The Heart - Swimmer vs. Runner and Athletic Heart Syndrom

The Heart of a Swimmer  vs. Runner

Regular exercise changes the look and workings of the human heart. And researchers are discovering that different sports affect the heart differently.

Reprinted from Gretchen Reynolds and related articles in Wikipedia

Do world-class swimmers’ hearts function differently than the hearts of elite runners?

A new study finds that the answer may be yes, and the differences, although slight, could be telling and consequential, even for those of us who swim or run at a much less lofty level. 

Cardiologists and exercise scientists already know that regular exercise changes the look and workings of the human heart. The left ventricle, in particular, alters with exercise. This chamber of the heart receives oxygen-rich blood from the lungs and pumps it out to the rest of the body, using a rather strenuous twisting and unspooling motion, as if the ventricle were a sponge being wrung out before springing back into shape.

Exercise, especially aerobic exercise, requires that considerable oxygen be delivered to working muscles, placing high demands on the left ventricle. In response, this part of the heart in athletes typically becomes larger and stronger than in sedentary people and functions more efficiently, filling with blood a little earlier and more fully and untwisting with each heartbeat a bit more rapidly, allowing the heart to pump more blood more quickly.

While almost any exercise can prompt remodeling of the left ventricle over time, different types of exercise often produce subtly different effects. A 2015 study found, for instance, that competitive rowers, whose sport combines endurance and power, had greater muscle mass in their left ventricles than runners, making their hearts strong but potentially less nimble during the twisting that pumps blood to muscles.

These past studies compared the cardiac effects of land-based activities, though, with an emphasis on running. Few have examined swimming, even though it is not only a popular exercise but unique. Swimmers, unlike runners, lie prone, in buoyant water and hold their breaths, all of which could affect cardiac demands and how the heart responds and remakes itself.

So, for the new study, which was published in November in Frontiers in Physiology, researchers at the University of Guelph in Canada and other institutions set out to map the structure and function of elite swimmers’ and runners’ hearts.

The researchers focused on world-class performers because those athletes would have been running or swimming strenuously for years, presumably exaggerating any differential effects of their training, the researchers reasoned.

Eventually they recruited 16 national-team runners and another 16 comparable swimmers, male and female, some of them sprinters and others distance specialists.

They asked the athletes to visit the exercise lab after not exercising for 12 hours and then, when on site, to lie quietly. They checked heart rates and blood pressures and finally examined the athletes’ hearts with echocardiograms, which show both the structure and functioning of the organ.

It turned out, to no one’s surprise, that the athletes, whether runners or swimmers, enjoyed enviable heart health. Their heart rates hovered around 50 beats per minute, with the runners’ rates slightly lower than the swimmers’. But all of the athletes’ heart rates were much lower than is typical for sedentary people, signifying that their hearts were robust.

The athletes also had relatively large, efficient left ventricles, their echocardiograms showed.

But there were interesting if small differences between the swimmers and runners, the researchers found. While all of the athletes’ left ventricles filled with blood earlier than average and untwisted more quickly during each heartbeat, those desirable changes were amplified in the runners. Their ventricles filled even earlier and untwisted more emphatically than the swimmers’ hearts did.

In theory, those differences should allow blood to move from and back to the runners’ hearts more rapidly than would happen inside the swimmers’.

But these differences do not necessarily show that the runners’ hearts worked better than the swimmers’, says Jamie Burr, a professor at the University of Guelph and director of its human performance lab, who conducted the new study with the lead author, Katharine Currie, and others.

Since swimmers exercise in a horizontal position, he says, their hearts do not have to fight gravity to get blood back to the heart, unlike in upright runners. Posture does some of the work for swimmers, and so their hearts reshape themselves only as much as needed for the demands of their sport.

The findings underscore how exquisitely sensitive our bodies are to different types of exercise, Dr. Burr says.

They also might provide a reason for swimmers sometimes to consider logging miles on the road, he says, to intensify the remodeling of their hearts.

Of course, the athletes here were tested while resting, not competing, he says, and it is not clear whether any variations in their ventricles would be meaningful during races.

The study also was cross-sectional, meaning it looked at the athletes only once. They might have been born with unusual cardiac structures that somehow allowed them to excel at their sports, instead of the sports changing their hearts.

Dr. Burr, however, doubts that. Exercise almost certainly remakes our hearts, he says, and he hopes future experiments can tell us more about how each activity affects us and which might be best for different people.

In other articles summarized here from Wikipedia (https://en.wikipedia.org/wiki/Athletic_heart_syndrome) 

We find discussion of Athletic heart syndrome (AHS), also known as athlete's heart, athletic bradycardia, or exercise-induced cardiomegaly is a non-pathological condition commonly seen in sports medicine, in which the human heart is enlarged, and the resting heart rate is lower than normal.

The athlete's heart is associated with physiological remodeling as a consequence of repetitive cardiac loading. Athlete's heart is common in athletes who routinely exercise more than an hour a day, and occurs primarily in endurance athletes, though it can occasionally arise in heavy weight trainers. The condition is generally considered benign, but may occasionally hide a serious medical condition, or may even be mistaken for one. 

