Something to think about...

Athletic Heart Syndrome

Definition

Athletic heart syndrome is the adaptation of an athlete's heart in response to the physiologic stresses of strenuous physical training. It can be difficult to distinguish medical condition from an athletic heart.

Description

The heart adapts to physical demands by enlarging, especially the left ventricle. Enlargement increases the cardiac output, the amount of blood pumped with each beat of the heart. The exact type of adaptation depends on the nature of the physical demand. There are two types of demand, static and dynamic. Static demand involves smaller groups of muscles under extreme resistance for brief period. An example is weight lifting. Dynamic training involves larger groups of muscles at lower resistance for extended periods of time. Examples are aerobic training and tennis. Cardiac enlargement is associated with dynamic training. The heart's response to static training is hypertrophy, thickening of the muscle walls of the heart. As the all of the heart adapts, there are changes in the electrical conducting system of the heart. Because of the larger volume of blood being pumped with each heart beat, the heart rate when at rest decreases below the normal level for nonatletes.

Causes & Symptoms

Athletic heart syndrome is the consequence of a normal adaptation by the heart to increased physical activity. The changes in the electrical conduction system of the heart may be pronounced and diagnostic, but should not cause problems. in the case of SUD, other heart problems are involved. In 85-97% of the cases of SUD, an underlying structural defect of the heart has been noted.

Diagnosis

The changes in the heart beat caused by the electrical conduction system of the heart are detectable on an electrocardiogram. Many of the changes seen in athletic heart syndrome mimic those of various heart diseases. Careful examination must be made to distinguish heart disease from athletic heart syndrome.

Prognosis

The yearly rate for occurrence of SUD in people less than 35 years of age is less than 7 incidents per 100,000. Of all SUD cases, only about 8% are exercise related. On a national basis, this means that each year approximately 25 athletes experience SUD. In persons over 35 years of age, the incident of SUD is approximately 55 in 100,000 with only 3% of the cases occurring during exercise.

Improving Your Lactic Acid Treshold

The expression lactic acid, or lactate, is used most commonly to describe the intense pain felt during exhaustive exercise, especially short events like the 400 meters and 800 meters. To explain what it is we have to look briefly into how the working muscles use energy (ATP). Actively contracting muscles obtain Adenosine Triphosphate (ATP) from glucose stored in the blood stream and the breakdown of glycogen stored in the muscles. Initially Pyruvic Acid and small amounts of ATP are generated from the breakdown of glucose. The Pyruvic Acid mixed with oxygen is converted to carbon dioxide, water and ATP. When muscles contract vigorously for long periods the circulatory system begins to lose ground in delivery of oxygen. In these conditions most of the pyruvic acid produced in the breakdown of glucose is converted to lactic acid (LA). As the lactate is produced in the muscles it leaks out into the blood and is carried around the body. If this condition continues the functioning of the body will become impaired and muscles will fatigue very quickly. When oxygen becomes available the lactic acid is converted to pyruvic acid and then into carbon dioxide, water and ATP.

Given that high levels of lactate will be detrimental to preformance, one of the kep reasons for endurance training is to enable the body to perform at a greater pace with minimal amount of lactate. This can be done by long steady runs, which will develop the aerobic capacity by means of capillarisation (formation of more small blood vessels, thus enhancing oxygen transport to the muscles) and by creating greater efficency in the heart and lungs. If the aerobic capacity is greater, it means there will be more oxygen available to the working muscles and this should delay the onset of lactic acid at a given work intensity.

Anaerobic Threshold

Lactic acid starts to accumulate in the muscles once you start operating above your anaerobic threshold. This is normally somewhere between 85% and 90% of your maximum heart rate (MHR).

What a low Lactate Threshold means

If your lactate threshold (LT) is reached at a low exercise intensity, it often means that the "oxidative energy systems" in your muscles are not working very well. If they were performing at a high level they would use oxygen to break lactate down to carbon dioxide and water, preventing lactate from pouring into the blood.

If your LT is low it may mean that:
1. you are not getting enough oxygen inside your muscle cells
2. you do not have adequate concentrations of enzymes necessary to oxidize pyruvate at high rates
3. you do not have enough mitochondria i your muscle cells
4. your muscles, heart, and other tissues are not very good at extracting lactate from the blood.

Improving your lactic Threshold

The aim is to saturate the muscles in lactic acid which will educate the body's buffering mechanism (alkaline) to deal with more effectively. The following are example sessions (running) to help improve your LT.

~ 8 * 200 meters at 100% effort - recovery 4 minutes
~ 4 * 75 seconds at 100% effort - recovery 5 minutes
~ 5 * 60 seconds at 100% effort - recovery 2.5 minutes
~ 3 * 90 seconds at 800 meter pace - recovery 4 minutes
~ 3 * 120 seconds at faster than 1500 meter pace - recovery 5 minutes

A session should be conducted once a week and commence eight weeks before a major competition. This will help the muscle cells retain their alkaline buffering ability.

So what have we learned here?

The Good - Lactic acid serves several important functions. It protects you from high acidic levels; it serves as a fuel source for muscles and organs; it is also a precursor to important energy compounds.

