Essential Sports Nutrition

6/25/19

TriWeek: Swimming Tips


It's National Triathlon Week!

National Triathlon Week is an initiative created by USA Triathlon to celebrate multisport and all its constituency groups. "National Triathlon Week is a celebration of not only triathletes, but all members of the multisport community, including officials, coaches, race directors, families and friends of triathletes and more."

On behalf of Triweek, I'll be sharing some information on each sport (swim, bike, run) to help you make the most of your triathlon training journey. If you are new to the sport (or thinking about training for a triathlon), I hope you find this information helpful.

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Without a doubt, a pool offers a very controlled, safe and consistent swimming environment.

Add in 1000+ athletes in the open water and you have a very different situation compared to pool swimming.






As a triathlete, you must remember that your swim training should be preparing you for open water swimming. You are not a competitive swimmer - you are a triathlete. Your race day swim will last between 10 minutes to 2 hours (depending on the distance) and when you are finished swimming, you need to have the energy to bike and run (knowing that as the race continues, you'll be experiencing more fatigue). Because of the unpredictable and uncomfortable nature of open water swimming, it's important to equip yourself with the proper technique and fitness that will help you swim efficiently and confidently on race day.  

  1. Improve your body posture in the water. If you did not grow up as a swimmer, you likely struggle to "hold" yourself in the water. In other words, it takes a great amount of extra energy just to position your body in the water so that you don't sink. Unlike land sports, where gravity helps you hold your posture, in the water, you are not familiar with your body weight. Once you are in the water, you weigh about 10% of what you do on land. It’s no surprise that when you are in the water, you expend a lot of extra energy in your legs (kicking) to help you stay afloat. Because of poor body posture, there's a good chance that you are dragging yourself through the water, making swimming extremely exhausting. As an example, think about how easy it feels to swim when you have on your buoyancy shorts, a wetsuit or a pull buoy. The buoy or buoyancy garment is helping you achieve good posture in the water. But remove the added buoyancy and you lose that good posture in the water and swimming suddenly feels more difficult This has less to do with your swimming fitness and more to do with your swimming posture. 
  2. Tautness - When you look at a "fast" swimmer, they are usually stiff and firm. Most triathlon swimmers are soft and floppy in the water. Tautness in your core and torso is what helps you swim more efficiently in the water, helping you conserve energy. Once you learn how to swim with a “stiff” or taut body, it will be easier to achieve good posture in the water, helping you swim faster (less drag) with less energy expended.
  3. Improve your body alignment - When you swim, proper alignment helps you swim through the water with the least amount of resistance possible. Without good alignment, errors occur in your stroke. If your body is anything but aligned (ex. noodly, scissor kicking, crossing your arms over the midline of the body), you create an excessive amount of drag and you must expend more energy than needed to move through the water. It's important to avoid excessive movements that are preventing you from staying in a straight line. 
TRIATHLON POOL TOOLS

As it relates to your swimming fitness and technique, the greatest benefit you'll receive is through the use of pool tools. Many newbie triathletes try to master perfect swim technique, similar to a competitive pool swimmer. However, gliding, rolling and a slow arm cadence will not help you in the open water. 