Athlete's heart most often does not have any physical symptoms, although an indicator would be a consistently low resting heart rate. Athletes with AHS often do not realize they have the condition unless they undergo specific medical tests, because athlete's heart is a normal, physiological adaptation of the body to the stresses of physical conditioning and aerobic exercise. People diagnosed with athlete's heart commonly display three signs that would usually indicate a heart condition when seen in a regular person: bradycardia, cardiomegaly, and cardiac hypertrophy. Bradycardia is a slower than normal heartbeat, at around 40–60 beats per minute. Cardiomegaly is the state of an enlarged heart, and cardiac hypertrophy the thickening of the muscular wall of the heart, specifically the left ventricle, which pumps oxygenated blood to the aorta. Especially during an intensive workout, more blood and oxygen are required to the peripheral tissues of the arms and legs in highly trained athletes' bodies. A larger heart results in higher cardiac output, which also allows it to beat more slowly, as more blood is pumped out with each beat. 

Another sign of athlete's heart syndrome is an S3 gallop, which can be heard through a stethoscope. This sound can be heard as the diastolic pressure of the irregularly shaped heart creates a disordered blood flow. However, if an S4 gallop is heard, the patient should be given immediate attention. An S4 gallop is a stronger and louder sound created by the heart, if diseased in any way, and is typically a sign of a serious medical condition. 

#heartofswimmer

#athleteheart

Early Marathon Swimming in USA

Early Marathon Swimming in the United States

Friendships cast in the belly of competition, team sport outlive today's trials and tribulations of fast paced life and distance for Steve Conder and Don Macdonald. 

In the summer of 1980 then standout high school swimmers, along with a third (Craig Kercher) and coach (John Gibson) who had all swum for Bryan Rathke's UN-defeated Goshen Redskin swim squad embarked on what would be their biggest swim challenge yet, joining the early namesakes of US open water swims like John Kinsella, Lynn Cox, and others albeit not at that level but certainly well ahead of a sport that today is exploding.

Macdonald, Conder and Coach Gibson welcoming
the beach after a successful swim.

Marathon swimming

A class of open water swimming defined by long distances (at least 10 kilometers) and traditional rules based in English Channel swimming. Unlike marathon foot-races which have a specifically defined distance, marathon swims vary in distance. However, one commonly used minimum definition is 10 kilometers, the distance of the marathon swimming event at the Olympic Games.^[1]

As in all open water swimming, tides, surface currents and wind-chop are major determinants of finish-times. For a given course, these factors can vary dramatically from day to day, making any attempt to draw conclusions about athletic ability by comparing finish times from performances undertaken on different days meaningless.

One of the earliest marathon swims was accomplished in 1875 by Captain Matthew Webb, when he became the first person to swim across the English Channel. Similarly, perhaps the most famous marathon swim of all-time was accomplished in 1926 by Gertrude Ederle, when she became, at 19 years of age, the first woman to swim across the English Channel. In doing so, she demolished the existing world record for the crossing, by employing the crawl stroke technique.

The Triple Crown of Open Water Swimming includes three of the most well-known marathon swims: (1) 21 mi (34 kilometres) across the English Channel, (2) 20.1 mi (32.3 kilometres) between Catalina Island and the mainland in Southern California, USA, and (3) 28.5 mi (45.9 kilometres) around Manhattan Island in New York City, USA.

The Ocean's seven is a collection of seven channel swims: (1) North Channel between Ireland and Scotland, (2) Cook Strait between the North and South Islands of New Zealand, (3) Molokai Channel between Oahu and Molokai Islands in Hawaii, (4) English Channel between England and France, (5) Catalina Channel between Santa Catalina Island and Southern California, (6) Tsugaru Strait between the islands of Honshu and Hokkaido in Japan, and (7) Strait of Gibraltar between Europe and Africa.

Competitive Friendship Builds Life Long Resilience

My friend Steve Conder whom I swam across Lake Wawasee and Syracuse (8 miles) in the early 1980's accompanied by our fellow swim team member Craig Kercher and coach John Gibson did what was barely even known back then an open water swim.

Back then we learned about fueling the hard way.

We began swimming together in grade school along with a whole bunch guys and girls (whom I will not try to name as I would inevitably miss someone accidentally, but you know who you are). These friends became all close and through our parents families included.

After high school we all went our separate ways. Many on to college or not but usually catching up in the summer. Years turned into 10, 20, and 30.  Social Media made it easy to get back in touch, catch up and realize his was the foundation to life long resilience. Warriors in the finest Redskin tradition competing against each other with the highest regard pushing each other well beyond our youthful character to become among the best in the State of Indiana's swimming tradition. Competitive spirit pushed us both to become our best, our friends and coaches (school and family) always supporting us to challenge the next thing, to push harder, to believe in ourselves. Little did we know these attributes would follow us for years. 

We have all shared in personal failures throughout life, felt sorrow for the friends, coaches and family we have lost, but I would say these teachings allowed us to stay on course, persevere and to realize there is no "I" in "We".

Marathon Swimming and Heart Conditions - Who would have Thunk?

Endurance athletes who exercise for three hours or more have an increased chance of dying from a cardiac arrest


Heart attack risks are greater for athletes who compete in endurance sports. I wish someone would have explained this to me before. I have recently learned that I am one of these athletes, now 50, that faces this challenge. This could be my biggest test of resilience yet. Not getting to swim the English Channel last summer due to poor weather may have just saved my life...read on and I implore you to get a full stress test (not a regular EKG) before you jump in the water.




