2023 IRONMAN World Championship Race Report

Woohoo!! Happy to report that I crossed that magic finish line on Ali’i Drive once again! After a very long Ironman season and a “train a bit but mostly have fun” approach to the twelve weeks between Ironman Lake Placid and the world championships in Kona, I wasn’t sure what to expect from my body and mind on race day. Coming off an amazing day at Placid (which you can read about here), I was as low-stress as I have ever been going into an Ironman, and I think that the relaxed energy and have-fun mentality set me up well for a great race. Here’s the recap!

Pre-race: Travel to Kona was overall smooth. I broke up the journey from Boston to Hawaii with a 2-day stop at Stanford for some research meetings, and that helped me adjust to the time change and minimize the impact of long-haul travel on my body. I arrived in Kona on the Wednesday before the race and got a few solid pre-race swims, runs, and rides in. I also made sure to get any and all bike mechanical issues out of my system before race day with a full tire-and-tube overhaul at the “Canyon House of Champions,” where the Canyon staff were doing bike maintenance on all Canyon bikes for free. Betty finally begins to pay for herself!

My dad arrived on Thursday and Connor flew in on Friday, and Team Katie was ready and in position for the Saturday morning start. My age group (25-29) was in the second-to-last wave at 7:15, so we actually started after the first pro women (led by the unstoppable Lucy Charles-Barclay) had finished the swim. I hadn’t done a mass deep-water swim start since my last time in Kona, and I had forgotten how chaotic that format can be. The entire age group (plus the 18-24 year olds, who were grouped with us) had to swim out 100-200 yards to the starting line and then tread water there for a few minutes, jockeying for a good starting position while trying to stay afloat and not kick anyone. Wetsuits are not allowed at Kona because the water is so warm, but the added buoyancy of the salt water almost made up for it as we floated there waiting for the gun to go off. I stayed as far to the right as I could so I had a direct line to the first buoy, and at 7:15 exactly, the race began. 

Swim: Historically I’ve felt that male athletes have been the most aggressive during triathlon swims, but the women of Kona proved me wrong! The long rectangular swim was chaotic and crowded for almost the entire time. I reminded myself that I had survived plenty of tough swims before, but that didn’t mean I enjoyed it when multiple people grabbed onto my shoulder or hip and pushed me down under the water as they fought for a good position. That said, I was probably guilty of doing the same, especially when I caught up with slower swimmers in the waves ahead of me, and the sheer number of people on the swim course made many of the collisions inevitable. My mild frustration at the chaos mostly melted away when one woman accidentally hit me on the arm as she took her stroke and actually took the time to shout “Sorry!” as my ear broke the surface. Apology accepted. 

Despite the challenging conditions, a quick glance at my watch every time it beeped for 500 yards revealed that I was having a really strong (for me) swim. I had done almost no open water swimming since Ironman Lake Placid and had avoided long endurance sets in the pool because I don’t really enjoy them, but I was somehow going faster with each passing 500 and feeling really smooth despite the ocean swells and mild chop. Excitement about the strong effort propelled me forward to the end, and I was out of the water in 1:10, which was about six minutes faster than my first time in Kona and not far off my time from Placid. Surprisingly pleased with the result, I jogged through transition (with comfort-driven stops including a quick rinse with the hoses, chamois cream applied, sunscreen, and a snack), and then I was onto the bike. 

Bike: The Kona bike includes a short out-and-back in town and then a very long out-and-back on the Queen Ka'ahumanu Highway (Queen K for short) all the way to a town called Hawi. It is notoriously known for sizzlingly hot pavement, relentless sun, high winds, humidity, and a surprising amount of elevation gain. Although it’s an intimidating course, I felt pretty confident about how to manage the conditions because I had done it before. For me, that meant prioritizing staying cool (with icy cold water bottles dumped all over me as I rolled through aid stations), fueling and hydrating as much as possible in line with my race plan, and staying in aero for most of the ride. 

For Placid and most of my training, I had used power to guide my Ironman bike effort, but my power meter had been broken for a few weeks leading up to the race, and I had actually been enjoying using heart rate and perceived effort as a guide instead. After consulting with Jim, I decided to not try to get the power meter fixed in time for the race and instead would focus on three key stats: average speed, average heart rate, and current heart rate. We wanted to maximize average speed (which meant being as aero as possible, especially on flats and downhills) while keeping average heart rate at a sustainable level (in zone 2) and not letting current heart rate spike too high, especially on any climbs or very windy sections.

This strategy worked well for most of the ride, and after initially spiking in the first 20-30 minutes of the ride, my heart rate settled into a very sustainable zone. The beginning of the Queen K had a nice tailwind too, so my speed was looking great and I felt pretty comfortable as I headed out to Hawi. I did well with nutrition and hydration for the first 1.5-2 hours, and although it was already a scorcher out there, I was staying on top of the cooling pretty well by grabbing cold water bottles at the aid stations and dumping them down my back and on my head, then returning to the aero position.

After about two hours, I started to feel a bit nauseous and crampy, which was likely driven by the extreme heat and the salt water I had accidentally swallowed during the swim. It was really hard to take in any of the solid food I had in my bento box (something about a soggy, congealed bar stuffed into a hot plastic box was not really calling my name), but I had about 50 grams of carbs / 200 cal in each bottle with a mixture of Skratch Superfuel and LMNT, so I knew I would be okay (if not optimal) from a fueling perspective if I could finish the bottles. I stopped at an aid station for about a minute to pee right before the long climb to Hawi, and that very quick break did help me refocus for the climb, which had a stiff headwind the whole time and was relentlessly hot and sunny. (I still have not mastered the art of peeing while on the bike.) Watching the pro women on their return trip to Kona offered a nice distraction—I could see Lucy up front, followed by Taylor Knibb, and then a huge gap to the rest of the pack. One of the tough parts about racing is that you can’t really watch the pro women’s race unfold, so it was great to get a glimpse of what was going on as I rode.

When I got to Hawi, I stopped again briefly at bike personal needs to switch out the three bottles I had finished for three new ones I had sent ahead. Unfortunately, I had déjà vu to the World Champs in St. George when I grabbed the bottles and realized that they were, once again, hot from having sat out in the sun for most of the morning. In my nauseated and sweaty state it was very hard to motivate myself to drink down the tea-like fuel, and I started to get concerned that my nutrition strategy was going to fall apart. Luckily, the long downhill from Hawi gave me some time to let my heart rate settle and digest the liquid without expending as much effort, and I was able to finish one of the bottles and get back on top of my nutrition strategy. 

The toughest part of the bike for me was from about miles 75-105, where we had a headwind, everything felt like it was uphill, and I was frankly just done being on the bike. I focused on just making it to the next aid station, and the next one, and the next one, and I got a few power-ups by grabbing the cold sport-top coke bottles they had stocked at the later aid stations (this was the only type of nutrition/hydration that felt appetizing at this point). In between, I worked together with a small group of women that were all about the same pace, staying the legal five-bike-lengths apart but keeping an eye on each other as a pacing strategy. I found that relative to other riders, I generally did well and would pass people on the climbs without much effort (a testament to my Upper Valley training), but was not as fast on the flatter or downhill sections since I don’t have access to a lot of that type of terrain. 

In the last seven or so miles of the bike, I passed the pro women on the run course and cheered loudly for Lucy, who was still well on her way to the overall title. I was thrilled to be done and glad to have a pro race update, and as I descended back into town I began to prepare myself for the run. I finished the bike in 5:55:00, about a minute faster than my time at Lake Placid and a result I was really happy with given the challenging conditions. 

Run: I again took a little bit of time to eat something quickly in transition and put on dry socks, and my legs felt pretty good as I jogged out onto the course. It was nearly the hottest time of the day—around 2pm—but I felt confident in my cooling strategy (ice down the kit and water on my head at every aid station) and knew that I could propel myself forward as long as I kept my heart rate in check and stayed on top of fueling and hydration. I saw my Dad and Connor in the first mile on Ali’i Drive and appreciated the familiar faces cheering me on. 

The Kona run course starts with about 7 miles in town on Ali’i Drive with plenty of spectators to keep you energized, then features the infamously steep climb up Palani Drive to the Queen K, a long out-and-back with a turnaround in the notoriously hot and hilly Energy Labs section, and then a return trip on the Queen K and down Palani to the finish line on Ali’i Drive. I felt good on Ali’i Drive and made it through the first 12 or so miles without any walk breaks except a strategic power hike up the steepest section of Palani, and I did a good job of taking in the SIS gels every few miles and coke, ice, and water at most of the aid stations. It was fun to see my Dad and Connor at mile 8ish, and my Dad literally sprinted down the road so he could get a better video of me passing by—go Dad!

Past the top of Palani, my heart rate was steadily in the low-to-mid 150s at roughly 8:30-9:00 mins/mile, which was exactly in line with my race plan. Even so, morale was up and down—similarly to the early and middle miles of Ironman Lake Placid, it was a bit demoralizing to do the math of how many miles (and hours) I still had left to go when all that I wanted to do was lay down in front of an air conditioner. After the halfway point, I made a deal with myself and said I could take a short walking break at every aid station (just enough time to grab adequate hydration and fuel) as long as I ran everything else.

