During the last weeks the heart of athletes moved into the center of concern. There have been cases of sudden cardiac death, there have been athletes withdrawing from the sport because of heart issues. I thought it may be of interest for you as an endurance athlete to get an idea about what is still a normal heart and when is a heart under suspicion to be a sick heart.
Sudden cardiac death needs to be questioned. If one had known the history, the decent symptoms before the incident, if one had interpreted the signs correctly at the right time, maybe distress could have been prevented. An ECG can give a lot of information, if one is able to read it right. Looking at an ECG without knowing that it is an athlete’s heart, may lead to misinterpretation and panic. A physician needs the experience to read the curve. There are common and training-related abnormalities (up to 80%) of an athlete’s ECG. These physiological ECG abnormalities are more prevalent in highly trained endurance athletes than in other athletic subgroups.
Normal ECG curve
An endurance athlete’s heart undergoes structural changes that show in an ECG, not only the heart muscle thickens, also the conduction system of the heart works with a different rhythm. Regular physical work-out leads to an increased vagal tone which means that the heart beats slower (bradycardia) – of course, you know and feel that. Slight arrhythmic heart beats are not uncommon either. Especially, if the heart beats very slowly. These phenomena are functional which means they normalize during exercise, they don’t lead to dizziness or passing out and they are reversible, e.g. if training is discontinued. Cases of less than 30 beats/min and marked sinus arrhythmia needs closer attention, it may be a pathological condition like a sick sinus syndrome (those guys receive a pacemaker). Continue Reading →
I found a very interesting article about the harmful effects of painkillers in the New York Times. Especially now, where so many of you are training extremely hard for the climax of the year in Kona, the Ironman world championship, these research results maybe of interest for you and, may even be helpful for your preparations.
Painkillers as various study were able to prove are widely used in endurance athletes. Most of the athletes take drug like ibuprofen because they want to avoid pain during a competition. At all levels and in a wide variety of sports athletes swear by their painkillers. A study published earlier this month on the website of the British Journal of Sports Medicine found that, at the 2008 Ironman Triathlon in Brazil, almost 60 percent of the racers reported using non-steroidal anti-inflammatory painkillers (or NSAIDs, which include ibuprofen) at some point in the three months before the event, with almost half downing pills during the race itself. In another study, about 13 percent of participants in a 2002 marathon in New Zealand had popped NSAIDs before the race. A study of professional Italian soccer players found that 86 percent used anti-inflammatories during the 2002-2003 season.
Famous physiologist David Nieman published a study that showed the effect of ibuprofen on immunity and muscle recovery. Ibuprofen had a significant negative effect on both. And the worst of it, the painkiller did not even help to reduce pain during a race or decrease muscle soreness after it. David Nieman belongs to those scientists who first discovered the outstanding importance of a healthy immune system for athletes. Continue Reading →
Yesterday I bumped into the story of John Snow who was able to end the cholera epidemic in London 1854 very quickly because of his innovative way of combining observations and drawing the respective conclusions. He applied statistics and graphics. So does my beloved Hans Rosling (those who pass by here on a regular basis know my fondness for him). It is dazzling what figures can tell us, if we manage to visualize them, extract them from the obscurity of myriads of columns of figures. Rosling is an artist in doing so.
If you find some time to listen to his talk, you may realize the similarity of their mindsets. John Snow did a mapping of London’s epidemic and Rosling does the same, only is it a mapping with a global approach. The problem(s) they analyze with their respective methods lead them to the same conclusion: looking at a situation on a local level, discriminating, contextualizing is more rewarding than anticipating and generalizing.
When do we act, how do we act, and how do we justify our decision in a realm of uncertainty and risks? I just read an essay about John Snow and the Cholera epidemic in London 1854. This was yet a time where bacteria were not yet discovered, where a manifold of theories circulated to explain disasters of this kind.
Snow’s observations, his assessment of the situation, his method of interpreting his observations / data made a cause-effect relation transparent that lead the way for an intervention policy stopping the epidemic. With his investigative approach Snow was able to submit all the necessary data that were convincing enough for policy-makers to act.
Snow's map of observations
Source: www.personal.psu.edu