How Exercise Can Kill You

I am still in a bit of shock and disbelief that I am writing this blog. I have been a sport and exercise junkie for over 60 years, and I have lately discovered the new sport science that says I, and countless others who have done the same, may have been harming ourselves by training too hard for too long.

My running began at the age of seventeen with the ambition of one day making the Canadian Olympic Team. I was fortunate enough to have a famous Canadian sport and fitness guru named Lloyd Percival as my coach, at least for the first few years, and in the summer of 1959, he took me and couple of team-mates to Philadelphia’s Franklin Field to watch the first-ever Russia Vs. America Track & Field Meet – a post-war event held in the spirit of friendly international rivalry. During the 10,000 metre run, an American, as well as a Russian competitor began to wobble badly from heat stroke in the very last lap, and both of them collapsed right there on the track. It was a chaotic scene, with fans screaming, officials and athletes trying to help them up, and confusion over who had lapped who, and so on.

But I asked Lloyd one question, the answer to which became a kind of template for my training ever after. As I watched the Russian fall prostrate on the track at the finish line, as if dead, I asked Lloyd: “Can you damage yourself by running that hard?”

His answer was, “No. The outer body will always give way before the inner body.” In other words, before you can damage your heart or other organs, you will cramp, faint, throw up, tear a muscle, whatever, and that will stop you. That answer became my MO as they say, for most of my athletic life, such that I could not describe the intensity of some of the workouts we did in the early, most competitive years, complete with my own occasional wobble, throwing up, or near passing out, or crazy cramping from exhaustion. All was good. I figured I could out-train the next guy, no matter how hard he tried, any day, and it might hurt a lot, but there would be no serious health consequences. I never had a lot of athletic talent. But I could out-train almost anyone. So, I made it to the Pan American Games in the Decathlon (Silver medal, 1963), the Tokyo Olympic Games (11th place, Decathlon), two Commonwealth Games in the 400m Hurdles (1966, Jamaica, and 1970, Edinburgh – 6th place both times), and … a lot of other international meets and Canadian Championships.

But I was wrong. And so, it now appears, are countless thousands, if not millions of athletes who run, swim, cycle, or cross-country ski, or do other endurance sports intensely, the most dedicated of them middle-aged and older racers who, as God is my witness, are thinking, as they train: “Just imagine what I could have done if I had just started younger!” Marathons around the world often host 20,000 or more such athletes, and some Orienteering and ski marathon races in Europe host 50,000+ competitors!

And, like me, they all think: if some training is good, more is better. The outer body will give away first.

But that is not true.

Recently, in the middle of a x-c ski race, I had a bout of Atrial fibrillation (AF). I have always had a little cardiac arrhythmia, especially after a coffee or a coke. But AF is a chaotic arrhythmia. So … I got checked out.

An echocardiogram and a Holter monitor session revealed that I have so-called “athlete’s heart”: enlarged atrial chambers, and what looks like some scarring, stretching, thickening of chamber walls, and a few other unusual things not seen in the hearts of sedentary people (who have other issues!). Scarring of the heart muscle interferes with the normal electrical signalling of the heart. The electrical current has to go around the scar tissue, or is simply blocked by it. Some of this is due to aging (I’m 76 now, and still skiing and cycling a lot), and we know that older people experience more AF than younger. But the rest of the damage is likely a consequence of long-term intensive endurance exercise – like, over 60 years of it!

AF can be very dangerous if not brought under control with drugs, or eliminated with surgery. But ventricular tachycardia (V-Tach – a very fast beating of the ventricle), of which I have had a couple of short instances, is even more dangerous if it mutates suddenly into ventricular fibrillation, whereupon the ventricle quivers a lot, instead of beating, so that it stops ejecting the blood within. The result is sudden death. That got my attention. And the attention of my cardiologist, too. So I am on a Beta Blocker, which is a designer drug that blocks the body’s own supply of adrenalin to the Beta-1 cells on the heart muscle, thereby slowing it down.

Yesterday, when I went cycling on a beautiful hilly course, I couldn’t get my heart rate over 110 beats per minute, on hills where it would normally hit 130 or 140bpm. That felt really strange. As for my research? Lots of surfing the web and watching Youtube videos on this topic. Here is a good one by Dr. James O’Keefe, of Kansas City, who specializes in these matters, which tells the story:

I have also been studying a new book by Case, Mandrola, and Zinn, entitled The Haywire Heart: How Too Much Exercise Can Kill You, and What You Can Do To Protect Your Heart (VeloPress, 2017). The subtitle is particularly arresting. The book is a fairly easy read, except for the section that explains the electrophysiology and biomechanics of the heart muscle (an incredible organ if there ever was one!), and it gives incisive commentary on all the most relevant recent research on how and why “The Dosage Is the Poison”, so to speak. In other words, good exercise (mild to medim intensity, not too often) is very health-protective and good for you. Bad exercise (too hard, for too long), is dangerous and can, ummm, kill you. In short, exercise describes an upside-down U-curve: More is good for you for a while, and then it makes things worse. This means that exercise that is hurting the outer body, is very likely hurting the inner body, too.

I forgive my coach for giving me bad advice. At the time, it seemed true. And I have loved my sporting life. But now I have to learn to love slowing down a lot.

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