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The Runner's Ticking Time Bomb?

Long-distance racers have a history of dying. Pheidippides, the first marathoner of us all, croaked at the finish line. Recently, two runners, both under the age of 40, collapsed near the finish line of a half marathon in Raleigh, North Carolina. Though the race’s organizers said that the men’s deaths appeared to be from natural causes, the frequency of racing-death headlines is not so natural.

Studies published in the Journal of the American College of Cardiology say that about one in 200,000 runners will experience sudden cardiac arrest, and one in 50,000 will experience a heart attack from coronary artery disease during a marathon. According to the Heart Foundation, 250,000 Americans suffer sudden cardiac death annually. Many of these incidents can be linked to preexisting conditions. It has been calculated that one in 500 U.S. high school athletes has a usually trivial and identifiable cardiac “abnormality,” such as hypertrophic cardiomyopathy, or HCM, a thickening of the muscle wall around the heart.

The American Heart Association has linked HCM to a third of the 1,866 recorded athlete deaths over the past three decades. Of that number, many are runners like Micah True, star of the national bestseller Born to Run, as well as athletes such as University of Southern Indiana basketball player Jeron Lewis and Chicago Bears defensive end Gaines Adams. But these are rare and high-profile cases. Still, if the probability of experiencing cardiac arrest during physical activity is seemingly so low, and if knowledge about the problem is at an all-time high, then why are athletes dying so frequently?

Maybe because you don’t know you are dying. “The symptoms of a heart attack are the same as the side effects of exercise,” says Bonnie Taub-Dix, a registered dietitian who appears regularly on Good Morning America. “Your heart is racing, you are sweating, your chest hurts, and it’s hard to breathe.”

In a report on Fox News, Gordon Tomaselli, a cardiologist at the Johns Hopkins Outpatient Center, explained an athlete’s ability to run right through all the warning signs. “In order to have symptoms, it’s a supply-demand situation. You only get chest pains when the demand on the heart outstrips its ability to supply blood and nutrients to other organs,” he says. “So you can be totally asymptomatic, and your first symptom is sudden death.”

While the symptoms may be hard to pick up on, underlying conditions are not—as long as you look for them. ECG tests are the best method for pinpointing any preexisting heart problems, and while the idea of making tests mandatory for race participants has been tossed around, event directors and runners alike know that wouldn’t be practical. Beyond testing, knowing what your body is saying, and when to stop during the miles logged, is even more important. “Moderation is the key to everything,” says Taub-Dix. “Running and exercise are great for your health, but there is such a thing as too much of anything.” 

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How to Race (and Live) Like a Spartan

“Am I intense? Yes, I’ll be the first to admit it.” So writes Joe De Sena about a third of the way into his new book, Spartan Up!, out May 13 from Houghton Mifflin Harcourt. To which any reader is likely to reply, out loud, “No kidding, Joe!” De Sena, 45, is the creator of the Spartan Race, a massively popular obstacle race series that he’s grown into a $60 million business since 2010.

In Spartan Up! De Sena tells his personal story—kid grows up poor in Queens, New York; takes over dad’s pool-cleaning business; gets rich on Wall Street but also fat; finds himself through adventure racing; and moves to a Vermont farm—but mostly he works at convincing you that to find happiness and success in life, you need to suffer.

That’s the point of a Spartan Race—the plunges into frigid mud puddles, the crawls under barbed wire, and the climbs over greased walls are supposed to hurt. So are the daily training hours for your next race. As De Sena sees it, endure the pain and everything else in life seems easy by comparison. Regardless of what you think of the obstacle-racing trend, it’s hard not to finish Spartan Up! without feeling motivated to push harder during your next run, ride, or burpee session. With that in mind, here are a dozen of De Sena’s prescriptions for going farther and faster, and generally bettering yourself, pulled from the pages of the book.

{%{"quote":"Upset? Stressed? Mad? Run. Still feel that way? Run faster."}%}

When you push your body to its limits, when you are out of breath and in pain, when you are lying on the ground exhausted—that’s the kind of experience that reveals to you how bad things can be. By doing this, you’re changing your mind’s frame of reference to set new standards. When that challenging workout is over, the small worries of the day seem like nothing.

If you never want to get sick again in your life, do 30 burpees a day. This works assuming you eat healthier as well.

The easiest way to convince your body that sitting in traffic is not worthy of a stress-induced freak-out is by showing your body what real stress feels like in the controlled setting of a daily workout.

You can either go to bed satisfied with your efforts today or stressed about what you left for tomorrow.

Be extremely physical and use every minute of your time. My wife thinks I’m nuts, but I will exercise in public if I have time to kill. She gets embarrassed, for example, if I am doing burpees in the airport. Being healthy should never be embarrassing. 

Preparing for the unexpected is easy. You just need to do the unexpected. Break out of your routine. Go for a run at night. Swim in the open ocean. Stop and climb a hill in the distance. Go farther during that bike ride.