Swimming tools are not crutches (or cheating). Every tool has a purpose and each tool is designed to help you improve your body position, tautness and alignment in the water for more efficient open water, triathlon specific swimming. I've been swimming competitively for over 20 years and I use the same pool tools as Karel, who has only been swimming since 2012.
Whereas you may not feel the benefit of using the pool tool immediately, the goal of using the tool is to help you swim better without the tool. In open water, you have no walls to rest on, no black line to follow and you have to navigate yourself through waves, chop and current, as well as hundreds of other swimming bodies. Your pool tools will help you become a better triathlon swimmer. 
  • Ankle strap - The ankle strap/band/lock is an effective method to force you to be “taut” in the water. By eliminating the use of your legs, requiring you to keep a more taught/stiff body with your core, you are forced to use your upper body to move you through the water without the use of your lower body. If you have poor body position in the water and struggle to keep a taut body position, you will likely find it impossible (and exhausting) to swim with the strap as you feel like your feet are dragging on the pool bottom. With time, by using the ankle strap (and a small buoy or buoyancy shorts for a helpful lift), your body position and tautness will improve.  The ankle strap will also minimize excessive hip rotation. A higher cadence and stronger catch will also increase your propulsion through the water – which is the most efficient way to swim as a triathlete (propulsion should not come from kicking!). 
  • Pull buoy - To help with your body position, a pull buoy is a tool, not a crutch. Therefore, anytime you swim with the buoy, you want to feel how the buoy is lifting your body in the water. As you swim with the buoy, you’ll find it easier to keep your head, hips and feet in a straight line and your legs and hips will not swing from side to side with every stroke. The buoy is also a tool to "rest" your legs while requiring you to use more of your upper body (which is what you need for more efficient open water swimming).  Let the buoy be an aid to developing better form in the pool and don’t hesitate to use the buoy when you feel tired in the water, when form suffers. Keep the buoy between your thighs. Another way to give your body a lift without restricting your legs is through buoyancy shorts. 
  • Snorkel – A snorkel is a training tool that helps you focus on technique without the disruption of moving your head. The snorkel also allows you to focus on all of the components of your stroke without needing to turn your head to breath. Many stroke flaws, like scissor kicking, crossing your hands in front of the body and swinging hips occur when you turn your head to breath. The snorkel allows you to correct specific flaws while also building fitness in the water.  I suggest to use a nose clip if you feel like you are suffocating with just the snorkel. If you normally do flip turns, you can do an open turn with the snorkel, if needed. 
  • Paddles – Paddles offer a strength component to swimming. They should not be viewed as a way to swim faster. You want to think of the paddle as an extension of your forearm position. We have our athletes use three different types of paddles for each provides a different tool for the job to help with your arm mechanics and catch.  For example, the FINIS agility paddles do not have a strap, which forces you to have a palm positive hand position to correct incorrect technique when your hand enters the water and pulls through the stroke. Paddles should be small (the size of your hand) and should be used wisely as poor form with a paddle can cause shoulder issues. 
  • Fins – Sure, you may feel super fast with fins but when used properly, they are designed to help you with fluency. Fins help you move through the water with a rhythm, providing less work for your lower body as you focus on your upper body mechanics.  Do not overkick when using fins. And to avoid cramping, you need to kick from your hips and not from your knees, feet or calves. Think of the fins as an extension of your legs, with the kick coming from your hips. Fins will also help you work on ankle flexibility. Fins can help you learn how to drive your kick from your hips and not from the knee. Fins are also helpful when performing drills (ex. single arm drills).  Kicking is important but it doesn’t propel you forward as an open water swimmer/triathlete. Save your legs for the land! If you cramp with fins, this may be a sign that you tense your calf or feet muscles when you kick. Also if you run before you swim, you are more likely to cramp. Make sure to warm-up your ankles and feet before you swim and be sure to relax your feet, calves and legs when you kick lightly in the water.  

Triathlon swimming take-away tips: 
  • Swim frequently (3-5 times per week) and consistently throughout the entire year. Stay accountable to your swim training. 
  • Be patient. Swimming is a technique driven sport. It's takes a lot of practice. 
  • When you are tired from running and biking, you'll feel it the most in the pool. Don't get frustrated when you form feels off. 
  • Incorporate swim "bricks" where you swim and run or swim and then bike to get yourself use to transferring from the horizontal swim position to being more upright. 
  • Make every swim workout purposeful - with a specific warm-up, pre-set and main set to get the most out of your time in the pool. Avoid non-stop, continuous swimming "workouts" as you'll only teach yourself how to swim with poor form due to fatigue. 
  • Stay present, focused and dedicated to each swim session. You need a clear pathway so you know where you are going with your swim training.
  • Your swim training should first focus on your body position. Next comes the strength/propulsion component. Then comes specificity to prepare you mentally and physically for the open water. Focus less on gaining speed or trying to achieve a certain distance for each swim but instead, focus on swimming efficiently and effectively so that you can become swimfit for the open water. 