Channelopathies



(A) Two essential elements precipitate a cardiac event in LQTS. First, a cardiac channel defect results in a 'recharging glitch' that often can be seen on the surface ECG by a prolonged QT interval. Second, a trigger is often needed (in this case, swimming) to cause the stable but prolonged recharging system to degenerate into the trademark arrhythmia of LQTS, torsades de pointes (TdP). The outcome (if the heart ever loses control), fainting, seizing or dying, depends on whether or not order is restored to the rhythm, either spontaneously or by a defibrillator. (B) The linear topologies for the three principal cardiac channels that account for two-thirds of LQTS are shown. The gene responsible for LQT1, KCNQ1 (commonly known as KVLQT1) encodes the alpha subunit of the IKs potassium channel. The gene behind LQT2, KCNH2 (commonly known as HERG) encodes the alpha subunit of the IKr potassium channel. SCN5A, responsible for LQT3, encodes the INa sodium channel. Additional heritable arrhythmia syndromes are shown.


© 2004 Nature Publishing Group Ackerman, M. J. Cardiac channelopathies: it's in the genes. Nature Medicine 10, 463-464 (2004) doi:10.1038/nm0504-463. All rights reserved


Article from Peak Performance:

About 1 in 50,000: if you run marathons or participate in other forms of exercise which last for three hours or more, that's your approximate risk of suffering an acute heart attack or sudden cardiac death during - or within 24 hours of - your effort. For every 50,000 athletes, one will be stricken during such prolonged activity(1). Running a marathon or cycling intensely for three hours is riskier than taking a commercial airline flight, even in these troubled times!

You might think we shouldn't make such a claim in a newsletter which appeals to serious competitors, including a large number of marathon runners. But at Peak Performance our job is to provide you with all the facts about your sport, not just the pretty ones.

The truth is that marathon runners, ironman triathletes and long-distance cyclists, swimmers, rowers and cross-country skiers are all in the same boat. In fact, any athlete who participates in a strenuous test of endurance lasting about three hours or more has an increased chance of dying during - and for 24 hours following - the exertion, even when the athlete's chance of a death-door knock is compared with the risk incurred by a cigarette-smoking, sedentary layabout who spends the same 24 hours drinking beer and watching TV. The reasons for this are not entirely clear, but the heightened risks of a visit from the Grim Reaper are unsettling to most athletes, especially those who exercise in the hope of improving cardiovascular and overall health.

To find out why strenuous exercise temporarily increases the risk of death, researchers at the University of Innsbruck in Austria recently studied 38 male participants in the 1999 Tyrolean Otztaler Radmarathon, a cycling race which covers 230k, with an altitude change of 5,500m. The Radmarathon is often said to be comparable in difficulty to the hardest mountain stages of the Tour de France (2).

All 38 subjects were experienced, well-trained amateur cyclists who were free of cardiovascular risk factors and without evidence of heart disease. The Austrian researchers were especially interested in monitoring their blood levels of a specific heart enzyme called cardiac troponin I, which happens to be the most sensitive and specific marker for the detection of heart-muscle death.

Cardiac troponin I values, which were essentially at zero in all athletes before the beginning of the Radmarathon (thankfully, since you don't want your heart to start dying on you just before you begin a 230k bike race!) increased in 13 (34%) of the cyclists immediately after the competition. The risk factors for elevated cardiac troponin I included: age - being young was 'bad'; race time - racing fast increased the risk, and the highest post-race cardiac troponin 1 level was detected in the athlete with the fastest Radmarathon time; pre-race training distance - the higher the overall training volume, the greater the chances of increased cardiac troponin I after the race.

Taken together, these results suggested that younger, fitter athletes, who put more stress on their hearts (via greater training volume and higher racing intensities), were the ones most likely to incur myocardial damage.

Why heart muscle cells may die during prolonged exercise

Why were cardiac troponin I concentrations up after the Austrian race? According to the researchers, many of the well-trained athletes probably experienced sub-clinical cardiac injury during the event and this was associated with the actual deaths of heart-muscle cells. The mechanism underlying such cardiac cell deaths is unknown, although one popular theory suggests that the heightened adrenaline/noradrenaline levels sometimes observed during prolonged exercise rather perversely lead to the constriction of coronary arteries, which results in localised cell death within the heart. (Adrenaline and noradrenaline - also known as epinephrine and norepinephrine - are hormones released by the adrenal glands in response to stressful situations.)

Heart-cell death during strenuous exercise? Yes, it is a bit like having a small heart attack at the same time that your heart is performing magnificently! In fact, cardiac troponin I is usually undetectable in the blood serum of healthy people but is typically found in those who have suffered a myocardial infarction (heart attack), congestive heart failure, or myocarditis (inflammation of the heart muscle). In fact, the enzyme is used predictively by heart specialists: the higher the level in a particular patient, the poorer his prognosis.

This sounds bad! But has anyone besides the Austrians uncovered evidence of heart-structure damage after strenuous exercise? Actually, yes: one study of finishers in the Hawaii Ironman Triathlon found that 9% displayed elevated cardiac troponin 1 levels and, further, that these individuals also exhibited abnormal heart wall action and function during echocardiographic analyses(3). Another investigation found cardiac-troponin increases in 11% of the finishers of an alpine cross-country marathon (4).

