TriDot Podcast .135

Preventing & Treating Triathlon Injuries: Your Core is Core

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Intro: This is the TriDot podcast. TriDot uses your training data and genetic profile, combined with predictive analytics and artificial intelligence to optimize your training, giving you better results in less time with fewer injuries. Our podcast is here to educate, inspire, and entertain. We’ll talk all things triathlon with expert coaches and special guests. Join the conversation and let’s improve together.

Andrew Harley:  Welcome to the show. Today is part three in a series we’ve been doing with Dr. B.J. Leeper all about how to prevent and treat triathlon injuries.Back on episode 108 we talked about leg injuries, on episode 120 we talked about arm and shoulder injuries, and now we’ll wrap the series up here in episode 132 talking about maintaining a healthy core. Joining us for this isDr. B.J. Leeper. B.J. graduated from The University of Iowa Carver College ofMedicine with a Doctorate in Physical Therapy and Rehabilitation Science. He isa Board Certified Orthopaedic Specialist, a certified Strength and ConditioningSpecialist, and a USA Triathlon Level I Coach. He specializes in comprehensive movement testing and is an avid triathlete himself with over 50 tri’s under his belt. So B.J., are you ready to get our abs and our core rocking today my friend?

B.J. Leeper: Yeah, absolutely. I was just thinking maybe I should use a Jeff Raines pun and AB-solutely.

Andrew: AB-solutely.

B.J.: But why would I want to do that? That’s just corny. But yeah. No, excited to chat about this. There’s a lot of interesting things to cover here. So looking forward to it.

Andrew: Next up is pro triathlete and coach ElizabethJames. Elizabeth is a USAT Level 2 and Ironman U certified coach who quickly rose through the triathlon ranks using TriDot. From a beginner to top age-grouper, to a professional triathlete. She is a Kona and Boston Marathon qualifier who has coached triathletes with TriDot since 2014. Thanks for joining us Elizabeth!

Elizabeth James: You know, this is just my pleasure. We’ve gotten some really good feedback about the first two episodes in the series and I know that today is going to be another great conversation you know, just as we continue to look to provide athletes with some good information about keeping their bodies healthy and injury free so that they can keep training.

Andrew: I'm Andrew the Average Triathlete, Voice of thePeople and Captain of the Middle of the Pack. As always we'll roll through our warm up question, settle in for our main set topic, and then wind things down with our cool down. Lots of good stuff, let's get to it!

Warm up theme: Time to warm up! Let’s get moving.

Andrew: Kind of putting a fun twist on today’s warmup question, as a sort of thought experiment, we’re going to do a triathlon “would you rather.” B.J., Elizabeth, would you rather race your next multisport event1) wearing baggy clothes during the swim leg, 2) wearing run shoes and not being able to clip in for the bike leg, or 3) wearing bowling alley bowling shoes for the run leg? You have to pick one of the three for your next race, which would you rather have to do? B.J. Leeper?

B.J.: Oh man, I was not even prepared for this. I feel like it’s not even a question though, is it? I mean who would not choose to just use run shoes instead of not clipping in. I don’t know. I guess it depends on the distance, but I definitely would not go baggy clothes on the swim and bowling alley bowling shoes would be miserable for the run leg. Although I do have big feet and I usually have the freshest pair of bowling shoes when I goto the bowling alley because nobody wears size 14 hardly.

Andrew: Oooo!

B.J.: So, but I will still have to go run shoes, I mean hands down, for sure.

Andrew: Okay, so you would rather wear run shoes and just kind of put them on the platform pedals and just have the pedal without clipping in for the bike leg, right? That’s what you’re going with here?

B.J.: Yeah, I mean even for a longer distance race it wouldn’t be ideal, but I would pick it over the other two for sure.

Andrew: Alright, pro triathlete Elizabeth James, which of these three would you rather have to do for your next multisport event?

Elizabeth: I’m definitely thinking along the same lines asB.J. there. When you first said it I was like, “Well, I wonder what distance?”Like, maybe for a super sprint tri I could get by with baggy clothes for like a 200 meter swim or 300 meter swim, but I think overall no matter what distance I would rather wear just regular run shoes and not be able to clip in the bike than those other two options. Gosh, wearing bowling alley shoes just sounds like a disaster waiting to happen. But I mean, slip and fall and ugh, and for me the swim is already hard enough.

B.J.: I want to know who would actually choose that.

Elizabeth: Right, yeah!

B.J.: Who would actually choose that, the bowling shoes? I want to know. If we have a listener that would actually choose that, Iwant to know who they are.

Andrew: Well, we’re going to find out because we’re going to throw this question out to our audience and see what they have to say.I think for me, I would rather do the swim in the baggy clothes.

Elizabeth: Really!?

Andrew: I get that it would be miserable, I get that itwould weigh you down, I get that it would slow you down, but I’m already slowerat the swim anyway so I mean, while I’m falling behind on that leg, I might aswell fall just a little bit further behind and then be happy on the bike andrun. The thing with the swim is it’s also the shortest leg of the race and soif I’m slowing myself down for the shortest leg of the race I’ve got muchlonger on the bike to be happy and not be miserable just with the tennisrunning shoes. What I do expect when we throw this out to the audience is thatmost people will agree with you two. I really do. So I’m almost wonder like,should I have made the bike option less appealing? Should I have said likemaybe you have to bike barefoot on your pedals. Or maybe I could have made therun one less miserable by instead of bowling shoes just said like non-runningshoes. Like you could use whatever shoes you want, they just can’t be actualrunning shoes. I don’t know. There’s probably some other things I could havemixed in here to make the three equally miserable as opposed to making maybethe bike a little bit more feasible, because plenty of people already do that.When they’re new to the sport you don’t have the clipless pedals yet and sothat’s already a viable way to bike. So maybe this one is on me for making thistoo easy, I don’t know. What do you guys think?

Elizabeth: Well I was thinking, you know, like, I’vealready done that.

B.J.: Right. I think we need to clarify the baggyclothes.

Elizabeth: Yes! Okay, and Andrew, does it change youranswer if you have to do that for a full Ironman?

Andrew: Ooo, I don’t know that it does, because…

Elizabeth: Really?

