Parents sometimes mention that footballers get drunk
and do not rest well and still can make it as footballers, and some of them are
world champions.I tell them that
football is very different from triathlon; Leonel Messi can vomit frequently
before the game because he is too anxious and worried; it nothing happens.He can do that because there are 11 players
in the game.In triathlon, you can lose
the race in a few seconds if you are too anxious or worried.In triathlon, attention to details is
extremely important the whole time.One
can hardly take a day off because training demands are different to meet.Even further, it is impossible to train
without recovery if somebody expects to improve with training.
Mexicans have a word to say NO-MAN (PUTO); in the
sense of not being brave and fearless as the icons of the Mexican Revolution.Over the years, it also became the meaning
for gay.It is different from the evolution
of the word “gai,” in French, or “gay” in English:
The term was originally used to
refer to feelings of being "carefree", "happy", or
"bright and showy". The term's use as a reference to homosexuality
may date as early as the late 19th century, but its use gradually increased in
the 20th century.
The Mexican team is going to pay for shouting “puto”
when the goalkeeper from the other team plays the ball.That is what football has become: the best “thug”
with some ability on the feet became the best footballer.Watch Neymar, Rooney, Ibrahimovic or Suárez.
I have a patient who told me that he was going to the
gym with young man to exercise.He is a homosexual
and older than fifty years of age. He has difficulties following the routines
of the young men.He did not want to
quit going with the men but wanted to see how to overcome the hassle in the gym.I told him:“Touch the Mexican´s icons; tell them that you are ‘puto.’”In the sense of not being brave and fearless;
he laughed and jokingly told me: “I think they know that I am a ‘puto.’”
Thugs behave better when they have people around them
when they perform.Guess what?The only championship won by a country from America in
Europe was in Sweden; no European team team have won in America.It was won by the
Brazilians in 1958.Fans in the arena
and environment play a big role on performance.Players concentrate better when people tells them to concentrate.Players fight better when people are around
and they feel in control of the environment. And do not forget about money, if Ronaldo gets so much money, he is not going to play with his legs against the USA, Ghana or the others.
In this fight between the thugs, the “pussy” is the one
who losses.Triathlon champions are
totally different from footballers.
We have part one acclimation where we explained what
happened to one of our athletes. I read what
happened to Tommy Zaferes a week ago in Dallas and saw images of Lescure
falling 50 meter before the finish line in Huatulco this past weekend.
The Seizure:
Once I crossed the line I
immediately flopped on the floor and started seizing. Personnel came over and
moved me out of the way like a limp bag of rice and got me to the paramedics. I
apparently had a heatstroke and then a seizure (which the doctors say can cause
death, brain damage, and major organ failure). They airlifted me to a hospital
and called my parents right away to fly out from California. I ended up being
intubated and on a ventilator for 19hrs before they moved me to another
hospital. I had major short term memory loss and had no idea what was going on.
I don’t remember, but I need to thank Courtney Kulick from USAT, Rob Canalas
from ROKA, the Huffmans,(and anyone else I don’t remember) for being there for
me until my parents, and girlfriend (who flew from London!), came. The support
I received was amazing!
Bonus Material:
The doctors said that all
my sodium levels were normal (if I wasn’t hydrated or if I didn’t have enough
electrolytes these should have been completely depleted) so they think that I
had a small virus which wasn’t showing any symptoms leading into the race and
that the race conditions and effort put me over the top and caused the heatstroke
and seizure. Having a heatstroke in these conditions isn’t that uncommon, but
having a seizure is what caused all the panic.
My body temperature was 103
at the hospital.
I am a doctor and have followed patients who have had
this problem. It is not about temperature
in itself.It is mainly related to
humidity.32 degrees Celsius with 90%
humidity makes the condition for many athletes being exposed to heatstroke.To produce the phenomenon of heatstroke we do
not need the highest temperatures, what we need is very high humidity (this is a Petri dish for heatstroke).The body in itself takes care of increasing
the temperature when is unable to decrease the temperature by sweeting
(evaporation of water through sweeting is the way we use to cool down our body).You did not have a virus Tommy; your acclimation
to humidity was not enough.
Several years ago, perhaps the year 1999 or 98, José Merchan was winning
the race in Ixtapa, Mexico, for more than 100 meters when he felt down 200
meters before the finish line. I have seen several athletes falling after that,
including Sara Groff (in a video).