You can talk all you want about mental strength and positive attitude… Mind over matter only takes you so far before you find yourself beyond your body’s literal control.

The pain of regret, the pain of failure—the drive to avoid feeling this pain ever again is what pushes us to work harder, to be a better person.

A good training partner can push you farther and faster when things are going well, but they can become essential when you’re burned out or training or skipping workouts and start slacking. You are conspiring against your own laziness by having a friend help hold you accountable.

The alarm goes off at 5 a.m.—what do you do? Believe it or not, our success in life hangs in the balance. If we go through life hitting the snooze button, our chances for success plunge.

Work harder. Be better. Do more.

Look for a feature-length profile of Joe De Sena in the upcoming July 2014 issue of Outside.

Excerpts from
SPARTAN UP! by Joe De Sena with Jeff O’Connell to be published on May 13th, 2014. Copyright © 2014 by Spartan Race, Inc. Used by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

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Until the Teeth Fall Out of Your Head

One day, during your struggles, you look down at your thigh. You should see a familiar scar from an old childhood wound. But now that scar has begun to pull apart, skin separating, as if the stitched seam in a pair of jeans has started to unravel.

Meanwhile, your teeth have grown so loose in your skull that, if you had the strength in your hands, you could pluck them out with your own fingers. The hair follicules on your legs have turned purplish. You bruise at the slightest touch.

As one description puts it, if this malady continues on its course, “the body will degenerate into a bleeding pulp for which death is a blessing.”

This is not some rare and frightening disease recently emerged from primate populations in Central African jungles. Rather, it is one of the oldest human maladies known. For four hundred years, it had a profound effect in shaping world history, and yet is almost forgotten today.

This “bleeding pulp” of the human body represents the end stages of scurvy.

A Disease as Old as Us

Scurvy has probably been around as long as humans existed—Hippocrates made note of it in Classical times—but it wasn’t until about 500 years ago that it threatened the balance of emerging world powers. Basically, scurvy is caused by the lack of what we now call Vitamin C (or ascorbic acid). Most animals need Vitamin C to survive, but most of them can manufacture it in their own bodies, with the exception of certain primates, bats, and guinea pigs.

To describe its role in the human body, I think of it as a kind of atomic welder in the body’s foundries that make proteins. One of the most important proteins the body manufactures is collagen, which helps form the tough, connective tissues—ligaments, tendons, skin, blood vessel walls. Scurvy sets in when there is no vitamin C to weld together the collagen protein in these tissues.

“The Explorers’ Disease”

This became glaringly obvious starting in the late 1400s when sea-going European explorers made epic voyages in search of new lands. They sailed for months without fresh food that contains Vitamin C. Scurvy typically appeared among the crew after ten or twelve weeks at sea, but sometimes sooner. Vasco da Gama’s expedition around Africa to India in 1497 suffered mightily from it, saved by an Arabian trader who happened by with a boatland of oranges. A French expedition led by Jacques Cartier, his ship trapped in the ice in the frozen St. Lawrence River in the 1530s while looking for a Northwest Passage, lost 25 out of 110 men.  

Cartier ordered an autopsy on one 22-year-old victim to try to understand what this curious malady was.

“It was discovered,” according to the expedition’s journal, “that his heart was completely white and shriveled up, with more than a jugful of red date-coloured water about it.”

(One of my favorite scientific books of all time, which describes some of these events, is Kenneth J. Carpenter’s “The History of Scurvy and Vitamin C.”)

Once European nations developed navies to colonize and defend distant lands far across the seas, the death toll from scurvy skyrocketed. By one calculation based on nautical records, between 1500 and 1800, scurvy appears to have claimed around two million sailors.

What’s bizarre is that it took so long, literally centuries, for European powers to figure out a reliable cure such as the famous British Navy lemon juice, which was instituted around 1800. Countless cures were lying under the noses of every expedition and were long known to native peoples. Cartier’s expedition was saved from utter decimation through the knowledge of the local Indians, who, in the depths of frozen winter, showed the clueless Frenchmen how to brew tea from the needles and bark of a tree called the anneda, much later identified as the white cedar, or arborvitae. This happened to be very high in Vitamin C.

Other native peoples in cold regions throughout the world—where there are no fresh fruits or vegetables available in winter—had figured out over the millenia what herbs or barks or animals to consume that happened to be high in Vitamin C and would keep them healthy during the long frozen months. The Inuit of the Arctic, for example, chewed on whaleskin, extraoridnarily high in vitamin C, while the Yukon Indians knew that the adrenal glands of field mice would keep them healthy in the winter.

Collapse of the Overland Expedition

In my book, Astoria, I’ve written about the possible effects of scurvy on Wilson Price Hunt’s Overland Party in the winter of 1811-12. They were trapped in a huge canyon (unmapped then but known today as Hell’s Canyon of the Snake River) with little or no food. I suspect at least some members, such as the collapsing Scottish fur trader Ramsay Crooks and American hunter John Day, were succumbing both to hunger while also severely weakened by scurvy.

