Injuries and Adrenal Fatigue – Can You Train Through Either?


Author’s Note: I am not a doctor, nor do I claim to be. Information in this post is from my own research from as reputable sites as I could find. If you have better information, please feel free to share, as long as you cite your sources.


Athletes can be a stubborn bunch. Even those of us that should know better, that coach or advise others, tend to not follow the best practices when it comes to injuries.

You know who I am talking about.

When we are training for a specific goal, a target race, the only “A Race” on our schedule, nothing will deter us from those long training days, the early morning sprints around the neighborhood, the sneaking out of work early to get a swim in before a scheduled bike ride. Miles or Time in training equals success on race day, so the inverse must also be true, basically, that time or miles lost during the training period costs us on trace day. We will run through small aches and pains to the point that we are hobbled, then after an evening of ice, compression, and elevation, get right back out there the next day and do it again.

The trick is when is it time to say “enough”?

We are a short-sighted bunch. We either refuse to see the big picture or are so narrowly focused on the end event that we just don’t see it. We only see “today” and do not take into account what happens tomorrow if we continue to train through an injury. A slight tweak in an Achilles is run through until it changes from a “hurt” to an “injury”. When I played football the coach would always ask us as we lay writhing on the ground if we were hurt or injured. Back in the late 70’s when I played this was a HUGE distinction. If you are hurt, you can play, and if you can’t play, then you are replaced, and possibly never getting back on the field. This happened to me my last year of playing against New Smyrna Beach (damn them ‘Cudas). I was chasing a running back (#44 – will never forget that number) down the sideline and leaped at him just as he was about to score, grabbing him by the back of the shoulder pads (something that is illegal in today’s game). I snapped him backward (though not in time since he did cross the goal line) and I went flying into the spectator area, which was very close to the sidelines. I rolled a number of times before coming to a sudden stop against the concrete. When I got up I felt that my knee was off, but I limped back into the huddle for the extra point attempt. Back in these days, there was very little kicking, so they went for 2, using the same running back and I met him coming through the middle of the line, just as he planted his helmet directly to the same kneecap.

I couldn’t get up. My knee would not bend. A couple of teammates helped me to the sideline and sat me on the bench. My Defensive Backs coach came over and asked if I was OK. I told him “I can’t bend my leg”. He shook his head at me, swore, and yelled “Ingram … get in there for Harris” and walked away. I sat there for a few minutes, scared to pull my pants up to see what was there before the trainer came over. I leaned against the trainer we had as he pulled up my pants. My kneecap was about an inch off center. He looked at me and said “grit your teeth” which I did as he grabbed the knee and pushed it back in place, telling me it was “just dislocated” and would be OK. “Just ice it”. Since we lost that game (we played on Thursday nights) we had a practice the next day. I hobbled into my head coach’s office and told him I didn’t think I could go. All the coaches looked at each other, and then he said “fine … sit on the bench” without ever looking at me. I walked away, hearing them laughing when I closed the door, and never saw the starting lineup again.

So, when I feel a tweak, it is my first instinct to try to push through it. One day, to me, could mean not making the lineup, in this case, not starting the race. When I hear of others that have a nagging issue I am the first one to tell them to sit out, to rest, that losing one training day is better than losing the whole year, but I am the worst culprit. I am not alone. I know coaches who say the same thing to me yet are out running or biking on injuries themselves. As I said .. we are our own worst enemies.

Sometimes the injuries are evident, like a sprained ankle, a plantar fasciitis issue, a swollen knee, but often they are not, especially when we are dealing with true adrenal fatigue (AF). Once your cortisol levels drop to zero, there is no recovering from that other than taking time off. You cannot “train through it”. The issue is recognizing AF is not always easy, because it can feel amazingly like just being tired, or over-trained. So you take a day off, maybe two, and then hit it as hard as you can once more. And it is just as bad, or worse, than before.


What is Adrenal Fatigue?


From the Adrenal Fatigue website, AF is defined as a collection of signs and symptoms that results when the adrenal glands function below the necessary level, most commonly associated with intense or prolonged stress. As the name suggests, its paramount symptom is fatigue that is not relieved by sleep but it is not a readily identifiable entity like measles or a growth on the end of your finger. You may look and act relatively normal with adrenal fatigue and may not have any obvious signs of physical illness, yet you live with a general sense of unwellness, tiredness or “gray” feelings. People experiencing adrenal fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.

