Marathon Training and Performance Strategies Based on New Research

NEW ORLEANS - June 1, 2007/PRNewswire-USNewswire/

Two studies presented at the American College of Sports Medicine's (ACSM) 54th Annual Meeting in New Orleans examined marathoners and marathon performance, giving further insight into what makes a great runner. The first study looked at physical and training characteristics of all, not just elite, marathon runners and how these characteristics affected race outcomes.

Gender, body size and training miles were the greatest predictors of race success. In general, male runners had faster race times than female runners, due to men's greater aerobic capacity and ability to pump more blood through the heart than women. Successful marathoners of either gender were very light in proportion to height. Another key factor to race success was training mileage per week. Although a high per-week mileage was not necessary to merely finish the race, greater mileage increases aerobic fitness and usually leads to faster race times. Surprisingly, years of running experience did not play a significant role in race success. This was probably due to having many experienced marathoners who were not fast runners, and many fast novice marathoners who have not yet learned the most effective strategies for running their best race. Non-serious past injuries and physical symptoms during the race, such as nausea, also had no significant bearing on outcome compared to the other variables studied. "Basically, 'legs and lungs' are the major body parts that marathoners need to run a successful race," said James Pivarnik, Ph.D., FACSM, one of the lead authors on the study. A related study examined weather conditions for optimal marathon performance, and found that the fastest marathon times were run in cool conditions of approximately 50 degrees Fahrenheit. Although the study did not examine why this was true, lead study author Matthew Ely believes that cooler temperatures allow for sufficient dissipation of metabolic heat and therefore maintenance of thermal equilibrium during a race. Since weather during a marathon can be unpredictable, Ely recommends that marathoners be prepared to run in all weather conditions. "The last four years of the Boston Marathon have been hot, warm, cool and cold," he said.Ely can relate his research to personal experience. He recently finished 79th of all male competitors in the Boston Marathon, and placed third in ACSM's five-kilometer Gisolfi Fun Run in 2004. The Fun Run is held yearly at ACSM's Annual Meeting.The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 international, national, and regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine. American College of Sports Medicine

Marathon Training Update

Now that my corneal ulcer is healing, I am able to resume marathon training. I was starting to feel like a slug. I reviewed and adjusted my training plan to incorporate cross training in a manner that would not cause me to over-train (which I have historically done).

I have allotted Friday as a rest day. The rest of the week is devoted to running, weights, and cycling. Monday's are devoted to one hour of either yoga or spinning. Tuesdays, Thursdays, and Saturdays are short runs of no more than 10km, so I bring Iniko with me. Eventually, I plan on trail running on one of those days to give my knees a break from the pavement, and to utilize my muscles differently on unpredicatble terrain. My long runs are spent focusing on my endurance, and refining my form.

My nutrition has been on track. I ensure my meals are heavy in carbs in the morning and increasing in protein and decreasing in carbs as the day progresses. My goal is to drink lots of water. I have a tendency to not feel very thirsty, and so I tend to be dehydrated on every run. I have been aiming for 3 glasses of water a day (I can easily not drink for three days...not healthy), and this realistic goal has been achieveable so far. A little CrystalLight helps make water more palateable.

Over the years I have noticed that my sweat smells like ammonia after a run. This has puzzled me for years. I finally did some literature research out of curiosity....I also wanted to know what I could do to stop smelling like a cat litter box (okay...so it's not THAT bad). I was told that this is an indicator of dehydration. Other causes are a high protein intake or not eating enough carbs before exercise (I'm definitely guilty). Liver expels the excess protein in the form of nitrogen, which cells convert into ammonia and pass through sweat and urine. Another cause is that during prolonged, exhaustive exercise, skeletal muscle generates ammonia from oxidation of branch chain amino acids (BCAAs) to make adenosine triphosphate (ATP). In the process, the amino group is removed from the BCAA, producing ammonia.

Elevated ammonia within the skeletal muscle and blood negatively affect performance. Neuromuscular function is impaired by ammonia, leading to local muscle fatigue. Ammonia can cross the blood-brain barrier. So it accumulates in the brain when blood levels are high. The brain's capacity to get rid of ammonia is adequate for short-term maximal exercise, but it is overwhelmed during prolonged, exhaustive exercise. Abnormally high levels of ammonia in the brain can disrupt normal neurotransmitter function. Ammonia depletes the excitatory neurotransmitters, glutamate and its precursor, gamma-amino butyrate, leading to central fatigue. Training and diet affect the production of ammonia during exercise. Endurance training decreases the amount of ammonia produced in skeletal muscle, thereby lowering blood and sweat ammonia concentrations. Depletion of muscle glycogen following a low carbohydrate diet increases the blood ammonia response to exercise due to increased use of BCAAs for energy. Carbohydrate consumption during prolonged, submaximal exercise reduces muscle ammonia production from BCAA degradation.

