Just Like Starting Over

Below a post from Heidi Littenberg, Reno Wheelwomen and Silver Sage athlete. Silver Sage Sports and Fitness Lab has been the proud title sponsor of the Reno Wheelmen since 2007.


Maybe John Lennon wrote his classic song, Starting Over, about me and my bikes?  It seems that way, as a summer full of work and big deadlines forced me to mothball my 2014 riding/racing plans in mid-July.  Training, racing, and just enjoying being active became rare occurrences as my huge workload engulfed everything for several months.  Both of my bikes sat there, looking at me longingly, just hoping I’d have some time and enough energy for even a quick spin.

Nearly four months and ten pounds later, I’m in Starting Over mode.  Just like the song, I’m re-establishing the relationships with my bikes and my body.  It’s far more challenging than I expected.  During this reboot process, I’ve found that being sedentary is indeed addictive, eating too much is far too easy, and the voice telling me to get off my butt isn’t loud enough.  So, I chose a recent milestone (my birthday) as my fitness kick start, like a New Year’s resolution.

Each day, for the most part, I focus on the workouts Julie Young provides, using each one as a stepping stone from “just get moving” to “full training mode”.  Some days, the “get off my butt” voice isn’t enough to get me going. But lately, it’s getting louder and I’m listening to it more and more.  The “get off my butt” voice has the assistance of a great coach who is giving me the structure and progression I need to make it out of the dark cave in a safe and sane way.  Without the structure and the exercise progression, it’s likely I’d be letting my situation turn into a downward spiral.

I’m an impatient person by nature (I think it’s genetic!), so having that guidance to be patient and focused on quality is equally as important as the “get of my butt” voice.  Julie’s calm nature reminds me that Starting Over mode is a journey that has to be taken one step at a time.  The next step is to start laying out goals for 2015 that can form the basis of “full training mode”.  I’m excited to start looking at myself as something like an athlete again.


How to Avoid a Cold

Below a post from Silver Sage Sports sponsored, Far West Elite XC Ski Team member, Sabra Davison.

How to avoid a cold…

Winter is coming! It’s inevitable, and I’m excited! In short, every nordic skier this time of year is switching to power based explosive strength, are fine tuning their weaknesses, and are logging serious ski-specific hours. That’s a given, so let’s talk about something else!

I was sick with the typical change of season cold last week, as many of you I’m sure are experiencing. My sister, Lea Davison, a London Olympian and Specialized Global athlete, was asked to write up some of her tips for getting over this change of season cold. I followed them religiously last week, and guess what… they worked wonders.   Have a read below!!


 My sister came to visit me in Tahoe City. It’s been amazing to have my favorite person in the world meet the elite team and see my new stomping grounds. Lea and I used to race and train together every day, as we were both perusing careers as professional cyclists. Now that I’m focusing on nordic, we use each other’s sports to get each other fit in the off season. So naturally, Lea and I have reunited and made single-track exploration our main business. We also rounded up a few of our friends on Team Luna to ride help show us some of the best trails.   I have to say one of the crowning achievements from the week was not training related, it was learning how to make maple marshmallows.   They are incredible, and you should make them immediately!




How to Avoid a Cold: Top Tips from XC Mtb Rider Lea Davison
Out smart the common cold by following Lea Davison’s top tips

Lea Davison is XC Mountain Biker who rides for the Specialized Global team. She just took third place at the World Championships and is an expert at avoiding illness. As we head into winter, we are surrounded by coughs and sneezes so why not follow Lea’s top tips to see if you can become as talented as she is at avoiding a pesky cold:

“If your friend’s second cousin has a cold or if someone coughs 10 rows back on the airplane you go into full cold fighting mechanics, full on assault. Here are my top tips to avoiding a cold:

  • Garlic– some people roast a whole bulb and go for it. But I usually do raw as I think it is more powerful. You don’t make any friends but at least you are not sick. I chop it up, put oil and salt on it and dip bread into it.
  • Ginger– I juice ginger and have a straight up ginger shot which is a little tough to take, it is very similar to a normal shot of alcohol, it burns in the same way but it’s good. Sometimes I combine it with apple cider but straight up if you are fighting a cold.
  • Zicam– I always have Zicam with me which is a zinc formula or just zinc tablets. I take that very frequently. You take it one every four hours until the symptoms reside but I will sometimes take two at once.
  • Probiotic– If I am really coming down with something that I need to fight off, I’ll take a pro-biotic.
  • Steam– If I am starting to come down with a cold I will steam my face so it is better for breathing and pop in some Olbas oil in there too. I have also heard a sauna is good to sweat it out.
  • Rest– If I have a cold, I just go for an hour light spin if I am feeling a little energetic but otherwise you are better not train and  just sleep it off. I used to freak out about taking three days off, but then I had hip surgery, took four months off the bike and I was fine, so taking a couple of days off won’t make a difference. It is way better to get quality training and take a day off and get rest than it is to run yourself into the ground. When you are ill, it is your body telling you that you are too tired. You get a cold because you need to rest.”

We also have it on good authority that Vicks First Defence is another must have for the winter season. The British riders never fly without it, and also bring along Strepsil throat lozenges and hand sanitizer when they are travelling.

2014 HealthInsight Quality Award

Reno, NV (October 14, 2014) – Silver Sage Center for Family Medicine has been presented with the 2014 HealthInsight Quality Award for providing high-quality patient care. Silver Sage is the only office in Nevada to have won this award six times.

The 2014 HealthInsight Quality Award recognizes physician office practices that incorporate patient engagement tools and strategies into their care processes; use care management methods regularly; participate in a data reporting quality initiative; and achieve exemplary performance on nationally recognized quality measures related to diabetes, cancer screening and immunizations.

“We’re honored to once again receive this award from HealthInsight,” said Dr. Andrew Pasternak. “I think it reflects the care and effort our providers and staff put into every patient visit.”

The award is presented by HealthInsight, a private, nonprofit, community-based organization dedicated to improving health and health care in Nevada, New Mexico and Utah. The HealthInsight Quality Award program began in September 2004 to promote transparency in health care. HealthInsight aims to help providers improve health care and help patients become more active and informed participants in that care.

“HealthInsight commends Silver Sage for its commitment to excellence in improving patient care,” said Marc Bennett, president and CEO of HealthInsight.

Silver Sage Center for Family Medicine provides high quality health care for the entire family, treating the entire spectrum of medical conditions ranging from simple ear and sinus infections to more complex problems like heart disease and cancer. For more information, visit www.silversagecenter.com.


IronMan Tahoe 2014

Silver Sage Sports and Fitness Lab athlete, Richard Medalen shares his experience prepping for Ironman Tahoe 2014, and dealing with the event’s surreal cancellation and resulting disappointment. True to Ironman athlete resiliency and persistence, Richard turned this disappointment in to opportunity.

2014 IronMan Experience


In Sept 2013, I was in Tahoe and saw IronMan athletes walking their bikes up the Brockway climb.  I have had a lot of experience cycling and knew that in about any situation, I would be able to pedal my bicycle up Brockway.  However, I had never done a triathlon, never swam more than 400 yards or run more than a 5k, so I didn’t realize how much work it would be to complete an Ironman.  But I was interested and ready for a new challenge so on somewhat of a whim I signed up for the 2014 Lake Tahoe Ironman the next day.

Now the work really began.  First I had to educate myself on triathlons, transitions, gear and training plans and schedules.   I had one year to figure it all out.

I got some goggles and swim gear and found a local pool to swim at.  I also signed up for a Triathlon Class at the local Community College.  I quickly realized that pushing harder when I was swimming would only make me tired and technique (that I didn’t have) was key.   I worked on my swimming and drills and had a local swim coach give me some pointers.  It was a slow process, but I did see improvement and by September was feeling confident on my ability to finish the swim portion of the race.

Now running turned out to be my biggest challenge.  I have very good aerobic fitness, however, my 48 year old joints, knees, hips and back were not used to the stress of running.  I started with about 3 miles and worked my way up to about 7 miles in about 3 months.  However, I started feeling pain in my legs, hips, back.  Nothing too concerning but it was clear that my body just was not trained for running.  I was committed to the IronMan and I wanted to do everything that I could to be ready for it.  So I kept running and training for another 3 months and worked through various aches, pains and injury.  I was sure feeling old.