Andrew: …I don’t want to ride 112 miles wearing– likewithout being clipped in. I mean, you just gain so much more to every pedalstroke. I’ve said on the podcast before, I don’t want to ride my bike anylonger than I have to. So that swim is long and slow for me so what is theproblem making it a little bit longer and a little bit slower?

Elizabeth: See, I’d be worried I wouldn’t make the swimcutoff with baggy clothes.

B.J.: Yeah, I’m picturing on the baggy clothessomebody wearing like this loose windbreaker jacket on the swim and like thesebaggy sweat pants and that would just be miserable.

Elizabeth: Uh-huh.

Andrew: Yeah, but say it takes my swim split from 1:20to 1:50, you know, I’m not going to lose 30 minutes on the bike by wearingtennis shoes I don’t think. So that’s my– We’ll see when we throw this out toour audience about me being the only one picking that. I might be the minorityand we’ll see if anybody out there is just wild enough to say, “You know what,I like bowling. Let’s try the bowling shoes.” So guys, as always we will throwthis out to you. Make sure you are a part of the I AM TriDot Facebook group andthe Monday that this episode comes out we’re going to throw this question out,would you rather race your next multisport event 1) wearing baggy clothes forthe swim, 2) wearing just normal shoes not being able to clip in for the bike,or 3) wearing bowling shoes during the run leg of your event? Can’t wait to seewhat you have to say.

Main set theme: On to the main set. Going in3…2…1…

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Andrew: Combining threesports that spin our extremities around and around, we probably are moreworried about injuries to our arms and legs than we are to our core, but thecore is the center from which all other movement flows so keeping it healthyand happy is vital to success in tri training. Good thing today we have Dr.B.J. Leeper and pro triathlete Elizabeth James here to talk about taking careof your core. So as we get started talking about core health, B.J., Elizabeth,have any of y’all ever dealt with core injuries in your time in athletics?

Elizabeth: Well Ithink before we even jump into that, I mean, one of the first things toestablish here is that your core isn’t just your abdominal muscles and I thinkthat this is a very, very common misconception. So like core work isn’t justcrunches. You know, it’s strengthening the middle of your body kind of fromyour chest down through the mid thigh and therefore, core injuries aren’t justan injury to that six-pack either. They can involve pain in the hips, glutes,low back, and so having established that it is more than the abs, yesdefinitely. I have had some core injuries in my time in athletics. In highschool I had issues and I know it’s kind of like a colloquial name for it, butit’s called like snapping hip syndrome where it’s like the muscles and thetendons that are near the hip bones just become very, very tight and kind oflike when you move they snap over that like hip’s bony protrusion on the side.

Andrew: Eeeh, yikes!

Elizabeth: Yeah, itsounds gross. Then I mean, my hip flexors have given me a number of troubles. Ihave struggled for a long time with just kind of this major anterior pelvictilt and that’s where like my hip flexors are so incredibly tight that it kindof pulls my pelvis out of alignment and really inhibits the correct firing andrecruitment of my glutes. So yeah. When we talk about core injuries, I havebeen there. Still kind of there. So yeah, something I can definitely speak to.

Andrew: B.J. were youtracking with everything Elizabeth just said?

B.J.: Oh yeah. It’sreally common and she brings up a great point. Like, when we talk about thecore and it’s not just your abs. I mean most people use those twointerchangeably, but when we’re talking about the core as we’re discussingtoday it’s really a region and I like to use—we’ll talk about this a little bitmore as we go—but I like to use the analogy of a box of muscles where you’vegot the tip of the box, the bottom of the box, back and sides, and when we’retalking about the core with that analogy the back of the box is where we talkabout a lot of injuries . I’m right in the category in my history. I’veprobably mentioned on this podcast before, but just had a bad back injury inhigh school playing football where I herniated a disk in my lower back and whenthat affects you in that you with the pain I had, there was a time period whereI could hardly walk, it was excruciating to sneeze or to cough and by far oneof the most painful experiences I have ever had. We see it all the time in theclinic, back injuries, core injuries, whatever you want to call it. It’s a verycommon problem and definitely very common in triathlon too.

Andrew: Well it’sinteresting that for both of you, your primary experiences with core injuriesgo back to youth team sports and not to endurance sports. We’ll kind of learnhere that—really we’ve learned in our previous episodes and of this series thatmost triathlon related injuries are lower quarter. Upper quarter injuries aremuch rarer than lower quarter injuries so to B.J. even for the three of us onthis podcast, it seems like our injuries are team sport related from our past.So how about our core in relation to triathlon? What percentage of enduranceathletes will have problems in the center of our body?

B.J.: Yeah and it tendsto be very similar to the general athletic population too and a lot of it isbecause we’re all active people, a lot of us did play sports when we wereyounger and like we always say, one of the biggest predictors of future injuryis previous injury and a lot of us have had previous injuries in that area andit correlates to that for future potentially. But when we try to look at theresearch of what’s out there with regards to the specific triathlon population,there’s not a lot. It’s kind of convoluted. You’ll see some percentages thereof some studies that have been looking at that where, like you said Andrew, thehighest percentage is the lower quarter, but you’ll see on average at least 20%of triathletes deal with lower back pain or areas in the core and I’ve seenstudies even show that number closer to 75%.

Andrew: Wow.

B.J.: I tend to believeit’s much closer to that as well because…

Andrew: Well, and thereare those people, B.J., who have had back pain at all, they’re at home rightnow or they’re in their car, or wherever they’re listening, on their biketrainer maybe, they’re nodding their head like, yep. If you’ve dealt with backpain you know you’ve dealt with back pain and you know how debilitating or howworrying back pain can be.

B.J.: Yeah and we seeit all the time and anecdotally, in the clinic, 90% of the patients I’ll seeare related to spine related injuries, knee or shoulder. The largest percentageof that being in and around the spine. So I think in the triathlon communityit’s very common. Exact numbers it’s hard to say, but like many of us haveexperienced with regards to the back area or core related area we know it’saffected us in some way, shape, or form and definitely probably impacted ourtraining or racing in triathlon.