Is the positive post-exercise increase in cardiac troponin I really something to worry about? Were the heart cell deaths merely a small piece of the cardiac pie? Could the lost cells be replaced by regrowth of healthy heart tissue? These key questions are very difficult to answer, especially as no histological analyses of heart tissue were performed as part of these studies, and neither were echocardiograms or electrocardiograms (ECG) carried out to determine whether heart function was impaired. To play it safe, the Austrian researchers suggested that endurance athletes 'should at least undergo serial cardiovascular examinations looking for subtle evidence of myocardial dysfunction'.

The good news for endurance athletes on the cardiac front

Before you get too spooked by these findings, bear in mind that there is also some good news for endurance athletes on the cardiac front. For one thing, it's clear that regular exercise protects you from heart attacks over broad time frames; for example, over the course of a year regular exercisers will have fewer cardiac failures than their sedentary counterparts. Also, some studies have not linked extremely strenuous exercise with cardiac damage: for example, when sports medicine specialists at the University of California studied 23 ultramarathon runners who completed the 100-mile Western States Endurance Run, a rugged race through the Sierra Mountains over steep terrain and through temperature extremes, they were unable to find any race-related cardiac damage (5).

The 23 runners completed the 100-mile race in an average time of 23.5 hours, with a range of 18.9-27.1; their ages ranged from 29 to 62 (with an average of 45) and all but three were men, none with a history of heart disease. Although all of the subjects suffered massive skeletal muscle damage during the competition (as evidenced by huge increases in serum creatine kinase levels after the race), not a single runner exhibited heightened cardiac troponin levels after the extremely prolonged exertion was over.

None the less, an increasing body of evidence indicates that some heart damage can occur during extreme exercise. In the very latest study completed at Massachusetts General Hospital and the Harvard Medical School, researchers tracked 82 runners with an average age of 47 who ran the Boston Athletic Association Marathon for five consecutive years, from 1997 to 2001. These runners had no history of coronary disease, were non-smokers and averaged 25 training miles per week(6). But their cardiac troponin I levels increased roughly 6.5-fold both four and 24 hours post-race.

No one knows how long exertion related heart damage lasts

Again, we must pose the key question - is this exertion-related damage to the heart long-lasting, or does the heart recover promptly without long-term negative effects? Unfortunately, no one knows the answer to this question right now. If you are interested in running marathons, you will have to decide for yourself if the real risk associated with the race is tolerable or not - and whether the long-term perceived risk is serious enough to warrant changing your competitive activities.

Our traditional argument that prolonged endurance activity is not bad for the heart is based on evidence that marathon runners have fairly low death rates from cardiovascular disease (when you look at them away from the race itself and the 24-hour 'window' that follows it). Essentially, research indicates that well-trained endurance athletes have about 40% of their sedentary counterpart's risk of dying from a cardiac problem on a typical day (7). If strenuous exercise is really so bad for the heart, why aren't endurance athletes keeling over at higher rates?

Note, though, that this latter argument is not entirely compelling. It is possible that marathoners might have even lower frequencies of heart attacks if they gave up marathoning and focused on shorter events which are less taxing for the heart. In support of this theory, former marathon runner Dr Arthur J Siegel of McLean Hospital in Belmont, Massachusetts (one of the investigators in the study cited above) recently told Reuters Health that running a marathon is, in effect, like overdosing on a good thing. With a more moderate approach, cardiovascular risk would still be lowered, while the elevated risks associated with marathon-like events would be avoided. Add marathon efforts to the brew, and you get the general reduction in risk but with an added risk associated with the race itself (and perhaps its long preparatory runs).

If you are having second thoughts about running marathons, you should know that the previously quoted rate of one death per 50,000 marathon runners might be a bit high. For example, there is evidence that in male runners aged 30-64 who have not been diagnosed with heart disease, there is approximately one death for each 800,000 'person-hours' of running or jogging (8). This implies that if 800,000 healthy middle-aged males began running the New York City Marathon, one of them would probably die during the first hour of the event, another during the second hour and another during the third. This kind of death rate would create some bad publicity, so it is a good thing that the New York Marathon limits the number of entrants to less than 30,000 (thus trimming the incidence of death to about one every seven years). If one assumes an average finishing time of four hours, the 800,000 figure projects a death rate of one per 200,000 marathon entrants, considerably lower than the earlier estimate of one in 50,000. Incidentally, it is known that females have a much lower risk, although the relative mortality rate has not been quantified.

Expressing the 800,000 statistic in a different way, we can say that healthy, middle-aged males who run for one hour each day can expect to die while running once every 2,192 years (800,000 hours divided by 365 hours of running per year = 2,192 years). By the same token, individuals who run two hours per day should die while running about once every 1,096 years. When the risks are seen in this light, many endurance athletes will consider them acceptably low, especially as the general risk of heart disease is reduced by strenuous training.
Heart deaths are not random events

In addition, when deaths do occur, they are certainly not random providential events. Post-mortem analyses usually reveal that something was wrong with a dead athlete's heart prior to the race (no surprise there). For example, in the study which led to the death estimate of one per 50,000 marathon entrants, a total of 215,413 runners who competed in either the Marine Corps Marathon from 1976 to 1994 or the Twin Cities Marathon from 1982 to 1994 were monitored. Three of these 215,413 runners died during their races (always after the 15-mile point) and one succumbed shortly after completion of the event. Autopsies revealed that three of the runners actually had atherosclerotic coronary artery disease (narrowing of two or three key coronary vessels), even though they were symptom-free before the races. The fourth victim (also symptom-free before death) had an anatomical defect related to the left main coronary. Thus, marathon racing didn't destroy these athletes' hearts as they paced along the streets of Washington or Minneapolis but rather uncovered 'weak links' in their cardiac systems which could not stand up to several hours of strenuous, continuous exercise.