I soon found myself next to another woman around my age who seemed to be running at the same pace as me with the exact same aid station strategy, and we ended up sticking together for over ten miles and keeping each other on pace. It turned out that she had qualified at Lake Placid as well, and I was super grateful to have her by my side for those tough final miles. We were moving more efficiently than a lot of people around us at this point; the carnage was starting to set in and I was just glad to not be falling apart. 

The sun started to set around mile 22 back on the Queen K, and at that point I knew that all I had to do was run home. I took my final aid station walk break at around mile 24, and then put my head down to pick up the pace for the final descent of Palani and turnaround on Ali’i Drive. That section felt longer than it had the first time, but I saw Connor at the bottom of Palani and again on Ali’i Drive, and I knew my Dad was at the finish line, so it was easy to break out a smile even though my body was beyond ready to be done. The crowds got louder and the lights got bright as I approached the famous Banyan Tree that stands behind the finish line, and I crossed the finish line once again to those magic words—this time announced by two amazing female announcers—Katie Clayton, you are an Ironman. Marathon time 3:57:46, total time 11:16:57. 

General thoughts: Kona was a well-executed race for me. I hit my goals of swimming, biking, and running faster than my first time at Kona, and my overall time was my second-fastest Ironman (behind Placid earlier this year, which I’m glad remains my perfect golden race). I exceeded my expectations given my more relaxed approach to training since Placid, and feeling the fitness I had built early in the season shine through months later in a completely different environment was affirming. I’m also really proud of how low-stress I was going into and during the race, and I was glad to see that putting less pressure on the result didn’t really change my ability to perform and motivate on course. And it was amazing and inspiring to race with all women—more races should be like that!!

More broadly, I’m super happy with how the season came together and grateful to Jim for building a plan that helped me achieve all of my goals for the year (and maybe for several years!) in Ironman racing. I actually feel a lot of closure with the Ironman distance, and I’m proud of everything I have learned from over five years of looooong endurance events. I’m excited to focus more on unstructured adventures, trail running, and gravel riding next year, and I may try some shorter distance races and/or adventure races that don’t require 22-hour training weeks and as much time running and riding on pavement. Before that, though, I plan to fully embrace the off season and enjoy moving and adventuring for fun only. It’s been a long time coming! 

Thank you to everyone for following along and for supporting my race and life journey! You all make this fun. :) 

Contraception Choices for Female Athletes

For anyone, choosing the right method of birth control presents a challenge. This challenge becomes even greater for female endurance athletes, as different methods have different pros and cons related to health and athletic performance. I’ve spent the last couple of months learning about the pros and cons of various contraceptive methods as I’ve debated whether to switch up my routine, and this post summarizes what I’ve learned about contraception and its effects on athletic performance. I should caveat this post with the disclaimers that (1) I’m not a doctor, (2) I have received no formal medical training (although this post has been checked and edited by multiple nearly-doctors and female badasses in my corner—you know who you are and thank you!), and (3) contraception choices are very individual-specific and have no “right” answers. You should absolutely do your own research and make an informed decision about what is best for you! 

Combined oral contraceptive pills (OCPs): OCPs deliver estrogen and progesterone systemically (i.e., throughout the body). A big pro is that it is easy to stop taking them for any reason without going through a medical procedure (such as IUD removal). However, some important cons for female athletes are that OCPs have been linked to worse athletic performance outcomes, including decreased VO2 max, higher oxidative stress, and/or decreased ability to adapt to intense training. This is largely because estrogen changes the body’s ability to hit intensities and recover from stress. Since OCPs pump a large amount of estrogen and progesterone through the body throughout the month (approximately 6-8 times the amount we produce naturally), women are effectively in a continuous high-hormone state and miss out on the natural fluctuations in hormones that generally allow them to hit higher intensities in the first half of their cycle (the follicular or low-hormone phase). When female athletes use OCPs, experts estimate that around 11% of their performance potential is left on the table. 

Moreover, an important misconception about OCPs is that they give you a natural period. There is a “withdrawal bleed” associated with the fourth week of the cycle (a placebo pill), but this bleed is not a normal period and does not indicate that a woman is cycling naturally on her own. This is why using OCPs for female athletes experiencing hypothalamic amenorrhea (stopped periods) is generally a bad idea (unless it is being used to treat other underlying health conditions such as endometriosis, PCOS, chronic pelvic pain, menstrual migraines, premenstrual dysphoric disorder, ovarian cysts, acne, or hyperandrogenism), because it masks the underlying problem of energy deficiency and may not fix the associated declines in bone density and other negative health outcomes. 

Note: Other options that include systemic hormones are the patch, the DePo-Provera injection, and the implant. There is less research on how these methods impact female athletes and endurance training given their often less-desired side effect profile, but there is reason to believe that they have similar systemic effects on performance. 

Hormonal IUDs (in a class known as long acting reversible contraceptives (LARCs); brands include Mirena, Kyleena, Liletta, Skyla, etc.): Hormonal IUDs (intrauterine devices) are small, T-shaped devices that are inserted vaginally and placed directly inside the uterus by a medical provider. Hormonal IUDs release small amounts of the hormone progestin (levonorgestrel) into your body, which prevents pregnancy by stopping sperm from reaching and fertilizing eggs via changes to cervical fluid that inhibit sperm transport and changes to the endometrium that inhibit implantation, among other mechanisms. Pros are that they are highly effective, can be used for 5-7 years, and do not release estrogen into the body, so they are not associated with the same negative effects on athletic performance as combined OCPs. By contrast, research suggests that they mimic a natural cycle and might even be beneficial at reducing PMS-related performance declines in the late luteal phase. Fertility also usually resumes immediately after IUD removal, while it can take longer to resume when coming off of combined OCPs and other systemic methods. 

However, important cons for female endurance athletes who are training at a high level and/or are worried about potential energy deficiency are that they can lead to stopped periods, which eliminates a key indicator that an athlete is handling fueling, training, and stress appropriately. (Note: This can also be a pro for those who are not worried about energy deficiency and prefer the logistical benefits of not dealing with a period.) The differences between hormonal IUD brands are the size (for example, Mirena and Liletta are slightly larger than Kyleena and Sykla) and the amount of hormones that are released into the body. For the Mirena, for example, which has 52 mg of levonorgestrel, about 20% of women will stop getting their period after a year, and for the Kyleena, which has 19.5 mg of levonorgestrel, about 12% will stop their period. There is currently no way to predict how a woman’s cycle will react to a hormonal IUD, but it’s important to keep in mind that IUDs can be removed. It also takes people a few months to adjust to the influx of hormones that come from the IUD, so cycles can be irregular and many people experience spotting as they adjust. People usually have their new normal cycle by 3-6 months.

Finally, IUD insertion can also be painful. That said, there are a variety of things you can do to mitigate this, including asking for lidocaine-prilocaine cream, taking misoprostol prior to insertion (though the data are mixed on whether this helps), using ibuprofen for cramping, and scheduling your training around the insertion procedure to give your body a chance to rest and do its thing. Many women agree that a small amount of discomfort is worth it for the peace of mind that they will not get pregnant. 

Progestin-only mini pill: For women who do not want the systemic effects of estrogen and progesterone but also do not want an IUD, there are progestin-only oral contraceptives. These pills are thought to have similar non-effects on athletic performance as an IUD and are easier to stop taking for any reason, although they are not localized. 

Copper IUDs (also a LARC; most common brand is Paragard): The copper IUD (Paragard) is a hormone-free IUD that works by creating a toxic environment in the uterus for sperm. It is one of the only hormone-free birth control options for women (other than medical sterilization and FAM) and is highly effective. It can also be inserted as an emergency contraceptive method, and is effective for up to 10 years. A big pro is that you will still get a period while using a copper IUD (allowing you to use your period as a guide for health and performance), but a con is that periods can generally be heavier or more painful for several months after insertion. Like with hormonal IUDs, the insertion procedure can also be painful, and the copper IUDs are the largest in terms of size (although they are still objectively small and do not interfere with athletic performance or sex). 

Fertility awareness method (e.g., Natural Cycles): Some people prefer to avoid hormones and devices altogether and will use the “fertility awareness method” to track their cycles and prevent pregnancy. By tracking indicators like basal body temperature, cervical fluid consistency, and cervical shape, you can identify with some certainty what phase of the menstrual cycle you are in and avoid unprotected sex during your fertility window, which can be about 7-10 days for most people. Apps like the Natural Cycles app have made tracking easier, and many women enjoy learning more about their own physiology throughout the process. However, this method does take a lot of effort and tracking behaviors, and it rules out unprotected sex for several days in a given month, which many people dislike. 

My experience

My main considerations related to choosing a birth control option were the following: (1) I probably want to get pregnant eventually, but not anytime soon, and I want to have high confidence that I won’t get pregnant now; (2) I do not want birth control to negatively impact my athletic performance; and (3) I like to use a natural menstrual cycle as a regular indicator that my body is handling stressors, training load (energy output), and fueling (energy input) appropriately. As someone who experienced RED-S (relative energy deficiency in sport) in college (you can read more about that here), point #3 was particularly important to me. 