6/21/19

SIPE and Triathlon Swimming - what you need to know




A year ago, we experienced something incredibly scary as we had a coached athlete suffer from SIPE (Swimming induced pulmonary edema) during the swim portion of IM 70.3 St. George. Thankfully, he survived. Other triathletes, sadly, have not been so lucky. He is an experienced and fit triathlete so this was a big shock for us all. The water temp was in the low 60's and he was wearing a wetsuit. He didn't have a warm-up in the water. After entering the water, he started out with his effort and quickly felt tightness in his chest. He mentioned he felt a similar tightness (but not as severe) on the day before the race during a pre-race practice swim. He started to cough severely and noticed pink phlegm coming from his cough - he was able to get to a kayak to rest. He tried to swim to the next kayak but was getting weaker. He finally exited the water and went to medical. The med tent didn't take his BP after the event but he later followed up with his doctor. All was ok with his heart but we learned a few things from this.

"While the exact pathophysiology of SIPE remains uncertain, it is believed to be related to exertion, immersion in cold water, and overhydration. The body's normal response to exercise is to increase cardiac output to meet the increased oxygen demand. Although an increased cardiac output is known to cause pulmonary edema in racehorses, this increase is rarely enough to produce such an effect in humans. Cold-water immersion is instrumental in this process because the peripheral vasculature constricts to divert blood away from the extremities in an effort to maintain the core body temperature. This results in a central pooling of blood, leading to an increased preload, increased pulmonary artery pressure, and an increased cardiac output. The vasoconstriction also causes an increase in afterload, which leads to an increase in pulmonary vasculature resistance. The increased cardiac output from exertional activities coupled with an increased preload and afterload from immersion appear to be sufficient to rupture the pulmonary capillary membranes, thus resulting in pulmonary edema. In several documented cases of SIPE, it has been noted that the patients consumed anywhere from two to four liters of water in the hours leading up to their swim in an effort to remain well hydrated. It is believed that this degree of hydration led to a fluid overload that contributed to the onset of pulmonary edema by increasing the pulmonary capillary pressure. Patients may present with symptoms, such as cough, dyspnea, hemoptysis, tachypnea, and confusion with hypoxia, after exertional cold water activity such as swimming and scuba diving."

First off, triathletes need to take the swim portion seriously. This includes race day tactics and swim training preparation. Far too many triathletes don't train appropriately (or enough) to be prepared for the open water. For most developing triathlon swimmers, you need to learn how to swim at different intensities in the (with proper open water techniques), have more practice in the open water, know your abilities when you start the swim portion of the race and understand the demands of your swim course (ex. waves, currents, etc.).

We need every triathlon to offer a practice swim on the morning of the race. Not only does this provide a sport-specific warm-up but it gives athlete time to acclimate to the water and to adjust swim gear to the right fit/comfort. But to be honest, even when a practice swim is allowed, most triathletes don't take advantage of this practice swim because they don't want to be wet or they want to save their energy for the actual race. At IM 70.3 FL, there is a pool at the race venue. This year, I would guess there were no more than 50 total triathletes in that pool in the 90 minutes that the pool was open before the start of the race. You want to prepare your heart for the effort of the swim before you actually start swimming. 


I am strongly against the use of "boosters" before a race - caffeine, energy drinks, etc. There is so much anxiety and stress from swimming alone and the added stress on the heart is not worth it. Triathletes need to create a go-to warm-up strategy before the race - something that is familiar and well-practiced. This can help ease nerves and reduce anxiety. 
There's so much emphasis on sodium before a race that many athletes are overdoing it on pre-load and salt pills in an attempt to off-set the effects of dehydration. However, a hyper-hydration style beverage (or pills) may predispose an athlete to SIPE due to the potential of retaining excessive fluid. This will be worse if an athlete already has high blood pressure. SIPE is connected to a quick increase in blood pressure.  

Although a wetsuit can be to blame, many triathletes feel more comfortable swimming in a wetsuit due to the buoyancy. However, triathletes need to practice in the wetsuit (at race intensities) to ensure it's the right fit (and race intensities are realistic). Gerry Rodrigues did a great discussion on his Tower 26 podcast on finding the right wetsuit. 