This brings us to the issue of screening: could you take a test which might reveal that your heart was vulnerable to trouble during strenuous exercise? The relevant test in this case would, of course, be an exercise stress test, during which an ECG reading is taken as you run at increasing intensities on a treadmill. These 'exams' can frequently unmask fat-filled coronary arteries.

Unfortunately, the tests do not have a very high predictive value since as many as 63% of those who 'fail' a stress test actually have completely normal cardiovascular systems(9). Furthermore, the rate of such 'false positives' among endurance athletes can be 100% (ibid), because the natural thickening of the heart in response to endurance training changes ECG readings!

This high frequency of 'wrong calls' is troubling, not only because of the inaccuracies associated with stress testing it reveals but because many of those with false positive results are then subjected to more rigorous and invasive medical procedures, including thallium stress testing (in which a dye is placed in the bloodstream during exercise) or coronary catheterisation (in which a long tube is snaked through blood vessels into the heart). These tests are expensive and not without risk; in fact, coronary catheterisations may be riskier than marathons!

None the less, about 34% of physicians who run the Boston Marathon believe that people should undergo an exercise stress test before beginning a strenuous exercise programme(10). Interestingly enough, though, only about half of these doctors actually permitted stress tests to be performed on themselves before they began training for Boston!

Stress tests carry their own risks

One reason for this 'do as I say, not as I do' attitude may be that stress tests themselves are not without risk. The risk of dying during a stress test is a matter for debate, but has been estimated at anything between 1-in-20,000(11) and 1-in-500,000 tests(12). As you can quickly calculate for yourself, if the true stress test death rate happened to be 1-in-25,000 and the true marathon death rate stayed at 1-in-50,000, and if stress testing was used to 'screen' marathon entrants, two people would be killed during stress testing for every one athlete potentially saved!
There's more! The vast majority of individuals who die during or shortly after exercise would have had completely normal stress tests, even if the tests were given the day before they died (13). Some experts believe that stress testing can only detect about 20-25% of the likely victims of sudden, exercise-related death. None the less, if you have one or more of the known risk factors for coronary disease (obesity, diabetes, cigarette smoking, high total cholesterol, low HDL-cholesterol, high blood pressure, high stress levels, or a family history of heart disease) you may want to talk to your doctor about stress testing. If you happened to be in that 20-25% group, it would be helpful to have your cardiovascular problem detected.
Distance eventers should look for signs of heart trouble

Whether or not you have risk factors for heart disease, if you compete in distance events you should monitor yourself closely for premonitory symptoms of heart trouble. The warning signs we all know about include chest discomfort or squeezing, throat tightness, and pain that radiates into the jaw or left arm. There are other signs of trouble which are less well-known, including unusual fatigue. If you are uncharacteristically tired and are confident that this is not due to an increased training load or a recent infection, don't ignore it; mention the problem to your doctor and see if you can arrange for a routine physical examination.
In addition, a sudden, unexplained drop-off in performance which is not associated with overtraining could also indicate that something is amiss with your ticker, as could the sudden onset of heart palpitations. Finally, be particularly wary of chest discomfort of any kind which appears during exercise and then disappears afterwards. Angina often does not express itself as sharp pain; typical symptoms include squeezing sensations in the chest, and feelings of pressure or chest tightness. It is possible that up to 50% of people who have heart attacks while exercising experience a fair number of small warning signals during the days or weeks leading up to the attack - so watch out! As noted US cardiologist Paul Thompson points out, 'If you think there is something wrong, there usually is, and a physician should be consulted'.


Pheidippides, one of the first endurance athletes in recorded history, dropped dead shortly after his 21-mile, 1,470-yard run from the plain of Marathon to the agora of Athens in 490 BC. True, no autopsy was performed on the Greek messenger, and his death could have been caused by dehydration or an unsettling encounter with the god Pan in the mountains north of Athens (described in some early accounts of this first 'marathon'). In addition, we don't know how fit Pheidippides was before his fateful run, which certainly would have delivered a great shock to an untrained cardiovascular system. None the less, it is certain that exertion-related deaths do occur at a low frequency, even in well-trained athletes. The paradox of exercise is that it increases your risk of dying at the same time that it reduces it.

Re Print from Peak Performance Owen Anderson


References

1. Journal of the American College of Cardiology, vol 28, pp 428-431, 1996

2. American Journal of Cardiology, vol 87, pp 369-371, 2000

3. American Journal of Cardiology, vol 83, pp 1085-1089, 1999

4. Journal of the American Medical Association, vol 282, p19, 1999

5. American Journal of Cardiology, vol 80, pp 379-380, 1997

6. American Journal of Cardiology, vol 88, pp 920-923, 2001

7. New England Journal of Medicine, vol 311, pp 874-877, 1984

8. Journal of the American Medical Association, vol 247(18), pp 2535-2538, 1982

9. New England Journal of Medicine, vol 293, pp 367-371, 1975

10. The New England Journal of Medicine, vol 301, pp 792-793, 1979

11. Chest, vol 77, pp 94-97, 1980

12. Running Research News, vol 5(6), pp 1, 6-10, November-December 1989

13. The New England Journal of Medicine, vol 321, pp 320-324, 1989

Welcome to the Life of a Open Water Swimmer - My Closet, Office and Shower

For those of you who aspire to be Open Water Swimmers getting in practice time is about the same as working out at the Gym. 

