Lethal threats of marathon running

Running without practice could prove fatal

Last weekend, four male competitors died during the Great North Run, the world's largest half-marathon event. Stifling temperatures and high humidity were blamed. Here, leading sports physician Dr Tom Crisp describes what happens to the average runner's body during a marathon - and why a few unlucky people never make it to the finish line

0-30 mins (3.25 miles) Body heat rises
Even before the race has started, a runner will have a raised heart rate due to adrenaline and the excitement. This is perfectly normal and helps to get the body prepared for the challenge.
An average male runner, aged about 40, should have a resting pulse rate of close to 80 beats per minute. Women tend to have slightly faster resting rates.
In the first half-hour of the race, the heart rate of both men and women should climb to about 140 beats per minute. A healthy person who has done plenty of training should find this no problem.
Body temperature, which starts at around 37C, will also climb to around 40C. The hotter the weather, the hotter the runner will be. The body increases the output of sweat to try to cool the body.
Temperatures in the North East last Sunday reached 68F (20C), four degrees higher than the average, which meant runners were at greater risk of over-heating.

30mins to 1 hr (6.5 miles) Mild dehydration
Now, the runner should be in his stride and the going should be relatively easy. The heart rate will be at a steady 140 beats per minute. The body will be relying on carbohydrate fuel, in the form of glycogen manufactured by the liver.
Mild dehydration could become a problem, particularly if someone has failed to drink plenty before a race. Drinking alcohol the night before, or even too much coffee on the morning of the race, can make dehydration more likely.

1 to 2 hrs (13 miles) Burning fat
The body now starts to burn fat to power the muscles. The efficiency of this depends on the fitness of the runner. Stores of glycogen are running low.
The heart rate may have crept up and the body temperature could be hovering at 41C, which is as high as you can safely go before the risk of heat stroke, which can be fatal.
A fit runner should only be running at around 70 per cent maximum effort and keeping some in reserve.
A runner must make sure he gets regular drinks to stop himself becoming dangerously dehydrated. In some cases, he may suffer stomach cramps due to the fact that oxygen-rich blood has been diverted away from the digestive system to the muscles.
Some runners also suffer from diarrhoea, caused by the interruption of the normal bowel motion.
The bladder should not need to be emptied because the kidneys slow down urine production during strenuous exercise due to the fact the blood is diverted away from the kidneys.

2 to 3 hrs (19.5 miles) Lactic acid build-up
This is the point when many runners realise they can go no further. The body's glycogen stores are now exhausted and the muscles must rely on the breakdown of fat.
People who have not trained properly can start to go into anaerobic respiration, when there is too little oxygen reaching the muscles.
If you are out of shape, your body is not very efficient at taking in oxygen, and you hit your anaerobic threshold while exercising at very low levels of intensity.
One of the by-products of anaerobic respiration is lactic acid, which causes pain and muscular cramps. Lactic acid also makes it more difficult for the body to break down fat, so a runner slows right down.
At the end of this period, many runners hit the so-called Wall.
This is a psychological and physiological barrier when you feel that you cannot go another step.
Glycogen levels have bottomed out so blood sugar levels are very low. Blood sugar is needed as fuel for the brain, so you can feel faint and woozy. Some competitors are mentally exhausted, or even just bored.
Lactic acid levels may be high and the levels of important salts in the body, known as electrolytes, which include sodium and potassium chloride, may be very low.
The joints, particularly the knee caps, will be sore because they are under an enormous amount of stress as the legs pound the hard road surface.

3 to 4 hrs (25 miles) Exhaustion point
The runner's body is now reaching exhaustion point and his pace has usually slowed right down.
This is the point where people at risk may suffer from heart attacks, because the heart is under maximum stress. For an unfit runner in a half-marathon such as the Great North Run, that point will come much earlier.
Dehydration is also more likely, which thickens the blood and slows down the circulatory system. This means that the heart is working even harder to push the sluggish blood around the body.
There are two possible types of heart attack victim. Younger runners may collapse for no apparent reason if they have an undiagnosed genetic condition called cardiomyopathy, when the heart muscle is abnormal.
Older runners, in their 40s and 50s, are more at risk of collapse due to pre-existing coronary heart disease, when arteries in the body become narrowed by fatty deposits made of cholesterol.

