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 …

You Are What You Eat

As I have progressed through the last 7+ years from a 300 pounds couch potato (mmm potato) to a more active athlete the biggest change I have made has not been in the amount of activity I have on a weekly and daily basis (though that has been significant), but more about the way and what I put into my mouth every day.

It has not been easy.

There are days that a pizza calls to me like a siren calling a sailor to his death. When I walked out of the gym where I used to swim, directly across the parking lot is a 5 Guys Burger.

Damn, I really wanted that burger.

But, for the most part, I have been able to push these cravings aside and eat sensibly. I have made some missteps here and there. I am only human. But the trick I have found is not to fall off the wagon and stay off. You need to get right back on that wagon, not the next day, but immediately after you do it.

As most know my weight issues started with my cancer diagnosis in 1994. I went from 180 pounds and peaked at 313. At 313 pounds I decided that enough was enough. I could blame it on cancer, and continue to not try to stop the progress, totally give in and stay on the couch, eating my potato chips that were balanced on my ample gut, and watch The Biggest Loser. I actively sought out a doctor that specialized in weight management. I was tired of hearing the same old story about how my body would never be what it was and that I needed to take the Synthroid and learn to cope with what I was dealt.

No. Not any more.

I was given a full panel of blood work and they found that not only were my TSH levels all out of whack, but my Testosterone levels were at 165 (they are currently at 212). I addition, what little T I had was being overly converted to estrogen, which basically put me in starvation mode and made me hoard fat.

Not good at all.

So I was switched to natural thyroid, put on a weekly regimen of T injections, and given medication to block the estrogen production. Immediately I dropped 25 pounds, and I mean within two weeks. I felt better even at a heavyweight of 270. I completed my first triathlon at that weight, but all it really did was give me the boost I needed to not only maintain my new activities but to strive for that goal weight of 200 pounds I thought was out of reach.

The weight continued to drop until I reached a low point of 236 in the Winter of 2011. By January 2012 I was again 255 pounds, and I am currently at 275. The frustrating thing is that I am doing nothing different than I was initially; I am actually eating even better than I was, I work out 4-5 days a week, and have completed a marathon, a number of half marathons, and 5 half Ironman and 70.3’s. My calorie deficit each day averages 750, which means I should be losing 2 pounds a week. But I am not. I am gaining weight.

I think my body is just very temperamental. I tried juicing and was told by some that juicing is not as good as I thought. I tried Fitlife Foods, which are actually very good meals but can’t afford to keep doing that. Am I doomed to just battle this every day until I can no longer compete, then just gain all the weight back and end up at the end no better off than I was when I started?

It is very discouraging, to say the least, more so because I feel I am doing everything right at least 90% of the time but not getting the results. I have still yet to find someone who can explain to me how a small slice of cake weighing less than 3 ounces turns into 1.5-pound weight gain the next morning.

I mean, how is that even mathematically possible??

Another issue with nutrition is finding what works for you. Those of you currently competing in triathlons, or other endurance races, know that the supplements are not cheap, and if you dole out $50 for a vat of protein powder that you don’t like, or worse that doesn’t like you, well … that’s a lot of money to just throw down the toilet (pun intended).

So, as far as nutrition goes, I keep trying to learn as much as possible. Reading books. Watching documentaries. Talking to fellow athletes. Anything I can to pick up on a tip or two. Everyone has an opinion, and so many contradict each other (Carbs bad! No! Carbs GOOD!) but what it comes down to is eating well and finding out what works for YOU.

  • Eat natural foods that are full of color.
  • If Man had a hand in it, leave it alone.
  • No fast food.

Pretty simple rules …

Now if only the weight would follow …

Skinny Fat

Ever heard of this term?

Most people have a different idea of what the term means. On Urban Dictionary, the term Skinny Fat is defined as

A person who is not overweight and has a skinny look but may still have a high fat percentage and low muscular mass. Usually these people have a low caloric diet, that’s why they are skinny, but are not involved in any sports activities or training’s and that’s why they don’t have any muscle. Since between the bone and the skin those people only have fat, the skin can be deformed easily because the skin layer is on an unstable matter (fat).

I am not sure I buy that description. When I think of the term Skinny Fat I think of people who are thin, and appear in shape but eat or behave in such a manner that, metabolism aside, would make an average person overweight. We all know these people. These are the runners who average 8:00 miles and post all over Facebook and Twitter how they scarfed down a pint of Ben & Jerry’s as a “reward” (how undoing all the work you just did is classified as a reward is beyond me). They are the ones that scoff at your No Sugar No Grain effort because, well, it doesn’t affect them in the same way.

The body is a lot like a database … Garbage In Garbage Out

What these people don’t realize is that looking in shape and being able to perform at a high level, the way they are inside, fueling themselves with unhealthy food, is affecting them in ways they may not see for decades.