The Shoshone Indians saved Hunt’s Overland Party from this fate. When a group of Hunt’s party finally escaped Hell’s Canyon and reached some Shoshone villages, the Shoshone fed them, among other things, dried, pounded “wild cherries.” It’s not clear just what type of cherries these were, but some cherries (or cherry-like fruits) are extraordinarily high in Vitamin C. The acerola, or West Indian cherry, contains about 1700 mg of Vitamin C per handful, or 170 times what the human body needs daily to recover from scurvy. Experiments on conscientious objectors during World War II showed that 10 mg per day of Vitamin C cleared up the symptoms of scurvy within a few weeks.

Whatever kinds of cherries, it is almost certain that the Shoshone Indians ate rosehips, either dried and infused in teas or mixed with other foods. Rosehips are another power pill when it comes to Vitamin C (each cup of fresh rosehips contains close to 1,000 percent of the human daily requirement for Vitamin C). With pounded wild cherries, and rosehip tea or rosehips mixed in stews or in pounded meat, Hunt and his Overland Party were restored from their possible scurvy and debilitating nutritional weakness. With these mega-doses of Vitamin C from ancient, traditional sources, the Overland Party continued on its way to the Pacific to start the first American colony on the West Coast.

The Hardest Way West

In this exclusive excerpt from the new book, Astoria, the legendary Overland Party attempts to establish America's first commercial colony on the wild and unclaimed Northwest coast—provided, of course, they survive the journey.

Peter Stark is a full-time freelance writer of non-fiction books and articles specializing in adventure and exploration history. His most recent book, Astoria: John Jacob Astor and Thomas Jefferson’s Lost Pacific Empire; a Story of Wealth, Ambition and Survival, tells the harrowing tale of the quest to settle a Jamestown-like colony on the Pacific Coast and will be published in March 2014 by Ecco/HarperCollins.

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A Fitness Center That Takes Your Breath Away

Athletes can take their workout to new heights at an altitude training room in the Bay Area.

The recently opened Air Fit, run by fitness company Leisure Sports, is a 1,100-square-foot room equipped with a massive compressor and air tank that reduce oxygen levels in the room. In theory, this allows athletes to improve fitness without having to increase exercise time, potentially lessening the muscle and joint strain that comes with longer sessions.

“The idea of hypoxic training is that the body has to work harder to do the same amount of activity,” says Matt Formato, business development director at Hypoxico Altitude Training Systems. The equipment manufacturer, known for its altitude sleep tents and workout masks, helped Leisure Sports develop Air Fit. The two companies first teamed up fall 2011 to create The Summit Training Studio, a 400-square-foot altitude workout room at ClubSport in Tigard, Oregon.

Beyond the increased calorie burn, Formato, along with Dennis Dumas, director of wellness at Leisure Sports, says that training at altitude can improve lactate thresholds, oxygen utilization, and metabolic rates, possibly increasing red blood cell counts as well, which can afford athletes a competitive edge both at altitude and sea level.

Despite such claims, most altitude training research focuses on the effects of living in the mountains and training at lower elevations, rather than on interval training in hypoxic environments. The live-high-train-low approach is the preferred altitude training program for elite athletes, explains Jay Kearney, a former physiologist with the United States Olympic Committee who works with Osprey Leadership Consulting as a performance adviser.

Some sports physiologists are not quite convinced that hypoxic interval training can provide all the same physical changes.

“The bottom line is that one cannot expect to see an increase in red blood cells or an improvement in lactic acid metabolism when the ‘dose’ is based on a two-hour workout, even if that workout is done three to five times a week,” says Randy Wilber, senior sports physiologist with the United States Olympic Committee.

But Formato and Dumas counter that the science of altitude training rooms is so new researchers haven’t had time to publish their findings on living high and training low. Some early studies point toward benefits in oxygen utilization and sprint performance, but these are still ongoing.

Because few nonprofessional athletes are blessed enough by geography to have access to high-altitude training and its benefits, Air Fit has a ready audience. The new facility opened this month at the Quad, a Pleasanton, California, gym. There, as many as 27 members at a time can take high-altitude classes that include circuit training, rowing, spinning, and one-on-one sessions.

Unlike athletes who use altitude masks attached to a machine, users of Air Fit don’t have to be tied to a stationary bike or treadmill. “We wanted to offer something no one else was,” Dumas explains. “It’s not just a room built for hypoxic training, but it’s built for high intensity, functional training.”

Many of the Air Fit classes—Summit Yoga and Mile High Circuit, for instance—will be programmed to simulate altitudes of 5,000 to 6,000 feet. Oxygen levels can be set to approximate those at altitudes as high as 22,000 feet, but Dumas says that such extreme settings will be used exclusively by elite athletes training to summit Everest or other major peaks.

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