Can I Do Triathlon With Afib?

If you have been diagnosed with afib, is it worth training for multisport endurance competition, such as triathlon? This post, prompted by a reader diagnosed with afib, contains valuable advice from a cardiologist whose father is an ultramarathon runner.

Disclaimer

What is Afib?

Cardiologist Dr. Brian Saluck, Citrus Cardiology Consultants, P.A. describes atrial fibrillation (AF), or afib, as “a rapid heartbeat which is irregularly irregular. This means that the duration from beat to beat is different and the rhythm of the heart is not regular.”

He also noted three categories of AF:

  • Rapid AF, for which the heart rate is above 110 beats per minute (bpm).
  • Controlled AF for which the heart rate is between 60 and 110 bpm.
  • Slow afib for which the heart rate under 60 bpm.

The irregular-irregularity common to all types makes afib a condition to be taken seriously. According to StopAfib.org, “If you have non-valvular afib, you are nearly five times more likely than someone without the condition to have a stroke; if you have valvular afib, your risk is 17 times higher. In fact, about 15% or more of all strokes in the US are related to afib. You also have twice the risk of dementia, three times the risk of heart failure, and a 40 to 90 percent increased risk of death compared with people your age who don’t have afib.”

What Are Risk Factors For Afib?

Several factors contribute to the risk of stroke or heart failure in patients with non-valvular atrial fibrillation (AF). These include the patient’s history with diabetes, hypertension, congestive heart failure, valve disease, and prior stroke or transient ischemic attack. Other factors include age, gender, and if the patient has sleep apnea.

Medical professionals often assign a number to each of the primary risk factors to arrive at a score called CHA2DS2-VASc. The risk score is used to define a treatment plan, including prescription of medications such as anti-coagulants.

Is endurance exercise a risk factor for producing an Afib event?

Is there such a thing as exercise-induced AF? “Yes, for some people, exercise can be a risk factor, ” according to Dr. Saluck.

“There is a thought that in athletes whose resting heart rate is too slow, exercise can induce an afib. A normal heartbeat, over 50 bpm, suppresses other irregular heart beats. However, if the sinus heart beat, that originating from the sinus node of the heart, is low, the irregular heartbeats can take over.”

Planning To Start Triathlon But Have Afib?

“The potential risk of exercising with AF is heart failure, ” stated Dr. Saluck. “As you demand more oxygen to the heart, the heart is not relaxing normally. When you are in afib, you lose the atrial kick that normally occurs when the top part of the heart, called the atrium, contracts during the peak filling of the ventricle. That extra little contraction improves the cardiac output by 15 to 20%.

“When you are not in a normal rhythm, that is in afib, you do not have the normal contraction of the sinus node. When the atrium does not contract, you lose the extra 15 to 20% efficiency. A person with afib can go into heart failure because of this.”

A person diagnosed with afib should check with their doctor before beginning triathlon training.

According to Dr. Saluck, “a patient with afib who is considering triathlon should have an electrocardiogram (EKG or ECG) and an echocardiogram, which is a sound wave picture of the heart. These will ensure that the structure of the heart is intact and that there are no valve problems with the heart which can cause the afib, such as a mitral valve regurgitation or aortic valve narrowing (stenosis), something older adults are more likely to exhibit.”

“A lot of times, afib is a marker for underlying ischemia or decreased blood flow to a heart artery. So, if the patient has risk factors in the family and has afib, I might want to do an exercise stress test by putting the patient on a treadmill to see how their endurance is and what their heart rhythm response is to exercise.”

“We also want to make sure their electrolyte levels are okay and check their thyroid to make sure it is not off.”

Depending on the patient, their initial results, and their history with endurance sports, including the distances and duration of the events, these tests may be repeated yearly or less frequently. “If everything with the initial tests is normal, the patient is probably good for five years.”

Managing Afib While Training For And Competing In Triathlon

Plenty of men and women diagnosed with AF take part in endurance sports, such as triathlon. Applying the advice of their primary physician or cardiologist means they can derive the benefits of exercise while minimizing the risks associated with the condition. Here is an approach for managing these risks.

Be Aware of Afib Related Signs and Triggers

While training or racing, listen to and look at your body for signs of AF. For example, are you feeling shortness of breath? Do you feel fatigued? Are legs becoming swollen? These could be warning signs of heart failure.

Not all the sports of triathlon may pose equal risk. A May 2023 publication in Clinical Journal of Sports Medicine reported an association between swimming and AF. In their paper titled AFLETES Study (Atrial Fibrillation in Veteran Athletes and the Risk of Stroke), authors Pallikadavath et. al. wrote, “This is the first study to demonstrate that swimming was associated with an increased risk of AF when compared with other sports and after adjusting for lifetime exercise dose.”