Listen, folks … according to research stated in several sources (“Wheat Belly”, “Fat Chance”, “Good Calorie Bad Calorie”), only 20-25% of people can process sugar correctly. That means for every 4-5 people you know, only one can afford to eat sugar filled food and process them in a way that it will not affect them health wise. In a triathlon with 3,000 people that is 600. And most of them are the elites at the start of the race. Want proof? Go to a longer distance triathlon (Olympic or a 70.3) and watch the finish line. The elites are coming in under three hours, and they are all fit, fuel with sugar (not all, but most), and train like animals. Then near the end, you see the rest of us. We train hard also, we struggle through the race and finish, but we are overweight.

And where did we make our mistake?

We make mistakes by trying to emulate the professional triathletes eating and training habits. Pick up a magazine and leaf through it. Most are filled with “Training Plans of the Top Pro’s at Kona” or “Mirinda Carfrae’s Nutrition Plan”. We eagerly scoff this stuff up and fix our plans to match the pros.

And it fails 80% of the time.

I was (am) one of these people. Through my first season (2011) I ate like I had been eating to lose the initial weight and dropped from 313 pounds to 236 (between May 2010 and September 2011). Then, because I was now a “triathlete”, I changed my eating and fueling habits in Season 2 (2012) to match what the elites did. I started using sugar filled crap to refuel (chocolate milk anyone??) and added carbs back to my diet. My races got progressively worse through the season and I went from my low of 236 back to 263. Today I am at 278.

I learned my lesson, but here in 2018, I am still struggling to find what I lost in 2011. My weight is still in the 280-pound range and refuses to budge (though most of this is my own fault). The difference is that I was diagnosed with psoriatic arthritis in 2014 and it has affected my training load. So, even with my healthier eating lifestyle, I am gaining weight. I am finding more and more that even a little bit of processed food, no matter how healthy I think it is, affects me in a negative way. My energy levels have fallen and I find it harder and harder to get it there to train unless it’s a weekend and I have a team obligation, and even then I am finding it harder.

So what is the takeaway?

The people you see running these amazing race times and scarfing the sugar crap may be part of the 20%. And if they are not, it will catch up to them at some point. Some of these people may never be fat or overweight. They may go through life judging their fitness by what they see in the mirror and on the race clock, oblivious to the damage they are causing internally until they drop dead of a heart attack at age 45. Stick to your guns and stay the course. Don’t be swayed by the ads and the magazines. If these athletes and/or celebrities were honest they would tell you that they don’t really use half the crap they are shilling.

Have you ever seen a pro scarfing chocolate milk right after a race? Didn’t think so!

Yes, there are people who are reading this and saying “there’s nothing wrong with sugar. Your body needs sugar. I eat sugar all the time and never have a problem!”, and more than a few that will comment on how they, in fact, use chocolate milk. As I have said, there are people who can do it. There are also people who smoke their whole life and never get cancer. Doesn’t mean that smoking is healthy.

The problem is that most do not see sugar addiction as a valid addiction

As an ending note, I am not talking about anyone specifically. In these types of posts inevitably someone I know thinks I am talking about them. I am not. If you want to eat crap and feel it’s OK, then have at it, but please … PLEASE … don’t characterize it as “healthy” or “OK”.

This is what my base issue is. On a social media post, someone who was having trouble with sugar cravings posted that it bugged them that a gym (in this case Lifestyle Family Fitness, now currently out of business … go figure) would have donuts on Wednesday for their patrons, and how she felt it was detrimental to those struggling. A valid point, and one that I share. Of course, there is always one person who chimes in with the “eyes on your own plate” metaphor. The respondent’s point (and I quote) was “if you want a doughnut just eat a damn doughnut. One doughnut won’t kill you”.

And there is the problem. People do not see a sugar problem, or over-eating, as a real “addiction”. If someone had written “I am a recovering alcoholic and seeing booze all the time is really bothering me” you wouldn’t tell them “hey man, eye’s on your own plate. If you need a drink then have a drink. One drink won’t kill you”.

Or would you?

I think the point is if you think I am talking about you, then maybe you need to really read what I am saying.

The Best Way to Lose Weight

Disclaimer: This is one of those posts that people reading either scream “YES!!!!” or scream “What an Idiot!!!”. Let me start off right away by stating this … if you disagree with anything I am about to talk about, or if it doesn’t jive with what you have seen or experienced, let’s take it at that and move on. Everything … and I mean everything … I write about on this site or on my various social outlets are an n=1 issue. 

I will start by saying this … I have been having a hard time with my weight again … and it has gotten to the point where I have had to take a hard look at what I have been doing vs. what I was doing when my weight was dropping in 2012-2013. After reading through my past logs and postings, and comparing them to what my current practice is, I have found some large differences, and the bottom line is that it all comes down to self-sabotage. I knew what worked in the past, and I have actively gone against what worked, for whatever idiotic reasoning has been in my head. It is time to halt this train and get my head straight again, and this posting is part of that, so bear with me as I share what I have found works and doesn’t work, for me.