For all of these reasons, not being on birth control and tracking my cycle naturally was the right choice for me for a while—that is, until I confronted the reality that condoms aren’t perfect and had to take plan B (an emergency contraceptive). While that was ultimately the right decision, it was an objectively bad experience for me for multiple reasons (happy to elaborate for anyone in a similar position who is curious), and I was confident that I didn’t want to have to take plan B again unless absolutely necessary. So that meant that I needed to find a new birth control solution that would give me greater certainty that I could avoid an unwanted pregnancy. 

I was fairly certain that all methods that featured systemic (non-localized) doses of estrogen and progesterone (including OCPs, patches, injections, implants, etc.) were off the table for me because of their potentially negative consequences on athletic performance. That left me with hormonal IUDs, a copper IUD, or the fertility awareness method. FAM seemed like a lot of work to do correctly, and I was worried that I would not feel as confident about the effectiveness of the method as I would with an IUD.

The copper IUD was attractive to me because it contains no hormones, but I was concerned about the performance effects (and logistical nuisance) of potentially heavier, longer, and more painful periods—especially when I’m well on my way into a big IRONMAN build. I actually sent Colleen Quigley—an Olympic steeplechaser-turned-triathlete and social media influencer who has been amazingly vocal about her copper IUD experience—an Instagram DM asking for her thoughts, and she reiterated that she loves the copper IUD now but would recommend getting it placed during an off season rather than during peak training, which wouldn’t have been an option for me until the fall. 

For the hormonal IUDs, my main hesitation was the idea that I could end up not getting my period, which would make it harder to have an objective indicator of overall health and balanced energy input and output. Ultimately, I decided to go with the Kyleena, one of the two lower-dose hormonal option (my OB-GYN told me that the Skyla, which is technically the smallest and lowest hormone dose, is being phased out of use because it’s not very different from the Kyleena and only lasts for three years before it has to be removed or exchanged). I then learned more about ways to keep tabs on your cycle even without having your period as an indicator, including:

• Keeping track of other menstrual cycle-related symptoms, including patterns in resting heart rate or heart rate variability, breast tenderness, feeling more bloated (a result of fluid retention), mood swings, sex drive, cervical fluid, etc.

• Keeping track of symptoms related to energy balance, including weight loss, mood swings (especially anxiety/depression), persistent illness, injuries, sleep quality, performance declines, always feeling cold, etc. 

• Optionally, getting bloodwork done to measure estrogen, progesterone, and testosterone to let you know whether you are in the follicular or mid-follicular phase. 

The insertion procedure itself was not fun at all, which is another important potential con for people considering getting an IUD. I had heard that the Kyleena insertion might be the least painful (compared to the Mirena or the Paragard) because it is the smallest in size, but holy hell it was an experience. I took misoprostol the night before the procedure, which is theoretically supposed to make insertion less painful by dilating the cervix. I also took ibuprofen about 30 minutes before the procedure and throughout the day afterwards, and I had planned a very easy training day. Even so, my OB-GYN had to do the insertion twice because according to her I have “the strongest pelvic floor she has ever seen” (humble brag, I know) and it hurt a lot both during and afterwards. But I woke up the next day feeling a lot better and have only experienced mild cramping and other PMS-like symptoms in the days following, and have mostly resumed normal training. 

I’ll have to do a follow-up post in a few months to definitively weigh in on how the IUD did or did not affect my experience as a female athlete, but for now, I stand by the decision that I made. I know that my odds of getting pregnant are extremely unlikely, I am confident that the IUD is unlikely to negatively impact my performance, and I have a plan for how to stay on top of health indicators even if I end up in the minority of people with an IUD that do not get a period. I also feel empowered for making an informed decision. Special thanks to the many amazing friends, doctors, and other important women in my corner who shared their experience, expertise, and insight to help me figure this out—girl power!

Some resources if you want to learn more about contraceptive methods and pros/cons:

• The Contraceptive Conundrum (Stacy Sims)

• The Effects of Contraception on Female Athletes’ Performance

• Bedsider Birth Control Support Network

• A guide to figuring out which IUD is right for you

• Will an IUD make your period go away?

• Colleen Quigley’s IUD story

• IUD comparison chart

• Contraceptive Choice Center 

• ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life

• The Female Factor

• Taking Charge of Your Fertility

• The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility

• The Lowdown: Contraception Reviews

A few favorite social media follows on topics related to contraception/ the menstrual cycle and female athletes:

• Dr. Stacy Sims

• Colleen Quigley

• Tina Muir

• Dr. Hazel Wallace

2021 IRONMAN World Championships in St. George Race Report

It’s hard to believe, but the IRONMAN World Championships in St. George—and a six-month training block that featured the highest training volume I have ever done—is over. The epic journey to race day was full of plenty of ups and downs, and the stress of it all peaked about a week out from the race with last-minute bike mechanical issues and COVID close contact scares. Luckily, everything mostly worked itself out by midweek, and I arrived in St. George on the Wednesday before the race with my co-pilot husband Connor and a functional bike. We checked into our condo with Jim and Ben and then proceeded to get the final race prep logistics underway. 

Pre-race jitters

The pre-race “training plan” called for extremely light movement that was designed to “activate, not overload” the body. This meant that on Thursday morning, we drove out to Sand Hollow Reservoir to do a practice swim. Unlike at Lake Placid or Kona where you can go swimming in the open water whenever you want to, the practice swim at St. George was highly regulated. You lined up in your wetsuit with all of the other racers during a specific time window, put on a timing chip, and swam a designated 900-yard course with turn buoys before exiting the water. It felt like a super chill open water swim ‘race,’ and the experience of having to line up and wait to swim, enter the water when it was your turn, and then follow the course exactly was a really nice way to simulate how race morning would feel. 

At 59.4 degrees F, the water itself was freezing. It was the kind of breathtaking cold that numbs your hands and feet and gives you a headache. Jim and I wore silicone ear plugs and wetsuit booties, but it was still the coldest water that I have tried to open water swim in. We completed the loop, but I exited the water with a sinking feeling that even the swim during this race—which was supposed to be nothing more than a warm up for the bike and run—was going to present many of its own challenges.

On Friday morning, we continued our pre-race activation sessions with a short run and a short ride. I ran early in the morning, but it was already hot out and my heart rate was higher than it should have been—probably a combination of conditions and nerves. I then headed out for an easy spin with Ella and Jim. The bike had been one of the bigger challenges for me leading up to the race. Fitness-wise, I was prepared, but mentally I was struggling to overcome a lot of anxiety on the bike that had started happening during our race simulation weekend in St. George a month before (you can read about our experience here). I was so nervous that I ended up in panic attack mode once again during shakeout spin and had to get off the bike and calm down for 10 or 15 minutes before soft pedaling back to the house. This was not an ideal way to close out the pre-race workouts, and it definitely shook my confidence. The rest of the day was spent getting organized and trying—unsuccessfully—to stay relaxed. My parents Bruce and Julie, and Jim’s son Soren, all arrived that afternoon and evening to complete our support squad. 

Race morning

Race morning was a bit of a logistical nightmare. Unlike at most races, where T1 and T2 are in the same location, the St. George T1 is located a 35-minute drive away from town at the reservoir, while T2 is located in the center of town near the finish line. This meant that all athletes had to show up in town with our special needs bike and run bags (bags that we have access to during the bike and run), drop those off, then board school buses and drive out to the swim start. Jim and Ben were scheduled to start earlier than I was, so they left the house with my dad at 3:45 am, and Connor and I got a ride over to the town square at 4:30. I ended up waking up before 3 am (for less than four hours total of sleep), and saw Jim and Ben off before heading out in the later shift. 

I was able to get on a bus fairly quickly, but Connor was not allowed on the athlete buses and had to wait on a separate line to board a bus for spectators. I put in headphones for the ride over and tried to stay relaxed, sipping on electrolytes and snacking when I could. There was a lot of nervous energy on the bus, and zoning out was the best way to avoid absorbing even more nerves. 

When the bus arrived, I headed over to T1 to put my snacks and bottles on my bike (which I had dropped off the day before), topped off my tires with air, and then found Jim and Ben. Our pro move was to bring inflatable sleeping pads with us so we could lay down on a comfortable spot while waiting for *over 2.5 hours* to start the swim; most athletes were just laying or sitting on the ground. Although it was a long wait, time went by quickly, and before we knew it it was time to get wetsuits on and get ready to go. Jim started around 7:15 am, Ben was close to 7:30, and I was scheduled to start at 8. Just as they were getting ready to line up for the swim start, I found Connor, so I had someone to wait with after they left. My parents and Ella and Colleen all arrived soon after that. Then it was time for good luck hugs, a few photos, and the dreaded walk to the holding pen where I would line up with everyone else in my age group. They shuffled us along faster than expected, and all of the age 18-29 women entered the water three at a time in our green swim caps a little before 8 am. 

