Not Dead. And no longer in grad school.

 The following things have changed since I last wrote on this blog:

• Finished two clinical rotations
• Bought a house
• Passed board exams
• Moved to Maine
• Graduated with my doctorate in physical therapy
• Got my first job as a physical therapist

For my last year in grad school, I served as president of the student association, mentored students in two courses, and applied for and was accepted to the national honor society for DPTs. I pushed myself hard in the last two terms and paid for it in health and stress level. Now I'm a DPT and have a full-time job working standard office hours for one company for the first time ever. I don't think I knew how hard I'd pushed myself until after graduation when I just had to do one thing--go to work every day. No studying, no exams to prep for, no meetings to plan or resources to put together. At the end of each day, I can come home and play video games until bedtime if I like. It's delightful.

I've given myself some time and space to mentally recover from four years of school and everything that went with it. For the first few months, I still didn't feel motivated to exercise in even the most basic of ways. I mean, not even a short walk in the evenings. I can tell I'm coming back from that level of stress and fatigue because I actually want to work out again. I've started exploring my new home on my bike and I've been getting to work early in the mornings so I can have a short run before I start my days.

On one of those morning runs I passed a sign for the Kennebec River Rail Trail that had featured sponsors, and one of the sponsors was IronMan 70.3 Maine - Augusta. Hmm, I thought. I live near Augusta. In fact, I work in Augusta. That's interesting.

So I signed up for IronMan 70.3 Maine today. And I guess maybe it's worth tracking my training journey on this blog again. I'm coming back from no fitness at all for the past few years to try to get in shape for a 70.3. And I know from experience that you can't fake your way through a 70.3. Maybe there are people out there who are similarly out of shape and want to get back to training or competing or at least participating in mass-start events and my journey will inspire or motivate or inform or something. Or maybe it will be entertaining to follow. At the very least it will be good for me to get my thoughts out of my head and onto a screen.

That's it for now. Here's a pretty picture from my bike ride today as a thank you for reading.

Maine is a very pretty place to live.

Foot orthoses (AKA insoles, footbeds, shoe orthotics, etc.)--do they help?

As part of my coursework this term, I assessed the research on foot orthoses, the insoles that go in your footwear to (theoretically) improve foot and ankle alignment. The goal was to evaluate 3-5 journal articles, which required a very narrow research question. I focused on the ability of in-shoe orthoses to prevent recurrence of plantar fasciitis in amateur runners. Unfortunately, there's almost no research on that question, and the research that's out there is fairly old. Isn't it strange to think that research from 1981 is 40 years old now? Not that 40-year-old research has no utility, but with the advancements in shoe technology and biomechanical testing that have occurred in the past 40 years, I'd prefer to base my recommendations on research from the last 20.

You can read my full appraisal below, but I will summarize the main take-aways in lay language. There's very little research on whether insoles (custom or over the counter) can prevent injury in runners. Most of the research on orthoses looks at biomechanical and kinematic variables--running on force plates and looking at motion capture, that kind of thing--but doesn't directly measure the incidence/recurrence of injury. There are separate studies that connect those variables to various running injuries. For example, one study I read showed that there's a connection between vertical reaction forces and plantar fasciitis in runners. Another study showed that a certain type of over the counter insole reduced vertical reaction forces. Ergo, maybe those insoles will prevent plantar fasciitis. Unfortunately, that kind of connection doesn't mean much in academic research, because you never know what kind of unrelated variables might be causing both things. Until there's a study that directly measures those insoles' effect on vertical reaction forces AND plantar fasciitis, the connection is only speculative.

My conclusion is that there's not enough evidence to say that insoles help prevent plantar fasciitis, but based on what's out there, it doesn't look good. I wouldn't recommend insoles to my runner patients or clients for the purpose of preventing plantar fasciitis. Since I didn't evaluate all the research out there, I can't say for sure whether insoles might be helpful for other purposes. For my own training, and I imagine for many of you reading this, the question that interests me more than injury prevention is performance optimization. Could insoles improve alignment of the legs during biking to where you could get a few more watts to the pedals? Would better alignment from insoles lead to faster running times? 

My guess is that there's even less research out there on those topics. And from what I've read so far, there's probably no performance benefit; in fact, insoles might decrease performance as the body tries to adapt around a device pushing it out of its groove. But I can't say for sure without more study. And if there's no research out there yet, maybe that's a project that I could take on in the future!

