TDR and other ultra racing problems, especially issues that caused you to stop

[febikes]

So as a TDR non-finisher I am starting to plan my next attempt.

Part of my planning can be based on my 1500ish miles and how my body responded.  Hopefully next time around I can work to avoid problems for the next race.  In addition to understanding my body problems and trying to learn from my experience it would be helpful to learn a bit from the problems of others.

To start off let me share what happened to me from the perspective of body breakdown.

Day 1: no issues, body felt great, long day but no real body issues
Day 2: felt tired but no body issues
Day 3: very hard and very long day but no major body issues while moving but lots of hike and bike and lots of cold with wet feet. 
Day 4: Starting from Eureka both feet in really bad shape, swelling in front third of foot, almost could not walk.  My shoes seemed to be flexing a lot and were a bit tight with foot swelling.  I replaced the shoes in Whitefish with a larger set that had more room for my swollen feet.
Days 5...10: Both feet went back and forth in levels of pain, best times was "bad pain" worst times was "blinding pain", swelling was constant.
Day 11: blinding pain from both feet, felt I would lose consciousness from pain of walking if any pressure was on my forefeet (both feet about the same)
Days 12..16: rested in hotel room, never got out of bed, feet condition was blinding pain and extreme swelling.  Zero recovery in four days.  Finally decided to fly home.
Days 16...30: Very slow recovery, at this point pain is manageable and swelling is still there but seems to be going down slowly.  Doctor did xrays and sees no bone damage.  The doctor thinks I have a very bad case of "Sesamoiditis"; I am certain it will recover but it seems slow.

For me the injury seems to have all been from day three even though it only manifested on the morning of day four.  From that point the injury got worse but then doing a section of hike-n-bike for watershed divide triggered extreme pain such that on the final bit of riding into steamboat I was almost unable to focus my eyes and had trouble moving.  It seems to me that I had no option but drop out of the event.  If I had rested earlier it might have been better but it is hard to know because I have never had such a problem with my feet in the past.

For next attempt (might be 2014 or 2016) I am planning to do a lot more hike-a-bike in training and will bring a pair of light boots in addition to a pair of top quality cycling shoes.  I figure actually having the boots for the hiking sections might be worth the weight depending on what I find in my training.  It could be that I have really week bone structure in my feet (I have mortons toe and may have other feet issues).  The weird thing is that prior to this I have never had any really bad foot issues but I normally do almost no hike-a-bike and in the past few years I have done very little hiking.

Other then the feet I had some minor issues with my achilles tendon on my left foot but this was only an issue on day three and seemed to get better as the days progressed.  The tips of my fingers also went numb but it was mostly minor and was not slowing me down or really causing much of an issue.  The numb fingers recovered about a week after I stopped.

I had no saddle sores and my leg muscles and the joints of my knees and hips never caused any problems.  I also never had any saddle sores.  Prior to the event I was worried about my taint but I think keeping good shorts and lots of chamois lube worked.  I was also a little worried about knee and hip pain but I think my joints were ready because I did 3K+ training in the build up to to the event.  The one thing I neglegted was hike-a-bike and cold weather training and this is where my problems came from.

In any case what sort of problems did you have in various years and what are ways do you think cope well.  I think we can learn a lot from comparing notes on things that went wrong.

[ride MT]

what a great thread topic. nice! this stuff is the real business for sure.

[THE LONG RANGER]

Knee pain almost sidelined me going from, "bad" on day one, to, "worse" on day two, to, "intolerable and scary" (thinking: "am I doing irreparable damage?!") by day three.  By day four, it all cleared up, save for the, "usual" aches and pains you'd "expect" on such a ride - esp. on a single speed, with little in the way of recovery time.

The problem was the saddle I was training on - a Brooks B17 that was somewhat out of shape. A little curious as to why, but I think it's from sitting on it out of whack, while waiting for lights to change (as you do here, in the city). That little deform part started the knee pain from whack biomechanics. (The other theory is that one leg is longer than the other.)

I performed a cardinal sin and replaced the saddle the week of the race with a Selle An Anatomica Titanico X, dual coated, no slit. Incredibly, once that was broken in (which took days, not weeks): no more knee pain. No saddle sores. And the saddle held up. It felt a little like cheating. So happy. The Specialized Saddle I used last year, as fancy as it was, was not the correct choice for the Tour Divide for me and my bottom was a war zone, afterwards.

