No pain, no gain mindset ‘is dangerous’

WASHINGTON: As the average age of competitors in endurance sports rises, a spate of deaths during races or intense workouts highlights the risks of excessive strain on the heart through vigorous exercise in middle age.

The 40- to 60-year age bracket holds 32 percent of the membership in USA Triathlon, the sport’s official governing body. More fitness-conscious than previous generations, their numbers in competitive races are swelling, along with their risk of cardiac arrest. Triathlons, the most robust of endurance races, are believed to be the most risky.

“People need to understand that they’re not necessarily gaining more health by doing more exercise,” said David Prior, a cardiologist and associate professor of medicine at Australia’s University of Melbourne. “The attributes to push through the barriers and push through the pain are common in competitive sport, but that’s also dangerous when it comes to ignoring warning signs.”

Cardiac arrest, when the heart suddenly stops beating, can be caused by heart conditions, including abnormal heart rhythm and thickening heart muscle or arteries.

The death rate for triathlons is about twice that for marathons, owing to the increased intensity of the competition and the initial swimming leg, according to a study in the journal Mayo Clinic Proceedings last year.

“The swim seems to be a particularly dangerous time,” said marathoner Andre la Gerche, a cardiologist at Melbourne’s St Vincent’s Hospital. “Paradoxically, in the marathon, it’s the opposite: It’s the last mile of the event where the vast majority of fatalities occur.”

Researchers speculate that sprinting to the finish produces adrenaline that may trigger an abnormal rhythm in runners with susceptible hearts.

Open-water racing triggers two opposing mechanisms of the involuntary nervous system, according to researchers at England’s University of Portsmouth. A “fight or flight” response activated by physical exertion, cold water temperature or anxiety tries to speed up the heart rate and causes hyperventilation. This occurs as the body tries to slow the heart rate to conserve oxygen in response to facial wetting, water entering the mouth, nose and throat, and extended breath- holding, the scientists said.

Runners should maintain their pace or slow down in the last mile and not sprint unless they have trained for it, the International Marathon Medical Directors Association said in 2010 in response to racerelated sudden deaths. – Washington Post

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