alter G treadmill purchased my sports doc…..and yet I baulk. Frozen. Panic sets in. I know it means being weighed, and for someone who has just had 6 months off normal training, that is paralyzing.

But why should it be? I weigh 5kg more than the average of those 5 elite females put together – their real weight, not the one they put down on our team bio page. I am healthy, lean, fit and carry as much muscle as a good Ironman athlete should. Yes, I’m a few kgs up from my race weight, but that is OK too – because I am not race-fit right now. My body is as it should be right now, and I would like to be able to “own” that.

In the end, I guess you could call me a hypocrite. It upsets me that those women feel the need to lie about their weights, and it saddens me that that will send a very wrong message to young impressionable athletes coming through. It’s as if we are expected to achieve the impossible: to have muscle and minimal fat, and good bone density, and yet to weigh in at featherweight. Consider who is setting these expectations, and whether it is a sad modern extension of the female bullying epidemic, insisting we be perfect and able to do-it-all and yet so ruthlessly judging one another for how we all look/dress/work/live/parent…..the list goes on. I can tell you that my doctor, who is a male, didn’t give two hoots about my weight. And you rarely hear males bitching about their fellow mates, judging how they live their lives. Food for thought.

My plea is for female athletes to start “owning” their beautiful bodies. Be proud that you weigh a little more than your unfit ~~skinny~~ counterparts because you actually have muscle tone. Be proud of what your body can do, and how far it has come. For those of us who have climbed from the dark depths of an eating disorder, also be kind and forgiving – for your body has been through so much more than you will ever know, and every day it wakes ready to heal a little more and to help you to keep fighting the good fight.

Never forget that. Own what you are, and be proud. Starting a revolution starts with one tiny step, and you just never know who you’re inspiring by how you live your life.

K xoxo

December 8, 2013 by Ana To Athlete

Here comes The Fighter

“Only a man who knows what it’s like to be defeated can reach down to the bottom of his soul and come up with the extra ounce of power it takes to win when the match is even”. – Muhammad Ali

Today, I ~~commiserate~~ celebrate the half-way point of my foot rehab journey. 4.5 months since the surgery, 4.5 months until I can run again.

Never before have I yearned for running, the first and longest love of my life, so fiercely. When I was running competitively at university, I had a beautiful old man of a coach who was in his 70’s (and still running…) and had been coaching distance runners for most of his life. After thrashing ourselves and giving 100% of what our hearts had to give at any given session, we would warm down and joke and laugh amongst the group. When all was said and done, he would look at me with those wise wrinkled eyes and say “I have never met someone who loves running like you do”. In my youthful naivety, I used to laugh at him. But right now, if you asked me to choose between running and my husband – my two grand loves – well I’d have to think about it! I’m joking ~~sort of~~.

Early days….

And yet, never in my life have I found it so hard to keep the “athlete mindset”. Not as in, screw training why bother. As in, screw rehab I want to go run, PRONTO. I want to get back to racing ~~weight~~ fitness, PRONTO. Hell, I want to race, and feel the best pain in the world. Not rehab pain. Not idle resting pain. Or surgery pain. Just the deep, all-encompassing fantastic pain of racing. I want that. And my heart yearns so extremely deeply for it, I feel a black hole that can’t be patched back up.

And God knows all too well that I am not patient. Ironic given all those years of being a patient. I suspect this may be God’s way of testing me….so that I learn patience. And so that I learn the most valuable lesson of my life to date: I am an Athlete. I am no longer Anorexic. Or an Athlete with an Eating Disorder. Facing the surgery, all those months ago, I remember with clarity driving home from the surgeon’s office crying, desperately hoping, but desperately fearful that I could not do this. I could not do this, without Ana. This was going to be the hardest test of my “recovered” life.

And in these last weeks that have passed, I cry again – because I know I am there. Throw vulnerability to the wind, I’m fighting the good fight.

There you are. I finally found you.

K xo

July 22, 2013 by Ana To Athlete

About Me

About me –

Anorexia and I shared space in my world (Ana hogged it 85% of the time…) between the age of 12 and 21. While the onset was pretty sudden at age 12, of course the interchange between “Anorexia Patient” and “Recovered” labels was not an overnight exchange – but I have put it as age 21 as that was the first time I honestly, truly decided for myself (and was not forced) that I wanted to recover. The actual road to recovery was a rocky one but I am happy to report that I have maintained a healthy weight for 5 years now. It’s part of my history, but I don’t allow it to define me. It is what it is. I would rather not have gone through it, but I do try to now focus on all of the lessons that I have learnt and am certainly hoping that some good will come from it via Ana to Athlete. I still refer to it as “Ana”, or the “Ana years”, for many reasons – not as an affectionate thing, more because “Anorexia” sounds so harsh and scary and brings back too many horrid memories. And I guess, because it’s a safer name, with softer connotations – it’s too easy to pigeonhole people with the more formal name when really, no two cases are ever the same and no two people are the same.