Other than that, headwinds going into Jackson (or just GOING into Jackson) to get a new wheel for my failing rear, were severely soul-sucking and I almost didn't make it out of Jackson, with that new wheel - I was looking around for a motel and a bus schedule. It took forever to source a new wheel and even though it was late, I knew it was imperative to get back on route and continue on. I hadn't slept a good night's sleep since Lima, MT, but after riding almost non-stop to Jackson, taking hours to source the wheel and riding back on route - and then collapsing under a bridge, by the next day, I felt about a million times better emotionally and was able to hustle to make up time.

Making rational and logical decisions while basically on a thread of consciousness is something to at least expect. If it wasn't for a few kind words from friendly face, a free pastry from the coffee shop and a total kick ass bike shop in Jackson (or two!), man, dunno if I'd make it back out there.

Glad I did, since after that, every day just ruled. Something about having to face that sort of distance, with that sort of problem (rear wheel breaking!) and getting through it, you feel a little invincible. I had no idea I could lay down that sort of mileage.

[DenisVTT]

It might seem a little dumb as a solution but if the hike-a-biking in the north was the problem, maybe starting from the south would be the solution.

That's because as most of the hike-a-biking occurs in the north, by the time you're done with it going NoBo, the finish line is right there and you can stop.

In other words, if the unbearable pain going SoBo started to occur on Day 5 after Day 1 to 4 had extensive hike a bikes, and you were on a 20-day pace, then going the other way you're on that terrain by Day 16, and after the 4 days of hike a biking you're now in Banff and can rest instead of having to pedal another 2 weeks+.

There are occasional hike a bikes in the south, but they are much shorter and are not done in the snow. You may however potentially have more knee problems as some of the climbs are steeper and longer in the south. You may also need to train at altitude as the elevations are higher, earlier (that will also make your call-ins while you bike even more hilarious!  )

Just a suggestion.

[candrus]

I raced from South to North mainly because of the forecast lousy conditions in Canada and northern Montana.  From fall to early summer my training had been in rain and slush and I simply couldn't imagine enjoying a race that began in such gloom.  My feet and hands quickly go numb in cold weather so it wasn't just about my mood.  This race strategy proved ideal for me.  I was able to get myself to New Mexico a week early to acclimatize to heat and altitude.  As a bonus, this put me in Silver City for a few days -- a charming town sprinkled with generous and interesting people.  Except for a heat-related headache at the end of the first day I had only minor health issues.  The weather was nearly perfect, the winds usually pushed from behind, and I had the pleasure of meeting each southbound racer along the way.  I was surprised to find out from them that the most common injury was related to feet and lower leg tendons and they attributed this to the cold and snow walking early in the race. 

My only time of discomfort and slight alarm was the day of going through the Flathead basin in Canada where the many water crossings soaked my shoes.  Although the day was sunny and I changed into dry socks and Gortex oversocks once I got to the pavement, the night ended with a fast glide into Sparwood with the temperature below 40 degrees.  I had no feeling in my feet when I reached town and I still experience tingling even ten days after finishing the race.  It seems that at least for some of us the feet are the weak link in endurance racing and this requires a race strategy that may include avoiding cold, boots, platform pedals, and motel rooms to thaw out.  Plastic bags from Subway stuffed between socks and shoes are probably not going to be a sufficient strategy for many of us.

[Marshal]

High Miles and Long Hours—so so much to be discussed as this is the true key to a successful TDR race imo

Skipping environmental conditions/solutions for the moment (cold, wet, heat etc) a quick categorization of the common/key TDR ‘body’ issues gives us:

The 3 body/bike contact points---Hands, Feet, Derriere
The 2 most common repetitive motion (RM) body issues--Knee and Achilles

IMO the 3 contact points should be addressed by (in descending priority):
1)   Position
2)   Surface or contact area
3)   Bike suppleness (frame stiffness, suspension, tire size etc)

And the 2 RM areas should be addressed by (again, in descending priority):
1)   Position
2)   Training
3)   First Aid

I feel the # 1 priority, for both contact points and RM, is “Position” so I would ‘start’ there. 

Note: not to over emphasize the obvious but a position for long term comfort is not necessarily going to be the same as a position for maximum power or aerodynamics.  In other words all you know about your current/favorite ‘race’ position may need to be reconsidered for the TDR.

