Making a Comeback!

Incision Scar 3 weeks post-op

Knee Comparison 3 weeks post-op

After a successful fabella removal surgery on June 28, 2016, I began the long process of rehab. I spent a couple of weeks on crutches, then gradually had to teach myself to walk again then eventually run. The goal was to be aggressive with rehab but make sure I didn't have any setbacks. I decided my first race back would be the Des Moines Triathlon (Olympic Distance) on September 4. My total run volume before the race was less than 30 miles but I had a goal to race at 6:20 per mile pace for the 10k run and I did just that. It was not an impressive race, but I did have the fastest swim and bike. The aerobic engine was strong but the peripheral system was not quite ready to support fast running. I finished 6th, just one spot out of the prize money, but damn it felt good to be back racing.
Swim File:http://tpks.ws/tlQ5Z
Bike File: http://tpks.ws/faIoT
Run File: http://tpks.ws/yZ2fZ

I did a photo shoot with TYR in Long Island on Friday September 16 then stayed on the island to race the Mightly Hamptons Triathlon (Olympic Distance) on Sunday the 18th. This was only two weeks after Des Moines, but my run was progressing well and I had the goal of running sub 6 min miles. I was very close to my goal, but fell just bit short with a 6:02 average. I won the race and it always feels good to win, but this was just another step in the right direction. I came home from the race and Ashley and I welcomed the birth of our third child and second baby girl, Frankie Mae Tollakson on September 20. Ashley has been a total saint and allowed me to keep training and sleeping through the whole process.
Swim File:http://tpks.ws/UIXYk 
Bike File: http://tpks.ws/dsms1
Run File:  http://tpks.ws/SmshF

The training kept progressing and the next race on the schedule was Austin 70.3 on October 30. I never built up my run volume to my preferred race volume, but I did have 160 miles over a 4 week block. I would normally prefer to be over 200 miles in a 4 week block before a 70.3 and a little more before an Ironman. All things considered. I was healthy and ready to race.

Austin, Texas was unusually warm and humid for October and there was a dense fog on race morning. The worst of the fog was on the lake and the buoys were not even visible. The swim was delayed then eventually cancelled. The race moved to a time trial start with one pro starting every 30 seconds. I was number 10 and started 4:00 back of the first athlete. Matt Hanson was :60 in front of me and Chris Lieferman was :30 in front of me. I caught Matt Hanson about 11 miles into the ride then caught Chris Lieferman about 30 miles into the ride. Chris was able to stay with me for the remainder of the ride and we eventually picked up Joe Gambles as well. I was impressed with Chris's riding. I was misdirected by a volunteer right before T2, and so I came in just behind Chris and Joe, but we were all close. I made a small error in not wearing socks on the bike (for the duathlon) so my T2 was a bit slow. I was pacing the run with my HR just like coach Jesse prescribed. I was in the virtual lead of the race for a few miles but Chris Lieferman was gradually pulling away from me, and Michael Raelert was starting to catch me. I kept to the plan and kept my HR low until the last lap of the run and then let it loose. I had a negative split run and ended up posting a run 1 sec faster than Michael Raelert. Chris proved to be too fast for me and easily won the race. Matt Hanson was fast on my heels and posted the only sub 1:15 run with a smokin' 1;11. I was happy to place 2nd on the day, and finally win some prize money. The cancelled swim actually hurt me on the day. as the swim is typically a strength. This was yet again, just another step in the right direction for the season goal of Ironman Arizona.
Bike File: http://tpks.ws/KhNLB
Run File: http://tpks.ws/wINel

There were only 3 weeks between Austin and Arizona and I did this exact same double in 2012. This time however, I was totally smashed after Austin 70.3. It took me way longer to recover then I caught a cold from kids 10 days before the race. I thought I was going to be totally unaffected but it turned into a nasty chest cough the day before the race. My only major concerns going into the race revolved around my lack of run volume. I've raced plenty of Ironmans in my life so this was nothing new, but this was definitely my lowest run volume going into an Ironman. My longest run was 16 miles and I had one day were I did a 9 mile run in the morning and an 8 mile run in the afternoon for a total of 17 miles. Despite not having the run volume my race specific intensities were going well so I was happy with the quality of my running.

The swim was probably the warmest in Ironman Arizona (November) history. It was still wetsuit legal but upper 60's felt great. I started all the way on the left side of the swim and took it out hard and had clear water. After about 5 min solo, I noticed a large group to my left and merged with them. I sat in the group for a while until I noticed there was at least 1 swimmer off the front. I went to the front of the group and tried to close the gap but it was too much. I actually felt pretty terrible at this point in the swim, and slowed my pace considerably trying to let someone else do the work. Nobody came around (until Philip Graeves just before the finish). I led most of the front pack out of the water only because I wanted to minimize time to the swimmers in front. My chest cough was rough getting out of the water as it hurt to take a deep breath, but I was more focused on quick shallow breathing.