Andrew: So as Elizabethwas mentioning at the beginning of our conversation a lot of folks I think justthink abs. They think that six-pack, that eight-pack, you know if you’re reallyjacked like we all are right, and we might think of our back when we say core,but B.J. as we chat today, I love the illustration you guys already gave justby thinking of it as a box with the front of the box, the back of the box. B.J.kind of catch us up from a PT’s perspective, when we say core, what all is ourcore that we will be talking about here today?

B.J.: Yeah and we’llget into the anatomical definition of what I term the core, but I think thefirst place to start with all of it is really defining what is core stabilityor what is core strength? Because it’s really very complex. It’s much more thanthe abs like we’ve already referenced. The definition I’ve really liked of whatcore stability truly is, is that core stability is the instantaneous integrityof our pelvis and spine in the presence of full range of motion. So there’s alot there, but if we break that down, core stability is the instantaneousintegrity. What that means to me is that core stability is not something thatyou just actively consciously contract and do all the time right?

Andrew: Yeah.

B.J.: It’s somethingthat’s spontaneous. It’s instantaneous. It’s reflexive. It’s something that’spart of your subconscious timing system and that’s a key, key thing we’ll getinto a little bit. But then the other part of that definition of the corestability being the instantaneous integrity of our pelvis and spine in thepresence of full range of motion. That second part of that definition, in thepresence of full range of motion, or what we could consider like normalflexibility or full mobility, that’s a key, key component of the core. Becausein the presence of stiffness or if there’s tightness in the system, your brainwill not communicate to those core stabilizers in the correct way. There’s amisfiring or missed timing of those muscles stabilizing the right way. So core,it’s critical that there’s functionable mobility or normal mobility in thoseareas around the core in order for your core to fire correctly. So if we startwith that definition of what truly is core stability, it’s very much tied to timing,it's the right muscle, the right time. Then we get into the anatomy of whatmuscles are involved in that stabilization process and that’s when we can kindof get into things that are maybe a little bit more understandable as far aslike, “oh, I’ve heard of that muscle before.” But, if we lay out the picture ofthe core as that box. So think of this analogy of a box and really we have fourlayers of abdominal musculature alone that makes up that box, but the top ofthat box involves the diaphragm which is kind of known as our breathing muscle.The bottom of that box is our pelvic floor musculature which we don’t oftenthink of as a core muscle, but it really is part of that system. In the frontof the box is what most people look at when they consider the core. That’s therectus abdominis, that’s our eight-pack abs. The external, internal obliqueskind of make up the sides of the box. The transverse abdominis is kind of thisinternal corset muscle that’s like the back brace of our internal system. It’shighly critical. Hip flexors like Elizabeth eluded to is also part of thissystem and in the back of that box we’ve got a pair of spinal muscles. There’sthe small muscle called your multifidus which is a highly specified muscle forstability that we talk about a lot and then your lats and your glutes kind ofmake up what we call this posterior sling where your left lat kind of feedsinto the fascial layers of your right glute and vise versa on the left side. Soall that said, the core is really a complex system made up of a lot of layers,a lot of different muscles which makes it such a really powerful system andreally specialized system.

Elizabeth: I thinkthat’s really helpful to really envision that as that box and for you to kindof go through and say, “Okay, we’re not just talking about”–and I love how youuse the eight-pack abs instead of the six-pack abs that Andrew and I werereferring to. You can tell who has been working on their core.

B.J.: What pack inthere.

Andrew: We’ll raise itto 12 by the time this episode is done.

Elizabeth: There wego. Yeah.

B.J.: Yeah.

Andrew: I’ve got a12-pack over here and we’re going to–

Elizabeth: But yeah.Things like the lats, the glutes, the hip flexors, the diaphragm. I mean thoseare all needing to be considered and so from everything you’ve just said andkind of those specific muscles that you mentioned, what are the threats herefor kind of core injures as a triathlete? What would you say are kind of someof the main things that you’ve seen as a threat?

B.J.: Yeah, the biggestthreat to the system in the triathlon world is really a pattern that we astriathletes kind of get locked into and that’s largely the sagittal plane whichis kind of the front-to-back plane where like we’re running, we’re moving ourleg forward and back. Cycling, same thing. So it’s that front-to-back movementor what we consider the sagittal plane and this kind of takes me back to reallythe impetuous of how I got on this track of really studying triathletes andreally wanting to improve triathlon performance from a human movementstandpoint and mobility and strength standpoint. It was about 15 years ago. Ihad just gotten into the sport of triathlon and I was in Oceanside, Californiaat a seminar and I think I’ve shared part of this story before. But I was in aseminar and I was listening to one of the most world renowned PT’s discuss alot of different topics, but after the seminar there were just a handful of us,maybe four or five, just sitting around talking to this guy and he also ownedhis own clinic. He was a PT. He was on a seminar circuit and spoke a lot, buthe also ran his own practice and treated patients regularly. We were all justcurious. We were like, “Hey, on a Friday night at 5 o’clock, like last patientof the day, who’s the last type of patient you would want to see walk throughyour doors?” He literally did not even bat an eye and he just said “Atriathlete or an ultra runner.” And I was new to the sport. I was so offendedbecause I was like really into triathlon. I was like, “What!? Why would you saythat?”

Andrew: And you know forhim to respond instantly…

B.J.: Instantly. Yeah.

Andrew: …and not have tothink about it. That means he’s dealt with triathletes or ultra runners and hada bad experience.

B.J.: Exactly.

Andrew: So he can justrecall that that quickly.

B.J.: Yeah, and Igathered in talking to him, like there were two points to that. The first pointwas that triathletes tend to be type A and don’t want to give up theirtraining. You know, they’re slaves to their training which tends to be true inmy experience as well. But the other big factor like we’re talking about here,the biggest threat to triathletes is that we are sagittal plane beasts so tospeak and that’s what he alluded to. Like we train so many hours of our day inthis sagittal plane of movement and we don’t often mix it up with complimentarytraining or supplemental strength and conditioning to balance us out. So we getinto this pattern of sagittal plane overuse and we know that 75% or triathloninjuries are due to overuse, and so with the threat we’re talking about here isthreats to our core system, Elizabeth already touched on it as a problem shehas experienced in herself which is that anteriorly tilted pelvis or what wecall lower cross syndrome where hip flexors get tight, your lower back getstight. That’s a diagonal pattern that relates to each other. The opposite, theantithesis of that pattern is your anterior core and your posterior glutes. Theglutes and the core we often call the king and the queen of the body becausethey are that powerful and they have that relationship where the glutes oftenare considered the king, not because they’re necessarily priority over thecore, the anterior core like we talk about a lot, but because they are sopowerful. But if you think about that, if I’m at a position with my pelvis, mypelvis is tilted forward and I’ve got hyperactive hip flexors and as a resultmy lower back is also hyperactive, I could have the best ten-pack abs known toman.