With that, thanks for reading! If you want the gory details, see my critically appraised topic below.

No evidence that foot orthotics reduce recurrence of plantar fasciitis in recreational runners: A critically appraised topic

Jamie Morton, SPT, University of St. Augustine for Health Sciences

Background
A 44-year-old woman who enjoyed running and yoga presented to physical therapy with complaints of chronic plantar fasciitis. Upon examination, the patient demonstrated a structural forefoot varus with compensatory plantarflexion of the first ray. In cases of structural variation, compensatory changes at the foot may predispose athletes to repetitive trauma as the foot adapts to meet the demands placed upon it. In-shoe orthotics, whether over the counter or custom, may provide a means of external support, allowing the patient to return to her running and exercise routine without pain or future injury. This critically appraised topic seeks to summarize best available research to answer the question of whether in-shoe orthotics prevent recurrence of plantar fasciitis. Table 1 delineates the search methodology for this topic.

Table 1. Search criteria for literature review

P: Recreational runners
I: Foot orthoses
O: Reduced incidence of plantar fasciitis

Introduction
Running is one of the oldest and simplest forms of recreational exercise, a component of almost all popular sports, and widely practiced by athletes of many ages and ability levels. However, running related injuries (RRIs) are common across the spectrums of age and ability, with incidence ranging from 18.2% to 92.4% depending on population and study.(1) Reporting of incidence rates is complicated by the definition of RRIs in studies and lack of systematic data collection (not all runners who experience musculoskeletal injury related to running will seek treatment), as well as differences in populations studied and duration/follow-up periods.(2) Physical therapists frequently encounter both novice and experienced runners with RRIs related to overuse. Preventing recurrence of these injuries after treatment also prevents reduction in training volume, improves health and wellness, and allows retention of the beneficial effects of recreational running. In-shoe foot orthotics have been presented as one way of preventing running injuries, with advertisements in both mainstream and professional publications.

The causes of plantar fasciitis in runners are often hypothesized to relate to training load, underlying biomechanical factors, footwear choice, age, ability level, and so on.(2,3) Elucidating the causes of overuse injuries in runners is potentially complicated by multifactorial interaction of stressors.(3) A too-rapid increase in running volume may overload the tissues without giving them time to adapt. In novice runners, even a 5-minute jog may be more than the soft tissue can handle. Structural or acquired alignment issues (e.g., forefoot varus, calcaneal valgus) may further predispose certain individuals to excessive loading that their soft tissues cannot absorb. Custom or over-the-counter orthotics may provide enough structure and support to allow such individuals to begin running without pain or injury.

Summary of research
Relevant literature on treating plantar fasciitis in runners goes back to at least 1981(4); however, developments in footwear, orthotic, and diagnostic technology led us to limit our search to research published in the last 20 years, i.e., since 2001. To broaden the results in PubMed, we evaluated the “Similar articles” and “Cited by” sections of older papers (those published before 2001) and narrative reviews, case series, and case studies found during the initial literature search. 

Preliminary search of PubMed returned 4 results, including a clinical trial that addressed the outcome of interest.(5) Reviewing the references and citations of the PubMed articles revealed several randomized trials and systematic reviews of orthoses uses to treat plantar heel pain, but none that specifically addressed runners. Many trials examining the effects of orthotics in runners assess biomechanical measures, but do not directly measure plantar heel pain, incidence of running injuries, or clinical diagnosis of plantar fasciitis. An initial PEDRO search with the selected terms yielded no results, but a search using advanced parameters of keyword “runners,” therapy “orthoses, taping, splinting,” body part “foot or ankle,” and published since 2001 returned 22 records. Of those, three relevant clinical trials were found(6-7) as well as one Cochrane review that was mined for additional trials,(8) yielding one additional study.(9) Searching CINAHL Complete yielded three results, none of which were relevant or new. In total, four studies were included and are summarized in Table 2.

Table 2. Summary of articles

Discussion
Lewinson and Stefanyshyn(5) evaluated the effects of an over the counter insole (Dr. Scholl’s Active Series) on biomechanical variables correlated with RRIs, including peak vertical loading rate, which has been associated with plantar fasciitis.(10) They found inconsistent effects of the insoles on all measured variables except vertical loading rate, which was significantly reduced when subjects ran in their normal footwear with the insoles.(5) Although other authors have correlated vertical loading rates with plantar fasciitis in runners,(10) the authors did not measure injury incidence. The authors also did not explicitly recruit runners, although all trials involved the subjects running. 

