Pinvin Aftermath

! week after my crash and I am still on pain relief at night time.
My shoulder looks worse than it is but it is still a level 2/3 AC tear

This summarizes the injury and the choices for treatment:

Mechanism of injury
The most common cause for a separation of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint.
If the force is severe enough, the ligaments attaching to the underside of the clavicle are torn. This causes the "separation" of the collarbone and wingbone. The wingbone actually moves downward from the weight of the arm. This creates a "bump" or bulge above the shoulder.

This figure shows the intact ligaments around the acromioclavicular joint. The red arrow points to the ligaments that are around the joint itself. The gray arrow points out the important stabilizing ligaments underneath the collarbone.

The injury can range from a little change in configuration with mild pain, to quite deforming and very painful. Good pain-free function often returns even with a lot of deformity. The greater the deformity, the longer it takes for pain-free function to return.

• A mild shoulder separation involves a sprain of the AC ligament that does not move the collarbone and looks normal on X-rays.
• A more serious injury tears the AC ligament and sprains or slightly tears the coracoclavicular (CC) ligament, putting the collarbone out of alignment to some extent.
• The most severe shoulder separation completely tears both the AC and CC ligaments and puts the AC joint noticeably out of position.

Diagnosis

The injury is easy to identify when it causes deformity. When there is less deformity, the location of pain and X-rays help the doctor make the diagnosis. Sometimes having the patient hold a weight in the hand can increase the deformity, which makes the injury more obvious on X-rays.

Treatment

Nonsurgical Treatment

Nonsurgical treatments, such as a sling, cold packs, and medications can often help manage the pain. Sometimes, a doctor may use more complicated supports to help lessen AC joint motion and lessen pain.

Most people return to near full function with this injury, even if there is a persistent, significant deformity. Some people have continued pain in the area of the AC joint, even with only a mild deformity. This may be due to:

• Abnormal contact between the bone ends when the joint is in motion
• Development of arthritis
• Injury to a disk-like piece of cushioning cartilage that is often found between the bone ends of this joint

It is often worthwhile to wait and see if reasonable function returns without surgical treatment.

Surgical Treatment

Surgery can be considered if pain persists or the deformity is severe. A surgeon might recommend trimming back the end of the collarbone so that it does not rub against the acromion.

Where there is significant deformity, reconstructing the ligaments that attach to the underside of the collarbone is helpful. This type of surgery works well even if it is done long after the problem started.
Whether treated conservatively or with surgery, the shoulder will require rehabilitation to restore and rebuild motion, strength, and flexibility. 

At the moment I have chosen to wait and see method as the injury is causing not so much pain as mild discomfort and awkwardness in moving the left shoulder girdle.

Pinvin Lvrc

Pinvin - short and sweet.... 15 miles or so in and settled into a chasing group, hit a greasy spot on a fast ish LH bend and down we goes.
Scrapes to body and bike. My bony shoulder survived but has a massive contusion that is restricting movement a bit - but it is not broken.
Road rash on hip needs a huge wound pad to cover it!
2 weeks to next race - we shall how the pain subsides.
The fun part is that I have 5 spin classes to lead, starting to morrow night!
Yippee..  show me the money!

Have had to mull over why my accident happened when the front wheel washed out.
I had gone from the start and built up a gap and was bridged to by a team buddy. That gap lasted 7 or 8 miles but eventually chased down by someone who was racing out of category. In my opnion if you race out of category - especially if you are younger! you do not initiate chase downs or drive the bunch back.
When the bunch passed a group of 6 went through.
When I came down I was doing my damndest to get back to this group again. Probably fully anaerobic, my judgement for a dodgy corner was lax and my speed was excessive.
I admit my fault at the end of the day - but - still not happy!

Trend

The trend line for 5 and 20 minute power after the winter training season is very similar to the end of 2013 season.
This is a positive result for all the hard work over winter. Hard work in the sense of motivation to stick to the training regime.