Elizabeth: There wego. We’re up to ten.  

B.J.: I could have thebest glute strength known to man. Yep we’re just going to up it every time.

Elizabeth: Yep.

B.J.: So I could haveliterally the best core strength and glute strength known to man, but if I’mout of position with my pelvis because I’m so lower crossed, it doesn’t matterhow good my strength is there, I’m not going to be able to use those musclesefficiently or at all for that matter. I’ve seen a lot of people that drivetheir system so to speak from those two areas; hip flexors and lower back.Elite triathletes even that perform at a very high level, but still are nottapping into the king and the queen and some that even come off the bike andthey can’t finish a run because their back is so tied up. Their hip flexors areso hyperactive they can’t get out of it and they end up walking the run or theyhave to pull out. So I think that is the biggest threat, just really theoverall principle that we are sagittally plane driven athletes as triathletesand we have to figure out ways to balance that and some of us have moreproblems with that than others.

Andrew: So when wetalked about leg injuries and shoulder injuries, a recurring theme is howinjuries in our limbs can actually originate in our core. So B.J., now thatwe’re solely focused on the core and we’ve identified that main threat ofoveruse and getting our system out of whack and timing out of whack, talk to usabout how our core interacts with our limbs.

B.J.: Yeah, this is agreat question because it is, like we’ve already talked about, a timing issue.It’s the right muscle at the right time. So in isolation all of these muscleswe’re talking about that are part of our core can be strong individually, butif we’re not able to position the pelvis correctly like we just talked about orwe’re not able to transfer energy from the core to a limb like you’re kind ofasking here, really it doesn’t matter how strong those individual muscles are.I always like this analogy of a 4 x 400 meter relay where you’re passing thebaton. You could have the fastest 400 meter individual sprinters in the world,but if they drop the baton they lose and that’s what we’re talking about hereis how efficiently can your body pass the baton and it all starts with thecore. If your core is set up correctly and you’ve got the proper timing of allthese muscles we’re describing, then you are able to pass the baton andtransfer the energy from upper quarter to lower quarter or through the lowerquarter to the pedal or to the ground as you’re running. So it’s all about thatenergy transfer, but again if it doesn’t fire correctly, if that motor controlis off or the core isn’t firing at the right time then you lose. That dynamicmotor control is lost. There’s actually a lot of research on this especiallywith regards to people that have experienced injury in their core and a lot ofthe research is tied to lower back injury where there’s a specific sequencingof firing that happens with those smaller muscles like we were talking about;the transverse abdominis and some of those multifidus muscles that are thesesmaller intrinsic core stabilizers, they’ve done studies that have shown in thepresence of pain or athletes that have had a history of pain, those muscle firea split second after you’ve already moved a limb. So the natural timing of thatsequence is when you are planning a movement in your mind, your brain iscommunicating to your limb to take a step or to grab something with your arm orhand, your core will actually fire subconsciously a split second before youmove a limb.

Andrew: Wow.

B.J.: It’s just yournatural way of stabilizing itself before you go to transfer energy. However, inthe presence of pain, that sequence gets reversed. So basically what happens isyou go to move a limb and then your core all of a sudden is like a second thoughtlike, “Oh, we forgot to stabilize. Okay we’ve got it now.” But that splitsecond difference is where a lot of injuries can happen to the lower back andthe discs and things like that.

Andrew: Well andparticularly with these movements that we do where it’s repetitive just overand over and over again.

B.J.: Exactly, exactly.

Andrew: You know,stepping while running.

B.J.: So if you havethat and it’s exponentially magnified because you’re firing instead of 1, 2firing sequence, you’re going 2, 1 and even if it’s just for a split second,that dysfunction can get magnified over the course of however multiple stridesyou’re taking. However multiple pedal strokes you’re taking. So that’sdefinitely a huge area that the timing and the sequencing and it definitely isinvolved there.

Elizabeth: It’s sointeresting to think of it as like the 1, 2 and 2, 1. I’ve never even thoughtabout it that way. So I mean as an athlete that’s sitting here listening tothis and they’re like, “Wow. That’s fascinating. I want to make sure that I’mnot in that 2, 1 firing pattern.” How can you fix that? How can you fix thetiming of like the firing of the core system so that they don’t put themselvesat risk of injury?

B.J.: Yeah, I mean I’dlove to say it’s as simple as just do a bunch of crunches. It’s really morecomplicated.

Andrew: Hold a plank for21 minutes!

B.J.: Just plank. Workon the 12-pack right?

Elizabeth: See nowwe’re up to 12.

B.J.: We’re up to 12.Keep counting at home.

Andrew: When you get tothe point that you have a 13-pack you’ll have no more issues with this timingsystem.