According to Dr. Saluck, this finding may be consistent with the ‘divers reflex’ phenomenon. The ‘divers reflex’, or mammalian diving reflex, is a common response of all mammals to entering cold water. One result is a drop in heart rate. This happens when, with swimming, a person first enters cold water. If the heart rate is already low, as is likely for trained athletes, the irregular heartbeats can take over.

While training, pay attention to your body and learn its response to the unique stress from each of the sports.

Monitor Heart Rate and Heart Rate Signature

According to ActiveCor, maker of KardiaMobile ECG sensor, “Pushing too hard is the number one reason why exercise may become unsafe for someone with atrial fibrillation.”

Technology for monitoring heart rate has been available for many years and is even more widely accessible today.

According to Dr. Saluck, pay attention to how rapidly your heart rate rises at the beginning of exercise and how quickly it comes down after exercise. Normally, heart rate should rise slowly over three to five minutes. Once exercise has ended, it should drop considerably over one to two minutes.

Recently, companies including Apple, Samsung, Fitbit, and Garmin have come out with wearable devices having an FDA cleared ECG (electrocardiogram) function. While not a watch or wearable device, ActiveCor’s KardiaMobile is a small sensor device that connects to your smartphone to record an ECG.   

Start Hydrated and Stay Hydrated

Hydration level is critical to heart function and a common thread in many of AF triggers. As we become dehydrated, our heart rate naturally increases. Dehydration also contributes to an imbalance in electrolytes, particularly magnesium and potassium.

There is also a high association between alcohol and AF, especially for those who drink more than mildly. In addition to weakening the heart muscle, alcohol is also a powerful diuretic, contributing to dehydration.

Restful Sleep

Sleep apnea not only affects the quality of sleep but can also increase AF events. “As we age, we lose muscle tone. This can extend to the muscles in the throat, increasing the risk of sleep apnea,” says Dr. Saluck.

Manage Anxiety

“Mental stress and anxiety definitely increase your risk for heart rhythm disturbances. Anxiety in particular can change the hormonal receptors of the heart.”

Broken heart syndrome‘ is a stress-related phenomenon which can also cause AF. Sudden acute but stressful events, such as loss of a loved one, being in a car accident, or dealing with financial problems may trigger ‘broken heart syndrome’.

Stress, whether physical, mental, or emotional, must be managed for us to perform at our peak athletically as well as to control AF.

Conclusion – Can I Do A Triathlon With Afib?

A diagnosis of AF does not automatically mean a person cannot begin or continue with multisport endurance activities like triathlon, duathlon, or aquabike. However, it is important to involve your doctor and/or a cardiologist in the initial and ongoing discussion.

Cardiologist Dr. Brian Saluck offers a few key recommendations. First, hydrate well before starting and then stay hydrated with electrolytes throughout the training session or race. He also recommends wearing a heart rate monitor to make sure their heart rate does not go too high outside its normal range. If your heart rate goes high or you don’t feel normal, take a break.

Acknowledgements

Thank you to Dr. Brian Saluck, Citrus Cardiology Consultants, P.A. for contributing to and reviewing this post.

Share Your Questions and Comments Below

Do you have questions about doing triathlon with afib which were not answered? Did you find the information in this post useful? Let me know in the Comments below.

Comments: Please note that I review all comments before they are posted. You will be notified by email when your comment is approved. Even if you do not submit a comment, you may subscribe to be notified when a comment is published.

Combining Camping and Triathlon

Growing up, I had a full range of camping experiences. My parents, my siblings, and I started with a tent, graduated to a pop-up trailer, and then to a pull-behind trailer. Actually, we camped in several pull-behind trailers, each longer than the previous one. I was fortunate to experience a lot of the USA during my youth in this way.

However, somewhere along the way, I fell out of love with camping. After marriage, Joy and I tried tent camping and camping from a conversion van with varying degrees of success. Allergies to tree pollen and almost guaranteed rain made camping a hit-or-miss experience.

But, I never gave up on camping completely.

Now, as I begin this post, I am sitting outside our rented RV in a KOA campground in northern Utah. It is 81°F with a light breeze blowing down the slopes of the Wasatch Mountains just to my east. Meanwhile, Joy, who came up with the idea for this latest run at camping, is sitting in the air-conditioned motor home.

Our Experiences Camping With a Triathlon

The idea of camping at or near the triathlon venue has been appealing. This was especially true if it meant less travel the day before and the day of the triathlon. Even without this benefit, camping meant being able to eat more ‘home cooked’ meals.

We had planned to tent camp at Lewis Creek County Park before the Best in the West Triathlon Festival outside Sweet Home, Oregon. However, as I reported in the post about this triathlon, we abandoned this idea because of the high temperature in early September.