Once on my bike, I quickly went to the front of the race. Cameron Wurf passed me quickly but then I spent most of the ride in second place. I had two guys riding behind me for most of the ride until they fell off the pace at the start of the third lap when Lionel Sanders passed me for second place. My power on the bike was low, I was struggling to hold power that is normally quite easy for me. I focused instead on being efficient, using my watts to my advantage and staying as aerodynamic as possible. I had my lowest power ever at Ironman Arizona with an AP of 257 watts and an NP of 262 watts. I also had my fastest time with a 4:11 bike split. Link to my Training Peaks File here: http://tpks.ws/snJ1t This should tell you something about the conditions on the day. I was very happy to get off the bike and start running. I kept my run HR and pace very controlled. I quickly passed Cameron Wurf to put myself in 2nd place behind Lionel Sanders. It was only a few miles later that Brent McMahon passed me and I was back in third. My nutrition was totally dialed. I took one Glukos gummy every mile along with on course electrolyte drink. I did have to make a porta-potty stop about mile 10, at the TriSports aid station under the bridge. It was great to have Seton Claggett (CEO of TriSports) timing my potty break and shouting words of encouragement as I emptied my bowels. After the relief, I didn't have any cramping and felt well fueled for the marathon. . I was however starting to struggle to hold my pace and HR right about 13-14 miles into the run. My pace gradually slowed as I struggled to keep my HR reasonably high. I was soon in survival mode to get to the finish line...one mile at a time. I was close to breaking the 8 hour mark, but my pace at the end of the marathon was just a little too slow.

Bike File: http://tpks.ws/snJ1t
Run File:http://tpks.ws/7bdqy 

I was nowhere near Lionel Sanders who went on to break an Ironman World Record and Brent McMahon who finished in 7:50. I crossed the line in third with an 8:02:30 for my fastest time of my career. I was a couple of minutes up on 4th, but very happy to cross the finish line on the podium at an Ironman. This is my 5th time racing Ironman Arizona and I have 5 podium finishes, 3x3rd place finishes and 2x 2nd place finishes. Each year I have posted a faster time and I am still yet to win the race. I am at least making strides in the right direction. This was a great finish to 2016 and a great way to commence 2017. I am sitting in a solid spot with Ironman Kona Qualifying Rankings and look forward to taking a journey back to the Big Island in 2017 (after some more solid racing in 2017). I am super thankful to be healthy and back racing. Cheers to family, health, and passionately pursuing what you love.

Work hard,

TJ

The Fabella Bone is Connected to the Knee Bone?

What the hell is a Fabella bone? Fabella (from Latin, small bean), is a small sesamoid (floating) bone embedded in the tendon of the gastrocnemius (calf) muscle behind the lateral condyle (outside bump) of the femur (leg bone). The fabella bone is present in 10-30% of humans and is often thought to be formed as a result of muscle stress on a joint. It acts like a pulley allowing the muscle tendon to apply more force to the muscles. Extremely rarely, this fabella bone can cause lateral (outside) knee pain. There are very few published studies on the cases and almost all incidences of fabella syndrome occur in high level (professional) athletes.

As it turns out, my fabella bone had worn a nice little groove in the cartilage of my femur causing pain when running. It took a long time to figure out exactly what was causing my pain, and even once it was figured out, it wasn't a sure solution as it is often a constellation of problems causing the pain.

On January 2, 2016, I was doing a 13 mile run on the snow/ice covered roads in Des Moines, IA. About 8 miles into the run, I jumped from the street to the sidewalk and my right foot slipped on the ice then came to an abrupt stop. It hurt, but I continued the run. I stretched that evening then went to bed with very little pain. The next morning I could hardly get out of bed my right knee was in so much pain. I took it easy for 3 days and my knee was about 90% better and I resumed regular training. I had an MRI, X-Rays, and Ultrasound of my knee and all came back normal with no significant pathology but a possible strain and/or tendonitis in my popliteal tendon. 

 

I went down to Clermont, Florida, in February for the QT2 Pro Camp and put in three really solid weeks of training but left camp with a very sore knee. I had a second read on the MRI and it confirmed what the original read suggested. Strong in-tact knee with no major pathology but some possible tendinitis of my popliteal tendon. I continued through physical therapy and training and was managing the inflammation and pain. I was training, but was not training at the full volume I wanted to race a full ironman, but adequate for 70.3 fitness. 

 

I delayed the start of the season until New Orleans where I was unable to actually finish the race because I was left stranded on the side of the road at mile 46 with a flat tire and a broken valve extender. Next on my list was to race Eagleman and before the race I had stem cell injection in my knee to aid in the inflammation and healing of the tendinitis. I was back to running with little to no pain but just before the race I tweaked my knee again during a training run and decided I need to get in contact with the folks at the Steadman Clinic in Vail, Colorado, where I had two previous hip surgeries (both with great success). I scratched the race at Eagleman to figure out what was wrong. 

 

We did another MRI in Vail, and the same results showed up. No major pathology of the knee but some possible tendinitis of the popliteal tendon. I was fine to keep training and racing, it was really just a matter of pain management and it didn't bother me swimming or cycling and I was able to run on flat surfaces with little to no pain. The popliteal tendon attaches the small popliteus muscle to the femur behind the knee and is used for stability primarily when running on hills. I was careful to keep most of my running flat while letting the tendontiis calm down and managing the inflammation. I was icing regularly and using Voltaren anti inflammatory cream to manage the pain and inflammation. 