The swim

The first good thing that happened during the race was that the water was not as cold as it had been on Thursday. A few days of 90-degree temps on Thursday and Friday and mild evenings had warmed the water up to about 64 degrees, so it was definitely less shocking than it had been during the practice. I settled into a rhythm quickly and focused on keeping my stroke long and smooth and my effort easy. It was very bright in the water and I had chosen clear goggles that fit me better than my mirrored ones, so it was a little hard to see the turn buoys, but I think I sighted fairly well and was able to stay consistent with pacing. After about 1000 yards, I made the first turn, and realized that there were a few other women in green caps around me. I figured that if we had swam the same pace up until this point, they were probably trustworthy to draft off, so I settled behind someone with a strong kick and cruised there for another 1000 or so. I could tell that there was someone right behind me too, so we had a pretty nice pace line going on. 

One of the problems we kept running into was that there were a lot of slower swimmers ahead of us. Unlike at Placid, where swimmers seed themselves based on expected finish time, the World Championship races feature age group starts. The women were last (classic), so we had to fight to pass every slow swimmer in the previous waves. The water got pretty congested, especially around the turn buoys. I did my best to just stay near my drafting buddy who was pretty good at crowd control, and after about 3000 yards we had passed most of the slowest swimmers. 

With 1000 to go, I decided that my pace felt relaxed enough that I still had plenty left in the tank, so I moved to the front of the pace line and increased my turnover. I ended up dropping my pace line crew and cruised into the finish in a time of 1:10, which was about the same as Placid and considerably faster than Kona. Considering that I had only done one open water swim in the 8 months prior to the race (the 900-yard practice on Thursday), I was happy with my time and effort and left the water feeling ready to take on the bike.

T1 

The wetsuit strippers helped me get the wetsuit off in three seconds flat, and then I headed over to T1. As I jogged over to the change tent, I realized that my left shoulder was really hurting near my rotator cuff. I’ve never had an injury there before, but I think I just wasn’t used to swimming with the added pressure and weight of the wetsuit and had thrown something off. At least the major rotator cuff work for the day was done, so I put it out of my head and tried to get mentally ready for the bike. I threw on my helmet, glasses, socks, shoes, and fingerless bike gloves (useful for sweaty hands in the heat), made sure to put sunscreen on, and jogged out to grab my bike while eating a fig bar. I made it out of T1 in a few minutes, saw my family and friends cheering, and headed out on the bike.

The bike

My strategy on the bike was to hold back as much as possible. I had learned during the race simulation weekend that it was extremely easy to overcook it by riding “normal” IM watts since the heat, altitude, and wind are so challenging. That meant that I had to focus on impulse control above all else and prioritize keeping my HR in check, eating, drinking, and staying cool. 

As it usually is after the swim, my heart rate was skyrocketing in the beginning of the bike, and my rotator cuff was bothering me, but I was able to get things under control by taking the first out-and-back section nice and easy. There were people passing me that seemed to be attacking the initial rolling hills pretty hard. I fought the urge to keep up because I knew that I would probably see them later in the day. Within 30-45 minutes, my HR settled to a high zone 2 sustainable effort, and I actually felt a lot less anxious than I had felt previously. The course was closed to cars, the wind had not yet picked up, and it was warm but not yet HOT. I tried to smile for the on-course photographers and kept reminding myself to chill out and have fun any time my HR started to creep up, because I still had a long day ahead. 

At around mile 25-30, we rounded a corner and started the grind west towards St. George. This 20+ mile section had a bunch of relentless and annoying hills, and a really strong headwind was picking up. Temps were also creeping towards the high of the day (94 degrees F). I made a point of rolling through every aid station and grabbing a cold water bottle to dump on me, which always gave me a little boost before it all evaporated and left me completely dry and hot again in a matter of minutes. I find that encountering challenging conditions in the first half of the swim, bike, or run can sometimes be mentally harder than during the second half because of the sinking feeling that you still have so far to go. Grinding against that headwind and trying to stay fueled and cool, I hit a bit of a low morale point. I eventually hit a downhill cruise into town, where I could get to bike special needs and pick up my Skratch bottles that I had sent ahead. 

Unfortunately, my bike bottles (and everyone else’s) had been sitting in plastic bags under desert sun for hours, and the Skratch was actually hot when I first took a sip. The thought of getting all of that down in the already scorching temps made my stomach turn, and I spent the next few minutes puzzling through what to do so I could get enough hydration and electrolytes in. When I arrived at the next aid station, I met an amazing volunteer who offered to put ice in my bottles, which completely changed the game and got my hydration strategy back on track. She also dumped ice down my back and in my sports bra which really helped get that core temp down until the next aid station. I gave her my “best volunteer” bracelet and left the aid station feeling totally rejuvenated and ready to tackle the long climb up to Veyo. 

This was the point where I noticed that most people were really struggling. I don’t think everyone had figured out the body ice trick (or even the cold water bottle trick), and a lot of people started to fall off the pace. Even though we had a tailwind that was helping us up the climb, I saw some people walking their bikes up steep sections and others that were sitting in the shade with their head in their hands. I actually felt pretty good here, and I started to pass people who had flown by me in the first 10 miles. I made it up the Veyo Wall (a very steep section before town) and to the next aid station where I could continue the ice and water strategy. Coming to a complete stop for 30 seconds or so at every aid station from there on out definitely lost me a little bit of time relative to rolling through, but ultimately I think that the speed and energy boost I got from cooling off was worth the slowdown. 

From Veyo (mile 80) to the end of the bike, the carnage really started to take shape. We entered the windiest section of the course with crazy crosswinds that shake your bike, and it was the hottest part of the afternoon. I saw at least five grown men sobbing at aid stations, being consoled by volunteers. I saw people who had crashed out going 35 mph after being hit by a crosswind in aero. I saw people with heatstroke who had passed out in the kiddie pools filled with ice for drinks at the aid stations, and ambulances coming to retrieve them. I was definitely not feeling amazing, but seeing how rough other people’s race was going, I actually felt pretty good. I sat up during the windiest sections and held on so tight that my hands and wrists were hurting, but I made it through the wind in one piece without any crashes or panic attacks. 

The very end of the bike course was a real slap in the face. Riders come back through town near the finish, and then leave town again to do the iconic 1200-foot climb up Snow Canyon before descending into T2. The climb started at around mile 97, and the canyon itself felt like a furnace. The wind that had assaulted us for miles was totally gone and there were no aid stations in the canyon, so you basically had to just dig deep, put your head down, and climb. More people around me were walking than riding, and many had just abandoned their expensive tri bikes on the side of the road and were laying down 100 yards back in the shade. And these were fit-looking people! I truly had never seen anything like it.

Finally, I made it to the top of the climb and turned right to descend through the crazy wind tunnel section (yes, we had to do it twice). I saw my parents and Connor at an awesome spectator spot on top of an overpass, then cruised back into town and along the run course before making it to T2. I had finished the bike with an elapsed time of around 6:44 and moving time of 6:34, for over 112 miles and 7300 feet of climbing.

T2

Getting off the saddle felt great, and I took my time putting on run shoes, visor, and race belt before heading out to the run start. I was a little chafed from the bike and grabbed some much-needed vaseline too (thank you volunteers!). There was an aid station right at the T2 exit, and I grabbed some coke and dumped more water on me before cruising out to the course. I saw Ella, Colleen, and Soren right there, and was so excited to ever-so-briefly interact with friendly faces after hanging out in my own head on the bike for nearly seven hours. Then it was time to start the IM shuffle! 

The run

The run course in St. George is the type of course you would expect if the race designers’ goal was to put together the most brutal run possible (which it probably was). It’s two miles uphill, 4 miles downhill, then 4 miles back uphill, 2 miles downhill, and a little out and back in town that gives you a false sense of being close to the finish. Then you do that whole thing again. What the hell?!

Even though it was extremely hot and windy, I actually felt okay for the first two uphill and four downhill. I was grabbing coke at aid stations and dumping cold water on myself whenever I could. At the first run turnaround, however, I was definitely starting to hit a low point, and I knew that I was low on fuel and low on electrolytes (I had expected there to be base salt at the aid stations and there was not). I was trying to take in gels but my stomach wasn’t very happy with me, so I had to stop by the porta potties twice. I ultimately made a deal with myself and said I needed to keep running except through the aid stations, where I could walk for up to 30 seconds. Going from aid station to aid station like that made the massive mileage more manageable, because all I had to do at any given time was run another mile. What’s more, basically everyone around me was walking or stopped, so shuffling along at 9-10 minute miles actually felt pretty fast. 

After the first 13.1, I stopped at run special needs to try to get my salt pills that I had sent ahead there. The volunteers had some trouble finding my bag, so I wasted about a minute standing there waiting, but I ultimately think it was worth it because the salt immediately helped with the stomach issues and made me feel a little better for the second 2-up 4-down section. I also saw our support squad several times, which gave me a great emotional boost (Connor screaming “Is that my wife?!??? Woooooo!!!” was particularly awesome). It was nearly sunset, so the temperatures had finally started to cool off a little bit too, although I kept grabbing ice and water at every aid station because I was still pretty cooked from the whole day.  