Things to consider: 



  • Many athletes go into races overly hydrated - an increase in body fluid is not a good thing. 
  • Abrupt cold water exposure and/or compression of the wetsuit can push fluids to the core. I advise athletes to use a bottle of water to pour down the wetsuit and try to get wet before the race so the water is not a shock to the body when you can't warm-up in the water. 
  • Athletes who already have high BP can experience a further increase in BP at the race start - causing fluid in the lungs (similar to flash pulmonary edema). 
  • Interestingly, even though research has shown cardiac issues among elite athletes, I will generalize and say that swimming related deaths appear more common in the less experienced and in males. Instead of making assumptions of the risk of death in the triathlon swim, it would be beneficial if we could better understand more about the background of the athlete who passed away. For example, did this person have a preexisting heart condition, was she/he wearing a wetsuit for the first time, is she/he on any medications/drugs, what was the nutrition like on race day morning, was she/he stressed before the race, what type of training did she/he do on race week, etc.? This additional information may help us further prevent or reduce the risk of future triathlon swimming deaths. 

What can we do to reduce the risk:


  • Start slow in the water - give yourself time to warm-up and get breathing under control before taking your first stroke. 
  • No more than 30 ounce water on race morning.
  • Get a medical exam (as comprehensive as possible) before a race (or before training for a race). 
  • Fuel and hydrate appropriately - don't restrict, don't overdo it either. 
  • Take training and racing very seriously. Long distance triathlon should not be seen as the new "marathon" but as an extreme endurance event that comes with great risk. 
  • Choose races appropriately - consider the water temperature, water environment (ex. chop, current, etc.) and how you will prepare for your open water swim (can you do practice swims in similar conditions)?
  • Test out your wetsuit several times in advance - in the pool and open water. 
  • Take your health (and swimming ability) seriously. 

Additional reading:
SIPE
Triathlon swim deaths
Management
Diagnosis review
Risk factors

6/19/19

DEXA Body Composition Testing - Review (and results)


Several weeks ago I was contacted via email by someone from a company who asked if I was interested in receiving a complimentary DEXA Scan (along with Karel) in return of a review. As you may know, I am not a fan of the scale and I never weigh myself. Considering all that makes up your body, your body weight can’t accurately be told by a number on the bathroom or BMI scale. But this doesn't stop far too many athletes from daily or weekly scale weighing - often feeling like the scale runs or ruins the day.

A DEXA Scan is a reliable, gold-standard way to precisely measure body composition (I discussed this in my book Essential Sports Nutrition). DEXA stands for dual energy x-ray absorptiometry.  More than just a weight, a DEXA Scan tells you what you are made up of - muscle, fat and bone. You can see muscle asymmetry, visceral fat and bone density.

For the athlete with excessive body fat, weight loss may improve health and sport performance. However to pressure from society, coaches and social media, it’s not uncommon for many athletes to have body image struggles, feeling like the body should always look differently. Because many athletes resort to unsafe weight loss methods and strategies when feeling “fat”, the first step in a weight loss program is to gather baseline information of your current body composition – what are you made of? Your bathroom scale does not tell you what you are made of - it only tells you a number.

Understanding body composition 
Your body weight is made of two parts: body fat and lean body mass.

Body fat can be divided into two types; essential fat and storage fat. Essential fat is stored in organs, like the heart, lungs, spleen, kidneys, intestines and liver, as well as in muscle tissue, the central nervous system and bone marrow. Although a small amount stored in the body, the body requires this type of fat for bodily processes. Essential fat is very important for your overall health. Women have more essential fat than men for child-bearing purposes. Essential fat is also needed for hormone related functions.

Storage fat (the more familiar fat) consists of fat accumulation in adipose tissue. Subcutaneous fat helps to protect the skeletal structure and to conserve body heat. Visceral fat (or abdominal fat) lies just beneath the skin surface. An excessive amount of visceral fat has been linked to health issues. It's important to know your android fat level and gynoid fat level (and ratio) for metabolic health. Gynoid fat storage (pear shape) is common in women as this fat is stored primarily around the hips and thighs. This storage is often seen as healthy for child bearing. Android fat (apple shape) is stored in the midsection, predominately in the abdomen, but can be also be found in the chest and upper arms. This type of fat is consistently shown to place people at a higher risk of heart disease, diabetes, hormonal issues and more. Knowing the distribution of fat in your body can be helpful to monitor health risks and to minimize health issues later in life. Because a DEXA scan measures different types of fat in every region of your body (even your head!), the ratio of android to gynoid fat (A/G ratio) is something to monitor. You want this ratio below 1.0.