For those that choose to take on a something a bit longer in distance, practice time goes up exponentially, like the English Channel swim where I have been training one month for each mile.

In practical terms, everyday, this means adapting to your circumstances and finding time every day to practice. Below is a picture from my swim this morning at Tower Beach, Winnetka, IL around 6am. You can see my closet is my car trunk (new meaning to the saying 'junk in the trunk') the shower just off left of the picture is completely open so anyone driving into the parking lot sees you, no privacy. So you shower up, shave in your swim trunks, come back to the car wrapping the towel around you and doing a 'beach change' into the days work clothes. 

Like camping, you really never get rid of the sand but that's a small price to pay for the glorious swim and rising sun shine on your shoulders, fish swimming under you and every once and awhile a fellow swimmer or kayaker. 

This morning I was all by myself which for shower time was appreciated but I don't recommend this for swimming because of safety, no matter how experienced you are.  

Listening to your Body Part Two, Swimming and Neck Nerve Impingements

Listening to your body - Part Two

Continuing my aggressive efforts to learn, resolve and work through my recent set back, I have discovered what I already suspected. An old neck injury from an auto accident 25 years ago coupled with age and the tremendous pounding my body is taking on repetitive arm movements daily in training result in nerve irritation. We are now focused on managing this nerve irritation and the resulting sub-councious favoring of certain stroke techniques to compensate for this that may be leading to things like my recent pulled muscle.

Whether you are young or old, experienced or new at this sport of open water swimming, listening to you body and responding properly is very important in training or races. 

All too many times today we see ourselves (i.e. our ego as my coach likes to remind me), coaches, parents and kids push (our) themselves knowingly into physically and mentally stressing the body to point of injury all in the name of achievement. Pushing to test ones endurance is part of the effort, training and planning however this sometimes this results in injury. Dealing with the injury is just one part of the issue. Getting back to health and learning why it happened and hopefully to prevent a repeat is what I (we) are really after. We learn from our mistakes.

In my case, here is a little bit about what I am learning from looking deeper into what is happening to my body and why perhaps I had this set back. 

In this case, it was one of my own doing (step one, take full responsibility for your own actions). I needed to do a long training swim, well actually I will be doing many in the coming months, but this time it was the Tampa Bay (24 miler) to gear up for the English Channel later this summer. This was all about testing the body, mind and nutrition. 

I have for some time known that an old auto injury created damage to my upper spine area (C-4,5,6,7) and I had simply learned to live with the dull pain most of the time and move my neck around to relieve this pain as needed so just like many of you.

As a follow up to my intercostal muscle (strain, pull, slight tear) I had a Neck MRI read as many times nerve damage, inflammations and impingement's I am learning can present themselves as muscle weakness and your body response with favoring certain muscle groups, sometimes, sub-consciously to you while exercising.

Taking up swimming again several years ago helped as it strengthened neck and upper back muscles. As I progressed in my training over the past two years it also became obvious that balancing muscles front to back and left and left to right for proper body alignment and positioning when swimming these many long hours was critical. I continue to work on this every day in the water. I do not have the best above water recovery arm technique, never had, so its been a constant effort in my train.

After having my arm injury evaluated we looked deeper and made the likely connection to the neck nerves radiating out into my shoulders and arms. For Doc's you'll see this and know right away. For me it took my newly found Ortho Pod. neck specialist (Dr. Brebach here in Barrington) one glance and "whoops there it is" came right out. 

In my layman terms, the long light grey vertical tube running in the middle of the neck inside the white area is the spinal column nerves or cord, etc. Due to my accident, I have curvature of the neck to begin with plus the vertebra are close to and create a very narrow space or touching the vertical spine nerves / cord). Normally this is not a big problem but when you add in thousands and thousands of arm cycles and turning the neck to breath it slowly irritates nerves that go out to muscles in the shoulders, arms, etc. As you get more tired, your form naturally suffers and bingo...an injury like what happened to me at Tampa Bay.

Good news is I am on the mend, intense PT, supervised medication to reduce swelling and nerve irritation are helping plus a well deserved 5 days without being in the water seem to be the right medicine. 

I have been back in the water now since last week slowly progressing mileage up to about half of where I should be. Sunday I swam in Morse Reservoir in Carmel, IN where the water was 59-61f. This cold water felt wonderful on my body since the cold (like an ice pack you use) works to subdue the inflammation. I swam a nice 5k lap around the lake (2.4) miles in a comfortable hour or so and was very pleased with how I felt.

This morning still in Indianapolis, i stopped the local YMCA for my morning swim hoping to continue to build on my apparent good feelings. About 3000 yards into the workout it became clear that the 84-86f water (very warm) was not my friend like the cold water. The under arm 'rubbing / like strumming a guitar' sensation in the intercostals along my ribs under the Pecs and Scapula was irritated. I listened to my body and changed strokes swimming a relaxed cool down and stopped. I added some Advil's later and took a cold shower.

Its pretty clear in the absence of working through the muscle / nerve injury the colder the better for me is the plan. So I have decided to embrace my inner 'polar bear' and really focus on training in the cold water.

This will help me later as the English Channel's biggest challenge is the cold, period!

This is a good example of turning one challenge into what I plan (hope) will be a success.