 

I was all set to race in Mont Tremblant for the 70.3 and had a front pack swim, came off the bike with a pack of guys in second through sixth place and ready to run. On the first big downhill of the run about 1 mile into the run, I could feel my knee slightly give way then it started causing me a ton of pain. I had not been doing much hill running in training to keep the tendinitis at bay, but what I felt during the race was just too much pain. The pain grew more intense and I finally gave up on the run at mile 3, got some ice at medical and withdrew from the race. I flew back home to Iowa that night disappointed and in a lot of pain. I had a follow-up appointment after the race scheduled for Monday evening in Vail with Dr. Matt Provencher. I flew back out to Vail on Monday and saw him in his clinic that evening. Dr. Provencher did an exam of my knee and I tested positive for fabella syndrome. Dr. Provencher and Dr. Robert LaPrade agreed to add to me to their already full surgery schedule, on Tuesday June 28 at 7 AM to remove the fabella. 

 

These are both world class physicians who have worked with some of the top athletes in all sports. Dr. Provencher was formerly the medical director of the New England Patriots and Dr. LaPrade has done surgery on many of the most famous sports stars around. I arrived at the hospital in Vail at 5:30 AM and the doctors were there early to greet me and we started the surgery at 6:30 AM...ahead of schedule. The operating room was crowded with PA's and fellows eager to see the results of this rare combined super surgery of Dr. LaPrade and Dr. Provencher. What they found during the surgery was  I had a small tear of my meniscus (which was not present on the MRI taken just 3 weeks before). My popliteal tendon had severe tendinitis (from the fabella) which they debrided. They did a small release on my IT band to allow more movement and less friction in the area as a preventative measure. My peroneal nerve was also highly inflamed so they did a neuropathy to move the nerve away from the inflamed tendon. They also removed the fabella bone which was about the size of 3 dimes stacked on top of each other. My fabella bone had rubbed a groove in the cartilidge of my femur and had caused severe peroneal nerve irritation along with popliteal tendonitis. The surgeons extracted the fabella bone and now I have no posterior lateral knee friction. I just had this surgery one week ago on Tuesday morning and I spent last week in Vail doing rehab at the Howard Head Physical Therapy Clinic.

So what now? 

It is early July and I just had knee surgery. I am only 2000 points away from qualifying for Kona and still have 3 more races to score to get there. My hope was to score two 70.3 and race one Ironman and get all the necessary points to put me back on the start line in Kona. The reality is that I must undergo a 6 week rehab after this surgery and then rebuild my fitness. I don't know the rest of my race schedule but I am currently planning on racing the Des Moines Olympic Distance Triathlon on September 4, hopefully one or two 70.3 races, then Ironman Arizona on November 20.

I believe my best racing is still ahead of me and will take on this rehab with all the zeal of vigor of a champion.

Cheers,
TJ

"Change is the law of life." John F. Kennedy

Change is inevitable for all of us and everything must change at some point. This year I am changing triathlon coaches. I first met Cliff English while living at the Olympic Training Center in Colorado Springs in 2005. Cliff began coaching me in 2009 and for 6 years I made steady improvements in my training and racing. 2009 I raced Ironman Arizona and went 8:20:22 and finished 2nd. 2015 I raced Ironman Arizona and went 8:04:17 and finished 3rd. This was my fastest Ironman to date and also shows a solid 16 minute improvement on the same course over a span of 6 years. I had many highlights while under the tutelage of Coach Cliff, most notably winning the 2014 Ironman North American Championship in Mont Tremblant but also winning my first Ironman in Lake Placid in 2011. Overall, Cliff coached me to 8 Ironman podium finishes and all of my personal bests. I will forever be grateful for the time under Coach Cliff and I learned a ton about the sport of triathlon, but even more about myself as an athlete. 2016 is a big change for both Cliff English and for me. Cliff is now the head coach for the first ever women's NCAA division I triathlon team at Arizona State University. I know this a role where Cliff will excel and thrive. While Cliffwill be keeping a small roster of ITU and Ironman athletes in addition to his head coaching responsibilities at ASU, I felt it was time we both adjust our focus a little for improved results. 

Moving forward I will be coached by Jesse Kropelnicki at QT2 Systems. Jesse is an accomplished coach with a great resume and roster of professional athletes. I will be joining Jesse and his squad of professional triathletes at his annual pro camp in Clermont, Florida in February. I felt Jesse was the right coaching change for me at this time because of his detailed emphasis on strength, diet, and race nutrition. Jesse is an engineer by background and also an entrepreneur running one of the largest triathlon coaching companies in the world. I put my complete trust in Jesse as I move forward and focus on qualifying for Kona in 2016 and racing Ironman Brazil in May. As I move forward in my professional racing career it is important to build upon the knowledge and experience I have gained thus far. So as Coach Cliff hands off the reigns to Coach Jesse, I am both thankful for all the knowledge and expertise bestowed upon me by Cliff and optimistic that my best racing is still ahead of me under the guidance of Jesse. 

Work Hard,

TJ