After the final extremely steep uphill, I stopped taking aid station walk breaks and decided that I was close enough to the end that I had little to lose by opening up my stride to the extent that I could. I clocked my fastest miles in the last few downhill, dumped one more cup of water on my head to “shower”  for the finish line photos, rounded the corner, and saw that iconic finishing chute. My whole support squad was there screaming and I felt chills for the first time all day as I heard them call my name: Katie Clayton, you are an IRONMAN! Total run time 4:20, race time 12:30, 10th in my age group and 5th American. I had done it!

Final thoughts 

I have mixed, but mostly positive, feelings about this race. On paper, this was the slowest IRONMAN I have ever done, and it can be frustrating when your race power and paces do not reflect the power and paces you easily pull off in training. However, St. George also featured by far the hardest environmental conditions I have ever raced (or even trained) in, and I crossed the line feeling that my performance was similar to, if not better than, my performance relative to the conditions at previous races. I don’t feel like I emptied the tank as much as I did when I was fighting for my Kona slot at Placid, but I also know that I could have gone 1% harder and ended up walking the whole marathon or not finishing at all. With all that in mind, I’m proud of myself for racing smart, if conservatively. I’m also proud that I was able to face a lot of mental demons head on in the bike and keep it together, because that was what I was most worried about going into the race and it ended up being completely fine. 

Now, I’m excited to take a break from IM training and do some fun adventures while mixing in shorter races throughout the summer. I have my eye on doing another IRONMAN someday that doesn’t present such insane environmental conditions, because I do think I’m capable of a much faster day than I’ve ever truly been able to showcase. IRONMAN Norwich, anyone? IRONMAN Palo Alto? 

Finally, I’d like to say thank you so much to everyone who joined me in this journey. My husband, family and friends, my on-site and virtual support squad, and my endurance partner in crime Jim: you all make this happen, and I cannot thank you enough.

Final St. George Prep Thoughts

Three weeks from today is the Ironman World Championships in St. George, Utah. It’s crazy how fast the months and months of high volume training—most of it in the dead of winter in New England—have ticked by. The last few weeks before an Ironman event always feature a steady decline in volume, and with that, an increase in the amount of headspace I have to detach from the training grind and reflect on how I feel about my prep and the race itself. This post is about those thoughts.

For some context, Jim and I traveled to St. George last weekend for our final big race simulation (a 112-mile ride on the bike course and 13.1-mile run on the run course on Day 1, and another 13.1-mile run on Day 2). A full recap of that event is a story for another blog post, but in a nutshell, it was a really tough day. We battled extreme environmental conditions (heat, sun, wind, climbing, altitude) and some unexpected logistical challenges with navigation and road closures. The day hit an especially low point when we started the long highway descent from Veyo and encountered headwinds and crosswinds that shook my bike and made me feel like I was going to flip over. We then entered a construction zone that routed all of the cars in the right lane onto the shoulder we were riding on, and we were immediately surrounded with impatient drivers trying to pass us with no room.

At this point, my heart rate was skyrocketing despite going downhill, and I started to struggle to breathe. Within minutes, I realized I was actually having a panic attack. I was able to pull over into some bushes and get off the road, but I then spent 15 minutes hyperventilating, sobbing, and trying not to throw up. Jim eventually got me to calm down, but our day was essentially over at that point. We soft-pedaled back into town and skipped the Snow Canyon climb, then immediately began to feel heat stroke coming on in the 90F temps once we started our run. We turned around after a few miles and called it.

While scary, the whole experience wouldn’t have been all that bad if it were a fluke—a minor deviation from my maximally consistent approach to training. Unfortunately, that hasn’t entirely been the case. Since last weekend, I have started to feel the same panic symptoms set in during many of my workouts. Breathing faster for perfectly normal reasons (like intervals, even when swimming or running) freaks me out. Cars and winds make it worse, and I am not comfortable at all in the aero position on my bike because I can’t have my hands on the brakes. Worst of all, earlier this week we found out some devastating news that has made it hard to want to bike at all: on the same day as our race simulation, two cyclists riding in the bike lane on the St. George course were killed by someone driving on drugs about an hour after we had passed the spot they were hit.

I’ve been trying to process how I feel about returning to St. George to race. Truthfully, I’m not exactly sure what triggered these changes in my mindset. Winds, heat, traffic, elevation, and big volume rides can certainly be stressful, but I’ve experienced all of those things before. As Jim remarked, “We’ve done a lot of crazy shit, so it’s interesting that this was the first time I’ve seen you crack.” Ultimately, I think it’s a combination of environmental factors and a deeper realization that this race is going to be harder than any race I’ve ever done before. Some of the goals I started dreaming about while riding in the Vermont pain cave in February may not be realistic on this course. Even making it to the finish line in one piece—both physically and mentally—will be a challenge. After all of the hard work that has gone into prepping for this race, that’s a scary thought.

Even so, being open about how I am feeling has helped. My network of friends, family, and my endurance crew has been so supportive. Here are five mantras that my people have shared in just the past week that have pushed me out the door for those final sessions:

• Our bodies like to be alive and have great protection mechanisms, so this is a good sign that everything is working properly.

• If it’s hard for you (i.e. heat, wind, hills, etc.), it’s hard for everyone.

• Be gentle, and give yourself grace.

• The hay is in the barn.

• If you need to, talk to someone.

I’m not sure how the next few weeks will feel, but I’m determined to keep getting out there. I’m excited to keep you posted on how this final chapter of the St. George journey goes. And I’m taking recs for more mantras. :)

–Coach Katie

Part 2: The Female Endurance Athlete

In the second installment of our three-part series on female endurance athletes, I’d like to talk about something that all athletes like to pretend doesn’t exist until it stops them in their tracks: injury. While sports injuries are absolutely not a women-only problem, there are certain aspects of female physiology that make us more prone to imbalances that, when ignored, can lead to ACL tears, IT band syndrome, patellofemoral syndrome, and more.

How do women differ from men in our propensity to certain sports injuries? For starters, women’s muscle stretch reflex changes over the course of the menstrual cycle, which means that our connective tissues are less flexible at certain hormone levels than others. Second, because we are evolutionarily designed to bear children, women’s hips are naturally wider than men’s, which means that we are more likely to run with a knock-kneed gait and excessively overpronate. Third, women are anatomically smaller than men, which means that our joints and muscles are more compact and can create excessive friction when they rub together during activity. Finally, because inadequate estrogen due to menstrual cycle imbalances is a common problem among female athletes, low bone density tends to be more common among women than men, and this leads to a higher instance of stress fractures (see Part 1 in this series for more details on how to reduce the occurrence of stress fractures in female athletes). 

Does all of this mean that we should give up on participating in sports? Of course not! But as women, we need to take extra care to make sure that we work on core strength development and mobility work that can counteract the anatomical traits that may be working against us. Here is a list of things you can do to help prevent some of the most common injuries in female endurance athletes: 

1. Strengthen your hips! The most important thing you can do to offset lower body injuries is to strengthen your hips. In particular, the gluteus medius is a muscle that is notoriously known for being neglected in runners and triathletes because it primarily helps with side-to-side and rotational motion, and running, cycling, and swimming are front-to-back motions. A weak gluteus medius can lead to a whole host of hip and knee injuries because the motions that the gluteus medius supports radiate all the way down each leg. I recommend purchasing a set of resistance bands and using them to do monster walks, single-leg squat balances, and clam shells for 15-20 minutes at least 2-3 times a week, preferably before running or cycling. Check out this video for a whole bunch of different exercises that you can incorporate into your weekly routine. Remember that all athletes should also be following a more formal weighted strength program like this one that strengthens muscles besides the gluteus medius for optimal injury prevention. 

2. Warm up and cool down -- dynamically! Another habit you should try to develop is properly warming up and cooling down from exercise. Since women’s connective tissues vary in flexibility as our hormones fluctuate, warming up and cooling down can help us make sure that our muscles respond appropriately to changes in speed and effort over the course of our workout. I like to incorporate plyometric exercises like high knees, butt kicks, skipping, and lunges into my warm-up routine, especially when I’m doing high-intensity speedwork. For cool down, I’ll either swim, spin, or walk/jog at a very easy effort level until my heart rate comes back down and the lactic acid starts to flush out of my leg muscles. If you’re short on time, it’s better to cut down on your main set than to skip your warm up and cool down, and just 5-10 minutes on either end can make a really big difference for injury prevention. 

3. Develop your form! Since women’s naturally wider hips can cause gait imbalances when we run (and even when we cycle), it’s important to actively work on improving your form. You should watch yourself run on a treadmill in front of a mirror and check to make sure that your knees aren’t touching or collapsing into each other when each foot lands. Imagine that your feet are landing on train tracks with two parallel rails rather than on a monorail. It can also help to actively pump your arms to the front and back along those same imaginary rails, in line with how your legs should be moving. Another way to work on your run form is to incorporate some speedwork into your fitness program. On long, slow runs, it’s easy to fall into bad habits that can lead to overuse injuries, but speedwork can force you to use different muscles and change the way your body moves. Even adding some 20-30 second fast-paced pick-ups to your long runs can help break bad habits. Here is a video with more details on proper running form and how to use it to improve your runs.  