Oh Goody, Goody open water is coming in Chicago...

Average Times for English Channel Crossings - Updated

Average Times For English Channel Swimmers

Open Water Source analyzed 1,612 individual solo crossings of the English Channel between 1875 and 2010 that are included in Julian Critchlow's database ofEnglish Channel swimmers. All solo, two-way and three-way crossings were included (with the 2nd and 3rd legs of the two-way and three-way crossing counting as solo legs). The average times found:

Average female time from England to France: 12:48 (429 total crossing)
Average male time from England to France: 13:24 (908 total crossings)

Average female time from France to England: 13:33 (94 total crossings)
Average male time from France to England: 14:19 (180 total crossings)

The average times on a country-by-country basis is found at Open Water Source. Some interesting comparisons include the following:

Average time of female swimmers from Australia: 11:01 (23 crossings)
Average time of female swimmers from Canada: 11:53 (29 crossings)
Average time of female swimmers from Czech Republic: 9:17 (6 crossings)
Average time of female swimmers from Mexico: 11:04 (11 crossings)
Average time of female swimmers from the Netherlands: 10:28 (14 crossings)
Average time of male swimmers from New Zealand: 10:41 (15 crossings)
Average time of male swimmers from Spain: 10:35 (8 crossings)
Average time of male swimmers from U.S.A.: 13:01 (218 crossings)
Average time of female swimmers from U.S.A.: 12:13 (106 crossings)

An American Open Water Swimmer in Germany

The 'American in Paris' theme resonates as I recently traveled to Germany for work meetings and to meet with new colleagues.  Along with that came my first international search to discover places to swim.

This aquatic adventure expands further the dynamics of my journey to swim the English Channel and the many challenges that come with this commitment.

Apprehension of doing not only work in a new environment, not knowing where I was going most of the time, speaking barely any of the native language while still being comfortable with their cultural fundamentals coupled with pressure of meeting colleagues for the first, exchanging experiences, seeking collaboration and cooperation with a focus on developing new global business made finding a pool to let my mental exhaustion drift away One Stroke At A Time. In my professional life I solve clients challenges in sustainability, energy and environmental management systems. Akin to those old advertisements from the German company, BASF, my focused services do not 'make the product itself per say, but improve the quality and environmental management processes that make the product better'.

What does this have to do with swimming the English Channel you might be asking, plenty.

Like life, school or sport - seeking approval from your colleagues, wanting to be accepted as part of the team, a peer or expert in this case, wanting to offer something that will further the effort, win, get a new client. Doing this within the context of not knowing the language as well as English adds to the adventure and uncertainty. Thus being able to listen carefully, relax, be patient and allowing the activity to develop in front you while you keep the end goal in focus, never letting it out of your sight. Swimming long distances, especially in cold water, is like this. Your senses distract you at times from the goal, many hours of dull, mundane stokes, discomfort, pain at times all contribute.

These challenges are the same as any new cultural or educational experience. Being resilient to the challenge to understand that one miss-step is just that, a single event but to keep going. Both my excitement of returning to Europe for business and swimming here added much to the experience.

While I was 'on my toes’ professionally from sun up to well past sunset, I still had to find time to swim. So I was up at 5-5:30 a.m. well before anyone at the hotel. Packing my swim gear, work clothes just like home the night before. A new challenge faced me, with blurry morning eyes. WHERE IS MY COFFEE? Eating what Americans would consider odd foods for breakfast that seem more like lunch (meats and cheese) is a way of life. Great fresh organic foods and fruits come as well. What I found most challenging was trying to find small healthy snacks, my beloved bananas to take to the office. Since I each many smaller meals throughout the day, eating larger meals less often is very hard, I simple run out of energy.

All of these details were eventually figured out, I swam each day and was able to be relaxed and get the real work done.

I only wish it was summer and I could be outside in a wonderful alpine lake like those near Mondsee area outside Salzburg, Austria! Crystal clear cold and what scenery with a mere 8k across, perfect workout!.

Alas, its winter and the lakes are not open yet so the pool was what I had. A recently made friendship with a wonderfully kind German Expat and talented swimmer named Silke Jansson, who works for Siemens in South Barrington, Illinois (just south of my hometown) led me to a pool very near the global offices of my company just north of Frankfurt in Bad Vilbel. I had previously done Google searches for pools and discovered that in Germany this gets you spa and water park facilities. After Silke helped, I then discovered the best phrase to use is 'sport pools' and then I got somewhere. I also learned that in Germany they don't call pull buoys' and fins by these names or it could have been I was being incomprehensible. They are called, utensils? So I have now dragged my 'utensils' 10,000 miles round trip just to swim.

I ended the week as expected with reduced mileage only getting in 25,000 yards but the experience of swimming in a new land, finding a pool, getting to and from, finding the lockers all with little German language skills lacking on my part was fun. I didn't end up in the women's changing room. They have the same challenges we do, warder aerobics classes interfering with lap swimming, some share lanes and some swim in circles. They have water exercise classes for seniors and these pools are very warm.  I felt just like this past summers US 10k Open Water Nationals with water waters temperatures in the 80's, ouch.

Friends in far places!

Along the way I took side trip to Salzburg, Austria to see an old friend and business co-worker Armin Stein and his family. Jennifer, my wife, was able to come along for the short weekend preceding my business and we had a wonderful time, dinners with our wonderful host and sightseeing in Salzburg which probably could be one of our top spots in the world. We organized some new business possibilities so the trip was productive.