Adrenal fatigue can wreak havoc with your life. In the more serious cases, the activity of the adrenal glands is so diminished that you may have difficulty getting out of bed for more than a few hours per day. With each increment of reduction in adrenal function, every organ and system in your body is more profoundly affected. Changes occur in your carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. Many other alterations take place at the biochemical and cellular levels in response to and to compensate for the decrease in adrenal hormones that occurs with adrenal fatigue. Your body does its best to make up for under-functioning adrenal glands, but it does so at a price.

Pretty scary stuff right? I wonder how many of you reading this right now are walking around with it and never knew it? Dr. John Tinterra, a medical doctor who specialized in low adrenal function, said in 1969 that he estimated that approximately 16% of the public could be classified as severe, but that if all indications of low cortisol were included, the percentage would be more like 66%.

And this was in 1969 … you know … BEFORE the internet, 24/7/365 work days, terrorism, the ongoing conflicts in the Middle East, Donald Trump, etc. Imagine what the numbers would be today??

The problem is this; although adrenal exhaustion is a real medical condition that can be measured through blood tests, adrenal “fatigue” is not. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms, and there is no test that can identify adrenal fatigue (http://www.hormone.org/hormones-and-health/myth-vs-fact/adrenal-fatigue).

Eric Metcalf, MPH writes (and reviewed by Dr. Brunilda Nazario) on WebMD that:

Adrenal fatigue is a term that’s used by some to say that fatigue and other symptoms are caused by a poorly working adrenal gland in people who are under mental, emotional, or physical stress. But it’s not a proven medical condition. Your adrenal glands make hormones. One of these is cortisol, which helps your body deal with stress. According to the adrenal fatigue theory, if your life is too stressful, your adrenal glands may not pump out enough hormones, leading to a wide variety of symptoms. But there’s no evidence to support this theory. (http://www.webmd.com/a-to-z-guides/features/adrenal-fatigue-is-it-real)

Robert Vigersky, MD, a past president of the Endocrine Society, says the symptoms are very common in people in general. Though people often blame their hormonal glands, such as the adrenals or thyroid, for their tiredness, Vigersky says in many cases fatigue is due to common problems such as:

  • Poor sleep habits
  • Poor diet
  • Stress at work or home
  • Depression

All of these can affect your energy level without involving your adrenal glands. Fatigue is also a symptom of many diseases such as anemia, arthritis, diabetes, and heart failure, says Janet McGill, MD a hormone specialist at Washington University in St. Louis.

I know this … I fit into every symptom of adrenal fatigue but mine is due to 2 of the 4 (maybe 3 of the four) common problems, in addition to having psoriatic arthritis and no thyroid due to cancer. Adrenal Fatigue is a new buzzword (much like Celiac, where people want to be Gluten Free, but most are not actual Celiac diagnosed … ) so when someone throws that at you … take it for what it’s worth and get checked out before buying supplements. Do your homework, and do what is best for you using an intelligent mind. Lots of information is at your fingertips these days. There’s no excuse for being misinformed. And remember, just because the medical establishment doesn’t recognize something as a disease doesn’t mean it is not real (for example Fibromyalgia and Thyroid Disease were not recognized for a long time, and the effects of Low T is not agreed upon as well).

And if you’re tired … how about resting?

Just a thought …

Pain is NOT Weakness Leaving the Body

At its core what is “pain”?

Pain is your body telling you that something is wrong. It is not a weakness. A weakness is when you have NO pain and your brain is telling you to stop, because you’re bored, or you’re tired. That is not true pain. There is a reason for pain, and true pain is a warning bell for you to STOP whatever it is you’re doing at that minute, or it WILL get worse. I have a couple of examples of this.

The first one happened to me in high school. Playing Strong Safety (or Monster Linebacker as we called it) for the DeLand High Bulldogs against the New Smyrna Beach Barracudas. NSB’s running back, a big corn-fed farm boy, #44, hit the line and we all stacked the middle to stop him. From the corner of my eye, I catch movement to the right and see #44 heading down the sideline. I take off after him and catch him at about the 5-yard line, grab a hold of his pads in the back (which would now be a horse collar foul) and yanked with everything I had. He flipped, OVER the goal line, and I went flying into the bench area. I got up and felt a twinge in my knee, but it had been the first week that I had earned a starting slot and I was NOT about to come off the field. So I limped to the huddle and lined up for the extra point. At this time in High School ball no one really kicked field goals, so they were going for two. They handed the ball to Farm Boy again, he came through the middle where I met him head on …. only he ducked under my tackle and slammed his helmet, and that big old farm boy head, straight into my knee.

