[PREVIEW] I Need a Pro

I don't want to leave any stone unturned for my turn at the World Championships. I need a professional that can help me spot weaknesses before they cause a problem. So, who does that type of work? Finding them has proven a bit of a challenge.

TRANSCRIPT

THE LONELY TRIATHLETE

Episode: Finding the Right Athletic Therapist

There's a funny thing I've discovered about being a triathlete as I get older.

I'm becoming increasingly interested in things that have absolutely nothing to do with going faster.

Well... that's not entirely true.

I'm becoming increasingly interested in things that will allow me to go faster without breaking myself in the process.

And that has led me down a bit of a rabbit hole lately.

I've been trying to find an athletic therapist—or physiotherapist, or whatever the appropriate professional is—who can look at me and say:

"Okay, Todd. You're 58. You're doing all this swimming, cycling and running. Here's what you're doing well, here's what you're doing badly, here's what's missing, and here's what I'd change."

Not because I have an injury.

I don't.

And that's actually the point.

I'm looking for somebody who can help me be proactive about my strength and conditioning and injury prevention.

And I've discovered that finding that person is apparently harder than I thought.

So let me tell you about my first attempt.

I went looking for a physiotherapist because I figured physiotherapists know bodies.

They understand movement. They understand injuries. They understand rehabilitation.

And I thought, surely there are physiotherapists who also work with athletes who aren't injured.

That's what I wanted.

I wasn't looking for somebody to tell me how to recover from a torn Achilles.

I wanted somebody to look at my current strength program and say:

"Does this make sense for a triathlete?"

Because I've spent a fair amount of time developing my strength routine.

I'm not interested in becoming a bodybuilder.

I'm not trying to see how much I can deadlift.

I want the minimum necessary strength stimulus that produces the maximum possible benefit for triathlon performance, while minimizing the risk of injury.

That's the sweet spot I'm looking for.

And I wanted somebody with enough expertise to tell me whether I've actually found it.

Maybe I'm missing something obvious.

Maybe I'm doing an exercise that provides almost no benefit for triathlon.

Maybe I'm doing too much.

Maybe I'm not doing enough.

Maybe there's some glaring imbalance in my mobility or strength that I'm completely unaware of.

That's the kind of professional eye I wanted.

And I also wanted to talk about my injury history and perhaps get some advice about injury prevention.

And, somewhat optimistically, I was also hoping to have somebody look at my supplements.

Not necessarily prescribe anything—just look at what I'm taking and say:

"Yeah, that makes sense."

Or:

"Why on earth are you taking that?"

Because there's an awful lot of nonsense in the supplement world, and I'd rather have an informed professional challenge some of my assumptions.

So that's what I thought I was going to get.

I went to see this physiotherapist.

We did an intake.

We talked about my history. We talked about injuries. We talked about what I was looking for.

And then...

I squatted.

And squatted.

And squatted some more.

And at some point I found myself wondering:

How many squats are we doing here?

[Laugh]

And then there was some walking around the office.

And some twisting.

And some questions about whether I felt tight here or tight there.

"Does that feel tight?"

"Does that feel different?"

"How about when you rotate?"

And I'm thinking...

Okay.

I'm not a physiotherapist.

I don't pretend to know what an appropriate physical assessment should look like.

But this didn't feel particularly objective to me.

It felt very cursory.

Very rudimentary.

And I didn't come away thinking:

"Wow. This person has identified three things about my body that I never would have known."

Instead, I was thinking:

"I just did a lot of squats."

[Laugh]

And then things took a turn that I wasn't really expecting.

I ended up on the massage table.

And he performed something called visceral massage.

Now, I'm going to be careful here because I'm not interested in turning this into a podcast episode about something I don't fully understand.

There are people who believe visceral manipulation or visceral massage can have therapeutic benefits.

Fine.

But it wasn't what I had come looking for.

And what really confused me was the explanation I was given for how problems with your internal organs could potentially contribute to pain elsewhere in your body.

The basic idea, as it was explained to me, was that inflammation or tension involving your organs could somehow contribute to systemic inflammation and ultimately manifest itself as things like back or neck pain.

And I remember sitting there thinking:

Okay...

[Laugh]

I'm going to need a little more evidence before I'm signing up for a regular organ massage program.

And again, maybe there's something to it.

I'm not qualified to say there isn't.

But that's another important distinction I've learned through this whole process.

I don't necessarily want somebody who believes the same things I believe.

I want somebody who can explain to me what they believe, what the evidence says, and how confident they are that it applies to me.

That's a very different thing.

At the end of the appointment, we talked about potentially working together.

He said he could help me with massage.

He said we'd talk about my exercise program.

He said we'd talk about my supplements.

He even mentioned hydrogen water.

And I thought:

Okay. Maybe this is going somewhere.

And then...

Nothing.

I never heard from him again.

No email.

No follow-up.

Nothing.

And I was disappointed.

But after thinking about it, I don't actually think the lesson is:

"That physiotherapist was terrible."

Maybe he wasn't.

Maybe he would be fantastic for somebody with a completely different set of needs.

Maybe his approach works very well for some people.

Maybe I just wasn't his ideal client.