With about 6 months left to the Ironman, I decided I really needed a coach especially to help me with my running and training of all three disciplines together.  How hard should I train?  How much should I be running, biking and swimming?  How do I combine my workouts?   So I searched around and hired Julie Young as my coach.   We were aligned philosophically on many training areas.  I was particularly in tune with her philosophy of keeping things simple and to train smart and efficiently with a quality focus rather than a quantity.   Julie was extremely knowledgeable with firsthand experience and helped me become a better runner or the Ironman.    Right away she started working on my structural strength with uphill intervals.  She had me doing a bunch of non-running strength work with bands.  Within about a month, my hip issues were gone and I felt better about running.  These exercises made a huge difference.    I spent a lot of time trying to get stronger on the run.  I was surprised at how difficult it was to build up to the Marathon running distance.  With three months to go, I did a 11 mile training run and hurt my back.  This was such a struggle.  After my back was recovered, we went with a run 4 minutes, walk 1 minute strategy.  I was able to do this for 18 miles but it still was not easy.  I felt a little defeated and resigned that this Ironman would have some walking in the marathon for me.


I really did everything that I could to be prepared for the Ironman and I was ready.  For many weeks throughout the summer,   I stayed at a home in Tahoe that was at 7k feet of elevation to acclimate.  I swam in Lake Tahoe, rode the bike course and also ran every step of the run trail.  I stayed in Squaw Valley the week prior to the IronMan and I was ready for the event.  I attended the Opening Ceremony on Friday Night where they congratulated us for making it to the starting line and thanked all of the families of the athletes for supporting them.  My wife was a huge part of my training and helping me prepare for the event.  This was the first moment that I really processed how much effort really went into getting ready.  Also how much support I had in getting ready and prepared for this day.


The smoke was hanging around all week but we had a few good days as well as bad days leading up the the IM.  The paper on Friday declared that the smoke would not be an issue on the weekend so the IronMan was on.  Friday was the clearest day we had seen in Squaw all week and Saturday morning was beautiful.  It built a lot of excitement.  I checked in my Bike, T1, T2 bags on Saturday.  Organizing and planning all my Transition and Special Needs bags was quite a job in itself.   I didn’t sleep very much the night before because of the excitement.

Sunday, I got up early and headed to the start line.  There was a lot of smoke in Squaw and Truckee but by the time we got to the beach, it was clear.  I turned in my special needs bags, pumped my bike tires and got ready for the swim.  About 40Min before the start people were in the water.  I had my wetsuit on and I was calmly getting ready to jump into the Lake to warm up for the swim.  I was perplexed because the pros were supposed to start in 5 minutes and I hadn’t heard any announcements or instructions for warming up or how long before the start.  This was my first IronMan so I wasn’t sure how they started the race.  I was just a few yards from the water swinging my arms to warm up when the announcement came.  The message was that because the air quality was rated unhealthy on the bike and run course, the event has been canceled.  The reaction of the crowd was very mixed.  Some were sobbing and some were just moving on.  It was a very somber beach filled with athletes.  I did not process anything on the beach and instead started thinking about how I was going to get my bike, the bags and everything else back as well as check out of the hotel because my wife and I really did not want to stay in the smoky Squaw Valley site of the canceled IronMan any longer.  I was just going through the motions of taking care of all of the logistics and wasn’t processing what had happened.  However, when I picked up my T2 Bags from Squaw they were handed out the IronMan Finisher Shirt,Medal, and Hat to everyone.  I just took it and for about 5 steps put the hat on my head just so I didn’t have to carry it.  I stopped and took it off and it hit me how meaningful these little artifacts would have been had I completed the IronMan but now I didn’t even feel right about wearing a hat for 50 yards.  I thought about the finish line many times in training.  I would keep my pace up by thinking about the end of the race and how great it would feel having earned the IronMan Finisher Medal.  They handed us everything as if we finished but the items did not bring pride and a smile but instead brought a dose of disappointment.