I saw stars but managed to get to my feet and limp to the sideline where I was immediately yelled at by my coach for allowing not only the touchdown but also the extra point (obviously I had missed the practice where I was the sole person responsible on defense for stopping plays like this). I went to the bench and sat down but found I was having trouble bending my knee, so I motioned for a trainer. She pulled my pants over my knee and my kneecap was sitting to the outside of my leg. She freaked out and called the coach over, he looked at it, grabbed the kneecap, and pushed it back into place, then told the head trainer to get ice for the “pussy”.

Yes, that is NOT an exaggeration. It is exactly what he said …

On Monday afternoon I was back at practice.

I finally got the knee fixed in 2009 after once again ignoring pain while running on a treadmill and spraining the ACLs on BOTH knees.

A more recent example was a Fit Niche Pub Run in 2011. I usually am “off” for the first half mile or so of a run, so when I felt sharp stabbing pains in my right foot I didn’t think much of it. “It will loosen up,” I told myself. “You can’t afford to miss the miles with a marathon coming up”, so I pushed through it, and the funny thing was it did feel better after a while, and even after the run. I had forgotten about the pain until I got home and got my shoes off. It started hurting again but now was to the point that I could barely walk on it. So what did I do? I iced it for the night, iced it Friday, and Saturday headed out for my training run with Team In Training. I made it 2 miles before having to stop running. I went to a doctor and was told that I had probably ruptured the tendon the starts at my ankle and that I should rest it. I did …. for four days and tried to run the next week’s Fit Niche, made it two miles before hobbling back to the start. Iced it. Then Saturday headed to team run. Made it two miles. This finally got my attention and I sat until the week before the half marathon …. three weeks of no running. I finished the run with no pain and then finished the marathon.

So I started reading. Jeff Galloway and John Bingham mostly at that time. It has finally sunk in that I am not in these events to become a champion. I am in them to finish, to become healthy, and to have FUN. Where I had failed in the past to keep up with training was the same path I was heading down again. I had become obsessed with pace time, and finishing times, and had forgotten to have fun. PAIN is NOT fun.

Galloway says in his book that the pace for a half marathon should be one that is comfortable and that you can hold a conversation throughout the run and after the run. He has a formula that is basically multiplying your normal one-mile pace by 1.2 and that should give you your half marathon pace in the end. My normal pace at that time was in the 12:00 range, which means my half time should be in the 14:27 region. Guess where it was? Correct. 14:23. That means I held my normal pace through 13.1 miles, and I should be proud of that and be OK with that.

This might be I have started to “lose my motivation”. I have forgotten to have fun. When I watch Chrissie Wellington compete in the Ironman she was smiling the whole time …. she was pushing her body to its limit, sapping every bit of strength she had in her, yet she is HAVING FUN. The funny part is when you watch Crowie in the same race, he is grimacing, scowling, hating life. The “man” part.

So … PAIN is NOT a weakness. It’s a warning sign that you are pushing too far. If my Stepfather had heeded the PAIN he was feeling for a year when urinating instead of trying to be tough, we would have found the cancer, but instead, he waited until the bleeding was so bad he was almost passing out, and he died three months later at the age of 64. As “men”, as “athletes”, especially those of us that have seen success before athletically, we try to treat ourselves like we are still 17. but 17 was 38 years ago, and I have to accept that and change my definition of an athlete.

Am I an athlete? I don’t think so. Not really …. I may never really be one …. but I am going to keep racing …. and from now on I am going to have FUN doing it, no matter what my time and pace are.

Health and the 300-Pound Man

A large portion of a new lifestyle is getting your crap together. By that, I mean deciding that enough is enough and making the effort to change your way of thinking and living. Although hard, it is not as difficult as you may think, once the initial “lethargy” ends after your body readjusts. The hard part is facing the shaking heads, the tuts and clicks of tongues, from people who at first ask you how your losing so much weight, and then when you tell them how, proceed to tell you how that is not going to work, despite having proof right in front of them to the contrary.

It is amazing to me the reaction you get from people, especially those closest to you when you try to share with them what you have been doing to lose weight. It’s as if they take offense to the fact that you are improving yourself like they are being personally attacked. They tell you all sorts of things:

You’re neglecting your family!