4. Fuel up! Finally, nutrition can play a large role in injury prevention. In particular, female athletes need to make sure that they are not deficient in calcium and protein. Calcium helps us build strong bones, which is especially important for women who have experienced hypothalamic amenorrhea in the past and who are at an increased risk of low bone density, osteoporosis, and stress fractures. Eating calcium-rich dairy products and/or taking calcium supplements can help you make sure that you’re getting the recommended 1,000 - 1,500 mg per day. Protein is also crucial because it helps our muscles rebuild and recover after intense exercise. Aim to get in 15-20 grams of protein after finishing your workout to kickstart recovery and help prevent muscular injuries and strains. I’m a big fan of Evolve protein drinks and Orgain protein bars for quick and easy post-workout recovery, and I’ll usually aim to have a balanced meal with more protein, carbohydrates, and healthy fats within two hours of finishing my workout.

Sports injuries that arise from crashing your bike, tripping over a curb, or twisting your ankle on the trails are hard to avoid, but you can prevent many other chronic conditions that disproportionately affect female athletes by following a bulletproof injury-prevention program that focuses on strength, technique, form, and nutrition. Achieving your A goals involves staying healthy, so consider pushing injury prevention to the top of your priority list this year! 

Questions about injury prevention or anything else female-athlete related? Email me!

Resistance bands for warm up, prehab and strengthening exercises.

Part 1: The Female Endurance Athlete

When women compete and train at a high level in sports that prize a low body weight and a high lean body mass, it’s not uncommon for them to stop getting their periods. Experts estimate that this condition -- known as functional hypothalamic amenorrhea (FHA) -- may affect over 65% of female endurance runners. It’s also pervasive among triathletes, competitive swimmers, competitive cyclists, dancers, and gymnasts.

But it’s not talked about. In fact, periods have been a taboo topic in women’s endurance sports for years. That’s a big problem. Missing periods are a sign that hormone levels are off, which can lead to low bone density and stress fractures, and ultimately to infertility and other long-term health complications.

I have struggled with FHA since I started getting more serious about track and cross country running in high school. I’ve had two stress fractures in the past, and while my bone density is not critically low, it is lower than it should be for someone of my age. So after competing at the Ironman World Championships in Kona this October, I told myself that I needed a new goal: learning everything I could about FHA, getting my hormone levels back to normal, and sharing what I learned with my athletes, my training buddies, and my mentors. I took a deep dive into women’s sports physiology and came out of it with a big appreciation for optimizing women’s health in endurance sports. Here’s what I learned:

1. Fueling is key. The number one cause of FHA is low energy availability, which basically means that your body doesn’t have enough energy reserves to support all of the activities you do plus what it would need to carry a baby. Whether pregnancy is on your radar or not, women are evolutionarily designed to be ready to reproduce at any given time. If the body thinks that it doesn’t have enough energy in reserve for reproduction, it will shut down the menstrual cycle in an attempt to save energy for basic life functions. The problem is that this also shuts off the production of estrogen, which will stop you from building bone mass and lead to the fractures we talked about earlier. So if you have FHA, the first thing you need to do is increase the amount of fuel you’re taking in so you can convince your body that it has the energy required to carry a baby. This can be pretty hard for endurance athletes who train at a high enough volume and/or intensity that they struggle to get enough calories in to replenish what you burn. If you can’t increase your energy input any more than you already do, you may need to reduce your energy output, which brings me to point #2...

2. Take more rest. Another way to jumpstart a normal menstrual cycle is to reduce the volume and/or intensity of your training. This is important for flipping the low energy availability equation, as well as for reducing cortisol levels, which are another contributor to hypothalamic amenorrhea. Cortisol is a stress hormone that is secreted during exercise and other stressful situations, and while it temporarily helps you to perform your best while training, constantly high cortisol levels send a strong signal to your body that it is not a safe time to carry a baby. If you’re struggling with FHA, you should start by incorporating some intentionality into what workouts you are doing and why you are doing them to ensure that you aren’t unnecessarily piling on volume that keeps your cortisol levels high. It’s also crucial to build a dedicated off-season into the year where you dramatically reduce both the volume and intensity of your training, as well as a recovery week once a month and a rest day every week (while still fueling well during those times). Some experts suggest that women trying to recover from FHA should reduce their training to no more than 8-10 hours a week. These changes can help you build up your energy reserves and lower your cortisol levels.

3. Life stress matters too. Exercise isn’t the only reason behind high cortisol. Any constantly stressful situation -- work, school, moving, relationships, etc. -- can jack up your cortisol levels to the point where your cycle is impacted, and heavy exercise and underfueling will compound the problem. I’m pretty sure that I personally was under a constant state of high academic-induced cortisol during my four years as a student at Dartmouth, so it’s no wonder that I wasn’t getting a natural period even when I wasn’t training for Ironman distance races. If life stress is a problem for you, it’s important to prioritize stress management techniques, adequate sleep, and unstructured free time so you can prevent your cortisol from being even higher than it would be from training alone. (See our post on life stress here!)

4. Natural supplements can help. I’m not a doctor and I have no authority to give any medical advice, but I’ve had success with some natural hormone-regulating supplements for stress management (try HPA adapt) or menstrual cycle regulation (try Vitex, Femmenessence MacaHarmony, and Acetyl-L-Carnitine). They work best in the context of other fueling, exercise, and life changes and probably won’t fix FHA on their own, but they can certainly support you in moving things along as you’re working on recovering a natural period.

5. Birth control is NOT the answer. This one is important. Many doctors will recommend that you go on an oral contraceptive pill (OCP) if you have FHA because it forces hormone fluctuations that will cause a withdrawal bleed on a “standard” 28-day cycle. However, this is not a natural period. Medical experts who focus on FHA have come to the conclusion that birth control doesn’t actually help you rebuild bone mass, and it can give you a false sense of security because you don’t know if your body can actually support a normal cycle or not while on the pill. If you think you might have FHA, and you’re on birth control, you should talk to your doctor about these concerns and consider going off the pill to see whether you menstruate naturally. (This one hits close to home; a doctor prescribed an OCP for me when I initially stopped getting my period in high school and I stayed on it for four years. I ended up with a stress fracture twice during that time.)

6. Talk about it! A lot of women with FHA don’t talk about it with their coaches or teammates. But talking about it with people who are most directly involved in your athletic endeavors is the first step to developing a plan to fix FHA. If you’re working with a coach or team that refuses to support your attempts to prioritize your own health, you’re probably working with the wrong people. This was something that was difficult for me to do at first, but the outpouring of support I have received from everyone who has been looped into my journey has been really encouraging. I’ve also realized that FHA is so much more common among my broader athlete circles than I originally thought, and that has made me even more eager to keep the conversation going.  

With a dedicated off-season in which I fueled well and often, set hard limits on my weekly training hours and metrics, prioritized getting enough sleep every night, started taking hormone-regulating supplements, and actively practiced stress management techniques, I ended up getting back a normal cycle within two months after not having one for almost six years. I’ve been tracking my cycle using the FitR woman app and have been modifying my training accordingly, which I highly recommend for all female athletes. While I’m only just starting to increase volume and intensity for next season -- which will most likely not include a full Ironman because grad school is busy and wedding planning is busier -- I’m confident that I’ll be able to stay on top of my health and make adjustments if anything goes awry. More importantly, I think I’ve gained a better perspective on women’s sports physiology in general, and I hope that this will help me optimize my athletes’ and teammates’ experiences in endurance sports.

The good news is that periods are finally starting to lose their taboo in the world of endurance sports. Elite athletes like Lauren Fleshman, Elyse Kopecky, Tina Muir, Sarah True, Ruth Winder, and more are speaking out about FHA and/or the more general fact that women actually have periods. So any women out there who are struggling with an irregular or missing menstrual cycle, or who have a regular cycle but feel uncomfortable about even talking about in the context of endurance sports, should know that times are changing for the better. Periods are here to stay whether we like it or not, so we might as well start talking about them. 

P.S. More good news: the menstrual cycle does not actually have to be a performance limiter! I recommend Stacy Sims’ book, ROAR, for insight on how you can use your cycle to your advantage and optimize your training around fluctuating hormone levels.

Coach Katie Clayton

2019 IRONMAN World Championship Race Report

This weekend, I raced at the IRONMAN World Championship in Kailua-Kona, Hawaii, after winning my age group and qualifying at IRONMAN Lake Placid in July. Initially, I was hesitant about accepting the Kona slot because I was moving across the country at the beginning of September to start a PhD program in California. To add more challenges, a month before the race I developed IT band syndrome that caused significant knee pain any time I ran more than 3 miles. With all of those factors in play, finishing the race was in doubt.