Hirschmuller and colleagues(6) examined clinical effectiveness of custom insoles for overuse injuries in runners using a randomized controlled trial. After both control and intervention groups continued their normal running routine, they found a significant decrease in mean pain disability index (PDI) and subjective pain experience scale (SES) in the intervention group and subsequent increase in PDI and SES in the control group.(6) The sample included multiple RRIs, and only seven of the participants suffered from plantar fasciitis. The Hirschmuller study measures pain and disability but does not examine recurrence of RRIs. These two factors limit the applicability of this study. 

Shih, Wen, and Chen(7) applied a wedged foot orthosis to runners with history of patellofemoral pain or plantar foot pain with foot pronation in a randomized controlled design. They measured pain intensity and time to onset of pain during three 60-minute running tests (one to establish baseline, one immediately after application of an insole, one after two weeks of training with the insole). The intervention group (wedged orthosis) showed an immediate decrease in pain incidence and intensity and a further decline after two weeks running with the orthosis. The control group (flat orthosis) increased in pain incidence with an average decrease in pain intensity. Both groups showed increased time of onset to pain, although the effect was greater in the intervention group. This study did not examine recurrence of RRIs, and only one of the subjects suffered from plantar foot pain, which again limits the applicability of this study.

Finestone and colleagues(9) conducted a prospective study on military recruits to determine if type of orthotic (prefabricated vs. custom, soft vs. semirigid) reduces the incidence of overuse injuries in an otherwise healthy population. They found no statistical differences in injury rate, indicating that prophylactic use of insoles does not reduce injury rate in young, healthy males. The study did not report any baseline measurements of difference between the four groups, including differences in existing foot pathology. The study’s applicability is further limited by the sample, which consists exclusively of male military recruits with a mean age of ~19. It also does not specify how much running was involved in the basic military training the recruits underwent, and if the recruits ran regularly prior to recruitment.

Summary
Little recent research exists on the effectiveness of foot orthoses in reducing recurrence of plantar fasciitis in runners, a deficit noted by all authors of the included studies.(6-9) Considering the popularity of running, the high rate of injury and re-injury, and the commercial interests involved (i.e., manufacturers of prefabricated and custom orthotics), the lack of research—quality or otherwise—in this area is surprising. Given the results of the included studies, it is possible that more research has been performed but not published because of lukewarm results; if a company funds a study that shows no benefit to consumers who wear their product, they are less likely to disseminate that research. While some positive research exists from 30-40 years ago, the mechanism of effect was never established.(11) More recent studies examining the kinematic and biomechanical changes induced by foot orthoses fail to connect those variables to injury rates, so the benefit of foot orthoses remains largely theoretical.

Based on the current literature, there is no evidence to suggest that foot orthoses reduce the recurrence of plantar fasciitis in recreational runners. Custom and prefabricated insoles range widely in cost from $10 for neutral, prefabricated inserts up to $800 for custom orthotics. These products likely do not represent a good investment for most patients. Furthermore, since one possible mechanism of RRI involves introduction of unaccustomed stress with inadequate ramp up,(2,3) athletes who abruptly change their running mechanics with orthoses may predispose themselves to new injuries. Instead of prescribing orthotics, physical therapists should recommend gradual increases in training volume, proper footwear based on the patient’s needs,(8) and strength and conditioning exercises to best support the patient’s training volume and progression.