The Bad - Lactic Acid or, more specifically, the low blood pH caused by the onset of the blodd lactate accumulation, causes that very uncomfortable burning sensation we all love to hate. in order to improve lactate threshold, you must take yourself to this point and stay there...often!

The Ugly - Don't listen to this pain reaction and you will pay one way or the other. The burning sensation is often accompanied by nausea and vomiting. Worse than that, if you continue past this point, your body's defense mechanisms will actually stop muscle contraction.

As you can see, there is more to lactic acid than meets the eye. I hope you now have a better understanding of the characteristics of lactic acid; the good; the bad; and the ugly!

Upcoming May 5k races...

Sat May 3
Funner to be a Runner 5K Perth
Peterborough Achilles Track Club 5K Peterborough
Share the Spirit of Care 5k Run/Walk Richmond Hill
Sun May 4
Brampton YMCA 5K (unconfirmed) Brampton
Downtown Mudpuppy Chase 5K Kitchener
Erin Shamrock Shuffle 5K Erin
Path to a Better Heart 5K Windsor
Sudbury Sun Run 5K Sudbury
The Place d'Orleans 5K Orleans
Sat May 10
Lakefield 5K Run Lakefield
Mississauga Marathon 5K Mississauga
Mount Forest Trillium 5K Mount Forest
Wheres Franktown 5K Franktown
Sun May 11
Forest City Road Races CIBC Wood Gundy 5 London
Run with the Wild 5K Kingston
Sat May 17
5/10 Event 5K Trail Race Lindsay
Runners Den Confederation Park 5k Hamilton
Sat May 24
Get Fit in May Come Run for JA! 5K (unconfirmed) Chatham
MDS Nordion 5K run/walk Ottawa
Sun May 25
Cambridge Times Rotary 5K Cambridge
Do It For Live 5K Parry Sound Parry Sound
Jumbo Run 5K St. Thomas
Manulife Run for Research 5K (unconfirmed) Toronto
National Sports Jennifer Ashleigh 5K Tecumseh
Run for Ovarian Cancer 5k London
Triple A Run 5K Whitby
Woodstock Dairy Capital Run 5K Woodstock
Wed May 28
Barrie Rotary Fun Run 5K Barrie
Sat May 31
Cedar Springs Summer Sizzle 5K Burlington

Medically speaking...

My previous entries have mentioned a soft tissue mobilization technique called Graston. Some of you may be curious as to what Graston is. The technique uses patented stainless steal tools which are “combed” over the injured soft tissue. Once soft tissues are damaged they often heal in a haphazard pattern. This unorganized tissue is scar tissue, which is painful and restricts joint motion. This poor quality tissue may be the reason why an injury fails to heal on its own.
The brushing action will break down the scar tissue or adhesions that develop in response to damage, like an iron removing the wrinkles from a shirt. Once broken down the body absorbs the tissue and eliminates it. In addition, the combing action stimulates the body to produce new tissue. With the addition of simple rehab exercises the tissues become organized which decreases pain, improves strength, and restores joint mobility.
The use of the tools is about ten years old. However, the method is based on the theories of cross frictional massage which were developed by British orthopedist Dr. James Cyriax. Graston is a safe effective option for treating a wide variety of conditions. Base on clinical studies, it has historically resolved 87% or more of all soft tissue conditions. Graston can be used to treat acute (new) or chronic (old) injuries. Traditionally, patients receive between 6-10 treatments, but most see a positive response by the 3rd or 4th. Running injuries respond well to treatment. Shin splints, Achilles tendonitis, iliotibial band syndrome, ligament sprains, and piriformis syndrome are just some of the injuries that can be treated. For the dedicated runners out there this is a great technique because it allows you to maintain training throughout the treatments.
This technique is gaining recognition as a viable option for the treatment of soft tissue injuries and has recently been featured on ABC and CBS news. To view these news clips or gather more information about the technique please visit www.grastontechnique.com or contact me. See you guys on the road.


Shawn Engell D.C.

Medically speaking...

With the warmer weather arriving today and a new group of runners signed up (that includes me too) for the coach’s clinic, it is time to address running injuries. One of the most common injuries is shin splints. This condition is properly referred to as “medial tibial stress syndrome” and results from overload on the shin bone and the connection between the bone and the muscle. The pain of shin splints presents on the inside of the shin bone (tibia). It is usually worse at the beginning of a run and improves with movement. However, it will return with continued running and may persist afterwards.
Early diagnosis and treatment is the key. Shin splints can be difficult to treat if an individual ignores the signs and symptoms. For the new runners, don’t let injuries discourage you from participating, because you can get early treatment that is simple and effective. The pain typically will resolve and function will improve with ice, rest, and the use of soft tissue techniques like Graston. This latter technique addresses the muscular adhesions that develop when muscles are injured. Although treatment can be simple, prevention is the key. This injury can be avoided by learning proper running techniques and getting properly fitted for shoes or orthotics. These suggestions improve foot and ankle mechanics to remove stress from the tibia. In addition, pre and post stretching with the addition of strength exercises for the lower leg will keep muscles loose and strong.
This common injury is easily treatable with early diagnosis and should be no reason to give up the sport. Prevention is the key so listen to the coach’s suggestions and you will have a successful running career. I look forward to meeting and sharing the road with all the Northshore runners.

Dr. Shawn Engell,