Merchan finished the race after falling.It was very humid and hot when that happened.This year the same thing happened, one of our
athletes was stopped from racing before falling (9km) into the running.He started to have problems after 3k running.Ixtapa had above 32 degrees Celsius and 90%
humidity.Our athlete was used to the
temperature but not to that degree of humidity (it rained the night before and
the race was at 10am).He was hydrated
with 3 liters of water and electrolytes in the last two hours before the race.He was second when passing the first lap
(2.5k), after that he started to slow down until he was ready to fall at the 9k
mark.Our athlete mentioned that since
he started to slow down he had problems focusing things and does not remembered
when he was stopped until he was taken to the hospital and his temperature was
decreased to normal levels, when he recovered consciousness was in the
hospital.His blood pressure was 90/40
when he arrived, his skin was dry and hot, he was able to stand up and walked
with difficulties but he was incoherent.Potasium, sodium, magnesium was within the normal limits; CPK mildly
elevated 200 as well as creatinine 1.5, BUN within normal levels; his albumin
was less than 3 (he eats 4g of proteins per kilo on daily basis).Liver enzymes were within normal levels.He was able to leave the hospital two hour
later and took the plane back home four hour after the incident.His temperature was within the normal levels
after he left the hospital.Laboratory
test will be done today again.There is
a good article written regarding this subject for runners.A one subject research (himself) that gives
plenty information.
How Heat Affects Running
Performance There is little doubt that exercise performance is impaired in hot environments.
While the effect of heat on performance varies with the sport (for example,
less effect on cycling than running), there is a great deal of empirical data
showing a link between ambient temperature and performance. Various
authors have suggested performance impairments of between 1.6 and 3% in
marathon times for every 10 degrees above 55 degrees Fahrenheit. Below is an
interesting table from a paper by Scot Montain and colleagues at the US Army
Research Institute of Environmental Medicine illustrates the relationship
between elite marathoner finishing times and course temperature in the New York
City Marathon.
New York City Marathon: Top Times vs Temperature
The effect seems to be less dramatic for faster runners. The following
table from a 2007 paper by Matthew Ely demonstrates this nicely:
Effect of heat on slower vs faster marathoners.
Why are we slower in hot conditions? There are a variety of proposed
mechanisms, but the one that is most widely accepted is based on cardiac output
limitations.
When we exercise, we produce a great deal of heat. One of the principle
ways that we get rid of this excess heat is through sweating (evaporative heat
loss), as well as conduction and radiation of heat from our skin. To achieve
this, our bodies have to send a considerable amount of blood to the skin. This
blood is therefore not available to perfuse working muscles and deliver oxygen
to them. So a portion of our blood volume is essentially no longer able to
participate in oxygen delivery and energy formation in our exercising muscles.
The greater the amount of heat that we need to dissipate, the greater the
proportion of blood that is diverted to the skin (up to a point – this can’t
increase forever).
What is necessary for cooling isn’t the hemoglobin (the red blood cells
in blood) but the plasma, which is essentially water with a number of different
proteins and electrolytes in it. However, your body can’t separate the red
cells (which are the oxygen carriers) from the plasma – they all go along for
the ride to the skin.
How We Acclimate to Heat
If it is plasma that is the essential cooling component, is it possible to
improve this problem by increasing our total plasma volume? Yes, and that is
exactly what happens as we adapt to heat over time. Whether you acclimate
naturally to higher temperatures over the course of a season, or in a heat
chamber, the most significant change that occurs is an increase in plasma
volume. Other things occur as well (such as changes in sweat sodium
concentration, resting core temperature and heart rate), but plasma volume
expansion is the key. After extensive acclimatization, plasma volume can have
expanded by as much as 2 liters!
This may explain why the fittest athletes adapt to heat stress more
quickly than the less fit. One of the by-products of endurance training
(especially at high intensities) is an increase in plasma volume. So just by
training hard, you can derive some amount of heat acclimation. What about
specifically training in a hot environment to improve performance in a hot
race? There is extensive evidence that it is possible to improve our
performance in hot environments by training in similar conditions prior to
competition. Several studies have demonstrated performance improvements in
terms of maximum work rate, perceived exertion, time to failure at submaximal
work rates, and time to complete a specific distance.