Lean body mass is everything that is not fat. Your bathroom scale doesn't know how much of your body is lean vs. fat. For example, your scale doesn't tell you the weight of your bones, organs, muscles, fluid, ligaments and tendons. More so, if your body composition is changing, your weight won't tell you why it's changing - is it more/less fluid, more/less muscle, more/less fat, more/less bone?



When we think of words like lean, fat or overweight, what do those words really mean? For example, according to a height and weight table, I may be classified as normal weight (but on the high end), but this table doesn't take into account my muscle mass and bone density. And although excess body fat can have an impact on your overall health, you do need body fat for important bodily functions.

If you are concerned or interested in your body composition, I highly encourage you to ditch the scale and get a DEXA scan. The DEXA Scan website will help you find the nearest location (and pricing) to get your body composition tested. Although not every center with a DEXA scan is listed on this website, it's a good starting place. The average price of a DEXA scan varies from $50-150 (on average). I'd say that's extremely reasonable, considering all the information you receive and the ease of the test. It only takes ~6-8 minutes for the machine to run the scan on you - while laying down - and you immediately get your results right after the test.

Because a DEXA scan tells you a tremendous amount of information about your body composition, here are some practical applications from the analysis of your body composition:
  • If you feel the need to change your body composition, you should know exactly what you are made of before attempting to change your diet or exercise regime. And because you can't target your fat loss or spot reduce, even if you try to build muscle or reduce body fat, repeated testing (ex. every 3 months) can show you trends over time after establishing a baseline - particularly, how your body composition has changed over time. This will also emphasize the fact that healthy and sustainable body composition changes can not be quickly achieved, especially through extreme exercise or strict eating methods. Far too many athletes overexercise and undereat for the reasons of wanting to weigh less to perform better. If you are serious about changing your body composition, you need a very specific program/approach that will help you achieve your goals (ex. decrease body fat, increasing muscle) without compromising your health, performance and quality of life. And because body composition changes don't guarantee performance improvements, your primary focus for changing body composition should be for health reasons - not aesthetics. 
  • Although a DEXA scan is not a bone density exam, it does give you a general overview of your bone strength. As an athlete, you should be very concerned about this number. A high bone density (higher Z-score), means strong, healthy bones. Interestingly, a DEXA scan may tell you about  imbalances, that may have resulted in (or predispose you to) an injury. This information may help your PT/trainer better understand the exercises that you need to be doing to rehab appropriately (after an injury) or to reduce the risk of an injury. For example, in the DEXA scan, you can see the difference between your right side and left side bone density. A large imbalance may indicate a muscle imbalance from a past muscle injury or an injury waiting to happen.
  • Body weight is a sensitive topic and many athletes are trying to avoid the scale for that reason. I agree - the scale is not a good indicator of your self-worth, athletic talents or overall health. Because poor body image can lead to obsessive behaviors (ex. eating/exercising), a DEXA scan may give you reassurance and satisfaction that your body is actually in great health. I feel there's something extremely powerful in knowing exactly what you are made of - it also shows you how incredible your body is because of all that it's made of. Plus, if you have recently gained or lost weight, you want to be assured that it's the "right" kind of weight. For example, you could avoid carbohydrates for a few days and lose a lot of water weight. Your weight may be lower but your weight loss likely didn't come from fat. 
Karel and I found this experience to be very enlightening. We never obsess about our weight/body image and our eating habits are not regimented or strict. The information we received from our scans was more about knowing what we are made of, instead of feeling like we need to use this information to make changes. We don't plan on making any changes with our diet (or training) to change our body composition for we are both healthy, performing well and enjoy our current style of eating/training. Plus, we feel our body composition  naturally changes throughout the season based on our ability to adapt to training stress and recover between sessions. We also know that serious health issues can occur from getting too lean (the body gets weaker, not faster). And seeing that it's only June and we still have over three more months of Ironman specific training, we don't want to jeopardize our health in favor of attempting a leaner body composition.

