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 …

10 Ways to Improve Your Triathlon Swim

I know, John is writing about improving a triathlon swim?

Oh, how times have changed.

To the uninitiated, my swimming has always been the Achilles heel of my triathlon racing adventure. I CAN swim, but it is the single most anxiety-provoking portion of my race no matter how many hours of pool and open water time I spend. That being said, however, I have learned over the years a few ways to reduce it, at least on the physical side of things. The mind? Well, another whole story.

So here are ten ways that I have found greatly improves your swimming in a triathlon. No particular order.

Swim Often

Starting off with a no-brainer. The ONLY way to get better in ANY triathlon discipline is to do it as much as possible. Unlike the bike and the run, which can be done inside or outside in all kinds of weather, swimming requires a place to swim, which is not always the easiest thing in the world. Even here in Florida, contrary to beliefs, everyone is not right next to a beach or lake, so a pool is required. And let’s be honest, many pools in a gym are not the best in the world. If you go to a YMCA you will have to be mindful of the beginner swim classes, the children and adults treating it like a recreational pool and not a place to train (the horror!), and some that just don’t know pool etiquette (please let them know you are getting in a lane they are swimming laps in). Swimming once a week as part of a team or Masters class is NOT going to prepare you for race day. It just isn’t. If this is a weak area, or like me, causes stress and anxiety, you should be in the pool at LEAST twice a week, and probably more. Figure it out. Get in the damn water as much as possible.

Learn Multiple Strokes

If you are like me there will be a time during the race that you might tire, or get hit, have goggles knocked off of you, and any assortment of fear-inducing, cringe-worthy, moments. You have to prepare both mentally and physically for these occurrences. As my Team in Training coach puts it, “It’s not IF someone is going to grab you, it’s WHEN”. You must learn ways to kick through a grab to your ankle, a way to keep going if someone whacks you on top of the head, or if you just get tired from going out too hard.

The two strokes outside of the freestyle that has helped me the most are the side stroke and the backstroke. I will warn you to be cautious of the backstroke in open water, especially in a rough one, because water will go in your nose and your mouth. Again, practicing in the pool goes a long way to get over that fear. The side stroke allows you to keep moving forward and moves your face away from any swells that might be happening. Learn this also. It could save your race.

Hand Entry

Go to any pool and watch how people swim (especially novices) and you will see splashing. Here’s a tip:

If you are splashing while you are swimming you are doing it wrong!

A good swimmer glides through the water with hardly a ripple. This is a matter of working on form.

Your hands should be entering the water in front of your goggles in a downward motion, then moving straight down your body, and exiting out the back with force.

Imagine that your hand is creating a hole in the water. Stab it, and then slide your body through that hole. Your hands should never cross over your body. Straight in, straight back.

If it feels wrong you’re probably doing it right. Keep at it. I promise you it will become easier the more you do it.

Head Position

No Tarzan swimming allowed!

A Tarzan swim is when you have your head out of the water all the time. Go to the aforementioned YMCA and this is how you will see most people swimming.

Don’t do it.

The head goes into the water and should be looking straight down. Your body should “roll” with each stroke, so your face should roll out fo the water also. Breathe out through your nose, roll your head out WITH your body, take a breathe as it rolls back in, then breathe out.

In the pool, this is easy because you normally have a black line you can look at, which you will not have in the open water. That’s OK. The more you train yourself to look down the easier the transition will be once you get out there.

The flatter and more streamlined your head is to your body the more your back end will “float”. Don’t believe me? Next time you’re in the pool do a Tarzan stroke and notice how your backend sinks. Now put your face straight down and notice what happens.

See my point?

Pull

The past few items all work together, but I thought it would make more sense to separate them out.

The “pull” is how you get through the water. As stated before, the hand enters the water and go straight down your body, exiting to the rear in a strong stroke. You need to imagine that there is a barrier in the middle of you that will not allow your hands to cross over. Keep your palms flat, fingers together, and imaging “grabbing” the water as your arms move down the length of your body. If it helps, especially at first, make an effort to HIT your hips as you hand moves toward the rear, and out of the water. Your palm should be very visible to anyone behind you. As my old coach used to instruct, imagine you have a smiley face on your palm and everytime your hand leaves the water show the people behind you your “happy face”.