You’re obsessed and that is not healthy!

You’ve become a zealot!

They don’t see the full picture.

I do not feel 55. It is shocking to me to think I am in my mid-50’s. I look in the mirror and do not see an old man. I have very little gray, and the gray I have is in my beard. I have a full head of hair. I have no wrinkling. The man looking back at me cannot be 55!

But, alas, he is …

And this is where my concern for friends and family come in …

When you go through life you expect certain things to happen. You expect at some point to bury your grandparents. You expect to bury your parents. But as the oldest in my generation, I do not expect to bury sisters, brothers, cousins, children, etc. I should be the first to go. Now, I know life doesn’t work that way. I am not naive. The older you get, though, no matter how you look or feel, the more you are faced with the reality of your own mortality.

At the age of 46, I was 313 pounds. Something clicked one day, and I decided that I was not going to be 300 pounds anymore. My younger brother, Michael, who has always been active, said it best to me once.

“If I am going to die young it will not be because of something I could have prevented.”

As I stood looking at myself in the mirror that day I understood what he meant. At this point, we had both had our cancer scares (mine was thyroid, his testicular). The only difference being that mine did cause weight gain. The wrong part was that I used that fact to explain my laziness and slothfulness and to dismiss it as an effect of cancer.

Don’t get me wrong. Anyone that has had thyroid cancer, or even hypothyroidism, will attest to the fact that it really screws you up. You feel tired all the time. You can’t focus. The last thing you want to do after working all day is to get on a bike or go out for a run. The “will” may be there, but not strong enough to get over the lethargy that sets in. But the result in my doing nothing was a weight gain of 120 pounds.

Shortly after this decision to end this spiral I was driving home and heard a radio show with a local doctor talking about the thyroid issue and its effect on testosterone production. Even though he was not in my insurance plan, I made an appointment and paid out of pocket for the test and consultation. It is one of the best decisions I have ever made in my life. Not only was my thyroid meds out of whack, but my T level was also 97. So after adjusting the Thyroid and adding T Therapy, the weight started dropping. He was also the one that initially suggested that I sign up for a triathlon that was a year away (Escape from Fort DeSoto 2011).

I did.

And the rest, as they say, is history.

My weight leveled off for a year, and that’s where I discovered, though my Triathlon Coach, the Vinnie Tortorich podcast and Jon Smith and Debbie Potts on Fit Fat Fast (Debbie is now solo at The Whole Athlete podcast), and through that the books “Wheat Belly”, “Good Calorie Bad Calorie”, “Fat Chance” and a few more. After changing my eating lifestyle to No Sugar and No Grains (#NSNG) the weight started falling off again. In addition, my energy levels shot through the roof, and I was finding that my body was recovering from workouts, even long strenuous ones, much faster.

So, a breakthrough, and one I should share right?

That did not sit well with a few people. They try to poke holes in the eating method. They say it won’t work. “Calorie in calorie out” is the only true method, they posture.

The problem is that, even though I am standing right in front of them as proof that “calorie in-calorie out”, while indeed based on sound science, is not the only factor, it doesn’t phase them in the least. They stick to their food pyramid. You can show them the science, point them in the direction of numerous studies and academic papers explaining how wheat and sugar increases fat storage in the body, and they still stick to the old thinking.

“Go to a long distance Triathlon or Marathon, and after all the svelte and elite runners come through, wait and see the runners crossing the finish line at hour 7, 8, 10. They’ve all put in the work. They have finished their race. And the majority are still overweight.” ~ Vinnie Tortorich, Fitness Confidential

That was paraphrased, by the way.

The proof, as grandma would say, is in the pudding.

But you still read Facebook posts, and Twitter feeds, about people “carb loading” before a race (which has been proven NOT to work), or indulging in bad eating because “they burned it off during their workout”.

It’s all BS.

A wise woman told me once that I cannot take it personally when people listen to you and still go the other direction. All you can do is offer advice, and hope they listen, but if they don’t, then that’s their choice.

It’s a good way to think, and easy to do when it’s the odd man on the street or casual acquaintance. Not so easy when it is someone you care about. I want these people around me for a long time still. I don’t want to see them in a box. I’d prefer, as is the course of life, for them to see me in the box. I don’t think they understand that this is the place I am coming from … maybe selfish on my part because I don’t want them to leave me that way … but it comes from a true place.