Looks like I need to drink more water throughout the day, and certainly eat more carbs prior to exercising. I'll post on the outcome later.

Corneal Ulcer Follow-Up

Today was my third follow-up appointment with the ophthalmology resident at Sunnybrook Health Sciences Centre. I arrived at 9am and was seen quickly. He performed a visual acuity test at which I performed poorly related to blurry vision. My acuity appeared worse than before, but he did not seem concerned. After examination he stated that the epithelial defect in my cornea was improving. He contacted the lab to get the results of my cultures (results that he was supposed to have two days ago). My cultures were positive for Staphylococcus, a bacteria that is sensitive to vancomycin. The ophthalmology resident stated that I could now instill my drops every four hours, and recommended a fourth follow up appointment on June 8th. He eluded to continuing me on Vancomycin drops, discontinuing my other prescription, and adding on another antibiotic that would be "less toxic" on my eyes.

I decided to head to work after my visit at Sunnybrook. I thought I would attempt my routine work activities using my prescription shades; however, once there, I was encouraged to return home until my eye had healed further. A friend was gracious enough to drive me back to Ajax. This will be difficult because I am not fond of staying home if I am not ill.

Corneal Ulcer Follow-Up

On June 1st at 9am, I attended my ophthalmology appointment at Sunnybrook, where I was examined and discharged within one hour. Impressively timely, I thought. I was seen by a resident with the worst communication skills and demeanor I have ever experienced in a sub-specialty physician. He diagnosed a bacterial corneal ulcer after careful examination using a slit lamp microscope. Special types of eye drops containing dye, such as fluorescein, were instilled to highlight the ulcer, making it easier to detect. The corneal ulcer was vigorously cultured via three separate scrapings, and smears were obtained using a metal instrument sterilized each instance over a Bic lighter. Dropping the instrument on the ground prior to the first scraping, coupled with his poor bedside manner, did not instill the greatest of confidence.

The staff ophthalmologist (Dr. C. Birt) came in to examine my eyes briefly, and stated that I had corneal scarring on my left eye, and that I would likely have corneal scarring on my right eye after the ulcer healed. She instructed me not to go swimming over the next few weeks and explained that typical corneal ulceration begins with pain (aggravated by blinking), followed by increased tearing. Eventually, central corneal ulceration produces pronounced visual blurring. This explained why I had difficulty seeing objects clearly over the past few weeks. A hypopyon (accumulation of white cells or pus in the anterior chamber) may produce cloudiness or color change. She stated that corneal ulcers may heal with treatment, but they may leave a cloudy scar that impairs vision. Other complications may include deep-seated infection, perforation of the cornea, displacement of the iris, and destruction of the eye.

The examining resident made no effort to explain the diagnosis, prognosis, or treatment of a corneal ulcer, and every question I asked was responded to in a hasty manner, as if I interrupted some critical thought pattern. After prescribing me two strong ophthalmic broad-spectrum antibiotics ([1]tobramycin mixed with gentamicin; and [2] fortified vancomycin) to instill every 30 minutes (even throughout the night), he then instructed me to return two days later for follow up. I was reminded that corneal ulcers are an emergency and that I needed to be treated immediately with frequent follow up.

I returned June 3rd at 10am for my second specialist appointment. Apparently, he told all of his other patients to return at the same time. I was not seen until after 2pm. It was apparent that he was incompetent at scheduling his patients as well. The waiting area was awash with complaints as result of his scheduling-handicap. I was relieved at my chance to wait in the examining room. There, I observed patient records ripped in half and tossed in the garbage (an obvious breech of privacy). On the back of the door hung another resident's lab coat with his Sunnybrook identification tag attached (an obvious disregard for internal security). Lucky for them, I was an honest girl; however, I was tempted to take the ripped patient report and the resident identification and mail them to the hospital CEO with a note attached voicing my concerns about the accesibility of these two articles to the public. When the ophthalmology resident did see me in the examining room, he had misplaced my chart, and had not followed up on my culture results. He assured me that he would phone me with the results (which has not happened yet). He examined my eye and assured me that it had improved. I feel like I have glass shards under my eye lid, and I can barely open my right eye related to the photophobia; a note of improvement was a good sign. Fortunately, I can now instill my eye drops every 2 hours during the day and every 4 hours at night. He also requested I return for follow up on June 5th.