(To see more pictures from the Ironman, click here.) My fourth time working Ironman Championships in Kona, HI and this year proved to be no different than Ironmans past. Most ART practitioners who work Ironmans have stories to tell: Every year, the ART team treats last minute injuries occurring the week before the race, flare-ups of chronic injuries, and Ironman winners in for last minute tune-ups. We even treat in the transition tents during the race when someone cramps, spasms, or thinks they are too injured to continue the race. We treat age groupers, Ironman champions, nuns, eighty year olds, and athletes from all over the world. As you can imagine, it's quite the experience. This year, I had a few challenges of my own. Fabrice, from central France, finished 2008 Ironman in 97th place overall. His goal this year was to finish under 60 overall. However, he walked into our tent unable to lift his left arm past 60 degrees without excruciating pain. Meaning, there was no way he was going to be able to swim. To make matters more challenging, the race was in TWO days. In addition to excruciating pain in his shoulder with minor movements, he was also getting radicular pain, or pain down his arm into his hands. I did a quick assessment and determined he most likely had tendonitis of his rotator cuff. No time for an MRI to rule out a tear, I started ART on his shoulder. For those of you who know ART, we need movement of the body part to effectively treat the area. Since Fabrice could not actively (and sometimes passively) move his shoulder without tearing pain, I had to be very creative and treat within a very limited range of motion. After the first treatment, Fabrice told me he thinks his Ironman race is over, it won't happen. I told him to be patient and come back the next day- the day before the race. Anything can happen. However, I was even grim about his chances to race in two days. Fabrice came back the next day, and as I was treating another athlete, Fabrice walked up to me and said in his french accent shaking his finger with a squint in his eye, "You fixed me." He then showed me FULL range of motion of his left shoulder and stated his shoulder was 90% better. I reassessed his shoulder and just noticed a little bit of dyskinesis (abnormal movement of his shoulder blade) of his scapula and treated the last 10% of his injury and sent him off running to get ready for the Ironman the next day. My friend and fellow ART instructor said to me, "You never get tired of this, do you?" Fabrice finished the race, without pain! Not only did he finish it, he came in 75th overall, quite the feat given that just two days ago, he thought his Ironman race was over. Miracle #2: Natalie, a patient of mine, like all Ironman athletes, had been methodically training for the big race for months. This was her first Ironman Championship so she had been coming into the office twice a week and getting weekly massages for months before the race to keep her body and form in tip top shape. She did everything she could to make sure she was as ready as she could be for the race of her life. Until a car hit her 3 days before the race in Kona. Every year, athletes get hit by a car while they are biking the course. Unfortunately, Natalie was struck by a car at the end of her training ride, causing her to hit the ground hard on her right side, bruising her muscles, bones, and skin. Fortunately, nothing was broken or severely injured, but she did stiffen up quite a bit and that's the last thing you want going into the Ironman. Natalie came into the tent daily for ART treatment as well as got massages from her long-time massage therapist travelling with her to the Ironman. Getting hit by a car is nerve racking enough, but hit by a car 3 days before the Ironman Championships is just mentally debilitating. However, Natalie overcame the effects from the accident and finished at 11:08! Miracle #3: Rachel was on course to finishing her first Ironman Championships as a top finisher in her age group. However, 7 weeks before the Ironman, in the peak of training, she broke her foot. Not able to run for 7 weeks before the race, she was unsure of how she would perform, if she could perform at all. We had her try running and even at 20 minutes of running, she had some pain in the foot and some tight calves. She received ART treatment several times before the race on her feet, calves, and back. Rachel finished the Ironman in 11:43! Quite the feat given she wasn't able to train for the last 7 weeks. No, you never get tired of these miracles, big and small. Congrats to all of you Ironman athletes... because completing the Ironman is a miracle in itself.