Sounds silly I know but that visualization helped me.

If you use a Garmin you may notice there is a measurement called the “SWOLF”. it stands for “Swim Golf”, and much like golf, the object is to get that number as low as possible. The SWOLF measurement is derived by adding the time it takes to do one length (i.e. 25 yards) plus the number of strokes it took you. So, for example, if you go 25 yards in 30 seconds, and it takes you 12 strokes, your SWOLF is 42.

Easy right?

So to get that number UNDER 42 you can do one of two things: take less time using the same number of strokes (improving power), or using fewer strokes in the same time (improving efficiency). My opinion is to improve efficiency, so the aim would be to get across the pool in 30 seconds but only needing 10 strokes. Your time might stay the same, but you will be considerably less fatigue by the end.

A SWOLF of 42 (30 seconds in 12 strokes for 25 yards) equates to @ 70 lengths for a mile. This also means you are taking 840 strokes in 35:00 (assuming you stay constant and don’t tire at all).

Decreasing the SWOLF to a 40 (30 seconds in 10 strokes for 25 yards) equates to 700 strokes in 35:00.

140 fewer strokes in the same amount of time = a much less tired triathlete entering T1.

Kick

Stop kicking.

Seriously.

A swimmer kicks. A triathlete does not.

The kick is there to keep you straight and to aid in the roll of your body. Period. If you are kicking like mad during training and during a race, I promise you that your legs will be dead by mile 5 of the bike.

Triathlon is not a Swim, then a Bike, then a Run.

It is a Swim Bike Run.

All of these components drive the next one. Your optimal goal is to learn each discipline as it relates to the next one.

Your swim needs to be done efficiently so that you enter the bike portion with minimal fatigue (and likewise your bike needs to be done in a way to minimize the fatigue on your run).

The last thing you need to be doing in a swim is tiring out your legs.

Flutter your feet and legs to aid you, but not to propel you.

If you want good examples of this, check out Total Immersion Swimming. Loads of videos on their site and on YouTube.

Intensity

Heart rate is talked about often in the cycling and running portions, but not much in the swimming world.

And that’s a mistake.

Most of that reason is that there are not many ways to get your heart rate in the water. Technology has improved in this area, however, and Garmin has a special strap now that gather information and upload it’s after you are out of the water.

Nifty right?

Much of the anxiety is caused by elevated heart rates before the swim, entering the water and pushing too hard, etc. Like with everything (in my opinion) you cannot learn how to deal with something if you are not even aware it is there.

Swimming heart rates are normally lower than the other disciplines due to a number of factors; people just don’t “sweat” in the pool.

Again, this is a big mistake.

As with running and cycling, there needs to be a workout where you are pushing yourself to higher stress levels. There’s a tendency with swimming to zone out. The rhythm of the strokes, the breathing, even the feel of the water, tends to relax us and force us into a less strenuous training. But without hard data, we are mostly unaware that this is even happening.

You do not want to learn what it feels like to hit Z4 in a swim for the first time during a race. You should be learning to hit that zone in the pool.

Force yourself to be uncomfortable. If it gets too bad the end of the pool is never further than 25 yards (meters) away.

Breathing Hypoxy

In line with the last area, breathing is always the biggest fear of swimming.

Because we don’t breathe water.

Amazing right?

But as with everything else, we need to learn both HOW to breathe while swimming, and how to ADJUST that breathing when it is needed.

If you are training in a pool and always breathing to the right, for example, you are going to have a very bad race if the swells or waves are coming from the right and you have to switch to the left.

Training to breathe in both directions is essential.

The way I do this, to keep myself honest, is to always look at the lane dividers. So on the first length, I am breathing to the right, and on the return length, I am breathing to the left.

I also would recommend that you do some forced hypoxia training, that is learning to go longer than you might be comfortable with.

Do a few laps where you breathe on the 3-5-7-9 stroke.

