Exercising on the Edge

A couple weeks ago a strange and terrible thing happened: three runners died in the Detroit Half Marathon. The men, 26, 36, and 65, all died within sixteen minutes of each other. News of the tragedy gave pause (hopefully a short one) to endurance athletes everywhere.

In wake of the tragedy, the Internet buzzed with speculation as to what happened. One blogger was convinced that a demented person had poisoned the water at one of the rest stops. It will be interesting to see what the pathologists conclude, if made public.

Facts regarding each of the men's health and medical history are few. They were probably in pretty good shape based on what I've read. The death of the 65 year old was no great a surprise because, as every TOJ knows, odds of sudden death during exercise rise steadily as a function of age, and he reputedly had some lung problems. When young men die during exercise, it is usually attributed to an electrical conduction or other hidden heart defect.

The weekend after the Detroit event I received an email from Dr. Al Sears (http://www.alsearsmd.com/), who runs a wellness and longevity center in Florida, and is a strong opponent of aerobic training, especially running marathons. His email claims this type of exercise "shrinks your lungs and downsizes your heart's output." Further, studies have shown that blood samples taken from people who have completed marathons have exhibited the same enzymes that are present during a heart attack. Dr. Sears sells an program that is based on progressively short anaerobic bursts of exercise, which be believes are safer and help you live longer.

I forwarded his email to another TOJ who is a distance runner (had just finished the Humboldt County Marathon in California) and a physician. His reaction was illuminating. He said it might be true you live longer if you exclusively follow a short interval program like Dr. Sears, but there is no scientific evidence that it does. Furthermore, most distance runners use a variety of exercise, including intense progressive intervals.

This distance runner/physician's most important point was that how you exercise really depends on the outcome you seek. If you want to run a marathon, you have to train for it, which is true for any challenging physical endeavor. If your goal is just to live a long time, it might not be necessary to do many of the forms of physical exercise that a TOJ enjoys. Most TOJs exercise hard because it enhances the quality of their lives. Quantity, as measured in years, is just a secondary effect, and subject many other factors like genetics and environment.

My friend speculated that there might be subsets of people for whom distance running is good, and others for whom it is detrimental. But being able to identity who falls into which category waits future study. Right now, to use his words, we are still in the medical dark ages when it comes to long term effects of exercise.

For most of us, any exercise where you ramp up your heart rate -- whether in intense, sub-minute anaerobic bursts that leave leave you breathless or in long aerobic activities where you dwell minutes and hours at at the burning upper end of your aerobic capacity -- presents some risk. You don't know know where you reach a dangerous tipping point, and, luckily most of us never find out.

The men whose lives ended in Detroit did. While it is doubtless a tragedy for their family and friends, this TOJ admires that they were in the race.

New Mantra: Faster, Harder, Shorter

The "faster, harder, shorter" mantra, aimed at people of all ages who wish to achieve quick results on the road to fitness, is spreading like the H1N1 virus.

My last blog was about some anti-runners who recommended a grueling, once per week, 12 minute routine in which you do extreme resistance (weights or machine) exercise to the point your muscles fail. Half their book was a dire warning that running will debilitate or kill you.

Then I got an email from Al Sears, MD, who promotes a copyrighted program called PACEBOOK (I bought a copy and found some good stuff) that recommends short, intense, progressive interval training, which can be sprinting, biking, swimming, lifting, jump roping, etc. Like his book, his email had more dire warnings about jogging/running. Check out: http://www.alsearsmd.com/jogging-injuries.html

So I cringed when I picked up the the August issue of Trail Runner magazine (in which you'll find a snatch of poetry about running in mud they printed from my April 2009 blog) to see an article entitled "The Fabulous 4 (Minutes) - The Short - Intense - Workout That Delivers." It is about a system developed Izumi Tabata, at a Japanese sports institute in the early 90s, that involves sprinting as hard as you can for 20 seconds, then resting 10 seconds, then sprinting again. You do this eight times. Tabata discovered that this painful regimen can confer tremendous improvements in aerobic and anaerobic capacity. (I'd be wary of any regimen developed in Japan because, even today, it will be influenced by medieval samurai culture, which places a high value on suffering.)

I think there are great benefits to be gained from interval training. I do sprints once or twice a week. But it should be noted that the only injury I've had this year was a pull in the lower left Achilles tendon that occurred when -- sprinting! The anti-runners always offer scientific studies to support their attacks on jogging/running, however, often these studies are flawed or incomplete. If you want to read a good blog, with solid scientific thinking, that questions these broad claims for interval training over running, go to http://frayedlaces.blogspot.com/2009_06_01_archive.html.

If you haven't done intervals in a long time, start very slowly and build up. There is no hurry to get to "fitness." The journey itself is the goal. Start with the slow gentle approach to interval training recommended by Covert Bailey.

A TOJ knows that all physical activities come with some risk of injury. So what? To a TOJ, the real problem with the 4 minute this and 12 minute that is he or she enjoys exercising too much to be subject to time limits. Life's too short as it is.

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:

http://www.nytimes.com/2008/03/02/sports/playmagazine/02play-physed.html?ref=fitnessandnutrition&pagewanted=all

And if you are interested in the the hard science of OTS, go to:
http://www.woongbee.com/Cytokine/Cytokine%20bulletin/Spring%202001/spring2001-4.htm

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...