Still trying to process everything that had happened (or didn’t  happen) and figure out the next steps.  The Ironman organization sent us an email stating that we could get into the Lake Tahoe IM next year for $100 or register for a few other events possibly this year.  I thought about that for a day but focused on how much I really do love Tahoe.  I was married there,  I have ridden around the lake many times, done the Death Ride 5 times.  I spent a lot of my free time there in the summer and fall time.  This is the place where I want to complete my first Ironman.  So I made the decision to take the 2015 Entry for the Lake Tahoe IM and finish what I started, where I started it.

Now I have time to work on my run and hope to complete the marathon without walking.  I have time to get stronger and faster than I am now.   My swimming can also be improved.  I was just handed more time to do the IM.  I was ready to go on the beach this year and I really do believe I would have finished but with the extra time, I hope to achieve a performance level that I will be proud of.  Two things come to my mind often.

  • At the opening ceremony when they spoke about how difficult it is to get to the start line. That is absolutely true.
  • Results are earned in training and only picked up on Race Day.

With Julie’s help again next year, I plan to be on the beach ready to crush the time I would have had this year.  Most importantly though is that I am looking forward to it.  I am very grateful to my wife, coach, friends and family that have supported me on this journey.  This year would have been great but next year is promising to be even better.

Richard Medalen


Silver Sage Unveils New Corporate Identity

Reno, NV (October 10, 2014) – The medical professionals at Silver Sage have unveiled a new name – Silver Sage Sports & Fitness Lab – for the athletic side of the practice.

“We still work with professional athletes but there are many others, including busy professionals with families, who could benefit from our services and we hope the new name better reflects that,” explained Julie Young, Director and Head Coach. “We help our clients by removing the guesswork and providing a science-based structure that maximizes finite training time to help them achieve their goals.

“Our goal is help anyone with their athletic goals, whether they’re running their first race or they’re a seasoned veteran,” added Andy Pasternak, M.D.

While the Silver Sage Center for Family Medicine has maintained its name, both divisions have new logos, which were designed by the Estipona Group. “The new logo, is simpler and more modern,” explained Edward Estipona, Estipona Group president. “The former logo was too ornate and difficult to recognize from far away. Since the Sports and Fitness Lab logo will often be present at sporting events, it was imperative that it be recognizable from a distance.” The Estipona Group will also be assisting with the practice’s ongoing strategic communications efforts.

Silver Sage has also introduced a new website, designed by Nancy Rosenblum of digitalnordic, to make it easier for patients to find the answers they’re seeking. The new site is completely responsive, which means it can be easily accessed by mobile devices.

Silver Sage Sports & Fitness Lab provides integrated physiologic testing, biomechanical and coaching services to help athletes of all abilities and interests maximize their training time and achieve results.

Silver Sage Center for Family Medicine provides high quality health care for the entire family, treating the entire spectrum of medical conditions ranging from simple ear and sinus infections to more complex problems like heart disease and cancer.

For more information, visit www.silversagecenter.com.



Sugar Bowl Academy Dials up Dry-Land Training

Below a post from Sugar Bowl Academy, Head Nordic Coach, Martin Benes…

In the past couple of weeks, we have done two time trials. While many of our workouts were hampered by the smoke, we found some clear windows in the mornings before school to get out and do some hard efforts. One of these was an old standby, the Drifter uphill running time trial. The other was new, a skate rollerski race from Rainbow Lodge up to Soda Springs, just over 10 km. These hard efforts are always important, regardless of the time of year. In the fall, we will try to do more time trial efforts as they better simulate the demands of racing: both physically and mentally.

The Drifter time trial is a Far West Nordic mainstay, with records dating back to 2006. We meet just of the Donner Lake Interchange exit off of I-80 and warm up by walking and jogging up the trail a ways. The race itself is around 1.5 miles of uphill running, finishing just by Tahoe Donner XC’s Drifter Hut. It is a hard effort no matter your fitness and an opportunity to push and go hard. For us skiers, there is little technique to running up a hill, but there are tactics and race smarts. We always mark the halfway point, so that the athletes can try to really nail the second half of the race. We hope for pretty even splits between the first half and the second half, but we’re really excited when someone races the second half faster. We do Drifter a few times a year, giving the athletes an opportunity to dial in their pacing and effort, but also to show some improvement. Everyone’s body type affects their uphill running a little differently, so what we’d really like to see is personal bests.

