Friday, June 21, 2013

Part 2 - Physical Prep & Post-Mortem: Pengarang to Desaru, and Back Again: Cycling Adventure 29 - 30 Mar 2013

Super long rambly post. You should skip if you're not interested in cycling related information. This is a self-learning/ reflection post. Might be useful for other cyclists planning similar rides. Or experiencing similar pains.

  • Part 1 - Tripping on Two Wheels
  • Part 2 - Physical Prep & Post-Mortem [this post]
  • Part 3 - Post-ride Bike Upgrades

The sweetest part of the trip was, perhaps unsurprisingly, the most painful part.

Sweet, because I made it back from Desaru to Tanjung Pengelih in spite of inflamed tendons on both knees. It wasn't a debilitating injury, because I recovered in a few hours time when I made it home. But the inflammation threatened to stop my ride. I had no idea how serious it might develop and it became more painful as the ride wore on.

The inflamed tendons was least expected. Whether it was 100% preventable, I'm not sure. Apart from that, I was quite pleased my preparation worked out.

Staying adequately hydrated was top of my list.

I brought my 3-litre hydration pack, with 2 spare bottles of water on the bike. From past longer distance rides, I knew that it was far better for me to take small sips continually than to rehydrate a lot at intervals. Hydration salts also helped to get the body rehydrated (though taking too much at one go may cause loose bowels!)

On Day-1, I finished all 4 litres just before we reached the resort. On Day-2, surprisingly I ended up with about 1 litre water to spare, even though the weather was hotter. When we stopped for lunch on both days, I ordered Coconut if it was available (best energy drink, imo) and isotonic drinks.

The sun will burn skin and sap energy. I brought my arm sleeves (UV rated), had a scarf that covered my head under my helmet, and I applied sunblock on my neck and face. I still felt heat radiating from my skin at the end of the ride, but I wasn't burnt.

Keeping the packed weight to the minimum was part of the strategy. My 3 Litre pack could fit in the spare clothes, first spare inner tube, torchlight and batteries, bike pump (remember the pump, folks; no point having a spare inner tube when you can't pump up your tire), toothbrush and toothpaste, and that was about it. The resort would have other amenities. 

The other stuff, I carried on my bike. Like the spare bottles, hydration salts, some pre-packed almond powder mix (for "instant" sugar fix if I needed it) and deep-heat rub (kept on a small bag for easy access from the bike), another set of spare inner tube and bike tools.

I realised the 3 Litre hydration pack added about 3 kilogrammes to my own body weight. It was like instant weight gain. Unless the laws of physics change, I'll have to deal with that (or lose 3 kg before I start?)

Breakfast was essential. I would be asking for trouble if I were to skip this on the day of the ride (I learned the hard way once). During our bike trip, I made sure I ate rather than try to "lose weight". Not stuffed till I couldn't walk, but to make sure I listened to my stomach.

After Day-1, for dinner I opted for the buffet spread at the resort. My body seemed to crave for carbohydrates. I took two servings of pasta, made sure I included proteins and vegetables. I tried to avoid sugar when I can, but gave in to temptation that night by eating up a spare bowl of coconut milk dessert with Gula Melaka (in the land where Gula Melaka was made, if not invented, I could not pass that up).

The day before the trip, I consciously avoided caffeine in case I could not sleep. I made sure I had at least 6 hours of sleep. I was quite excited about the trip and knew I would have trouble sleeping. So the past 2 days, I woke earlier than my usual and that ensured that I was sufficiently tired to fall asleep fast. 

It all worked out. My hydration strategy must have worked, since I did not suffer cramps or headaches by day's end. I didn't feel exhausted so the food intake and sleep was enough.

Did I overeat? Hmm, I found that my metabolic rate kept up and 2 or 3 days after the ride, my pants didn't feel so tight around the waist.

The unforeseen thing was the inflamed tendons at the knees. I've ridden 80km plus and suffered leg cramps at worse. The sore tendons was very slight and not the sharp pain that I experienced on Day-2.

A fellow rider suggested it was Iliotibial band syndrome (ITBS). I looked it up after the ride and cross-checked against a few sites. It was ITBS.

On Day-1, it was only after we finished our ride and checked into the resort that I discovered the injury. My room (shared with 3 others) had a staircase. As I climbed, my right knee (the tendon on the outer side) felt sore to the extent that I limped up the stairs. Walking on flat ground was OK.

I didn't pay much attention to it other than doing some leg stretches. Then I went for dinner, came back, washed up and forgot all about it.

Next morning, while still in bed, I found my entire right knee was stiff. Simply trying to move my right leg under my own power was painful. Acually, any sort of movement of the right leg was just painful.

I remember wondering, groggy from sleep, how much it would cost to hire an ambulance. Or take a cab all the way to the jetty. And then as soon as I thought that, I quickly resolved that I had to make it back on my two wheels, no matter what. And that I could make it.