 

Racing Season 2014

Saturday 8th - Darley Moor

Dealing with injury

Accidents whilst training or racing are not inevitable but are nevertheless an ever present risk.
How do the professionals cope? With mixed results could be the answer.
Johnny Hoogerland - ribs and spine 2013
Cancellara - collarbone 2012
Schleck, Andy - pelvis 2012

Those are the headlines but away from the newspapers there is a lot of bruising and a lot of damage that nobody talks about which is obvious when you really think about how an unprotected body hitting a hard and unforgiving surface at speed.
Never understimate an injury. Depending on the severity of the accident you may have to wait weeks before you can get back on a bike.
Hoogerland had to wait a month, Cancellara a week and Schleck's post accident tribulations are well documented.

Getting on the bike with pain is a recipe for overcompensating and developing muscle imbalances or tendonitis. The drive to get back on the bike is hard wired in a cyclist. The thought of a full winter's training all for nothing can be a blight.
So if fitness evaporates, all is not lost. 
As a general rule of thumb, one week off the bike requires 3 weeks consistent training to regain. Top end peak power is the victim. Those short punchy climbs turning legs into blocks of concrete. Holding on in the bunch for 100km is not the issue, it is those 2 minutes of surges that can happen in a blink of an eye that opens up the holes in fitness.
However, too much too soon equals overreaching and that can lead to chronic fatigue.
Hoogerland and Cancellara have got through their accident trauma to notch up subsequent wins. For Schleck, his rehab has been fraught but still with a place on a Pro Tour team he can still be confident that an athlete's ability to regain pre accident form is more the norm than not.
 

 

Winter Training Block

This is the first serious winter training block. Sufferfest training videos are hard at any time but a concerted effort to do 11 workouts on a daily basis is not an easy option.
It will boost CTL but will leave a large negative TSB - so end result , you will be fitter but knackered.

Easier week

The training target for the month of January is a 10 point increase in TSS.
At the moment just having an easier few days before the Tour of Sufferlandria.

 Above is the predicted CTL (blue line) for January.

Tunstall Wheelers Training Ride

Post by Tunstall Wheelers - Racing Section.

Reason to be careful

The simple fact is winter riding is risky.
Sometimes too much so when it can impact a training plan.

 The best advice I can give is just be so much more viigilant. 
Black ice was the culprit. I thought it was a flat back tyre until I hit the tarmac hard. Nearly a week later and it is only just starting to heal and I consider my self with getting away with it as I could have chipped the bone very easily.
An injury like that would really have put all that training into the skip.
Luckily I have been able to maintain a training load.

Tunstall Wheelers Post

Post by Tunstall Wheelers - Racing Section.

How I Turbo

Picking the correct profile to turbo train to is actually quite hard.
No one wants to spend precious training time with wasted efforts.
This profile ticks all the boxes as far as I am concerned and I will talk you through the session as best as I can.

 The session is split into 5 blocks of 'work' divided by 'rest' or 'recovery' periods.

The first interval is the warm up phase. This is critical to get right as it will decide if you will carry on successfully to the end. 
Ensure the bike is in the small ring and a very easy gear to start with. Concentrate on easy pedalling but with a cadence over 90.
There are 5 steps with the final one at threshold level. Try to do this with the small ring. I use a standard 39. You may struggle if you have a compact 34 ot end up with the chain very crossed although that is not really going to harm the bike. After turbo training season is over you will be replacing the chain anyways as it willl have stretched with all the use you have given it making it unsuitable for road riding! Hopefully you have loosened up the legs muscles and prepared them
Phase 2 and you should be thinking of still keeping to the inner ring.
The opportunity here is to think about using a higher cadence 0f 100, 110+ if possible. Gear selection will dictate this range. A steady start but the extra efforts will be reflected in heart rate response.

Use those recoveries wisely i.e. shift up the block to your easist gear and just unload the legs whilst keeping the cadence up.
Phase 3 will take above threshold. Not for long but by the finish your heart rate response will be very noticeable. If not then you may have that threshold line in the wrong place.
As soon as it is finished ... unload , unload. I can't emphasise that enough. Racing is about recovering as much as actual balls out work.

Phase 4 is a 10 minute stint with 5 minutes of classic underovers to finish with. These will also find chinks in your armoury.
Phase 5 is also a classic of pyramid. The final thrash is as hard you want it.
Your heart rate should be going to its limit as close to max out as it will ever do in indoor training without the added surge of andrenaline.
Close down with some minutes of spinning out to recover.

January Target

To repeat 2013 CTL build of 15 in a month.

From 68 to 73