      Ideal TDR Position—this will of course vary depending on ones inherent flexibility, age, personal preference etc etc but—but in general the best position for the high miles, long hours of the TDR is actually a bike with TWO distinct positions:

First, is a position that places your body in a classic relaxed/upright touring position to reduce the pressure on the hands and stress on the lower back.. 

Second, is a position that totally changes the pressure on the hands and buttocks, and this is best achieved with aerobars.  Note: when new to aerobars one can over stress the RM areas (see RM #2 priority).

So, when we design our ideal TDR bike the ‘first’ position--a reasonably upright/relaxed position—is to be acquired with the correspondingly proper top tube/stem lengths etc etc. (the frame building experts can weigh in here).  The ‘second’ position is derived from aerobars, ha and some of you thought they were mainly for speed.

Before moving on to, #2, surface contact area-critical for the feet & hands, , anyone want to weigh in on the ‘upright relaxed position’ concept, combined with aerobars to produce a totally different/second position?
(febikes--per your TDR experiance and as a bike designer I am interested in your take on 'ideal' TDR positon)

[Use it or lose it]

On my ITT in August 11 I had solid pain and swelling in both achilles at the end of day 4 - I thought this was going to just get worse and lead to the end of my attempt. But it surprisingly cleared up the next day.

I can only think the pain was due to both having the riding position not exactly right, so I fine tuned that, and also my body adapting to the long hours. By the end my legs felt strong, all be it I was tired. But I was saddle sore and had to resort to two pairs of shorts for the last week! Even then I had to keep standing up every two minutes.

And I was expecting some knee pain but as said I think that so much training and riding on the event strengthens them up.

It does make me realise that there is a big element of luck in whether injuries will flare up. And this puts me off a bit in trying the TD again - maybe I had my lucky run to complete it and should rest at that!

[febikes]

(febikes--per your TDR experiance and as a bike designer I am interested in your take on 'ideal' TDR positon)

If your bike position is wrong you are going to be in real trouble on the road.

Bike position is hugely subjective based on flexibility of the rider.  What I can say is that my relaxed position worked great for times when I was riding.  I never had any issues with back, butt, knees, or elbows.  For my bike my bars are about level with my seat and the reach to the base is comfortable.  In actuality this is only slightly relaxed vs. the position I normally ride.  Next time around I may add aerobars but I am not sure.  It will take time to determine where my ideal aerobar position and if I want to rock the dork with aerobars on single speed style.  I also go single speed so I can spend a lot of time out of the saddle for extra comfort and keeping my efforts more in touch with the changing in terrain.

One thing about the bike that I think is critical is really natural handling so you feel comfortable without having to pilot your bike too much.  The ideal TDR bike position needs to be one that you ride a lot of time in so it will feel natural and you should experiment a lot to arrive at it then ensure you do some long training in the position.  In many ways I think that other then the aerobars the ideal TDR position looks a lot like the position you would ride in a six to eight hour single day epic ride.

TDR is a subset of ultraracing and it was my first event of the type so I am still learning (as evidence my my failure to finish).  For my next event I am thinking of TNGA or another similar event with more singletrack and less roads.

The best way is to start with a normal position based on your morphology then slowly adjust things as you listen to your body.  

And remember, as per Lance Armstrong: "it's not about the bike"

[febikes]

But I was saddle sore and had to resort to two pairs of shorts for the last week! Even then I had to keep standing up every two minutes.

I only made it through 10 days so I did not really experience the last week.

For saddle sores were you using creams to maintain your taint?  I was applying butt butter, udder cream, and/or DESITIN about every three to four hours from day one and washing or changing my shorts about once every 48 to 72 hours.  It's a TMI subject but it might be interesting to know how others maintain their taint.

I used a lot of DESITIN cream, it mixes nicely with sunscreen.  In addition I applied DESITIN to my feet and taint to help prevent any rash and blisters.  I had almost no actual rash, sunburn, or blisters in the 11 days on the ride so I think the preemptive approach was working for me.  

My general approach was to apply DESITIN and rub it in then apply butt butter or udder cream on top of the base layer at later points in the day.

A more expensive approach is to use DZ nuts and they have a much better video.
<a href="http://www.youtube.com/v/5uYBlBn004Q" target="_blank">http://www.youtube.com/v/5uYBlBn004Q</a>

[Marshal]

I listed Surface/Contact Area as the #2 priority. 