Kona is famous for its extreme heat, humidity, and winds, so even though the bike and run are slightly less hilly than IRONMAN Lake Placid, the conditions make it one of the toughest courses out there. October is Kona’s hottest month, and the swim is marked by big ocean swells, the bike by headwinds, crosswinds, and sizzling pavement, and the run by unforgiving humidity and sunshine. Most professional triathletes come out to Kona weeks in advance of the race to get acclimated to the heat, but I was busy learning about American political institutions and linear regression in dry and temperate California. I flew out to Kona with Connor the Wednesday before the race, and Jim and my dad met us there soon after.

Jim and I put together a race plan that took into account 1) the environment, 2) my semi-functional knee, and 3) the primary goal of the Kona experience, which was to have fun. Unlike at Lake Placid, there was no pressure to “qualify” for anything, and friends who had raced at Kona before reminded me that the race was just the cherry on top of a great season. We made pacing, fueling, hydration, and staying cool the top priorities. Here’s a summary of what that looked like and how it all went down:

The Swim: 1:16:02

The swim is a 2.4-mile single out-and-back in Kailua Bay. You swim about 100 yards out to some buoys that mark an “imaginary start line” in the water, tread water for a couple of minutes with your group, and then start swimming when the gun goes off (which was at 7:15 am for me). The plan was to take the swim pretty easy, sight as best as possible, and get physically and mentally prepared for the bike.

When the gun went off, it was actually pretty enjoyable. I found some people to draft behind at different points and sighted often, enjoying the tropical fish and coral underwater and the added buoyancy of the salt water. The wave start system meant that there were fewer people around me than there would have been with a mass start. Things got a little more hectic when we rounded the corner and caught up with the slower swimmers in the men’s 55+ age group, but I finished strong and felt good coming out of the water in 1:16:02, which was a little faster than what we had predicted based on my Placid swim time.

T1: 5:40

I quickly stopped at the hoses to rinse off the salt water and then headed to the women’s change tent, which was a zoo. I grabbed my bike bag and got my socks, shoes, helmet, and glasses on. A lot of people were running through transition, but I tried to just walk quickly to avoid aggravating my knee any more than it was going to be aggravated with the marathon. I made it out of there in 5:40 and was onto the bike.

The Bike: 6:14:52

The plan for the bike was to observe a *strict* heart rate cap of 150 bpm. In other words, if my heart rate went above 150, I needed to go easier. This was a pretty low cap, especially compared to my Placid effort, but the problem with Kona is that once your heart rate soars from going out too hard, it’s almost impossible to get it back down. I usually train based on power, but Jim actually told me to ignore power and base the entire bike around heart rate.

I stuck with the plan, and it was actually pretty easy to ignore power because my power meter was flickering on and off for the entire ride. My heart rate was mostly in the high 140s, and I fought to get it back down by easing off the gas any time it went above 150. The course takes you through town on a short loop, then up Palani Hill and onto the “Queen K” highway, where you bike out to mile 60 at Hawi and then back to town for a total of 112 miles. There are several sections of the course that each present different challenges: sometimes it’s intense headwinds or crosswinds, sometimes it’s oppressive heat as you bike by the lava fields, and sometimes it’s steady uphills that are usually accompanied by headwinds.

It was already hot by 8:35 am when I got on the bike, and the day just got hotter. Luckily, there were a couple of clouds that offered brief respite from the heat, and I learned early on that the best way to stay cool was to pick up an ice-cold water bottle at every aid station (approximately every 7 miles), dump the entire contents all over my head and neck, and grab a second one to drink and pour on me until I reached the next aid station. I was also trying to take in as many carbs as I could in the form of Infinit sports drink, a couple of bars, and some shot blocks. The headwinds and crosswinds picked up pretty quickly into the bike and it sometimes felt like I was either not moving forward or going to topple over, but I just stuck to my heart rate plan and ultimately made it to Hawi, where I benefited from a short but awesome tailwind on the downhill leaving the town. I battled a really tough headwind for the last 20 miles coming back into Kona, but I was glad that I had stuck to the heart rate plan and wasn’t feeling totally out of energy. Now it was time to get mentally psyched up for the big wild card: the run!

T2: 8:23

I took my time in T2 to make sure I was comfortable, because I knew there was a good chance I would be spending a long time out there for the run — especially if I had to walk. I changed socks, put on shoes, ate a stroopwafel, stopped by the porta potties, and put on my race belt, visor, and knee strap, which allegedly offers some relief from IT band pain. There were actually several women who were having various degrees of emotional breakdowns in the change tent, so I was pretty happy that I was still in good spirits after my controlled bike ride. I headed out of the tent and was off!

The Run: 4:05:03

The plan for the run was to keep my heart rate below 155, and per my doctor’s orders, “run until you can’t run anymore.” My doctor had said that I couldn’t necessarily make the injury worse by running through it in the race, but I was worried that I would be literally unable to get my leg to respond at all if the pain got really bad. I had never been more uncertain going into a run.

When I started, I actually felt pretty good. My IT band was a little stiff but I had no knee pain, and I was so happy about it that I couldn’t wipe a goofy smile off my face. I smiled all the way through the first 7 miles in town (no pain!) and enjoyed sticking ice and cold sponges down my back and dumping water on my head at every aid station. I took in a couple of gels but ultimately switched to Gatorade and flat coke because they were easier to stomach.

At mile 8 there is a big climb up Palani Hill and onto the Queen K (yes, we have to run and bike there), and that’s where it’s a little harder to keep morale up. The 17 miles on the highway and into the Energy Labs section of the run are very desolate and lonely. There are tons of spectators in town, but almost none on the Queen K. The whistling winds are punctuated by heavy breathing and wet feet pounding the pavement with a squelch.

On the bright side, I was able to run up Palani (still no pain) and continued to feel pretty good. I had to slow down my pace a little to stay under my heart rate cap, but I was doing sub-10 minute miles the whole time and I was so happy to be running for this long pain-free that I didn’t really care about the pace. I felt kind of like a ticking time bomb with a knee that could give out at any given moment, but I knew that the more miles I ran, the fewer I would ultimately have to walk.

As I ran through the Energy Labs, the sun started to set and I was getting tired. My knee was still holding up, though, so I told myself that I needed to keep running until 1) it gave out, 2) my heart rate spiked to a point where I couldn’t get it down, or 3) I literally fell over. None of those things had happened, so I pressed on. By mile 20, the sun had set over the Pacific, and the highway was pitch black. I could see the twinkling lights of the town, though, and the thought of the finish propelled me forward.

When I finally came back down Palani at mile 25, I could hear Mike Reilly’s voice and the roar of the crowds, and I started to get excited because I knew that even if my knee gave out now, I would still be able to walk, crawl, or even roll across the finish line. By some miracle, it continued to cooperate, and I picked up the pace for a smiling sprint down the finish chute. The crowd was roaring, the lights were bright, and as I crossed the finish line I heard those magic words: “Katie Clayton, from Stanford, California…Katie, YOU ARE AN IRONMAN!”

Finish: 11:49:57, 14th in AG, 5th American

The 2019 IRONMAN World Championship was not my fastest race, but it represented my best-ever execution of a race plan. I was enjoying myself for almost the entire time, I ran the whole marathon, and I didn’t end up in the med tent. And hey -- if the advice to “have fun” lands me with 14th in the world and 5th American in my age group, I’d like to think that I have a whole lot more untapped potential that’s just waiting to make its debut. - Coach Katie

Katie Clayton 2019 IRONMAN World Championships - Kona, HI

2019 IRONMAN Lake Placid Race Report

2019 IRONMAN Lake Placid Race Report by Katie Clayton

IRONMAN Lake Placid is done and dusted! After dreaming about crossing the Placid finish line for over a year and a lot of training (in 2019 alone I ran swam 296,222 yards, biked 4397 miles, and ran 932 miles), I’m pleased to report that IRONMAN Lake Placid was a success. I finished with a smile and punched my ticket to the October IRONMAN World Championships in Kona. Here are my thoughts on the course, the experience, and my plans until the next one!

Taper: I have a tendency to go into big training weekends and even some races with some built-up fatigue, but Jim made sure that I was fully rested for Placid. After months of 18+ hour training weeks, it was a huge change to go out for a 45-minute spin and call it a day, but I knew that the rest would pay off. I made it my priority to sleep a ton, eat a ton, and de-stress, and seeing my heart rate nice and low on the workouts confirmed that the taper was working. By the time we left for Placid, I was antsy and ready to channel all of my pent-up energy into the race.

Swim: Fast forward to the line-up for the 2.4 mile swim in Mirror Lake. Matthew, Chris and I got as close as we could to the front of the corral so we could start the swim in one of the earlier waves. Jim told us that most people tend to overestimate their swim time, so it’s best to start out up front. Chris lined up with the swimmers under an hour and Matthew and I were right behind him in the 1:01-1:10 group. The gun went off at 6:40, and we were in the water with the rolling start by 6:41. 

