Claudette Lajam M.D. has offered up $50 premes for the Women’s 3/4 and Women’s Elite races under her almost superhero-esque moniker OrthoChick.Net! Don’t complain boys … you’ve been getting the good premes since time eternal (since you make the rules). So women: race like your entry fee and round of drinks depend on your first lap!
I first met Claudette under not-so-appetizing circumstances. Somewhere in the wilds of Long Island I was forced off the road by a truck and landed squarely on my knee. After posting on the CRCA board I received numerous recommendations and all roads seemed to lead to Claudette’s office. I was fixed up (without surgery, thank god) and was back in action a couple weeks later.
Seeing that in my first ‘cross season I have managed to knock my knee against something in almost every race, I thought I’d use this interview opportunity to pick Claudette’s brain without paying a copay. And now I’m sharing ….
What is one thing everyone can do to keep their knees healthy?
The most important thing is keeping your weight at a reasonable level. Obesity is the worst thing you can do to your joints. Keeping yourself fit — obviously cyclists already do this — and at good weight is probably the most important thing you can do.
The second most important is to not ignore an injury. If something last for more than a couple days it needs to be looked at. When you tear away some of the soft tissues inside the knee, and your knee continues to swell and cause trouble, it’s going to cause damage to the cartilage inside your knee if you have loose torn pieces in there. So it’s important to have someone look at it, and let you know if it’s smart to continue your activity level, or whether you need more tests done. As young people, when you tear the soft tissues, you can actually ruin your cartilage.
.. Wow, so I think I need to see you again then.
It keeps swelling up?
Oh no this is another knee. With cyclocross you’re always banging yourself up and it is hard to figure out if it is just a bruise, or you’ve done something worse. What’s the difference between a bruise and “something worse”?
I can’t diagnose people over the Internet, but usually a bruise doesn’t cause swelling inside the joint. So if you bruise the soft tissue, and it is just the “meat” of the knee that is swollen, that’s one thing. If the inside of the joint is swollen, or if it is swollen in the back, that’s an effusion. The inside of the joint is full of water. The bruising of soft tissue is different. Sometimes you can tell the difference, but it is a lot easier when someone else is in the room as opposed to over the Internet.
A lot of time, when you hurt your knee, it is just a matter of switching your activity or cross training for a little while. Unfortunately a lot of people don’t do that, and they end up taking themselves out for two seasons instead of half a season.
How was your cycling season this year?
I didn’t have time to train so I didn’t race very much. But I did take a lot of pictures.
How did you feel when someone insulted the pictures you posted online?
Well they weren’t good! I just bought the camera. I had never done it before. I was just testing it out. You know what buddy, if you want to look at them, go look at them!
A lot of people who do this are amateurs. They’re never going to see a pictures of themselves competing. And even if it is a little blurry, people want to see a picture of themselves. I certainly do. So I posted everything that showed distinguishable people on my Flickr site.
I am not particular about my vanity!
Some of these people are so spoiled. Why isn’t a professional photographer taking pictures of me in Central Park. You know, I’m not a professional photographer I’m a surgeon! Give me a break.
Do you get a lot of referrals from within the club?
It’s more a matter of people who know me, and know that they can rely on the fact that I can understand where they’re coming from. I know they want to get back on the bike. And I know how hard it is to not be able to ride for a period of time. You get really addicted to it. Having a doctor who understand your activities is important.
When I went to the Emergency Room with my heart thing, the guy laughed at me because I used a heart rate monitor! And then I pulled out a printout. That really scared him.
We are the extreme of some things. Cyclists are very fit but we’re also idiots in a lot of ways. We abuse our bodies to a point that it is not so healthy. You’ve got to put ego under the table and take care of yourself.
I found that at the end of season, in terms of my overall body makeup, that I had suffered. My core strength had fallen away. I was only good for one thing.
That’s why coaches are increasingly making you work on your core strength and balancing other activities like Yoga and Pilates with cycling. Those are a good mix. And your diet is important. A lot of good coaches will check you’re not anemic and suffering from all of the high intensity work you’re doing. A lot of the cycling programs like Cycling Peaks are now making you input your sleep and stress so you can come up with a training stress score. That is probably one of the single most parameters of your training — not how much power you’re putting out — but how much stress you’re putting on your body and when you should take the day off.
I find that to be the best aspect of using a Power Meter. Knowing my power over 20 minutes is an exercise in futile comparisons. TSS keeps me healthy if I pay attention (note, I didn’t, and had a terrible sinus infection, and was diagnosed with non sustaining ventricular tachycardia and AVNRT).