What I am these days, is a Physiotherapist, Exercise Physiologist and director of a successful sports physiotherapy clinic with my amazing husband, who is also a physio. I am a 5-time Ironman finisher (and counting), and my favourite thing in the whole world is running – I think my relationship with running is borderline unnatural. But running and I, we have been through A LOT (I started running at the age of 12, so, you know…..we have a bond that is unbreakable!). I have two dogs, love my job, adore traveling and use baking as my therapy (did you think that went away after recovery? Sorry!! Haha). After almost a decade of Ana, you get pretty good at baking, so as a result I now do wedding cakes as a side hobby to Physio when I am not in full Ironman training (random? Extremely. Overachiever much? Yep that sums me up). I also have a small addiction to roses and forster the “nanna” within by sporadically tending to my rose garden.

Life is magical and you are beautiful. Embrace it.

K xo

July 22, 2013 by Ana To Athlete

About Ana To Athlete

ABOUT “Ana To Athlete”

This blog has come about 7 years after I was officially “recovered” from Anorexia – you know, according to the medical charts you now have a BMI above 18, are menstruating and managing to eat. You look pretty normal, you are expected to be a normal functioning part of society and to have the same normal problems that everyone else has….whoa hold up?! What the hell is “normal” anyway!?

As far as modern medicine goes, you are now recovered, but every ED patient knows that this is where the really hard work starts and alas – there is no-one there to help you anymore. You’re “recovered”, right? So everything must be fine. But no-one taught you how to live. How to laugh. How to enjoy food. How to be OK with this new “healthy weight” body. How to cope with the physiological issues that may remain with you for a while yet. How to address the fears and coping issues that got sent you down the ED pathway in the first instance. And not to mention the depression that is all too common in this stage.

WHAT THIS SITE IS, is a place for those of us who have been through the merry-go-round of “ED-Treatment-Recovery” (often with an addition or six of “relapse-recover-relapse” because let’s be realistic, no-one is perfect….) and have popped out the other side, now having our two feet relatively firmly planted in the healthy side of the ground, 90% of the time (what a mouthful!). My mission is to TALK ABOUT HOW TO LIVE AFTER ANOREXIA. And not just survive, but thrive. With a healthy dose of humour, experience, success stories, epic failures and celebrations. I don’t know it all, not even close. But I do know a lot, and I’ve been through a lot, and I would love to be able to help others in an area that is sadly lacking any information – the bridge between “Recovery” and “Happiness”. I would prefer they not be mutually exclusive anymore! So first and foremost this is a safe place to come to, like a “guide to life after Ana”.

Secondly, hopefully, Ana to Athlete will provide a platform for development of better recovery pathways, so that we can one day aim for reduced relapse rates and reduced rates of depression and anxiety disorders in recovered anorexics. There exists very little in research or practice to bridge the gap between leaving treatment, and achieving full participation in society (encompassing both health and happiness). Too often, the patient goes from a full support network – typically including a dietician, psychologist, nurse, fellow sufferers, and the routine of either a day or inpatient program – and once they have reached their goal weight it is assumed they are “healed”. But the mind is only partially healed, and the situation can be ten times worse because they now look normal – so they are assumed to be coping fine. It can be a fast and slippery slope into relapse from here, or worse – the improvement might remain static, so the person goes on to half-live a life carrying around a sub-clinical eating disorder. Too often, patients can hide behind their sport, “genetics”, or at times, their family network, and it never gets talked about. I would like to see more research and subsequent resources into bridging this gap in the future, and welcome any input from all of you out there regarding ideas and resources based on your personal experiences. In the meantime, I’m going to share what I have learnt along the way to becoming a successful athlete and happy adult following almost a decade of Anorexia.

And of course, as an extension of my recovery – the blog will delve into all that I have learnt about Ironman and in particular, female athletes. How best to train, eat, recover, race, psychologically prepare and generally celebrate life through the amazing sport that is triathlon. I don’t know many Ironman athletes who aren’t preoccupied with food and weight so to a large extent, the content is mutual.

WHAT THIS IS NOT, is a pro-Ana blog. It is not a “how-to-starve-oneself” manual, nor does it glorify ED’s – I wouldn’t wish one on my greatest enemy. Think of it more like a “how-to-love-life-and-become-a-kickass-athlete” guide: jump in and enjoy the ride.

Happy Training!