The Best Cardio for Losing Fat

Here it is in a nutshell. If you are training for a long course event, say a marathon or long course triathlon (70.3 and up), you are going to have a hard time losing weight. These events and burning fat do not go together. Long form cardio is not effective as a foundation for a weight loss program. Many people and sources have told me this over the past 8 years, from Vinnie Tortorich personally, to books by various authors, but I have fought this concept. I have fought it at my own risk. When my training went from sprint triathlons and half marathons to marathons and 70.3 triathlons I started gaining weight again. Not only did I start gaining weight, I also started getting injured, and the heavier I got the closer I was to getting hurt at some point. A vicious circle.

So what is?

The exact opposite.

The first two years all I was doing was the sprint and Olympic triathlons, and my weight was dropping. My weight was dropping because my training program consisted of 20-mile bike rides vs. 40-50 mile rides. It consisted of swim workouts of 100 meter splits to “long sets” of 400 meters. Runs were 3 miles, not 6-10 miles.

And you know what else I was doing?

I was lifting weights.

But more on that in a little bit.

So when doing shorter, higher intensity, work I went from 303 pounds down to 235 pounds. Then I started adding distance events, marathons, 70.3’s, even attempting to train for a 140.6, and my weight started creeping up again. The most frustrating thing? I KNEW better.

So, What Should I DO to Lose Weight?

So if long course training should not be the foundation, what should be?

The exact opposite. High-Intensity Interval Training (HIIT). This means a short burst of energy with short breaks in between.

This means an hour bike ride that is broken up into bursts of 10 minute, out of the seat, sprinting followed by a 1-minute spin, and then hitting it again. This means 1:00 running as hard as you can and followed by a 30-second walk, and then going again. It means sets of 100-meter pool sprints with a 15-30 second rest in between while maintaining race pace as best you can throughout each set.

It also means WEIGHT training.

When I was going to Powerhouse with a co-worker at lunch a couple of years ago, my weight was dropping fast. AND I was getting stronger very quickly. When my psoriatic arthritis flared up for the first time I stopped going, and my weight has been a struggle ever since. I am starting to think that the foundation of a weight loss program should be strength training, even before HIIT. But it has to be done correctly.

I have a history of lifting. It started back in my days playing football and as a member of the weightlifting team, but continued well into my naval service as a way to escape the monotony of being at sea for 6-7 months at a time, and the funny thing is, the lessons that were taught to me back then are proving to still be the most effective.

Muscle hypertrophy is when the metabolic effect happens, and subsequently, weight loss occurs, so the idea is to get into that state and stay there. Hypertrophy happens when the muscle is under tension, so “time under tension” (TUT) is the key. What this normally means, for most people, is the following:

0 – 20 seconds – strength is being built
20 – 40 seconds – strength is being built with the beginning of muscle hypertrophy
40 – 70+ seconds – no strength is being built and the muscle hypertrophy is constant

So, if you load up a bar with 200 pounds and bench press it three times, you are building strength and strength only. If you load the same bar with 100 pounds and bench it to failure, say 30 times, you are into hypertrophy and are starting to burn fat. It’s the old “High Weight Low Rep” to get strong method. Still seems to work.

The additional point is TIBS, or “time in-between sets”. Most people in gyms take forever in-between a set. They lift the weight for 30 seconds, then talk, or text, for 4 minutes before doing the next set.

This accomplishes nothing.

In order to “keep the burn” on, your TIBS should be under 45 seconds.

OK, So I Need to Lift Weights … What Weights??

This is easy …

When you walk into a gym and see all the fancy equipment lining the walls … ignore them… and head straight back to the free weights.

I know that is scary because that’s where the monsters live, but trust me … you only need 5 exercises to gain strength and lose weight.

  • Bench Press
  • Dead Lift
  • Squat
  • Barbell Row
  • Overhead Press

Yes, there are machines where you can do these exercises, and in a pinch, they will work, but free weights not only give you the weight to lift, they also cause you to balance the weight, which makes it a better exercise all around. Machines take the “feel” from you.

When I was going to Powerhouse we split these 5 exercises into two workouts. They were:

  • Workout A: Squat, Bench Press, Barbell Row
  • Workout B: Squat, Overhead Press, Dead Lift

The key, as is true with most thing, is FORM. Make sure you have the form down before adding more and more weight to the bars (and one more reason to use free weights over machines). This might mean lifting only the bar itself, but in the long run, it will save you from injury. If you feel unsure about asking for help, YouTube (and Endurance for Everyone has our own channel HERE) has plenty of video’s showing form and function. Kelly Slater is a valuable tool on there.

So .. That’s ALL There Is?

Of course not. As I stated in the beginning, everyone is different, so feel free to play with this a bit. The core is sound, however. Long Course Training should not be your base for losing weight. You will end up frustrated and injured. I know this for a fact, even if I don’t practice what I preach.

You also MUST watch what you eat. Just like a computer, if you put crap in you will get crap results. Eat no processed food, including sugar and grains (I know I will get comments on that one). Naturally occurring sugar, like in fruits and vegetables, are fine but cut out the artificial sweeteners, the Dixie Crystals, etc. If you need carbs, then fine, but it doesn’t mean eating pasta unless you can lead me to a pasta tree.

I hope this helps some of you.