However with a SS set up and the inherent increase in standing time it becomes all the more critical when considering the accumulative pressure on one’s feet.  Ahh SS on the TDR—it helps/saves the ol bottom but forces you to stand more thereby increasing the long term/accumulative foot pressure. 

So if you are doing the TDR with a SS (or you just stand for extended periods) your shoe/cleat sock/pedal combination moves up up up on the food chain.

Anyway If one dissects the foot/surface area interface we might start with:

#1 shoe/pedal contact area—the more the better for distributing pressure. 
Clip the shoe into the pedal and flip it over-- study the mating/contact area—any thing you can do to increase the shoe/pedal contact area will help distribute pressure over more of the foot.  Not all pedals and shoes ‘fit together’ the same, some combinations have better/more contact area and that’s what you want for the TDR.
And for some TDR racers I think platform pedals should be strongly considered. 
       Personal Note: If I ever do the TDR again I will experiment during the long term prep with flats or maybe a clip on 1 side & flat other side pedal.

#2 cleat position—in general the further back the better the pressure distribution.  Of course this throws off your normal, seat height and pedaling motion, affects the knee/Achilles, power development etc etc—so you have to spend the time to experiment/adjust/adapt--but if it helps solve TDR foot issues it’s worth it.
      Personal Note: over the yrs-- I have found that if I dremel the shoe slots about 1/8 inch or more and cut the sliding steel screw plate in half to get my cleats well back of the most rearward std position I can minimize “some’ of my foot issues.  Nothings perfect—I am still recovering from a stress fracture in my right foot from this yrs AZT 750.

#3 shoes & socks. 

This is such a personal/variable thing it’s almost pointless to discuss—

      But here is my take on the ‘best’ combination for the TDR.  Start with a mid level 3 strap mountain bike shoe.  These type shoes are stiff enough to distribute pressure but still semi-flexible for the walk/hike stuff. The 3 velcro straps allow for quick/easy loosing as feet swell or cinching down for hike-a-bike sections.  (for SS I might look at the stiffest sole due to all the standing—but this of course compromises walk-ability)
Use a high quality /new foot bed insert of your choice.  During the race use/change up with a combination of mid-to-thin wool socks for wet warmth and padding as needed.  IMO various thickness smartwool socks truly rule for multi-day racing for a variety of reasons!

[trebor]

      But here is my take on the ‘best’ combination for the TDR.  Start with a mid level 3 strap mountain bike shoe.  These type shoes are stiff enough to distribute pressure but still semi-flexible for the walk/hike stuff. The 3 velcro straps allow for quick/easy loosing as feet swell or cinching down for hike-a-bike sections.  (for SS I might look at the stiffest sole due to all the standing—but this of course compromises walk-ability)
Use a high quality /new foot bed insert of your choice.  During the race use/change up with a combination of mid-to-thin wool socks for wet warmth and padding as needed.  IMO various thickness smartwool socks truly rule for multi-day racing for a variety of reasons!

This is very much where I've landed. 3 strap mid-level shoes do it the best for me.

I suffer greatly from numb hands on long rides. I'm still numb to some extent from TD last year - at least there is a decrease in fine motor dexterity since last year. I also got sever whiplash in a crash, so that could play into that as well.

This year I've brought my bars up and a bit back and going with drop bars. It's proving more comfortable and versatile.

Lastly, Achilles, well, seems to affect many. Mine started acting up on day 3. It never got to "blinding pain" levels and after day 5 it started to calm down last year. However, I crashed the afternoon of day 5, so I don't know what was going to happen next. But I think I did diagnose it with the help of my bike fitter after the ride. 

The same fitter that eliminated knee pain and IT band issues I was having in mid-distance races (200-400 milers) prior to TD. Fittings I think, give you a point from which to start and you must listen to what the body says after that and fine tune. In the words of Eddie O, "Millimeters matter."

We'll see how it play out as I go for an ITT later this summer.

[Use it or lose it]

Yes I was using plenty of saddle cream. I think it was more like bruised sit bones which I was suffering from - rather painful! Not enough to stop me thankfully, but a real distraction all the same.