I was immediately struck by how many people were near me, but I tried to stay calm and find the underwater cable as soon as possible. There was lots of splashing and thrashing going on and I was kicked a few times as everyone found their groove. Once I got on the cable, I was surprised to see how many people were swimming to my left (avoiding the cable) -- it seemed just as crowded over there. I kept my eyes down and tried to swim smooth without overdoing it. 

The one disadvantage to swimming on the cable is that if you don’t sight, you won’t know when buoys are approaching, so I was pushed under a few of the big yellow triangles as I tried to swim through them. It was a little jarring at first but I tried to do a better job of picking my head up occasionally and/or not breaking my stroke if I hit a buoy. 

By the time I reached the first right hand corner, my left goggle had filled with water so I quickly picked my head up to fix it. Then as I made the turn I momentarily lost the cable, and it took me a little while to fight my way back onto it. Once I did, I came back around, finished the first loop, tried to fix my goggles again as I exited and then re-entered the water, and started all over. 

The second loop wasn’t as strong as the first; I felt fine, but most of the people around me on the cable seemed to be going much slower than they had on their first loop and I felt like I was at the mercy of the speed of traffic. I tried to fight my way around people who were particularly slow or who were splashing a lot or kicking too hard, but I ultimately decided that the energy it took to do that wasn’t worth the seconds I would save. After getting kicked and tangled in the turn buoys at least three or four more times, I backed off the pace and tried to just cruise in for the bike. Swim time was 1:11:06, and while I would have liked to go under 1:10, I really was at the mercy of traffic and I was just happy to be out of the water. 

T1: Once I got out of the water, some awesome wetsuit strippers helped me get my wetsuit off, and then I jogged down the blue carpet to transition. I passed the entire crew of Dartmouth supporters who were awesome and totally put a smile on my face. I grabbed my bike bag, got some help from some volunteers in the change tent to put on shoes, socks, helmet, and sunglasses, and before I knew it, I was on the bike course.

Bike: My heart rate was high as soon as I started the bike, and unfortunately it never really came down. I’m not sure if it was the swim, the excitement, the caffeine, or some combination of the three, but I kept seeing my HR in the 150s even though my watts weren’t out of control. Usually it stays fairly low in training (at The Endurance Drive Ironman Lake Placid training weekend I averaged 140 on the 112-mile course at race watts), so I was a little concerned about it and unsure whether to trust my HR or watts. I ultimately decided that watts was a more reliable metric so I focused on aiming for a normalized power (NP) of 160-170 watts - our race plan. Those watts came easily in the first hour on the climbs out of Placid. I focused on floating the uphills and crushing the descents (especially the Keene descent) and was happy to see that I was riding alongside some fast-looking people. Overall, the first lap felt good and was largely uneventful, and I came back into town in 2:52 (almost 20 minutes faster than my training weekend) with 164 NP for the lap. 

I stayed on top of nutrition with a bottle of Skratch and a Larabar in the first hour, a bottle of Infinit in the second hour, and a bottle of Skratch and a Clif bar in the third hour. I switched out my bottles at bike special needs for two Infinit and one Skratch after lap 1 and headed out on lap 2, where I was excited to see the entire support squad at Run Aid Station #2 cheering me on and my parents in the car coming into Placid from Sleepy Hollow near River Rd. It was after leaving town again that I started to feel the first loop, though, and I decided to back off the pace and watts so I could try to get my HR down. I was getting increasingly worried about the run because my HR had been in Zone 3 for most of the day, and I didn’t want to end up walking the marathon. I got it down to 150 and below, but my watts were definitely lower by then and I knew my pace wasn’t as strong as the first loop.

Morale had been pretty low from the Haselton Road turnaround to the top of the Papa Bear hill. I kept up with nutrition and hydration (one bottle of Infinit during hours 4 and 6, a Bonk Breaker and a bottle of Skratch during hour 5), but there was a strong headwind from Haselton Road to the end that made me feel like I was riding a trainer. I ended up making friends with a couple of people who were struggling along with me and commiserating over we were all so ready to get off the bike. After my loop 2 from hell, total bike time was 6:01:34, 159 NP. 

T2: Coming back into town at the end of lap 2 was awesome - the spectators were fantastic and I was SO HAPPY to give my bike away to the volunteers in transition and get my run shoes on. I made a quick stop at the port-a-potty, switched shoes, grabbed my gels, race belt, and hat, and I was off.

Run: My legs felt a little bit like jelly as I came down the hill by Lisa G’s, but they weren’t as bad as I thought they would be. I was able to throw down a few 8-minute miles without my heart rate spiking and I got a huge morale boost with all of my friends at the mile 2 run aid station. I saw Jim soon after that and he let me know that there was one girl in my AG who was 27 minutes up the road. That was actually pretty comforting because I didn’t feel like I needed to push it to catch her (the lead seemed way too big for an AG win to be realistic), and I was happy with a second-place AG finish for my first Ironman. I continued on down the hill and turned left onto River Rd., jogging through each aid station to grab hydration and nutrition.

I had a little bit of a side stitch and was feeling nauseous, so I couldn’t easily stomach the gels I had brought with me. I grabbed coke and base salt at the aid stations instead, and those went down easily. Unfortunately, my HR was spiking above 160 and it was getting really hot out, so I decided to tone down the pace to see if I could get my HR below the 155 cap Jim and I had planned. I ran an 8:45, then was above 9:00/mile, and I was feeling pretty bad but determined I could hold a pace in the 9s at a reasonable (155-160) HR. I continued to grab coke and salt and not walk the aid stations because I worried that if I started to walk, I wouldn’t start running again.

After finishing up the River Rd. section, I jogged back up the big hill and ran into Jim at mile 9ish. He informed me that the age grouper ahead of me was running 11s and 12s, and her lead had shrunk to 16 minutes. He told me to just keep doing what I was doing, running 9s without my HR blowing up and taking in whatever I could at the aid stations, so I did. I grabbed ice to throw down my shirt and dumped water on my head whenever I had the chance, and I kept the pace and HR steady. I ran up the Lisa G’s hill (which honestly was not as bad as I thought it would be), did the Mirror Lake Drive portion and saw more friends and family, and then headed out for lap 2.

I realized my shoe was untied at mile 13, so I stopped right before going back down the Lisa G’s hill to tie it and nearly fell over, but I righted myself and kept it up. When I saw Jim next at mile 15, he said I was only 6 minutes behind my competitor. If neither of our paces changed, I would catch her. But I was hurting big time, and walking sounded more and more appealing with every aid station. I also missed the coke at a few aid stations and only took in ice water with poor hand-offs, so I was worried about my nutrition and hydration status. Still, I gritted my teeth and kept running with my eye on the number on everyone’s calves for someone in my age group.

As I came down River Rd., I got a little bit of a second wind and continued to throw down 9s with a little less pain. Finally, just before the turnaround, I saw the girl who I thought was my competitor ahead. She was running, but my shuffle was faster than her shuffle, so I passed by her (we both gave each other some encouragement) and hit the turnaround. I didn’t look back after that, but I picked up the pace by a little bit out of fear that she would chase me down. 

By the time I made it off River Rd., I knew I had built up a bit of a lead, but I was really worried about my hydration and nutrition status. I was starting to feel dizzy and I didn’t want to pass out or DNF with so little to go. For the first time on the run, I walked up half of the hill after River Rd. just to keep my HR in control. I started running again as soon as I reached the top and met Jim and Connor around mile 22. While I couldn’t smile, I was happy that they were blasting my favorite songs on their portable speaker. Jim yelled that I had an 11-minute lead and reminded me to keep fueling, keep hydrating. I was pretty close to my breaking point but I continued on, ready to taste the finish.

By the time I got to the Lisa G’s hill I was pretty much done, so I speed-walked up part of it to avoid passing out and clocked my first 10-minute mile of the day, but I was able to pick it up again after getting to the top. My parents and friends were cheering on Mirror Lake Drive, and as I made it to the out-and-back I knew that all I needed to do was run another mile - just one. I rounded the corner, picked up the pace to sub-9s, and laid down everything I had left. I entered the transition area, rounded the track, and saw all of my friends and family along the finishing chute. I somehow managed to smile, and I crossed the finish line with a run time of 3:59:51. I then promptly semi-collapsed into Matthew’s parents’ arms (they were volunteering at the finish) and was carted into the med tent where I made friends with some amazing volunteers who were the first to hear me say, “I think I just qualified for Kona.” Total finish time: 11:22:19.

After: I was fine after I cooled down and got some fluids in me, and getting to hang out on the grass with my friends and family, watch Matthew, Chris, and Julie finish, and relive the whole experience for days after was arguably even better than the race, which was physically and mentally agonizing. Despite the agony of 140.6 miles, I decided to take the Kona slot, because I think that after a few more days of relaxing and active recovery only, I’ll be ready to get back into training mode. After all, this is the IRONMAN World Championships we’re talking about! It’ll be a little crazy to balance more Ironman training with a move out to California in a month and the start of my PhD program in political science at Stanford, but come on - it’s Kona!!!

Thanks a million to Jim and the tribe for everything they have done to support me on this journey. I’m pumped that it isn’t over yet! - Katie Clayton