References

1. Lopes AD, Hespanhol Júnior LC, Yeung SS, Costa LO. What are the main running-related musculoskeletal injuries? A Systematic Review. Sports Med. 2012;42(10):891-905.
2. van der Worp MP, ten Haaf DS, van Cingel R, de Wijer A, Nijhuis-van der Sanden MW, Staal JB. Injuries in runners: A systematic review on risk factors and sex differences. PLoS One. 2015;10(2):e0114937. Published 2015 Feb 23.
3. Bazzoli AS, Pollina FS, Johnson EW. Heel Pain in Recreational Runners. Phys Sportsmed. 1989;17(2):55-61.
4. Eggold JF. Orthotics in the Prevention of Runners' Overuse Injuries. Phys Sportsmed. 1981;9(3):124-131.
5. Lewinson RT, Stefanyshyn DJ. Effect of a commercially available footwear insole on biomechanical variables associated with common running injuries. Clin J Sport Med. 2019;29(4):341-343.
6. Hirschmuller A, Baur H, Muller S, Helwig P, Dickhuth H, Mayer F. Clinical effectiveness of customised sport shoe orthoses for overuse injuries in runners: A randomised controlled study. Br J Sports Med. 2011;45(12):959.
7. Shih YF, Wen YK, Chen WY. Application of wedged foot orthosis effectively reduces pain in runners with pronated foot: a randomized clinical study. Clin Rehabil. 2011;25(10):913-923.
8. Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev. 2011;(7):CD001256. Published 2011 Jul 6. 
9. Finestone A, Novack V, Farfel A, Berg A, Amir H, Milgrom C. A prospective study of the effect of foot orthoses composition and fabrication on comfort and the incidence of overuse injuries. Foot & Ankle International. 2004;25(7):462-466.
10. Pohl MB, Hamill J, Davis IS. Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners. Clin J Sport Med. 2009;19:372–376.
11. Nigg BM, Nurse MA, Stefanyshyn DJ. Shoe inserts and orthotics for sport and physical activities. Med. Sci. Sports Exerc. 1999;31S:421–428.

Not Dead. In Grad School.

From the first month of my matriculation

Hello, friends. I've been meaning to drop you a note for, well, about two years now. That's how long it's been since my last post. You know what else happened two years ago? I started a Doctor of Physical Therapy program.

In retrospect, I had enough information that I should have known what to expect. While doing observation hours as a volunteer at the D.C. Veterans' Administration, I had many conversations with the therapists about how difficult their doctorates were, how they ended up forming bonds with their classmates, like soldiers who have been through war. A few of the students who came through on clinical rotations mentioned that multiple relationships in their cohorts had ended during the three-year program. Everyone I knew--not just physical therapists--told me how hard grad school is, how it drains you, how it leaves time for nothing else.

(Except for Emily. She breezed through grad school, somehow.)

But, and I don't know if this has fully come across in all my years of blogging, but I have a pretty high opinion of myself. I paid lip service to how hard a DPT program would be, but internally I thought, "I'm smarter than most people, and better at school. And I'm older than most students when they start grad school. I'll probably be fine."

You may be able to guess, based on the fact that I have dropped off the face of the planet for two years, that I was incorrect. Grad school is hard. Grad school is hard for other people, and it is hard for me. I have gone weeks without riding my bike. I have gained and lost weight. I have broken down crying multiple times. I have experienced mild anxiety and depression (even before COVID-19 turned everything upside down), two things I haven't experienced since puberty. 

I've also learned so, so much, and not just in my chosen field of study. Sure, I know a lot more about anatomy and physiology, movement science, kinesiology, biomechanics, and so on. I've also had the opportunity to reflect deeply on my personal values, and on what drives me to want to help people as a therapist. I've discovered that I value knowledge above everything else, and my ultimate goal as a clinician is to teach people how to be healthier, how to heal themselves. I've also had to confront some of my weaknesses as a communicator, mostly by almost failing (not as bad as it sounds, because anything below a B fails hands-on skills in my program) interview-based finals. In one, I forgot to ask the mock patient what her goals were. I realized that sometimes I think I'm asking a question, but the other person doesn't realize what I'm asking, but as the clinician, the impetus is on me to help the patient give me the information I need.

Most importantly, I've learned that I'm not as smart as I think I am, and I don't know as much as I think I do. I went into the DPT program thinking that I was basically doing the job of a therapist already, just as a fitness trainer. That was based on some unfortunate experiences observing physical therapists in various settings; some of them were practicing at a level not far above what I was doing as a fitness professional. But the first two years of my program have pricked my ego and deflated my big head. Looking back, I feel like I didn't know anything coming into this program.; I've learned at least as much in the past two years as I had in the previous ten, and I still have two more to go. Even once I graduate, I will know just barely enough to start practicing, which will open up a whole new realm of learning potential--as one of my clients put it, "You'll have your license to keep learning." I love learning, so it suits me fine. But I hope I will never again have such an over-inflated view of my own knowledge; I find I enjoy life much more when I'm approaching it with an open mind and an eagerness to see what I can learn, whether that's from a class, a person, or a situation. And I get much more out of life, that way, than approaching with the attitude of, "Oh yeah, I know all that already."

I'm studying. Patty's helping.

Anyway. That's where I've been. Not dead, just busy becoming a physical therapist. Let's talk now of where we are going.