4+ hours (the last mile) Dangerous heart rate
Even exhausted runners will often push themselves to the limit at the last to try to make a target or beat the runner ahead.
The heart rate can soar to near the maximum of 180 beats a minute and the blood pressure goes through the roof. The core body temperature can go dangerously high. The heart can suddenly fail within sight of the finish line.
After the race is over. Beware hypothermia.
When a runner stops after completing a marathon, the blood pressure plummets and can even go too low. This can lead to fainting and giddiness. It is important to keep walking around so the blood pressure has a chance to go back to normal more slowly.
The heart rate should go back to normal fairly quickly, as will the body's core temperature.
In cold weather, a runner should make sure they quickly put on something warm, or they could suffer from hypothermia, when the body cools down too much.
A fit runner will have a normal resting heart rate just 10-16 minutes after the race is over. Muscles and joints will be very sore for several days.Read more:
http://www.dailymail.co.uk/health/article-362942/Lethal-threats-marathon-running.html#ixzz1oup8vB7F

Hiking - my first training in months !!

I did my first hiking in months @ the Bukit Jambul Hill.. and also preparing for the Dnonce Hiking Challenge so that I don't just show up at the hiking on 22 April without any hiking 'mileage'.. Did 62mins 3 rounds ascend & descend Bkt Jambul, with 2 mins reast in between.. No jokes.. It's crazy ! So on average it's 9.5-10.5mins up and down.. This is the toughest I hv done.. Usually did one round.. I must hv burst my lungs & heart muscles.. and it's dangerous.. I was so exhausted and felt uneasy the whole night. Really thought I would die from heart attack in my sleep ! Thank God.. I am OK by the morning. So no more such vigorous hiking. Will take it easy moving forward. Was thinking of doing the Competitive Hike. Now, it's gonna be FUN HIKE for me !! No way for compatitive unless I want to be brought down dead !!

At the same time, I tried on my heart rate monitor (HRM) for the 1st time.. Alas.. battery kong.. So I need to change that. I must start to track my heart rate so that I keep a good monitor on it and not pushing over the limit. Anyway, I got weird looks from others because I was wearing my Sundown vest and the side sleeve revealed the black strap. People must have been thinking why this guy wears a bra and it didn't help because I keep adjusting it (too loose) :)

As for my Brooks Cascadia 7 trail shoes - perfect start.. Love it ! stable and well protected.. and it glows in teh dark too :) Flourescent Yellow & Green - you can't go wrong with it !!

Know Your Heart Condition and Sports - blog repost from Trisupe's blog

I like this article from a blog by a fellow Malaysian runner / Facebook friend (Trisupe).. This came about after a 22 year old seemingly healthy & fit Singaporean man collapsed and died after crossing the SCMS 2011 Half Marathon @ 1:53. There has been many cases of heart related deaths related to running, cycling and some endurance sports. I still recalled ~2 months ago, 2 deaths were reported at Philadelphia Marathons 2 weeks ago....

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Know Your Heart Condition And Sports
Another life was lost last weekend during the SCMS 2011 run. A young 22 years old man by the name of Malcolm Sng (RIP) was known to be a fit person that earned the nickname "Man Of Steel" from those that know him. He was one of the fitter ones in his Basic Military Training (BMT), according to those that know him during his National Service days. He ran the 21km race in 1:53 - collapsed upon crossing the line and pronounced dead at 9.30am - an hour after he collapsed. His last run before this was in September 2011.

If all of you remember, there was another death in our country Malaysia during the SCKLM run in 2010 where a 10km participant collapsed with about 2km to go. Runners that saw that rushed to his aid and some even performed CPR on him. Sadly, medical was insufficiently equipped (no AED or defibrillator) and many would remember the inaction by authority that could had used his radio to call for ambulance.
Some would say that Singapore is so perfect - since the organizers was not apprehended on social media unlike what happened in KL. Lets look at the two incident objectively. Both has a young man passing on while running. Both started racing recently (before the incident) and both are at the best of their health, fitness wise. While one received immediate medical attention upon collapsing the end results for both were the same - they could never come back again.