B.J.: Yeah, exactly.Exactly. The interesting thing about all this, obviously it’s complex, but thereality is most of the body’s stability occurs at 20% of max capacity. Whichwhat that means is that by the time like if you’re loading your system,whatever it might be; lifting weights or moving with energy transfer. By thetime you get to the 20% mark of max capacity, everything that you do from thereon out is going to magnify how well you either did or didn’t fire your corestabilizers correctly. And remember this is a system that’s spontaneous. It’snot something that you’re thinking about as “Okay, I’m going to start to strideout with my run. I better fire my abs.” It’s something that’s just happeningwithout you being aware. But if that system is off like we just described,that’s already happening at 20% of max capacity and then it’s magnified beyondthat by how much load or how much force you’re exerting through the body. Sowhat you really have to do is you have to understand that’s what the process isand know that you can easily train that system, but there’s some steps you haveto consider to get that training done correctly. So it doesn’t require just maxexertional exercise. It can be done at low intensity. It’s just like theexample of passing the baton. Like, how much exertion does it take to work onthose? If you ever ran track you work on the baton passing drills of stick andyou’re swinging your arms and you hold out your hand to the next person andit’s a skill drill. It’s not that that requires smoking yourself running a 400,but that’s part of the key. That’s kind of like what we’re talking about. Youhave to train the timing and so when we go through the timing sequence, not toget too long winded, but there’s really kind of four basic steps if you want toconsider it and it almost sounds like you’re going to a self-help group wherethe first step is like–okay, first step acknowledge that there’s a problem,right? Because number one is subconscious dysfunction. So you don’t even know thatyou have a misfiring system in your core. You don’t even know that your coretiming is off, but the reality is you’ve got this dysfunction or this patternor this compensation we could even call it where a lot of times in the clinicwe’ll say “lights are on, but nobody’s home” where you have a muscle likeElizabeth’s hip flexor example where hip flexors are tight even at rest. Youmight be sitting there and you know your hip flexors are extremely tight andthere’s no reason they need to be on, but because they are so used to beingover utilized they’re compensating for something that you’ve got these lightson, but nobody's home. You have to acknowledge or you have to come to therealization that that’s actually happening and that’s largely where the resetwork we talk all the time about within PT or chiropractic or any type of carewhere the main focus of getting those resets is to inhibit that tone that’scompensating, that’s on. The lights are on but nobody’s home. You know we’vegot to go around and flip all the lights off because we know there’s no reasonthat they need to be on. You’re just sitting there. You’re supported by achair, yet your hip flexors are engaged thinking they need to be your coresupporting you and that’s where things like foam rolling, vibration, massage,dry needling, all these types of modalities can come into plan to help turnthose things off. But again, that’s the core problem. So it’s recognizing thatand then that’s really step two is conscious dysfunction. So once you’re awareof when that is happening you can feel that or know, “Oh yeah. This is what’shappening.” Like we talk about this in the clinic a ton with the neck; neckpain. A lot of people have tight upper traps and like for the example intriathlon I see this a lot where somebody is riding a bike and they’re in aeroand their upper traps are on fire because they’re trying to be your corestabilizing you. Again, it’s lights on, but nobody’s home. There’s no reasonthat the neck needs to be on in those situations, but because the core is maybemisfiring or not timing right you’re sitting there in aero and you’re ridingyour bike and your upper traps are like your abs all the time. So once you canrecognize that in your system you can start to have this conscious control. Youknow, you’re recognizing the conscious dysfunction and you notice that and youcan say “Oh yeah, my neck’s on. Turn my neck off. Relax my neck. Okay, relaxshoulders. Let my core fire. Let myself breathe more through my diaphragm or mybelly as I’m cycling.” So there’s all kinds of different tricks to start tothen work into that process. But again, self assessment and even movementscreening can help make you more aware of that dysfunction and that’s anotherbig step to correcting it. Then that’s when we can get into the third andfourth steps which are conscious function. So once you can correct it then youcan consciously– this is kind of where our strength and conditioning comes inwhere we have exercises where we are conscious of what we are doing. We canachieve what we need to do in activating our core correctly and we start totrain that through different drills to get this reflexive stabilization andthere’s a lot of different techniques for that and then you can start to feelwhen it’s right versus when it’s wrong. Then when you can feel that, you’vetrained it consciously, it starts to trickle over into your subconscious whereyou don’t have to think about it, it just happens. That’s when you know you’vearrived and that pattern has now stuck. Where you’ve changed the pattern, youknow you’re now firing in that 1, 2 sequencing, and there’s ways to screen forthat, but again it’s like that four step process of subconscious dysfunction,finding out there is a problem, acknowledging it, and now you’ve got consciousdysfunction. Training that out, you know how to do certain drills that you canactually turn that dysfunctional system off and engage your core functionally;that’s the conscious function. Then you train that enough to where it turns intosubconscious function. So it’s a long winded answer, but in essence again it’scomplicated, but there is definitely a sequence that you can train effectivelyto get out of it.

Andrew: Part of me beinga high injury prone athlete, is no matter what injury we seem to talk about onthe podcast, I’ve got a story where I’ve struggled with that part of my bodyand I’ve certainly shared some stories on the upper quarter episode and on thelower quarter episode and so here’s my story for the core episode and I shareit because it goes hand in hand with what you’re saying B.J. Years ago when Iwas a young 20-something, my brother and I in the Dallas area lived in nearbyapartment complexes and we both actually around the same time period injuredour backs. When I say injured our backs, my brother had an event. He was movingfrom one apartment to another. He picked up a heavy box, he turned with thatheavy box in his hands, and he felt a pop in his back and had searing pain thatlasted for days and days until he could get checked out. Around the same timeperiod, I was just a runner. I was trying to just stay in shape by running andI noticed in a lot of my runs my back, my lower back in particular, was justwearing out. If I would get to a steep enough hill or a big enough hill or if Iwas getting four miles, five miles into a run, my back was just giving out tothe point that I had to stop and walk when I was well capable of running that distanceand it was weird to me. So with both of those things happening at the sametime, my brother and I go to the same doctor together. We both got x-rayed. Weboth got screened. We both got prescribed to a physical therapist and thephysical therapist took a look at both of us and basically what he explained tome he was like, “Your brother has an injury. He slipped a disc, we’ve got toget that addressed with him in a certain way. You do not have an injury. Youjust need to address that part of your body and get that part of your bodystrong again.” Basically he was like, “With the running you’re doing, with thegym work you’re doing, you’re brushing your teeth right now, but I need toteach you how to floss.” Was the analogy he gave me. I need to teach you how towork out that part of your body, how to get that part of your body strong sothat when you’re running your running is supported by a proper core. So mybrother went to physical therapy for a couple months. I went to physicaltherapy for a couple weeks. He showed me a couple routines. He showed me somecore exercises and really B.J. in hindsight, he didn’t say this. He didn’t talkabout the system firing correctly in the 1, 2 versus the 2, 1, but looking backon it he was basically helping me get my system firing correctly and for mejust so long as I do some of those back exercises he taught me and keep thatsystem firing correctly I stay relatively healthy with my lower back and assoon as I stop doing those exercises, I feel my back starting to get tight. SoI say all that to say for somebody at home, they listen to this episode, theyfeel some back tightness, they feel some core discomfort somewhere in aworkout. How can we identify if the pain in our core or back is due to aninjury versus just needing to get our systems firing correctly again?