If you are still out there, dear readers, what would you like to know? What can I write that would be worth reading to you? If you are still out there, tell me. I have some ideas, like creating a beginner's guide for road cycling, similar to the series I did years ago on starting out in triathlon. I could answer questions on injuries, or at least try to. I'm planning my own investigation on the intricacies of bike fit, and I could share that. I could share my journey of trying to continue cycling during crazy times--you know, grad school, work, travel, global pandemic, etc. And if no one is still reading, I will still write for myself, and do whichever of these seems most interesting to me. But if anyone is still out there to get some value from my research, let me know what most interests you, what would most help you!

See you out there. In the meantime, don't forget to spin and smile!

Race Report: Giro di San Francisco (Women's 3)

I put this race report off for too long, and in the time since I started a doctoral program. My recollections are a little fuzzy.

The SunPower women had great representation at this race, but JL Velo and SheSpoke brought out even more women. The course is mostly flat, with one very short bump on the backside of the course. It's technical, with some fun, wide-open corners, although one of the corners is very bumpy and consequently kind of scary.

I got clipped in really fast and got off the front without trying at the start. I didn't push the pace, though; just set tempo until the rest of the field caught up with me. That took a lap or two, at which point I saw one of my teammates on the front setting a tough pace on the uphill! I tucked into the pack and tried my best to stay near the front and cover moves. Another teammate was also covering moves at the front, but she was recovering from a cold and not feeling her best. I got gassed from the work, but I didn’t want to leave her alone up front. I asked a third teammate to help her cover the front and I went to the back to sit in for a bit. That’s most of what I remember about the race.

With 3 to go, I found myself off the front with one or two other women, but it was clear they didn’t have the legs to make it last. I was sitting second or third wheel going into 2 laps to go, when everything exploded with moves and counter-moves. I was bleeding positions, but I saw two of my teamies up ahead of me so I didn’t worry too much. They looked pretty tired on the last back-side straight going into the last two corners, though, so I followed the wheels that were moving up around them and tried to make up ground. I left it too late; I wasn’t going from top 15 to top 5 in those two corners, not at that speed! I sprinted for one more position and ended up twelfth.

Main take-away is to be smarter and hold position better in the last few laps. That would be helped by not doing so much earlier in the race.

That's my last road race for this year! Now it's time for #cxishere!

Race Report: San Ardo

In which I get heatstroke.

The forecast for Saturday's San Ardo Road Race called for highs in the low 100s and winds increasing in speed throughout the day. I know from previous races that I don't handle heat well, but I figured I would go down and give it a shot anyway.

About 10 of us cat. 3s rolled out at 8:30 AM for 63 miles through central valley farmland. I had a teammate in the pack who was interested in doing well. My target for the race was to work for her. I helped set pace early in, tried to keep the speed up to discourage attacks, tried a few escapes on downhills to warm everyone's legs up. Everyone must have been feeling good early on, because the response to my pace increases was for the whole group to keep things hot through the first 10 miles.

At about that time, a rider who had come from Florida to collect some upgrade points countered a little attack I'd made and got a gap. At that point we'd already dropped a couple of riders. The lead group was only three strong, but that was enough that every team except ours was represented. I got to work trying either to chase the group back or get it close enough that my teammate could bridge across. Then there was a hill--the last short kicker before a long, straight, flat stretch. I got caught out there and dropped. That was around mile 12, and that was the last I saw of the main group.

I knew at that point it was nothing but a training race for me, and settled in for the long haul. I realized I'd forgotten to start my Garmin so I didn't even have training data for the hardest part of the race. The two groups ahead of me kept getting farther and farther away. The scenery was boring. The pavement was awful, possibly the worst I've ever had in a race. I've ridden gravel roads that are less obnoxiously bumpy. I was pretty salty about the whole thing and planned to throw in the towel after one lap (about 21 miles in, or 9 miles on my Garmin).

Then I had a snack and some water at the end of the first lap and figured I could soldier on at least until I got 30 miles in. That would be a good training ride. I planned to turn around when my Garmin reached 15 miles and head back to the start. I was passing plenty of traffic doing the same thing, mostly coming back after flatting (San Ardo is notorious for goatheads). I passed Tobin Ortenblad going back towards the finish after flatting. I was still feeling good when my Garmin hit 15, and about that time a group of masters came past me. I sped up a little to tag onto the back of their group and figured I'd go until they dropped me, then head back home.