Exactly. You just did a four day stage race. You should be spinning and relaxing!. A lot of people don’t take it that seriously. Part of that is the fault of being in New York. Everyone wants to get better instantly. We’ve persuaded ourselves we can heal ourselves faster than the average human. And you can’t.
And what is more ironic is that those scores are made for professional athletes. The tools are there for professionals to use. If anything, they are better than we are and we should take MORE time off!
… John, I’m getting a call from the hospital. Hold on …
We have to get you on a bike on Sunday! We have demo bikes!
That’d be a blast. I’d like to try. My coach thinks I’d be a good track racer but we’ll see how that goes. If can stop working for more than 2 minute…
It’s amazing you even get out on the bike! I’m an itinerant half employed business consultant and I get to ride a lot. You’re a real professional!
Last night I got home at 10pm and left at 6am. I didn’t have the energy. I hadn’t eaten anything all day. I almost fell asleep in the middle of a sentence. You work really hard. I told my coach … my schedule sucks. I find myself waking up a little early and doing an hour in the morning and an hour in the evening. You’ve got to find your time to do it.
And I’m realist. I’m 40 years old. I’m never going to be on a Wheaties box. I just want to have fun and be a little competitive and stay in shape. But people in your age group like Colin … you guys could do really well.
Colin is TEN YEARS younger than me. I’ll be a Master next year.
Oh yeah. Um. Yeah. Colin is an unbelievable athlete. It’s just sick.
He’s doing really well at ‘cross
He’s really intense. His father did a ‘cross race. He’s an opthamologist. He rides a little bit. He did a cat 5 race and he finished at the front of the pack.
I’m amazed that you can brave a pack after seeing all of these injuries!
I’m naturally an aggressive person. I played soccer my whole life. But when it comes to that, and I see people going down, or when I expect something is going down, well I just put the brakes on. Not worth it for me! If I do something to myself and can’t work that’s it. That is way more important to me.
And also, when I see people go down there is something that is programmed inside me that I have to go and attend to them. Maybe someday I can turn that off and assume that an ambulance is there to help them. I get drawn over to help.
Have you ever worked with a pro pro pro level athlete?
When I did my fellowship we took care of the Knicks and the Nets. I wasn’t their primary doctor but I was involved with their care. With my residency I was involved with pro level hockey, pro level basketball in Minnesota, and major league baseball. Professional athletes have a completely different barometer for injury.
This is what I tell my amateur level athletes … especially young ones. When they say I want to play, I want to play, I want to play, I say “who is paying you to play”? They say “nobody”. So I say you have one right knee, and what is that knee worth to you? If a pro athlete gets through a game getting cortisone shots and then by the end of their career they’ve destroyed their body and joints, they got paid to do that. That was the agreement with the people paying them. At our level we’re not getting paid to destroy our joints. Put yourself in perspective! What’s it worth!
When an athlete goes down, it is also their full time job to get better! They’ll spend the week under intense supervision.
Remember Rocky IV with the Russian guy? That’s what it’s like. You’re their product and their livelihood. As amateurs your body is not owned by anyone by you.
With most injuries with the knee, spinning is fine. Cycling is probably the best exercise for your joints, not your bone density, but most people can spin. Racing is just dumb. What are you getting out of this? You have to figure out who’s paying you!
You can’t solve these problems just with deep stretching right?
Well, the thing is yoga is very good but it takes a very long time. They say that in yoga you see progress in 10 year increments. Massage and manual therapy and strengthening your muscles is very important. I recommend those foam rollers from PerformBetter.com. The first time you do it it hurts like a mother, but it acts as a personal massage. It is very important to keep yourself limber.
When I do the roller, my girlfriend says I look like some strange modern dancer with a prop!
You’ve offered these two $50 premes in the women’s fields. Hopefully we’ll get a lot of women out at the race.
You already have a lot of people signed up! That’s encouraging.
With ‘cross your not going to be going 60 mph and bail on cement. You’ll be going 15 mph and bail on grass. My girlfriend said she’d be more likely to ‘cross than road racing.
The whole portage element is an interesting skill set. How do you run efficiently and get over this barriers?
At the end of the season I decided to go out and run. It’s amazing how ill prepared I was to run. Our bodies are specific to the activity. I was useless at running
Think about people who do triat, and have to get off the bike and do a marathon. They call it a brick. It is hard for the first few steps. Your whole body is like “what they hell”.
Thanks for everything Claudette. We’ll try to get you on a demo bike at the race!
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