[phil_rad]

I had minor physical problems this year but nothing to make me stop; fingers on my left hand started going numb after four days, nothing what a few accupuncture sessions wouldn't take care of. Some numbness in my toes and a slight cough that was bothersome. My biggest problem the one that got me two times is mental weakness, I just broke down mentally and couldn't go farther. I was partly bummed from the shitty weather and partly freaked about my hands; in 2010 I had some serious nerve damage done to my right hand and couldn't fully use it again until three months latter. After I decided to drop in Helena I felt better and I was confident that my descion was the right one. Now after 5 weeks I'm starting to think that I bailed to soon. I can't really justify trying it again unless I can get over this mental weakness; maybe I never will. But one things certain; the Divide won't let me be, I'm still thinking about it after two failed attemps. Help!!

 

[rooster14]

The Tour Divide was my first bike packing/ultra race and I ran into some pretty substantial issues that made my progress less than ideal through the beginning.

Knee pain plagued me majorly, this was entirely a result of lack of riding a 45lb bike in any manner of solid training prior to starting.  I worked through this by elevating my feet whenever i could, taking advil and massive amounts of stretching during breaks and before sleep and before starting.

Foot discomfort/dryness...i really wish i had brought along shoe covers/gore socks or seal skins...some sort of way to insulate and keep my feet more dry than they were.  I was lucky to not have any foot issues, but i really missed these items.

i did adjust my cleats at one point during the ride and noticed an improvement in my achilles and knee comfort.

also, TOE NAIL CLIPPERS! my toe nails grew crazy fast haha, it seems stupid, but they were uncomfortable, unsightly and sites for potential rub/blisters etc until i was able to trim them.

Saddle sores were just a part of life, using chamois creme was the only solution, the day would start off very tender and sore and eventually my body would just tell my ass that it was going to have to stop hurting because there was no choice but to sit on it.

while most people know this, avoid using a backpack.  it is crushing.  it isnt too heavy in the morning when you start off, but after you have drank down your bladder-full of water, it gets light and comfy and you fill it up again later in the day and it is absolutely crushing on the body and soul.  Do everything you can to equip yourself without having to carry gear on your person.

Keeping a positive attitude, believing that it will get better and simply pushing on even if you are literally pushing, was the best thing i had on my side...I also realized that mental breakdowns are a part of this experience...they have to happen.  
I did take an early day in Lima to get an early start the next day that really did a lot to recharge my batteries and my soul.

biggest thing is to listen to your body and when i ever do the TD again, i will keep the same mindset of not going crazy fast out of the gate, there is a lot of time to make a lot of ground and I still dont think the first 2 days are the place to make these huge moves (unless you are going for the record obviously)

have fun everybody!

[gbach]

Just to kind of chime in here, with consideration to a couple of the contact points previously mentioned, I've had good luck using Lantiseptic.  As far as I know you would need to carry all you needed or get more in mail drops as I've never seen it in stores.  The stuff works great on the taint. 

I've also used it short term on feet (had dry and cracked skin on one foot, then it started to rain... tissue wouldn't heal, causing a fair amount of pain with hiking) with success (i.e., kept me going).  This episode occurred on a 4 day "bikeabout" of the Colorado plateau going from desert to alpine conditions.

[Foster]

Dislocated my knee on day 2 and put it back in place, and continued to ride.  Noting I could really change or do about it except to continue to ride as long as I could.  Rested 3 days and made it to day 10 and another 600 miles after the injury.  Next year I will do everything the same except dislocating my knee.  No mental problems, in fact I was pissed that I had to quit (Last place was Butte).  I could not walk.  But once at the Denver airport and being pushed around in a wheel chair I had a realization that it was a good choice.  I still don't know how I pushed through the pain, but finishing the Divide became an obsession.  Once back it took me 2 weeks before I was able to ride my bike again.  See you all there next year.

[DenisVTT]

Dislocated my knee on day 2 and put it back in place, and continued to ride.  Noting I could really change or do about it except to continue to ride as long as I could.  Rested 3 days and made it to day 10 and another 600 miles after the injury.  Next year I will do everything the same except dislocating my knee.  No mental problems, in fact I was pissed that I had to quit (Last place was Butte).  I could not walk.  But once at the Denver airport and being pushed around in a wheel chair I had a realization that it was a good choice.  I still don't know how I pushed through the pain, but finishing the Divide became an obsession.  Once back it took me 2 weeks before I was able to ride my bike again.  See you all there next year.

Foster, the way you pushed through 85 miles of wilderness trail after dislocating your knee and putting it back all by yourself, then riding again for 600 miles, was nothing short of amazing and very much an inspiration.