FYI, it's against the rules to hop onto the back of a pack like that and draft. But I figured as long as I stayed out of their way, didn't interfere with their race, and withdrew at the end of the second lap, it wasn't going to do anyone any harm. And I felt much safer in the pack than I'd felt solo; I could follow them through better lines instead of staying on the rough part of the road close to the shoulder. I stayed with them through most of that second lap, but dropped off when they started attacking each other. A chase group from the same race (Masters 4/5, I think) came by me eventually, and I hopped on that train as well. They caught up to the first group I'd been with and I rode them until we passed the 1 km to go sign. I figured they'd sprint it out, and I didn't want to be in the way. I still wasn't feeling too awful, although I was annoyed at the terrible pavement (and glad that I didn't have to jockey for position leading into a sprint on those roads). I felt hot, but not overheated. I was starting to get chills, though, and that's never a good sign.

I rolled over the stop line and told the officials I was withdrawing. They didn't seem too interested. Started heading back to my car and felt worse and worse. By the time I got back to where I'd parked, I was so out of it that I got off my bike and stood there for several minutes, unable to motivated myself to take the next step. I finally managed to prop my bike somewhere and sat down in a camp chair for what felt like 20 minutes, with waves of nausea and dizziness washing over me. It took me that long before I could start getting changed, and even then I had to do it in short bursts--a little bit of activity, then a pause to let the nausea go away, then a little more activity. I changed into fresh clothes and went to a nearby bathroom (good thing it was there) to run cold water from the sink over the back of my neck. That helped, but I had to keep going back over there for more, and it was getting hotter and hotter. I'd ridden with teammates and had to wait for them to finish, but I was in no condition to drive away at that point anyway. Finally, the ambient temperature got so bad that even sitting in the shade with a cool breeze was too much for me. I hopped in my car and ran the AC. Then I remembered riding past a little gas/liquor store in San Ardo (pretty much the only thing there). I went over there and bought a bag of ice, then drove around the block with the ice in my lap and the AC blasting. I finally started to feel back to normal. That ice worked magic.

Lessons learned: don't do races in the central valley in August. Always bring a cooler with ice. Don't attack 10 miles into a 63-mile race, even just to test out the legs. Don't get dropped. But mostly don't do long, hilly road races in the central valley in August. Did I mention that I shouldn't race in the central valley in August?

The rest of the race turned out okay. The two groups came back together, and my teammate was one of only 5 women to finish the race. She got on the podium. And we had really tasty burritos on the way back.

But the consequences of that race have been with me all week. My lymph glands in my neck were swollen on Monday evening, and by Wednesday I felt so run-down that I could barely get out of bed. I think the combination of heatstroke and the gross, smoky air that I've had to breathe for the past several weeks (wildfires on the West Coast) have weakened my immune system to the point of almost but not quite getting sick. I failed a workout on Tuesday, left work early on Wednesday, and have made a point of not exercising at all since Monday. I'm feeling a little better today, so I plan to attend a CX clinic tomorrow and see how it goes.

That was my San Ardo. Reminder to self: don't race in August in the central valley!

On Bibshorts -or- Equipping Your Undercarriage

I had a conversation with a coworker recently about shorts. Specifically, she never wears bibs and I wear nothing but. She asked me why I prefer bib shorts. And I realized that I have a few reasons, but a major one is that it's what cyclists do. There's a little communal snobbery over bib shorts as opposed to regular shorts; those in the know are aware that bib shorts are better. So it's at least partly a tribal identifier to show that you're an in the know cyclist (similar thing goes for skinsuits in crit/TT/CX racing).

There are some non-snobbery reasons to wear bib shorts, too. The chamois tends to stay put better, especially if you have narrow hips. I don't have narrow hips, but I do have a narrow waist. In my case, wearing bibs instead of shorts removes the elastic waistband that never seems to hit me in the right spot. When I wear normal shorts, I find that my hip flexors start to get sore and my low back gets achy, I think from the pressure of the waistband. And I feel like my breathing is restricted if I try to relax and breathe into my belly. Getting back to the shorts staying in place, a moving chamois is a chafing chamois, so bibs help reduce chafing by reducing movement of the shorts against your tender bits.