In the last few paragraphs we’ve explored a bit about the effect of
heat on performance (bad) and the effects of acclimation on this (good). The
most meaningful physiological adaptation that occurs is an increase in plasma
volume (a lot like adding more radiator fluid to a car). However, there are
some other adaptations that occur – changes in sweat rate, changes in sweat
sodium concentration and changes in core resting temperature, to name a few.
The various adaptations occur with different amounts of acclimatization. Here’s
a graphical representation of the times over which an athlete can gain these
benefits...:
Heat Acclimation Methods
and Considerations
The work needed to achieve the benefits heat acclimation is reasonable. Most
laboratory based heat acclimation protocols have athletes spend about 1 hour a
day in a heat chamber for 7-10 days. Importantly, this needs to occur as close
to the time of the competition as possible, as the adaptations conferred by
acclimation decay rapidly without ongoing exposure. So there’s no point in
spending 2 weeks in a heat chamber a month before the race – the effects will
decay in 1-3 weeks.
As previously mentioned, the benefits of heat acclimation decay rapidly
if you do not maintain heat exposure. Estimates vary, but it’s possible that
you could lose half of the benefit in 10 days without ongoing heat exposure.
This raises some logistical problems for athletes living in cold environments
who are attempting to acclimate for a hot weather event. To benefit maximally
from acclimatization, the heat training sessions should occur as close as
possible to the event. That seems pretty straight forward. The problem is that
acclimation is quite physically demanding, and most athletes attempt to taper
in the week(s) prior to a big race. So, if you want to acclimatize optimally,
it needs to occur during your taper – which may cause overtraining, or at least
minimize the benefits of tapering.
As with all training, the more specific, the better. When it comes to
heat acclimatization this means that your training climate should reflect the
competition environment as closely as possible – the same temperatures as well
as humidity. Why is humidity important? As anyone who has survived an East
Coast summer knows, humidity makes it harder to lose heat via sweating.
Training in a humid environment does confer some benefit it you are training
for a dry, hot race, but not as much as training in a dry, hot chamber.
Interestingly, there is better “transfer” of acclimation if you train in a dry,
hot climate and then race in a humid, hot race than the other way round. So, as
much as possible, match humidity and temperature of your acclimation phase to
your race environment.
What about passive acclimation? That is, will sitting in a sauna at the
YMCA get us ready for running in Death Valley? Essentially – a bit, but not
much. Acclimatization is vastly greater (and more rapid) is you exercise during
the heat exposure. Whether this is again the principle of specificity, or
whether it is simply that core temperature rises faster with active acclimation
(increased core temperature is probably the stimulus for the adaptions that
occur) is not clear.
My
Experiences
To address these problems, I worked with the exercise physiologists at Simon
Fraser University’s Environmental Physiology Unit. They put together a low
intensity heat acclimation program specifically tailored to my needs (the
Marathon des Sables in Morocco). In brief, I ran on a treadmill at 50-60%
VO2max for 45-75 minutes over 9 sessions. The first 3 sessions were at 95F
(35C) and the next 5 were at 113F (45C). In the final (9th) session the temperature
was reduced back to 95F (35C). This allowed us to compare my physiological data
from the first and the last sessions. ..
Change in perceived exertion after 9 days of heat acclimation.
The Borg Scale above is used to assess subjective overall effort – I
clearly felt that the same speed was easier in the heat after 9 days. The
“thermal comfort score” below shows that I was bothered less by the heat after
acclimation...
Change in thermal comfort rating after 9 days of heat acclimation.
One of the most important ways to prevent heat injuries and to maintain
performance in extremely hot environments is to drink adequate amounts of
fluid. This seems obvious, but it is actually surprisingly hard to do this if
you are focusing on running. I think that one of the most useful benefits (for
me – not living somewhere hot) was learning to drink earlier and more
frequently. That I learned this lesson is well demonstrated in the graph of
fluid balances on Days 1 and 9 below...
Change in fluid balance after 9 days of heat acclimation.
Finally, what happened to heart rate? As you can see below, my heart
rate at the same speed and temperature decreased by about 9% – a very
significant improvement. Now, it didn’t get as low as what I would expect it to
be in “normal temps,” but the improvement was significant, and could be
expected to translate into a tangible benefit in competition...
Change in exercise heart rate after 9 days of heat acclimation.
So, in my experience, heat acclimation based on well documented
scientific principles can give athletes a significant performance enhancement
in hot environments. However, it is important to recognize the effect of
acclimation on the tapering period and to plan accordingly.