B.J.: Well the shortanswer is that it’s often hard to tell because many people that are having someof those, like you were saying, misfiring issues and having some discomfort notnecessarily due to a really acute event like your brother had. A lot of times peoplehave had microtrauma to their back or micro injury where they weren’t reallyeven aware of it, but they were having some subtle injuries over the course oftime. But the reality is it doesn’t necessarily matter because the solution toboth of those problems is roughly the same because whether you’ve had a realtraumatic event or whether you’ve had gradual kind of missed timing over thecourse of time because of a minor injury that you didn’t even realize washappening, your system still is off and it needs to be corrected and thesimilar solutions are for those potentially two different problems. Sohonestly, the solution might be the same. Like in your case with your brother,both of you need to be flossing so to speak, but the bottom line is if somebodyis struggling with the feeling of tightness in their lower back or hip flexors,most likely there is a motor control issue and improper timing issue of thecore and for some people that’s been– they’ve been patterned for a very, very,very long time and by the time they actually start to take notice of something,it may have been years that that was actually happening.

Andrew: Wow.

B.J.: But they justnever had pain to bring it to the surface and that’s what we see a lot of timesin the clinic is that people come in, they start feeling pain in their back andthey think “What did I even do?” And sometimes it’s nothing that they did at thatmoment, but it’s over the course of time just your body starts to find a wayand it works around an issue. So again, it starts to do that compensation whereit’s a subconscious dysfunction. You’re not aware that it’s happening until itbecomes a significant problem. This is my big disclaimer for why I think it’simportant that we all, from a muscle and movement standpoint, we all should begetting screened more periodically. Just like you go into the dentist and youhave your prophylactic checkups when nothing is wrong in your mind just to makesure that everything looks okay and you get your x-rays and your images. Ithink we need that in human movement. Screening of the muscles. Screening ofthe joints. Screening our patterns just to make sure that our bodies are okaybefore it does become a problem.

Elizabeth: I wouldabsolutely second that because I mean my issues with the hip flexors and theanterior pelvic tilt. I mean I’ve been compensating for years and years andyears and it hasn’t been until these past couple years that I have even noticedthat and then been able to address it, but now I’m fighting a long period oftime of bad habits and so had there been a screening or an opportunity toidentify that earlier, I’m sure it would be a lot easier to go through some ofthat reset process that it is now of breaking those habits and really having towork very hard to 1) even recognize what was going on and I can tell you I’mstill not at that subconscious function where we’ve still got to think about itto make sure things are firing correctly. So yeah. I’ll put in my secondopinion.

Andrew: Present dayElizabeth needed past Elizabeth to have learned all of this a long time agounfortunately.

Elizabeth: Yes. Yeah,but hey now, we’re going to save people from making that same problem.

Andrew: Yeah.

Elizabeth: So gladto be here and putting that knowledge out now. I guess kind of moving on fromthat, I think one of the questions that I have gotten so frequently as a coach.You know, we talk all the time about the importance of let’s make sure thatwe’re strengthening the core and they’re like, “Well, how do I do that?” B.J.,what would you say on the muscular level, what exercises do we need tostrengthen our core? How would you answer that question for a triathlete?

B.J.: Yeah, the firstpart is like exactly what we were talking about before is knowing yourdeficits, knowing if there is a timing issue and sometimes there are things youhave to go through to realize that outside of you’re just in pain all the time,right? So assuming you’re not in pain, like how do you know if you’ve got poorcore function or different things like that? I think the way we address that iswe do have to look at normal fundamental patterns of movement and then assumingthat those patterns are functional and normal, then when we’re talking aboutstrengthening our core– so we’re going to assume for the movement that you’removing well, you’re firing well. One of the best ways to strengthen that systemor strengthen your core firing is to think about exercises that focus onpatterns and not parts. So isolating strengths and parts is great for bodybuilders, but most athletes and triathletes included need to be able to moveand so if I had to go to one pattern that would strengthen our core and beprobably the best pattern we could make sure stays clean and we load and westrengthen, it’s going to be a fundamental pattern that I just consider, arehip hinge. For most people when they think of hip hinge they think of deadliftand it’s in that category of deadlift types of movements. But if you thinkabout it, one of the primary movement patterns we’ve had since we developedfrom an infant and getting the ability to walk, before you could walk andbefore you could even squat, you developed your hip hinge. I love as I wentthrough PT school and then took more courses and developed as a PT, I startedthen with my kids as they were growing up like testing these theories. Likethere’s these theories of development– of how we develop naturally. Like we don’thave to reinvent the wheel with machines and crazy apparatuses to strengthenus. Like, nature knows best how to develop us from when we were an infant towhen we started to walk. If you were to roll like a toddler, if you were toroll them a significant amount of weight, let’s say it was like a 10 pound oran 8 pound medicine ball or something. You rolled it to a toddler and had thempick it up. Almost always they would drop down like into a rock bottom squat,they would bring the weight close to themselves and then they’d throw theirbutt up in the air and they would hip hinge that weight to stand up with it.They wouldn’t squat that weight to stand up. You know at some point down theroad we all got in this box of lift with your legs, not your back. You can’thinge at the hips or bend your back. It will hurt your back, but naturallythat’s not how we move. We don’t move that way.

Andrew: Wow.

