Not Too Much, Not Too Little -- Part 2

Back in January, I wrote, "If some exercise physiologists and medical researchers are right, the risk to a TOJ's long term health due to over-exercising is much higher than just catching a head cold, a topic to explore in my next blog." Okay, it turned out to be a few blogs later. Here it is:

There are friends and enemies of prolonged endurance exercise. The friends sometimes oversell it and understate both some of its risks, as well as the advantages of other types of exercise.

The enemies, like Al Sears, MD, who promotes intense short, interval training in his PACE Program, or Lou Schueler et al, who advocate that healthy exercise consists of building buff bodies with weight lifting in books like The Testosterone Advantage Plan, like to demonize conventional cardio/endurance exercise. What is odd is the militant tone of these opponents of aerobic exercise, especially against running. Scheuler almost gloats about the unfortunate death of Jim Fiix back in 1984, who wrote the then definitive book on running. Fiix had a family history of heart disease and was a former smoker who took up running in middle age. My hunch is that most enemies of endurance sports feel that way because they are either not very good at it, so it feels like pure drudgery, and they have never experienced the endorphin high that hooks you like a dope addict.

It is true that sometimes endurance athletes die suddenly. For over thirty years, sports science has been aware that many highly trained endurance athletes have over-sized hearts and, often, irregular heartbeats. These irregularities were often the usual suspect when an otherwise healthy endurance athlete keeled over dead. But heart size is no longer considered the problem as it once was. Lance Armstrong has a hypertrophied left ventricle that makes his heart one third larger than the average person and can pump at 200 beats a minute, no problem.

As a friend of endurance exercise, I was concerned when I heard that Alberto Salazar, the great marathoner, suffered a heart attack (but again, a long family history, and already diagnosed risk factors) at the Nike training center in Oregon a couple years ago. Or when I read in Runner's World that Rich Trujillo, an fifty-something runner who has accomplished amazing track and trail running feats over decades, has had a heart bypass operation. And he still runs, a true DTOJ, double-tuff old jock.

You have to wonder if the real underlying cause of their heart conditions is what I first mentioned in the January blog -- chronic inflammation. Ironically, running is likely what has kept them alive, although they were unknowingly setting the stage for future problems. They ran often and ran hard at the highest competitive levels. Years ago, Ken Cooper, M.D., the father of the aerobics movement, noticed that an unusually high number of elite athletes were coming down with illnesses, sometimes very serious ones like cancer.

In recent years, exercise physiologists have been studying the sad phenomenon where athletes train harder and harder, yet their performance gets worse and worse. They have given the condition a name: Overtraining Syndrome (OTS). The subtle physiology of the condition is fascinating, and the net result of the cascading electro-chemical events in the body is inflammation.

The syndrome starts when an athlete over-reaches, that is, tries to exercise faster, longer, or more
frequently than their fitness level is ready to handle.

If you are interested in a good discussion for the layperson, Gretchen Reynolds wrote an excellent article about OTS in the New York Times. Just go to:

And if you are interested in the the hard science of OTS, go to:

So, you wonder, what does OTS have to do with TOJs, who are not elite athletes? TOJs work out hard and often, too. As you age, you are more prone to the very same fatigue and inflammation as the best. TOJs are exercise nuts, so they are predisposed to OTS. It's all relative. Where 100 miles a week might push an elite athlete into the inflammation zone, it might only take 30 miles a week to do the same damage for a over-zealous TOJ.

Or maybe you are one of the one in a million who do not develop inflammation, like ultra-runner Dean Karnazes. He ran 50 back to back marathons, one day after another, with no rest period between days. After the 50th, they drew some blood to measure the effects on his body from such an extreme effort. All the markers of inflammation, like cytokines, were absent.

The good news is that inflammation can be avoided or controlled by three factors every TOJ needs to understand: 1) rest and recovery, 2) the right foods at the right time, and 3) knowing when you are over-reaching.

More on each of those is coming soon. But first it's off to Moab...


Rick said...

Nice post, I agree that there seems to be much zeloatry out there aginst anything that smacks of endurance training. I differ, having been an acolyte of the HIT, paleo diet approach for the ten years previous to my plaque rupture cardiac arrest that resulted in a x6 bypass. i was playing team tennis and was lucky enough to have a cardiologist playing two courts away. He did 12 minutes of world class cpr assisted by anther doc in the club until a rescue squad arrived to defib me. Two of my bypass grafts were defective from the start. My ability to ride my bike 75 miles in 5 hours,run trails with my dog and workout better than most 62 year-olds is a testament to the body's ability to heal itself and (in my case) develop collateral cardiac circulation -all TOJ's should know about collaterals.

tuff old jock said...

Wow, what a great rebound from a near death event! Sounds like you've come back stronger than ever. Glad you're out there.