Another off-season memoir and review

A busy semester/work/training season delays a cold season reflection.

While the off-season plays an important role in race season performance, the race season mentality presents a danger to the athlete.  When building the aerobic base in the off-season the athlete's thinking can weigh too heavily on heat production from skeletal muscle, leading to inadequate protection of the skin with less heat from skeletal muscle.  At least the endurance/snow sport neophyte has such error potential, anyway.  In "Frostbite and Dermal Cold Injury" Katie Dolbec, MD defined and described frostbite as freezing injury with ice crystals in tissue and frostnip as a cold injury without freezing within the tissue, with a propensity to develop into frostbite.[1]  Cold injuries can be difficult to manage in the middle of a long run.  In 1977 the New England Journal of Medicine published a frequently cited case report, from Dr. Melvin Hershkowitz, describing frostbite of his penis.[2] This occurred before the proliferation of synthetic wind-proof underwear, but also before the proliferation on non-windproof synthetics, which are worse than cotton for cold injuries(see below).  This individual was missing some of the vascular skin that would offer some protection to the glans, even if providing something else at risk for cold injury.  This protection appeared to be the pattern in a different report in the British Medical Journal in 1989.  This report described frostbite and frostnip in seven subjects involved in outdoor winter activities in Norway.[3]  The circumcision status was listed along with the details of the cold injuries.  Only the circumcised subject had any symptoms in the glans following short cold exposure (i.e. a few hours at most).  That too was my experience following a 10-mile run on January day, slightly below freezing, in 2008.  I went out to run early in a weekend morning on quiet country road on the hills of central NH.  I was clad head to toe in synthetic apparel, which I wasn't thoroughly accustomed to.  Other than gloves, a hat, and jacket, my apparel was designed for breathability and wicking.  By the second split the distal end of my external organ became overwhelmed by the cold and I reached in my pants to warm it up, trying not be conspicuous.  Running biomechanics was compromised in so doing.  I would intermittently resume normal running for a few strides to gain speed and get back to warm shelter sooner.  Well over an hour after commencing my run I ran indoors to tend to my pain.  Only frostnip, but extreme pain for 10 minutes or so. I crouched, holding my crotch, and breathed as best I could.  Live and learn.  The pain confined to the mucosal/epithelial surfaces left exposed after someone specializing in the female reproductive tract (or one of his cronies) stripped away vascular skin.  No substitute for windproofing; but, a supplemental option involves skin expansion (Research it if intrigued).  In the spirit of Men's Health Month, it's time our bodies have some respect from womb onward.

1. Dolbec MD, K.  Frostbite and Dermal Cold Injury.  Wilderness Medicine.  www.wildernessmed.org/images/Frostbite_and_Cold_Injury.ppt.  Accessed 21 June 2013.

2. Hershkowitz, M.  Penile Frostbite, an Unforseen Hazard of Jogging.  New England Journal of Medicine. 1977 Jan 20;296(3):178.

3. Travis S, Roberts D.  Arctic Willy.  BMJ, 1989 Dec 23-30;299(6715):1573-4.