While the investigation is underway for Malcolm, the condition that caused the Malaysian boy to pass on was attributed to under laying heart condition.
In fact, he was not the first one. Remember the other race in Shah Alam where another young man collapsed and died while walking to his car?
Or the national junior badminton player that suffered the same fate after his training just recently?
Closer to home, i lost two friends; one an online friend i never met physically and the other, Kharis or TSB recently - both due to heart condition.
Here are the coincidental cause - cardiovascular or heart failure.
One of the most common cause is abnormal heart rhythm or arrhythmia. Lets look at what this foreign sounding medical terms (as with all medical terms too) is.
Arrhythmia is best described as irregular heartbeat. It has nothing to do with you getting excited when you see someone you love (aka skipping a heartbeat). It can occurs even with someone that has regular heartbeat (50-100bpm), low heartbeat (less than 50) or high heartbeat (more than 100). It can cause by a few factors such as:

1. electrolyte imbalance mostly due to natrium(sodium) - kalium (potassium) imbalance.
2. injury from heart attack or recovery from heart surgery, of which either one would contribute to changes in the heart muscle function/memory
3. Irregular heart rhythm which include other medical condition such as heart flutter, abnormal contraction of artery and/or ventricle.

As you can see, many of us that does the sports (swim and/or bike and/or run) are relatively "fit". Many of us are not aware of under laying condition of our own health, despite getting health screening perhaps only when the job job requires us to. Many a time, we would not be able to recognise the tell-tale sign, but the typical symptoms are:

1. palpitation of the heart (where you feel your heart skipping a beat or suddenly felt like it is drumming away)
2. Pain or tightness in the chest (oh-uh...)
3. Feeling light headed or dizziness
4. short of breath
5. feeling tired even though just doing menial task.

I have experienced up to all five of the above at any one time. Sometimes, we thought we are having low blood pressure or low iron level, but in actual fact, the cause could be more severe. Those that often misses out on their sleep and worked through the night will experience palpitation and feel lightheaded. Reason why rest is crucial for athletes as much as it to train.

So, the next question would be how one could actually strike out all possibilities and actually know what is causing the symptoms above? A comprehensive medical examination that includes ECG or electrocardiogram test, or a stress test (running on treadmill with HR and blood pressure monitored) could be an inexpensive way to prediagnose this condition.

Arrhythmia condition could be treated via drug usage, usually to thin the blood (such as aspirin) to prevent possibility of stroke due to blood clot. If the condition could not be treated by drugs, it will usually requires a lifestyle change.

We human are habitual beings, lifestyle change will be difficult to some and often it requires discipline and life-changing decision. Some of the suggested changes that should be incorporated includes quitting smoking, limits the consumption of alcohol and caffeine (including soft drinks) and perhaps even a diet revamp for a more holistic cardiovascular health including the health of the arteries and lipid (fat) profile. One of the more difficult change would be to limit the activities that causes the condition, especially if it involves the activities we love such as the swimming, cycling and running. The key to this would be a very conscious effort to STOP if we have fainting spell or tightness or pain in the chest. That would be the first indication.
Arrhythmia could lead to more deadly repercussion if not recognised such as heart attack.

Putting all the equations above, i could very generally equate the recent death of some of our fellow friends to possible over training with imbalance diet (electrolyte imbalance - could meant under or over dosing) while pushing very hard to accomplish to obtain a personal best timing possibly with inadequate rest due to anxiety before race days or running up to race day.

I am not a doctor, but my common sense tells me that the sign is always there and it is ourselves that choose to ignore them.

I often race with a heart rate monitor (HRM) so i could monitor my own condition if i am pushing myself too hard or within my own limits. I even stopped running once when i felt immense tightness on my chest just after 2km of running at an easy pace. It is never nice to just "drop dead" - life is too short to let it end that way.
Stay conscious, stay informed and stay alive. There will always be another race for another day.


http://www.tristupe.com/2011/12/know-your-heart-condition-and-sports.html