Not fun I know, but this will come in handy when in a race and you come up for a breathe and see that wave in your face and you have to duck back in.

As with all things, learning to deal with these issues in training goes a LONG way on race day.

Open Water Swimming

The easiest one for last …

Open water swimming …

Do it …

Often …

If you live close to the race course, do it there. If not, do it in the type of water the race will be in.

There is a difference between ocean and lake/river.

If the race is wetsuit legal, swim in the wetsuit before the race. Swimming in a wetsuit may seem easy, but it can be claustrophobic if you are not used to the tightness of the suit. Do NOT enter a race in a wetsuit if you’ve never worn it. Trust me on that one.

If you can stand the cold, don’t use one. It is much easier, even with the buoyancy issue.


So that’s my input for swimming a triathlon. We can do a deep-dive into any of the areas I wrote about for sure, but I think it gives a good overview of most issues.

I hope it helped.

I will finish with a good swim workout for you!

Warm Up: 300 EZ

Main Set: 4 x 100 (swim/kick/swim/kick); 100 EZ; 4 x 200 (:30); 100 EZ; 2 x 400 (sprint last 25)

Cool Down: 300 EZ

Total: 2800

Make sure to listen in on the show (Endurance for Everyone) and leave comments!

5 Tips to Speed Up Transitions

Everyone knows how to train for a triathlon very early on; get in the water as much as possible to increase comfort, ride as much as you can, run off the bike every training session, and on and on, but one piece that can make or break a race is the shortest of them all; the transition. Some people you can see fly through a transition with minimal time spent, and other (me included) struggle to go from one discipline to another quickly. Two 5:00 transition times adds 10:00 to your race, which is HUGE, so learning to get in and out as fast as possible can make a lot of difference in a race result.

Here are a quick 5 tips to makes this process faster, all coming from my first-hand experience.

Have as Little As Possible in Transition

It is a normal right of passage in triathlon from newbie to a seasoned athlete that your transition area shrinks. When you first start out you’re so worried about forgetting something that you bring everything. I have seen brushes, combs, battery operated hair dryers, etc. Once you start learning the amount you bring in starts to dwindle down. The bottom line is that you should only have what you absolutely need and nothing more. When you leave the area to head to the water the only thing left on your mat should be bike shoes, your helmet, glasses/sunglasses (if needed), running shoes, socks, hat, your bib, and maybe on course nutrition and/or water (depending on the distance racing). Everything else is extra stuff to worry about. Leave it in the car.

NO Clothing Changes

Especially after the swim. Ever try to put a tight bike jersey on, or tri top, when you are wet? Takes forever. Don’t do it. Full gear should be on your body in the swim. If you’re using a wetsuit it should be on you underneath. In a PINCH you can probably get away with changing your top before the run portion, but even that takes time. Seconds build to minutes in the blink of an eye.

Speed Laces and Powder

Sounds like a good buddy cop movie title, but a simple change in set up can go a long way. Tieing your shoes takes time. Get a set of speed laces (there are many brands) and learn to use them on your shoes. Some people don’t like them, but I swear by them. I even use them in normal road running events. Another trick it to douse the inside of shows with baby powder when you’re setting up. Your feet will slide right in even if wet, and the powder also helps with blisters if you have issues there.

Preset Items on Bike and Use the Bib

The transition from swim to bike is often the longer of the two, so anything you can do to get on the bike fast helps. Put your bottles ON the bike and put your bib on now. I put my bib over my saddle, so when I come into T1 I grab my helmet, glasses, then put on the bib and flip number to the back, then my shoes, grab my bike and go. When you come into T2, rack bike, shoes off and on, helmet off, hat on, start moving to the course and flip the race number to the front.

And finally … Practice the Plan

You cannot get good at something without practice. It’s the same with transitions. when doing brick training try to set it up as you would a race. Move as quickly from one thing (the bike) to the next (the run) in the same way you will at the event. Too often when brick training we take our time racking bike, locking it, getting some water, changing shoes, etc. It works for that moment, but as with everything else, you will race as your practice.