Bibs also eliminate the potential for a dumb-ass burn/tan. You know the dumb-ass tan, a.k.a. triathlete tramp stamp; it's the strip of skin between a short jersey and low-cut shorts that gets burned or really darkly tans because who would ever think to apply sunscreen there? Probably less common now that triathletes wear more skinsuit type things, but I remember seeing it on everyone at Wildflower in 2008. Bibs come much higher up the back, high enough that no jersey is going to be fulled up that far, unless you accidentally tucked your jersey into the back of your shorts when using a port-a-john. Also important for modesty--no plumber's crack showing to those behind you!

So that's why you should choose bibs over regular shorts. You'll notice that they're usually more expensive, but now you have some reasons why they're worth it. Next time, I'll talk a little about why you should spend more on shorts in general, and I'll begin a series of kit reviews based on my own experience.

If you have a favorite pair of shorts that you'd like to review, or if you bought a pricey pair and regretted it later, I'd love to feature your experience. Get in touch if you'd like to help me out with my series of kit reviews! I'm particularly interested in hearing from other women on their experiences, since it seems there are always many more resources of that type for male cyclists than us ladies.

Race Report: San Rafael Sunset Criterium (W 3/4/5)

In which I get dropped, lapped, and pull myself.

This was a cool race in which to participate. It's on the USA Crits calendar and draws a lot of big-name talent from around the country. I love to watch the USA Crits streams (An aside: buy a membership if you can! It's $55 for the year, gives you access to a bunch of older streams, allows you to watch all of the races live or on-demand, and part of the proceeds go to supporting the teams! If you like to watch live cycling, this is a project worth supporting!). I was very excited to get to see a major race in person, and to be part of the racing on the day.

However, I was coming off of a six- or seven-week block of training. Why such a long training block? Wouldn't my body disintegrate with such a long block? It was supposed to be a five-week block of sweet spot with a recovery week, buuuuuuut I had two weeks of travel coming up where I knew I wouldn't be able to do much, if any, riding. So I doubled up on a week of TrainerRoad workouts (repeated week 4 of Sweet Spot Base Mid-Volume 2, if you're interested) with the intention of taking two weeks pretty much completely off following for recuperation and adaptation.

If you were wondering, planning big races at the end of six hard weeks of training isn't a recipe for success.

The race was hard from the beginning. The field was relatively big for a 3/4/5 race, with riders at all ability levels. My body felt tired and worked, and I was having difficulty railing the corners as much as I needed to. Add in a few sketchy moves by women who didn't know any better, and I decided I'd rather be at the back of the field than on the ground. There was plenty of room to move up--a long straight on the backside of the course that was into a headwind and a long straight coming into the finish line that was slightly uphill. Any time I lost contact, I could lay down some power on the finish straight and re-establish contact, but I was getting gapped in the turns. I actually almost washed on the final turn, which was wide but downhill, on one lap. At one point I looked down at my power meter and realized that pushing 175 watts was destroying me.

I hung in for about 30 minutes, but I'd been gapped and chased back on several times at that point. A selection was made at the front. I was not anywhere near it. I started riding through other dropped riders. When the lead moto came around me, I knew I was close to getting lapped by the front group. After they went by me I took the next opportunity to pull over after the finish line next to the officials. I don't need points to upgrade from cat. 5, and I know from friends who officiate how difficult it is to keep results straight when lapped traffic stays on the course.

The officials wanted to leave everybody out there so that they can get the experience and the potential upgrade points, but I suspect that the results were a bit of a mess afterward. When I got pulled, there was a group of 10-15 riders in the lead group. At the end of the race, there were more like 20 women in that group. I think some of the lapped riders hopped back in with that group when they came around them.

If you're reading this and you ever have the opportunity to do that, resist the temptation. When you get lapped in a road race, just stay to the side until the group goes past and then resume whatever pace you were setting before. It's a little different in CX racing; you don't need to get off your bike and stop, or do anything unsafe to let someone lap you. Sometimes the course will be narrow enough that it's not safe to pass. When you have the opportunity (when it's safe, the course is wide enough, you're not going through tight corners or tricky single-track), you can move to the side so the other person can get around. And keep in mind that person might be trying to win the race and riding so hard at the moment that she's about to throw up, so cut her some slack if she's being rude or impatient. Probably she'll buy you a beer or something after the race.

Anyway, I feel good about the San Rafael Crit. It was still a fun scene in a cool town. And any road racing I do at this point in the season is all about fun and supporting my teammates. My training and performance is all building up to the CX season, which starts in just about a month! It's officially #CXisComing season!