And maybe—and this is important—I didn't do a particularly good job of explaining what I wanted.

Because I think I had this idea in my head that when I said:

"I want a performance-oriented assessment of my strength and conditioning program, with injury prevention as a secondary goal..."

that would be self-explanatory.

Maybe it wasn't.

So I started doing some research.

And I've spent a surprising amount of time trying to figure out what the hell I'm actually looking for.

Because I think I've realized that I'm not really looking for a conventional physiotherapy appointment.

I'm not injured.

I don't need rehabilitation.

I'm looking for somebody who understands endurance athletes.

Ideally somebody who understands triathlon.

And even better, somebody who understands the particular problems that come with being a middle-aged—or, apparently, officially an older—triathlete.

[Laugh]

Because the questions I'm asking aren't necessarily:

"Why does my knee hurt?"

They're more like:

"Is my right side weaker than my left?"

"Is there something about my hip mobility that could eventually cause a problem?"

"Is my strength program addressing the things that matter most for swimming, cycling and running?"

"Am I wasting time doing exercises that aren't giving me much return?"

"Is there something I'm neglecting?"

"Does my strength program complement my endurance training—or is it interfering with it?"

Those are the questions I want answered.

And perhaps most importantly:

Is there something about me that I can't see because I'm too close to the problem?

That's where I think a good professional can be incredibly valuable.

So I've gone back to the drawing board.

I've been looking at physiotherapists in the Victoria area, and I've found somebody at the University of Victoria who seems much more closely aligned with what I'm looking for.

She has experience working with endurance athletes—triathletes, cyclists, runners, rowers.

And she has connections to the triathlon world as well.

So suddenly I'm seeing some green flags.

And I'm about to make another appointment.

And I'm going into this one with a much clearer idea of what I want.

I'm not looking for a massage.

I'm not looking for somebody to tell me that something feels tight.

I'm not looking for a treatment plan because I'm injured.

I want an assessment.

I want somebody to look at me from the perspective of an endurance athlete and identify anything that's potentially limiting my performance or increasing my injury risk.

And then I want them to look at my strength program.

Here's what I'm doing.

Here's how often I'm doing it.

Here's what I'm trying to accomplish.

Does it make sense?

Is there anything missing?

Is there anything unnecessary?

And is there anything that you would change based on what you've seen in the physical assessment?

That's it.

I don't think that's an unreasonable request.

There's another thing I've realized through this.

I've always thought of physiotherapists as people you go see when something goes wrong.

You hurt your shoulder.

You hurt your knee.

Your back is killing you.

You go to the physiotherapist.

They fix you.

You go home.

But maybe that's a little too simplistic.

Maybe as I get older, having a good physiotherapist or athletic therapist in my toolbox is actually part of being a responsible athlete.

Not because I expect to get injured.

Quite the opposite.

Because I don't want to get injured.

And if somebody who understands endurance sports can spend an hour looking at me and identify something that I haven't noticed, that could potentially save me months of frustration down the road.

And it might improve my performance today.

That's a pretty good return on investment.

I think the bigger lesson for me is that the right professional is just as important as the profession.

"Physiotherapist" is a pretty broad label.

There are physiotherapists who specialize in post-surgical rehabilitation.

There are physiotherapists who work with chronic pain.

There are physiotherapists who work with professional athletes.

There are physiotherapists who are experts in pelvic health.

There are physiotherapists who are fantastic manual therapists.

And there are people who specialize in performance.

Those aren't necessarily interchangeable.

So if you're an athlete looking for this kind of help, I think you need to be very specific about what you're asking for.

Don't just say:

"I want to see a physiotherapist."

Say:

"I'm an endurance athlete. I'm not currently injured. I'm looking for a performance-oriented assessment. I want somebody to evaluate movement, strength, mobility and asymmetries, and then review my strength and conditioning program with an emphasis on performance and injury prevention."

That's a much better description of what I'm looking for.

And that's what I'm going to ask for this time.

So...

Attempt number one: not a great success.

Attempt number two: coming up.

And I'm actually quite interested to see what happens.

Because maybe the answer is:

"Todd, your strength program is actually pretty good. Don't change much."

That would be great.

Maybe she'll find something obvious that I've completely missed.

That would also be great.

And maybe she'll tell me:

"You don't need to be doing half the stuff you're doing."

Honestly?

That might be the best outcome of all.

Because one of the things I'm increasingly conscious of as I get older is that more training isn't necessarily better training.

I want every piece of my training program to have a purpose.

Swimming has a purpose.

Cycling has a purpose.

Running has a purpose.

Strength training has a purpose.

Recovery has a purpose.

And if I'm going to spend 30 or 40 minutes in the gym, I want to know that those 30 or 40 minutes are actually making me a better triathlete.

So that's the experiment.

I'm going to find somebody who understands the athlete I'm trying to become—not just the body I happen to have today.

And we'll see what she says.

I'll report back.

Because if I finally find the person I've been looking for, I suspect there are a lot of other aging triathletes who would like to know about them too.

And maybe that's the real lesson here.

Sometimes the hardest part of injury prevention isn't doing the exercises.

It's finding somebody who can tell you which exercises you should actually be doing in the first place.