Here is a recap of our body composition analysis from the Lovelace Family Medicine Center in Prosperity, SC. 

KAREL


Age: 42
Weight (weighed with shoes and clothes on, I feel this should have been a naked weight): 145.0 lb
Height (shoes on - I feel they should have taken our shoes off): 67.5 inches
Body fat percentage: 12.4%
Android: 13%
Gynoid: 13.6%
Android/Gynoid ratio: .96 

L Arm: 10.7% fat
R Arm: 11.3% fat
L leg: 12.9% fat
R leg: 12.2% fat
Head: 21.7%
Z score: 0.1
T score: 0.1
(a score of -1.0 or above is normal bone density. A score between -1.0 and -2.5 means low bone density or osteopenia and -2.5--4 is osteoporosis. A T-score is your bone density compared to what is normally expected in a healthy young adult of your sex. Your Z-score is the number of standard deviations above or below what's normally expected for someone of your sex, age, weight, ethnic or racial origin). 

L Arm: 0.950 BMD (bone mineral density, the amount of bone mineral in bone tissue)
R Arm: 0.997 BMD
L Ribs: 0.736 BMD
R Ribs: 0.639 BMD
T Spine: 0.887 BMD
L Spine: 1.093 BMD
Pelvis: 1.205 BMD
L Leg: 1.251 BMD
R Leg: 1.254 BMD



MARNI
Age: 37
Weight (weighed with shoes and clothes on, I feel this should have been a naked weight): 114.0 lb
Height (shoes on - I feel they should have taken our shoes off but I'll take the height increase :): 61.5 inches
Body fat percentage: 17.1%
Android: 13.9%
Gynoid: 23.2%
Android/Gynoid ratio: .60 

L Arm: 16.5% fat
R Arm: 14.3% fat
L leg: 21.3% fat
R leg: 19.5% fat
Head: 21.3%
Z score: 0.5
T score: 0.8
(a score of -1.0 or above is normal bone density. A score between -1.0 and -2.5 means low bone density or osteopenia and -2.5--4 is osteoporosis.)
L Arm: 0.794 BMD (bone mineral density, the amount of bone mineral in bone tissue)
R Arm: 0.842 BMD
L Ribs: 0.571 BMD
R Ribs: 0.632 BMD
T Spine: 0.966 BMD
L Spine: 1.212 BMD
Pelvis: 1.078 BMD
L Leg: 1.128 BMD
R Leg: 1.148 BMD




Although athletes tend to have lower body fat percentages, extremely low body fat can pose health issues - for men and women. When it comes to seeing where you stack-up with your body composition compared to someone else, be mindful that your body is unique. We must keep in mind that there an extreme variability of body shapes, sizes, heights, bone structure, genetics, weight and fat and muscle distributions. No two bodies are the same so it's not worth comparing your body composition (or image) to that of another athlete. Two athletes, each with 15% body fat can look extremely different. You can also be very fit at different body fat percentages. You can also be extremely lean but in poor health. This is why it's also important to never assume that weight loss will result in performance gains. Through DEXA testing, you can see how your body is put together and what you are made of. It's up to you if you want to do anything with that information.

Final thoughts....we found this process informative. I saw this as a wonderful opportunity to see how strong and healthy my body is in the inside and to see what I am really made of. Because athletes can become so overly focused on body image, make sure you are spending your energy in the right place - to become a stronger, healthier and better athlete. Performance gains don't come quickly and you should never make assumptions that lean = fit. Strive to be in great health and don't tie your happiness, confidence and self-worth to an image or body composition.

If you are interested in getting your body composition tested, you can use this link, DEXA Scan, to find your nearest location. 

I was not paid to write this post and all thoughts/feedback are my own. In return of this blog post, I received two complimentary DEXA Scan tests at a location of my choice. The closest location per the DEXA Scan website was ~90 minutes away. The test was performed on June 4th, 2019.