It took me 10 minutes of stretching -- on the bed -- using some yoga poses I'd learned, to be able to move the knee.

Somehow, that assured me that things would be fine.

I went for breakfast, came back to gear up, applied deep heat, still felt slightly sore while navigating the stairs up and down. But I felt confident this was only a small problem.

Cycling the first 10 km was fine. There weren't steep hills to tackle and only slight rises. Yesterday's uphill was today's easy downhill. Some cyclists in my group asked how I was doing (I told them about my tendon over dinner). I said it was holding up.

As much as I could, I transferred weight to my left and pedalled more with it.

After 30km, our group rested for lunch.

I got worried when both my left and right tendons (at the outer side of the knee) became painful by then. Standing was OK but I experienced pain when I tried to do 60 degrees knee bends. Trying a 90 degree bend would trigger a sharp pain at the sore tendons, painful enough that my legs felt like giving way. I needed to support my body weight with my arms if I needed to sit down or stand back up from sitting position.

Uh oh. I had a problem. The point in the ride where I'm experiencing real pain. 

For the remainder of the 20km, I couldn't enjoy the ride the same way a tourist would leisure take in the scenery. Frankly, the last two to three kilometres was a torture. I just focused on getting myself back.

I managed to complete the ride and made it to the boat. Ok, I thought. I can still stand. Not too bad.

It wasn't till I sat down in the bumboat for about 15 minutes that I discovered I could not get up without propping myself up. Both tendons near the knee were triggering a sharp pain. I didn't know it was ITBS then. Knowing what I know now, I would have done the related stretches every few minutes (see this and this).

The pain came when I tried to stand, or put weight (like climbing stairs). Otherwise I felt OK. Or so it seemed.

Back home, the longer I rested the knee/ tendon, the stiffer they were. Morning came and I couldn't move the knees without triggering a sharp pain. I took about 3 mins just to stretch out my legs before I can stand up. Had to prop myself up to stand. Then had trouble sitting cos knees couldn't be bent without experiencing sharp pain (and my pain tolerance was quite high).

Gradually my knees recovered. I didn't try to exercise my legs but I didn't remain stationary too long. By evening (almost 20 hours since the stiff pain) the slight swelling of the tendons are gone. I didn't apply any ice or compression. I seem to have recovered 90% after 24 hours thereabouts.

As I blog about this months after the ride, I have since learned how to effectively manage the ITBS. It's a matter of doing the right stretches before and after the ride. Should the pain come about in the midst of cycling, the same stretches could be done. Also, saddle and seat height adjustments helped (YouTube was instructive on how to adjust the bicycle).

I read one online article where the author suggested that ITBS shouldn't be treated with stretching. Well, stretching worked for me. Though, not all the various stretches. I employ two types of leg stretch postures that work well for me, so I think it depends on one's physiology.

I was mindful of risks in self-treatment. In this case, I had advice from a friend who's a physical therapist by profession. Another friend, who had experienced ITBS and recovered by applying stretches, advised me how to do it.

So far, since Pengarang, I have completed two 80km overnight rides and no serious ITBS.

Part of why I'm blogging this is not to take for granted that we did this in a group. Friends helping friends out.
[Image credit: sivasothi, CC-BY-NC-SA]

Friends who take their duties seriously: making arrangements for the bumboat ride and feeling apologetic that the boat wasn't booked in advanced; helping a fellow rider with a flat; being the last Outrider and always stopping to make sure no rider was left behind; packing a medkit and taking notes on what to include for the next ride.

For me, the real reward wasn't the sunrise view like this:
Sunrise at Desaru

I surprised myself that I was quite 'zen' about the ITB pain. I've a tendency to over-think about stuff. Over-thinking sometimes leads to creating more worries and being stressed out before the actual fact.

Yet when I realised my right knee was super stiff, it wasn't a sense of doom that came to mind. Instead, it was a quiet resolve that I will get over this and I'll find a way to cycling back.

It wasn't climbing Everest. Still, I'm happy with myself and I want to remember that.

OK, I compared my list to Siva's Bicycle Prep List. Hmm, I had everything. Except for powdering my spare inner tubes.

My packing list for the trip: Pengarang Ride Mar 2013:

Photocopy of passport (hardcopy)
Emergency numbers (hardcopy)
Credit card
Phone + battery extension

2 x spare tube + kit
Check batteries + cable + plug

IN PACK (hydration pack)
Hydration kit (check parts)
Arm sleeves
Front light
Back lights
Chain lube + cloth
Spare specs
water bottle x2 (carrier bag)
Hydration salts
Energy bars
Optional: Spares (Arm sleeves, Gloves, Headscarf)

toothbrush + paste
Moist tissues
spare clothes (t-shirt, shorts)

[Next: Part 3 - Post-ride Bike Upgrades]