Jennifer and I enjoy Salzburg and the hours of walking. This below picture is taken looking down from the 'sound of music' theater (Felsenreitschule – formerly the summer riding school for the Lipizzaner) where the Trapp family sang in the movie. Today it is still used for opera and music festivals such as the world famous Salzburg Mozart festival. One they are building a retractable roof over it. For those Americans that readily don't know, Austrians are indifferent to the commercialized 'sound of music' tourist business and being a proud and private culture don't really care much for Americans Hollywood impressions this has left, except of course for the tourist revenue coming from visitors.

We left Salzburg on Sunday returning to Munich where Jennifer was heading back home and I continued by bullet train to Frankfurt to find my new pool, hotel and next weeks work.

Swimming the English Channel - An example from Colin Hill

Here is good Youtube video link that captures the English Channel. This is Colin Hills effort.

Swimming a Million Yards?

Hi One Stroke At A Time followers - 


I was swimming away this morning through my 4600 yard early a.m. workout trying to think of anything but the pain and boring back and forth of the 25 yard pool. I was doing a bunch of butterfly then a series of no breath 25's, glad this doesn't happen often since as I was getting dizzy. 

I finally focused my mental game and in a compliment to my training partner Doug McConnell, started counting strokes (he does this allot, you see?). After getting into the several hundred stroke count range I of course lost track and eventually gave up, going back to my songs and pretending to chase fish and turtles. Not sure who is more unstable here me or him? Then after awhile, I seemed to hone in on some John Mellencamp tunes thinking for some reason about my inner Hoosier college days. My thoughts then focused on a meeting later in the morning with someone who was being kind enough to help me organize my charity work and give advice on mental health challenges parents and kids have in today's self imposed stressful society (My opinion, not hers).


This got me to thinking. I have mentioned in earlier blog writings the connection of my mental health (swimming all this way, not me personally stupid!) to the public subject in general. The relationship between marathon swimming and these challenges are quite profound. While I never conceptualized the depth and relationship before I started, It is clear to me now its the sheer amount of resilience that one has in any life pursuit that makes the difference. 


Since I am not an especially gifted swimmer, it takes me an enormous amount of day-to-day resilience "One Stroke At A Time' to swim a million yards and then some. I never dreamed this distance was remotely possible nor did I ever calculate, before I started, what this meant to me and my family. I knew it was allot, but...This is just like life, things happen, they stack up, the days roll on and we accumulate all sorts of bits and pieces. These affect how we feel, how we react, what we say and do to ourselves and others in all situations but most importantly how we see ourselves - our self worth, image and self respect. 


In this day of want, want, want maybe we as parents can instead teach ours kids and friends to be more resilient so they can give back. My parents did (Don and Jean) and I am so thankful. Merry Christmas and keep those 'Elbows High'


So for me this is how a million yards relates to resilience - Year to date in 2010, I have swum 684.85 miles or 1,205,343 yards or 1,102,165 meters. That's about 578,564 strokes and god knows how many hours? The plan between today and August 20th, 2011 (when my swim English Channel 'window' opens) is to average 33,000 - 35,000 yards per week (equal to the entire distance across the English Channel, one way, each week). That's an additional 1,122,000 - 1,190,000 yards; 680 - 721 miles; or 538,560 - 571,200 strokes for those of you counting. I am halfway home and still smiling :)

2.5 miles of lake Michigan practice, 1 miles up and down

Cruising through the weeks leading up to masters open water national 10k(6.2 mile) race and continue logging 28k yards per week. Spent this week in the open water, except two pool practices, focused on longer swims at a solid pace and working on technique. Tired but gaining confidence to swim through the next several weeks and big races to my real test, that at Boston 8 to 10 miles cold (55-65f) ocean race then on to my 6-8 hour English channel qualifying swim in the fall.

Had a good swim with my coach (Marcia Cleveland) in lake Michigan this week. Booked 2.5 miles in a 1-3 foot swells. Learning to sense the pattern of the waves, several big rollers and the calm. During the calm I take advantage and bi- lateral breath which balances my stroke and releives my neck stress, then back at riding the waves. It's amazing how different it is swimming in even easy rolling waves, the extra time it requires, to complete the same distance in a pool or smooth lake. But I am now confident I can take on some big wavy water if needed and be patient and work through it. Next on my trainig regime is to swim a night. I finally found a few folks willing to tolerate me crazy dream and help me out at night kayaking with glow sticks and head lamps while I swim. We'll try easy lake Zurich first and then move on to lake Michigan.

As for Boston, I will be honest I am a little nervous, it's my first big ocean swim despite the fact that I will have been swimming in and around martha's vineyard the week before. Guess where jaws was filmed ... You guessed it...martha's vineyard. Oh the joy of knowing this. But I have to face these fears because In the end, get busy living or get busy dying. I'll be just fine in all these but it's the mental game.

Thank you to everyone that sends notes and akses about how it's going. You can't imagine the challenge of something this big, the details, the logistics, the learning of both oneself and how to work with mother nature. Special thanks to jennifer, mom and dad, Katie, Ted, Kevin, and my swi coaches marita, Marcia and John, and doug McConnell (he inspires me every to try harder). Oh one last driving reason, to teach my daughter that despite very big odds, something like this can be done, I hope she someday she has a similar opportunity of a life challenge.