B.J.: We move with adeveloped hip hinge and that’s where our glutes, the king, are most at anadvantage to work for us is through a hip hinge. So getting back to thequestion of what are some of the best exercises to strengthen our core? We haveto tap into our hip hinge to start that process. So I’m a big proponent of hiphinge work, deadlift work where I like to make sure first that somebody has afundamental pattern of a hip hinge. So if you’re really tight and you can’teven get close to touching your toes or you can’t hinge at your hips to saveyour soul, there’s no way we’re going to start significantly load that. We haveto go after that pattern first. So again, you have to have a requisite range ofmotion, requisite mobility, and then we can start to load that pattern intothose dead lift type movements and specifically for the world of triathlon thesingle leg deadlift is one of my favorites because remember when you’ve got twolegs down, so you’re doing a bilateral deadlift, it’s very much still thatsagittal plane drive, right? But when you take one leg off the ground which isvery similar to running, you’ve got one leg down and one leg up, now you’ve gottriplanar stability that’s required. So when you’re doing a single leg deadliftand then if you start to load it, the weight is trying to pull your pelvis outof position. You have to own that pattern and own it with all your corestabilizing muscles to make sure you don’t fall out of it. So if I had to pickone drill and it doesn’t sound like a core exercise, but it really is, it wouldbe the deadlift and then from there working to single leg deadlift and thenfrom there working into more explosive patterns to train the core system andwe’re talking like plyometric types of things, kettlebell swings, box jumps,all kinds of stuff along those lines. Now there’s fundamental levels we can getinto where we’re doing things on all fours like quadruped, diagonals, birddogs, half kneeling chops and lifts, but I think at the root of it we have tomake sure that our hips and core are correct and we’re focusing in on that hiphinge and It’s a big misnomer and this is one of my pet peeves that–

Andrew: Talk about it.

B.J.: I feel like inthe endurance world, I feel like endurance athletes are afraid to lift heavy. Ithink we think or maybe other people have placed this in our minds like we’regoing to break because we are these sagittal plane beasts, we train a lot. Youknow in the endurance world you look at an endurance athlete and they’re maybemore of a slight build. They don’t look like your 100 meter sprinter athletethat’s muscle bound, but at the same time we’re not weak athletes. I think weneed to train endurance athletes with load, but we have to have earned theright. As endurance athletes, you have to earn the right to load. So it’s notlike you just, okay, they just said on this podcast I need to load heavier.It’s not like you just jump in the weight room and you start moving a bunch ofweight. “Oh, he said I need to deadlift so I’m going to just go for it.” Youhave to earn that right by clearing your patterns and knowing that you’re goinginto that load with a good platform to load. Then again, don’t be afraid toload because the nice thing when you add heavier weight is that the drillsoften become more self limiting. So in order to do and move that way correctly,you have to do it right otherwise you fail. So there’s some of these drillswhere I think you can create a scenario or a situation where you have to loador you have to engage things the right way otherwise there’s no way you canperform that movement and that’s the thing I like to get into with athletes isgetting them in a safe way to that place where they can load heavy and they’renot afraid to load a little bit heavier.

Andrew: Just followingseveral professional endurance athletes on Instagram, on Facebook, I meanElizabeth James included. I follow Gwen Jorgensen. I think of Sebastian Kienle.I think of Ben Kanute. I’ve seen several of them post from the gym and fromtheir time doing work in the gym and they are strong, they’ve got those 16-packabs. They are lifting, to your point B.J., under supervision with very properform. They are lifting some heavy weight in different ways and yeah, they’reendurance athletes who are as good as they are because they are also putting insome serious strength training and not afraid to be a frail little enduranceathlete. So great point there B.J. I want to ask you this too B.J., because wetalked about that box that is our core and you referenced how it starts at thetop up at our diaphragm and it goes all the way down. There’s a lot included inthere and so our core does quite a bit more than just help our arms and legsspin around correctly. A strong core helps us control things like ourdiaphragm. It helps us control our bladder, having a good core. So B.J. talk tous about some of the other benefits of maintaining a healthy core.

B.J.: Well, I meanthese two topics could be entire podcasts in and of themselves. I think it’ssuper important and unfortunately we don’t have all the time right now to talkabout these two that they need the due diligence, need the due time, but Ithink especially with the diaphragm, many treatment paradigms have been builtcentering around the diaphragm and resetting this critical core muscle. It’swhy I feel like yoga has so much power. Getting back to the reset of breathing,breathing correctly can be a huge part of that timing of our core system. Oneof the most sore times in my life after a workout has been after doing a yogasession with my sister-in-law. She’s a yoga instructor and I woke up, I feltgreat that day. I woke up the next day and my core muscles, my abs felt so sorein ways I’ve never felt before.

Andrew: Oh yeah.

B.J.: At the time I’mlike it was just this focused breathing and you know I was putting myself inpositions I hadn’t been in forever, but there’s so much power in that. There’sa ton of power and I didn’t touch a single weight at that point and so that’spart of that reset like we’re talking about before you would even considerloading through weight going and making sure you’ve checked those boxes onproper diaphragm function, proper breathing function. So there’s a lot there.Then going to the second part when we talk about the bottom of the box, thepelvic floor, again a very overlooked area that a lot of people don’t like totalk about because oftentimes it leads to incontinence issues and it’s kind ofan embarrassing subject for some people to talk about, but I can tell you inthe clinic it’s so very common. So many people struggle with that, but a lot ofpeople don’t talk about it and there’s specific ways to train your pelvic floorto build that system and honestly, these two areas of the diaphragm and thepelvic floor, is sometimes where people need to start. They need to start therebefore they do any of those other things we’ve just discussed. They need tostart with proper breathing, proper pelvic floor function and you know I see itall the time. I’ve experienced it with athletes all the time where they getdone with a race and they’ve just completely turned themselves inside out. Theygo to hug their knees after a race and there’s a continence issue and they lettheir bladder go a little bit and those are signs. Those can start to becomesigns that there are some things going on there that should be looked into andthere’s professionals within the PT world. I know there’s professionals in thePT world that they specialize, they build their practice completely around thatspecialization to train that. So there’s definitely professionals that can helpthere, but I would highly recommend that people pursue those two avenues of thebreathing and pelvic floor and again, we’ll probably talk about this more inthe future because they’re hot topics to discuss, but definitely an importantpoint.

Andrew: So training for aswim, bike, and run it’s already a time commitment so as we’ve talked about leginjuries, shoulder injuries and now core injuries and we hear that we need todo strength work to keep those areas healthy plus we need to take some time tostretch, foam roll, we can do yoga, etcetera. It all eats up time that a lot oftriathletes just don’t always have. So B.J., help us set a proper expectationfor how much of this we need to be doing on top of the swim, bike, and run. Howmuch time should we spend strengthening and maintaining our body?