Our second time trial was on rollerskis, so definitely more specificity than our uphill running. We felt like we needed a good skate rollerski time trial with enough terrain so that our skiers could use their different techniques and gears, but without any major downhills. A downhill is obviously good practice for a race too, but people have different rollerski speeds, and different comfort levels. As an added bonus, the road was pretty quiet at 7:30 AM and we could run a mass start. We wanted to make this one feel as much like a race as possible. We had a starting line, a double pole zone, cones marking off sections of the course, and meter marks close to the finish. We wanted it to feel like a race and for people to push hard, both physically and mentally.

They were both great time trials and what we saw was our athletes push their limits and see how hard they could go. While there were no prizes or medals on the line, both were good opportunities to get comfortable with competition. To get used to lining up with your friends and peers and laying it all out there, finishing feeling like you’re totally spent. You don’t need more than a handful of friends or teammates to have a time trial. Pick a start point and a finish point and you’ve got a race or time trial. It’s good to get the experience of racing head to head before it really counts.

“Rainy” day workout coaching tips

Below is an article we wrote to assist Girls on The Run (GOTR) coaches create a workout plan when confronted with circumstances curtailing normal activity, ie rainy or smokey days, or injuries.


Photo: Smithridge STEM Academy student and GOTR participant with her coach, Sara Holm, (pictured on right), presented a thank you poster to Julie on behalf of Silver Sage Sports and Fitness Lab. Silver Sage Family Medicine and Sports Lab sponsored a team of low income girls at her Title 1 school this year.  Julie provided the coaching tips below for “rainy” day workouts:

These apparently inopportune circumstances, whether rain, smoke or injury are actually just the opportunities we need to force us to mentally and physically mix it up. And as a result of this variety we become stronger, are less prone to injury, and have more fun with all the different aspects of activity and fitness.

These “rainy” day schedules are also an opportunity  to help girls learn better body awareness and movement mechanics to prevent injury. We should all be incorporating “rainy” day activities more consistently in to our fitness plans.

In girls, the lack lack of hip stability and consequently the inability to use it in movement and athletics coupled with over reliance on quads is greatest culprit and contributor to traumatic knee injury. So “rainy” day activities are the ideal to help the girls avoid this pitfall.

The overriding theme to these sessions,  is quality over quantity, so emphasize attention to detail by consistently cueing the girls.

Start with an activation circuit, these develop better brain to butt awareness, you have to feel it, before you can use it. I suggest doing these exercises, initially without mini-bands.

  • Clams
  • Fire hydrant
  • Side lying abductor
  • Captain Morgan

Movement prep will engage the girls mentally and physically, as well as heighten body awareness and balance, and fire the nervous system. Basically this prepares them for safe, effective movement. The key is to do these well, with stable balanced moves, neutral pelvis and spine, and good hip stability producing hip, knee toe alignment.

  • Knee hug to lunge
  • Standing hip twist
  • Standing quad stretch
  • Foos ball
  • Lateral lunges

In these timed circuits – the girls could team up in groups of four, each on one exercise of the circuit. They earn points as a team for number completed well with emphasis on quality over quantity.

Circuit #1

  • Crunch
  • Push ups
  • Bridge
  • Hula hoop

Circuit #2

  • Bicycles
  • Dips
  • Static squat – with good form, knees over second toe, knees at toes, sitting in to butt, femur to horizontal 30 degrees, and torso tilt with neutral pelvis and spine
  • Jump rope

Agility-aerobic circuits as tag team, scored on quality and completion time.

  • Hop scotch
  • Slalom course
  • Run backward, 10 meters ( or whatever available)
  • Balance beam
  • High skips
  • Dribble and shoot
  • Answer a question re health, nutrition, etc

Complete the “rainy” day with a stretching session, while chatting over “what was your favorite thing about the rainy day schedule.”

We should all, even uninjured on the clearest of days, include more “rainy day schedule” days consistently in our week. These types of workouts are invaluable to teach proper and safe ways to use muscles and hold body positions while moving in our activities!