It’s taken months of planning and thirteen years of health science training, but I’m ready for the challenge. Welcome to a whole era for Australian Triathlete magazine. QANDrA- Questions Answers Dr Anderson. My concept for up and coming articles is to let you guide what I’m going to write about in each edition. In my mind we might get some silly Danny Katz type questions, along the spectrum all the way to some Dolly Doctor.
You can tweet me (@DrMitcha), Insta me a picture (@Drmitcha) or send me a question on email (mitch@shinbonemedical.com). Then you’ll be the star of the next edition and have that old bug-bear question off your chest. Whatever you want to ask, be fearless- I have some golden rules when it comes to answering questions:
1. There’s no such thing as a stupid question
2. It’s never ok to laugh at someone’s genitalia, no matter how funny it looks.
I won’t even laugh in private at what I’ve seen and heard- this is your 100% beneficence and non-maleficence guarantee. It’s something we take seriously in the medical world…laughing at someone’s junk, that is.
So because this is the first QANDrA I had to solicit my own questions from some of my triathlete friends, who have consented to being fodder for my first episode.
Question One: Julie
“It’s started to get cold and it’s now off-season- why am I so hungry and how can I avoid putting on weight?”
It’s difficult at this time of year Julie! It’s a throw back to Neanderthal man and whats known as the ‘thrifty phenotype’. We’re programmed subconsciously to eat a little more as the temperature drops (especially when food is available in abundance), so we can insulate our bodies more as winter approaches. Unfortunately, pretty much all of us are already insulated enough!!
Just being aware of this fact can help you with a mindset of trying to be left with a lingering, nagging amount of hunger at the end of each meal, rather than completely sate yourself. There’s no clear evidence that timing of calories plays any role in how much fat you put on- it’s all related to how many. So try a strategy to eat your vegetables and meat first in an evening meal, have a glass of water…then put some carbohydrate (rice/pasta/potato etc) into the system. This will allow you to reduce your calorie load for the day and keep close (-er!) to race weight over winter.
Question Two: Andrew
“I’ve got a lump in my undercarriage that is painful and won’t go away. Should I squeeze it or lance it?”
This is going to happen to most if not all triathletes at some point in their triathlon career- a saddle sore. It’s an irritation of the perineum (otherwise known as the piece of skin that your saddle pushes on!) that is most likely a form of pressure response, which may or may not include an infection.
The pressure and firmness of cycling saddles can cause the subcutanenous tissue to fibrose and proliferate in response. And all that technical jargon means is a small patch of sub-skin gets angry and this causes a reaction in the surrounding tissues. Similarly, a small infection (hair follicle, pimple) may be the genesis of this response. These happen particularly when you’re starting or when you increase your volume by a large amount. There’s sweat and ….well, I don’t need to go into more details.
My advice is to ignore it (or try to) and it should resolve spontaneously. Take a couple of days away from cycling. If you can visualise a hair or there’s a pus-filled head on the lump then you may be able to clear the hair or pus by applying some gentle squeezing or lancing. Care must be taken to avoid high pressure- you don’t want to tear the skin and cause a serious infection. Professional cyclists have been known to need operations for this problem. So if it’s persistent, get along to see your doctor for some professional advice.
Keeping the skin clean and lubricated can help prevent saddle sores, as well as treating your cycling knicks with care and cleanliness. Make sure the pad or chamoix gets plenty of sunshine to kill any bacteria. There is a difference in chamoix quality according to price (to a degree) and gender specificity- so make sure you have the right one!
Question Three: Frank
“I’m a newby triathlete and have just started shaving my legs- I’ve come up with a strange rash all over my legs, what have I done?!”
I think you may have follicultis Frank- that’s an irritation of the follicles of the otherwise known as where your hair exits the skin! It can be caused by any number of reasons- infection, blockage, irritation or rarer skin diseases.
This can happen in people with sensitive skin and it’s a form of shaving rash. The shaver can usual temper the fierce response of his/her skin by moisturising prior to the shave and using some hair clippers to minimise the length of the hairs to be cut. Less hair means less pressure on the razor, which can spare the skin from a sever exfoliation! If you have persistent problems with shaving, wait three months for the skin and follicles to settle, then try with a lady’s razor- they’re designed for the job!
To minimise the risk of infection, make sure your skin is clean prior to the shave. Using some soap as the cleaning agent, but then shaving cream as the lubricant is the best way to have a clean and safe shave of the legs. Try not to swim immediately after you shave and avoid spas- these are ripe with bacteria and your skin is at it’s most vulnerable at this time.
With all of these questions, if you have a persistent problem- go and see your local GP. They’re a wealth of knowledge and can direct you to a specialist if required. Looking forward to hearing your questions for episode two of QANDrA: @drmitcha (twitter/insta) and mitch@shinbonemedical.com Thanks Frank, Julie and Andrew for their first up questions.