B.J.: Yeah, thisquestion is obviously individual. It depends on what your body needs. For somepeople I know that they would receive way more performance gains by focusing onlike three 30 minute sessions per week instead of that extra three by 30 minuteperiod being focused on swim, bike, and run training. I know they would get waymore out of their already existing swim, bike, and run training if they parredback part of their training to account for time to spend on strength training,but practically speaking, if we’re in fairly good places many of us can benefitfrom just maybe 10 to 15 minutes of corrective exercise work sprinkled into ourweek. Maybe just a couple times a week. But it all comes back to making surewhat you’re doing counts and matters. I would rather have somebody spend tenminutes doing two or three drills that are exactly what their body needs versus30 to 45 minutes of ten drills that most of it was just fluff or even most ofit potentially is making them worse.

Andrew: Yeah.

B.J: Some people aregoing about it where they know they should do it, they’re not quite sure whatto do, so they just do a bunch of generic things that they haven’t even knownif their body needs it or not. It’s like throwing paint on a wall trying tomake a picture. Like, they might luck out and one of those drills hits themwhere they need it, but oftentimes they might be just training theirdysfunction. They’re strengthening their dysfunction where it’s actuallysetting them up for issues further down the road. So I think the timecommitment is huge. You can get a lot of benefit in a very short amount oftime, but the key with that is like we’ve talked before, it’s be a sniper withyour training. Know where your training needs to be, dial it in, aim for thatspecific drill and even if it’s that one drill a couple times a week, that cango a long ways if it’s the right drill for you.

Cool down theme: Great set everyone! Let’scool down.

Andrew: Just a few episodes back on episodes 130 and131 to be exact we talked about training and racing short course triathlon. Ifyou have a sprint or Olympic coming up and have not heard those episodes, Ihighly encourage you to go check them out. Coaches Jeff Raines and JohnMayfield download their knowledge for setting yourself up for short coursesuccess. For those episodes I reached out to our TriDot ambassadors to see ifanyone had some recent stories from their own short course racing. We had loadsof good submissions and for today’s cooldown I wanted to share one that camefrom athlete Tocher Kellom from Sacramento, California. Here is his story ofusing another competitor for motivation to dig deep at the Folsom Lake OlympicTri.

Tocher Kellom: Hey Tocher Kellom here out in Sacramento,California. Wanted to give a quick story about an Olympic distance triathlon Idid in 2021. Toed the line out here at Folsom Lake in Folsom, California justeast of Sacramento. So the swim went off. Everything went well. I sighted well.Lots of folks were zig zagging and backstroking around, but made it throughlots of scrums and finished maybe seventh or eighth out of the water total. Wecranked– got in our saddles and clipped in and then no kidding three or fourpedal strokes later I heard a “ping” sound and I looked down and thought mychain had slipped off the ring and just needed to be put on like it happensshifting from big to small chain ring. But I couldn’t even see the chain so Iwondered where did this go? I looked back and 20 feet behind me was the chainsitting on the ground broken. Completely snapped. So I went over, walked overin disbelief and just like, “Great. My race is over. I’m going to have toborrow a mountain bike or what am I going to do?” Just completely distraughtafter all the training and to have it be stopped there. So luckily there was abike mechanic tent right there at transition and so luckily the mechanic wasfeeling hopeful. He finally got it going five minutes later so I thought “Okay.We’re good to go. Let’s get back on and just make up from that time. Pretendlike the swim was five minutes slow and let’s just go out and bike like hell.”Got back on the bike and just started flying past folks. I ended up getting ata really good pace, but then even though I was cranking at some guy in his limegreen Zoot tri suit passed me and just kept going further and further away. Iwas like, “How is this guy going so fast when I’m pushing it as fast as I cango?” So I tried the whole bike leg to try to catch him and I just couldn’t evensee him after a while. So I was thinking, “Okay, where is this green suit guy?Where is this green suit guy?” So I get to the run transition, fly off thebike, jump into my shoes and just start cranking away and then low and beholdon the U-turn to come back to the finish line half way on the run, I see thegreen suit guy. So on the U-turn I cut on the inside of the path and actuallypassed him. He was on my tail the whole entire return back for the next twomiles and so on an uphill I had to power walk because my legs were fried frompushing so hard. He passed me on the uphill then I stayed on his tail for thenext couple miles. So we were probably ¾ of a mile to the finish line. Therewas a fork in the road and I decided now was the time to go. I was on his heelthe whole entire time. So I pushed it, passed him on that little fork, thepaths joined again and then he was on my heel to then get to the last quarterof a mile and see the finish line, looking over my shoulder and seeing thatbright lime green right five feet behind me was terrifying and exhilarating. Sohustle, sprint at the end. The finish line folks were cheering and I justcompletely threw it all out there and had the legs to kick at the end andfinish really four seconds ahead of him to finish on the podium too by the wayfor the last spot on the podium. So getting third in the age group over theZoot suit guy was a tremendous accomplishment. Just an incredible, incredibleexperience and still by far my favorite race and really if anything is going tobreak it will and you’ve got to figure out how to set your mind straight,recover from that, and then really put that behind you and use that formotivation to just forge ahead and really throw the hammer down and have a goodrace. So again, thanks for letting me share. It just leaves room for what wecan improve on, or what I can improve on and then put all those lessons learnedand growth to the next races. So alright, signing off.

Andrew: Well that’s it for today folks. I want to thankDr. B.J. Leeper and pro triathlete Elizabeth James for talking about our core.Shoutout to Precision Fuel and Hydration for partnering with us on today’sepisode. Remember that you can go to precisionfuelandhydration.com and you canuse their free sweat test, the free quick carb calculator, and you can book afree one-on-one video consultation with a member of their team and then usecode TRIDOT10 at the checkout when you make your purchase. Enjoying thepodcast? Have any triathlon questions or topics you want to hear us talk about?Head to tridot.com/podcast and let us know what you’re thinking. We’ll do itall again soon. Until then, Happy Training!

Outro: Thanks for joining us. Make sure to subscribeand share the TriDot podcast with your triathlon crew. For more great tricontent and community, connect with us on Facebook, YouTube, and Instagram.Ready to optimize your training? Head to tridot.com and start your free trialtoday! TriDot – the obvious and automatic choice for triathlon training.

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