If you get a chance one day, I'd like to hear more about the incident itself, how you put it back (I mean, I had to put back a dislocated finger once and that was hard enough - How do you pull that lower leg away from your body?), and how you did the next 85 miles to Whitefish. To me, it was just the most amazing story of this year's TD.

And I have no doubt that you'll make it all the way the next time you try! 

[bruce.b]

  I'd be interested in the details of your knee dislocation too, because I'm curious and also to possibly learn from your experience. I watched my son dislocate his ankle when he fell off a bouldering problem. He grabbed it right away and pulled on it and luckily it popped right back in. I was about ten feet away and it was a scary and sickening thing to see. It was a week before the nationals and knocked him out of competing.

[Foster]

Getting my knee back in caused pain I cannot describe.  I didn't really know what happened until I tried to stand up after wrecking. Once I realized my knee was out of place I reached for my SPOT and almost pressed the 911 button.  But then I decided if I could get my knee back in maybe I could ride and finish the race.  Plus I didn't want to pay for a really expensive rescue.  I was already delusional by this point.  First I had to align everything because of how out of whack it was so I did this in the fully extended position of the knee.  Then I slightly bent the knee after aligning it.  Then I tried 2 times to get it back in place putting my foot on the ground and wrapping my left leg on the anterior side of my right ankle for some sort of traction, held my quad while trying to use the other hand to pull the Tibia/fibula as well as forward pressure.  My foot kept slipping on the ground and I couldn't get enough leverage.  While going in and out of consciousness all at the same time.  To get it back in place I ended up clipping into my bike pedals so that I could get enough traction to get it back in.  Once I did that the knee went back in place really easily and I barely had to try.  Not sure if you can completely picture how I put it back in but its the best I can describe it.  I took 120 mg oxycottin, 40 mg prednisone, and iced my knee a couple mins...which it hardly swelled surprisingly by the time I rode another 50 miles.  2 days later the swelling was like a softball, most like due to the fact that I ran out of prednisone.

I highly recommend saving your medications from other injuries to take on these events, they are worth bringing and weigh nothing.  Just put them all in a plasic bag and don't forget which is which.  I brought every single old prescription I had as well as NSAIDs, aspirion, anti-histamines, general anti-biotics, diarrhea meds, etc.  Because you never know what can go wrong out there.

I did a write up about my TD ride on a blog I just started if you want to check it out.  Its a little more brief about the knee but gives a general overview of my ride. 

http://headwindsandhills.com/2012/07/03/tour-divide-2012/

[DenisVTT]

Getting my knee back in caused pain I cannot describe.  I didn't really know what happened until I tried to stand up after wrecking. Once I realized my knee was out of place I reached for my SPOT and almost pressed the 911 button.  But then I decided if I could get my knee back in maybe I could ride and finish the race.  Plus I didn't want to pay for a really expensive rescue.  I was already delusional by this point.  First I had to align everything because of how out of whack it was so I did this in the fully extended position of the knee.  Then I slightly bent the knee after aligning it.  Then I tried 2 times to get it back in place putting my foot on the ground and wrapping my left leg on the anterior side of my right ankle for some sort of traction, held my quad while trying to use the other hand to pull the Tibia/fibula as well as forward pressure.  My foot kept slipping on the ground and I couldn't get enough leverage.  While going in and out of consciousness all at the same time.  To get it back in place I ended up clipping into my bike pedals so that I could get enough traction to get it back in.  Once I did that the knee went back in place really easily and I barely had to try.  Not sure if you can completely picture how I put it back in but its the best I can describe it.  I took 120 mg oxycottin, 40 mg prednisone, and iced my knee a couple mins...which it hardly swelled surprisingly by the time I rode another 50 miles.  2 days later the swelling was like a softball, most like due to the fact that I ran out of prednisone.

I highly recommend saving your medications from other injuries to take on these events, they are worth bringing and weigh nothing.  Just put them all in a plasic bag and don't forget which is which.  I brought every single old prescription I had as well as NSAIDs, aspirion, anti-histamines, general anti-biotics, diarrhea meds, etc.  Because you never know what can go wrong out there.

I did a write up about my TD ride on a blog I just started if you want to check it out.  Its a little more brief about the knee but gives a general overview of my ride.  

http://headwindsandhills.com/2012/07/03/tour-divide-2012/

Foster, by the powers vested in me, I hereby declare you Tour Divide 2012's Badassest Rider!

10 of 10 on the Badass scale!