Tuesday, September 3, 2013

Costochondritis 1, Wongstar 0.

Summer is over and so is my sub-5 comeback, or rather, it is postponed for another year. I hit a glitch a few weeks ago which I learned was a case of costochondritis. Sounds like a disease you get where you can't go to Costco without spending less than $100, doesn't it? Well here is what Mayo Clinic has to say:

"Costochondritis (kos-toe-KHON-dri-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum) — a junction known as the costosternal joint. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions."

and Wikipedia...because you know I Google'd the heck out of it:

"...a benign and often temporary inflammation of the costal cartilage, which connects each rib to the sternum at the costosternal joint, and is a common cause of chest pain. Though costochondritis is often self-limited, it can be a recurring condition that can appear to have little or no signs of onset."

Yeah, I'd never heard of it either! I was getting chest pains whenever I ran more than an hour and started to worry it was a heart issue. (It was around the 3rd/4th ribs just left of the breastbone...right by the heart area.) You know, having heard of multiple pro triathletes that had to retire due to heart issues--enlarged hearts, arrhythmias and heart valve issues...

Heart problems plaguing top athletes
Normann Stadler, Heart Surgery, and You
Elite Triathletes and Heart Problems

Kind of scary, but two different docs pegged me for costochondritis. I had an EKG to rule out heart issues. Like wikipedia said, costochondritis is sometimes caused by a traumatic event, sometimes the onset is spontaneous. The first doctor mentioned that it probably happened because I was in excellent fitness for so long (never had any issues when racing pro), but have been fairly inconsistent in my training, then tried going a little harder and my body wasn't quite ready yet. A lesson learned in sitting on my butt for many months and then trying to go 0 to 60 too quickly.

Now that I think about it, the first time it happened was 4 weekends ago. I was attempting my first set (in a really long time) of 21x800s on the track (with 200 easy recovery)...which was always a pretty standard teamTBB track set, total distance 21km or 13.1 miles AKA a half marathon. Never mind that it was the middle of a hot and humid August day, and that I hadn't done any track workouts in at least a year. It wasn't like I hadn't done ANY speedwork...I had just done them indoors on the treadmill, where it was cooler and air-conditioned, and I even used the treadmill that has its own built-in fans. I had done a half marathon set like this a couple weeks prior, only it was 15x800's with an easy 400 recovery.

Okay, maybe I'm an idiot, but I have this problem where I keep forgetting that I lost my athletic superpowers a couple years ago. Or just that I've lost the brain cells saying that it wasn't a good idea to attempt that track set at 1pm on a rather hot and humid day. I made it through 9 of them (and was pretty excited to be holding under 7:00/mile pace) before I got the chest pains. I figured it was the humidity, jogged super easy for 30 more minutes, then called it a day.

I forgot all about this episode until the following weekend, when I got the same issue 60mins into a 90min long easy run. Of course I ran an out-and-back loop, so there was no cutting it short, and my chest remained tender to the touch and somewhat painful even doing mini 30-minute easy runs after that second episode. So it was two weeks ago I got the official diagnosis and made the executive decision to call it a season, chill out and step it down.

My training hadn't been going too consistent the last several weeks prior to this issue, and I was already thinking of stepping down to the "Oly Rev" distance at the Half Full in October. (Plus I had done some bike course recon and felt REALLY weak...or heavy...ok, just SLOW on the hills...) But with the whole inflamed rib cartilage thing, I decided to back off the training for a few weeks, and cut myself a break. Obviously I am not good at figuring out how to make smaller goals to shoot towards after racing ironmans professionally. You could say I have a distorted perception on what a reasonable racing goal should be. (Duh.)

So the plan going forward is to step down even further to Olympic distance for next year. Should be fun! Maybe I'll try to build up for a fast half Ironman at the end of next year... instead of in the next month. Just give myself more time to get in some solid, consistent training. I still had the Navy-Air Force half marathon on the calendar coming up in 11 days, but decided last week that I didn't want to run it slow. I don't sign up for races to go slow. I can still run...only I am limited by the intensity. I can basically run under the pain threshold. I've still got my entry for the Army Ten-Miler in 7 weeks (Oct 20), which I'm going to see if I will be able to do. It's a really big local race and I'm hoping to be mostly recovered by then.

All that said, I got roped into being on a relay team this Sunday for the Nation's tri. One of our double amputee patients is doing the swim and hand-cycling the bike, and needs a runner. So...I get to bust out a 10km run. Hard for me to say no, when I just have inflamed ribs and these guys are missing multiple limbs! It should be fun, will keep you posted!


  1. That happened to me for awhile one year. Then it went away. So.

  2. Hi. I've been training for 8 years already at the gym. I've been doing weight lifting at least 4 times a week. Swimming every weekend (about 2 - 3 kilometers a day) and I've been cycling almost everyday. To and from the gym, to and from the pool, to the shops near my place, to the pubs to meet my friends around my area. So basically, I've been doing physical activity for 8 years, for almost every day. In December 2013 I sort of let go everything - I had one of those periods in life when I was trying to concentrate on other things so I couldn't train so intensely at the gym. I mean I still went to the gym but I didn't care about how many sets I was doing.. I was kinda doing whatever would come up on my mind and not following my usual routine.

    I stopped swimming because it was cold. There were one or two weeks when I trained only once a week. And this went on until end of January 2014. And then I decided to get back into the shape and I pushed too much on the "first" day of decision. So I got the same exact thing as you described. My sternum started to hurt, especially when waking up in the morning. And especially when sitting in front of the computer without any movements. So basically, it felt as if resting made it worse.

    I didn't pay too much attention because I thought it was just a muscle pain that I sometimes get when doing dips for example or dumbell flys. So I trained again and whilst training, it completely went away. So I thought - Ok, it was just a muscle pain. And then the next day I felt it again and it was even more painful.

    So I just stopped training for exactly 2 weeks. I stopped cycling, swimming, weight lifting. I tried to do as least physical activity as possible. Then I went to see the doctor, who said that it was a joint inflammation of sorts in my sternum. And he recommended Voltarol (cream) and Ibuprofen (tablets). I started with Voltarol and after about 3 days of use, I went back to the gym. I still had the pain but it was not as painful now and it would only appear in very certain poses.

    I didn't do ANY kind of chest exercise for another 10 days. I only did legs, abs, biceps and tiny little bit of shoulders. Everything very light weight.. Something like 5kg, 10kg.. Maximum 15kg (on biceps). And I usually do around 35 - 40kg on bicep curls. So I started very very slow.

    It's been about 2 weeks now since I started training again and yesterday I did my 35kg bicep curl (it is march 11, 2014 today).

    It was the second weekend I'm back to swimming already. I'm cycling again. And I'm lifting about 15kg less on chest than I used to (still increasing the weight slowly on chest).

    As for the pain, it is still there but it is so mild that I hardly notice it 90% during the day. That 10% is again some extreme pose like reaching for something in a strange way.. So basically, the pain is still fading away slowly and I think it needs about 2 more weeks to disappear completely.

    I really hope this will be of some use for all the others experiencing the same issues.