Three years later, during our six-week road trip through the southeast part of the USA, we did camp using a tent.

Not surprisingly, it rained during the two-night stay at our first destination, outside Logan, Ohio, where I did my Ohio triathlon. To be fair, we followed this with two lovely nights of camping in Kentucky. Okay, it doesn’t always rain when we camp.

However, given the high temperatures in late September and early October further south, we left the tent in our van for the rest of that trip.

Our tent at the KOA Campgrounds outside Logan, Ohio, location of the Hocking Hills Sprint Triathlon. Our tent included two blow-up beds, a fan, and Joy’s special toilet, complete with a ‘Dora the Explorer’ seat. Let us know in the Comments below if you want more details. Joy will be happy to share these.

A Newer Experience – Motorhome Camping at a Triathlon

Our latest adventure of camping around a triathlon occurred last summer. This time, we rented a 24 foot Class C motorhome from a private party in Logan, Utah. For two weeks, the motorhome was our home.

From Logan, we drove to Truckee, California, for the Donner Lake Triathlon. It was at this triathlon that we stayed (for free) in a grassy parking area within a hundred yards of the transition area for the race. We both really enjoyed this.

After the race, we drove back to southeastern Idaho for the Preston Triathlon and Seeley Lake, Montana for the Seeley Lake Triathlon. You can read more about our camping adventures in the posts for these two triathlons.

What We Have Learned About Camping and Triathlon

Here are three things we have learned in our efforts to combine racing in a triathlon and camping.

1. Camping at the location of the race is convenient

While I have not polled the group, I am sure that triathletes are mostly early risers. I am an early riser; my wife, not so much.

Rising, checking out of the hotel, and driving to the race location, all in the dark, is what we do. And, it is the cross my wife willingly and cheerfully bears for being married to a triathlete.

It was incredibly convenient to awake on race day at the race venue. After setting up my transition area, I went back to the motorhome and enjoyed a protein smoothie and coffee while counting down the time for the race to begin. Meanwhile, Joy slept.

After waking, she watched through the back window of the motorhome while lying comfortably in bed as we completed the swim leg of our triathlon.

Camping at West End Beach in Truckee, California, in a rented RV. Joy watched the swim leg of the Donner Lake Triathlon from the comfort of our bed while peering out the back window of the motorhome. She was a ‘happy camper’.

2. You won’t necessarily save money

We paid for the tent through savings in the cost of hotel rooms while traveling to compete in the Ohio triathlon. The story is much different for the motorhome.

Motorhome camping is clearly more comfortable than tent camping. With air-conditioning, we slept well in the motorhome no matter the outside temperature. Since arriving well rested on race day is important, this is a plus.

There is also the benefit of eating food that we prepare. This is both more healthy and less costly. The gas stove and refrigerator in the motorhome made this convenient.

On the other hand, motorhome camping is expensive. The unit we rented averaged nine miles per gallon (mpg) compared to 25-30 mpg for our van. This was when gasoline was $5 to over $6 per gallon.

Add to the cost of the additional fuel, the costs of renting the unit, and parking it at campgrounds with electricity and water hookups, and we spent $250 to $300 per day for the convenience of a motorhome.

3. Camping leads to a new triathlon experience

Even though most triathlons do not offer an option of camping at the race venue, there are still wonderful benefits of camping nearby. It is a treat to be outdoors, exploring new areas of nature with its diverse fragrances, sounds, plants, birds, and other animals.

Once we get away from the city lights, it is wonderful how vast the night sky appears.

Camping along with a triathlon is another way to see God’s handiwork up close. I took this picture from Salmon Lake State Park (Seeley Lake, Montana), where we camped three nights before the Montana triathlon.

You Might Want to Try Camping and Triathlon

The more I travel, the less appealing hotels become.

As you plan your races for this season, you may want to think about camping at or near the race venue. Clearly, there are benefits.

Contact the race director to see what options for camping exist, especially for races held in city or county parks.

Have You Combined Camping and Triathlon?

Have you camped at the triathlon venue before the race? What has been your experience with camping while traveling for a triathlon?

Please share your thoughts and experiences with us in the Comments section below.

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Becoming a Confident Open Water Swimmer

Lack of confidence in swimming in open water is one of the top reasons seniors give for not doing a triathlon. This post contains advice from other seniors who have overcome their fear of open water swimming to finish many triathlons and open water swim races.

Background

In early 2021, I conducted a survey about triathlon’s greatest challenges for seniors, both beginners and experienced triathletes. Nearly one of four respondents identified concern about the swim as a challenge.

My recent conversation with Pat and Joan Hogan about their triathlon journeys reminded me of this statistic. Fortunately, many seniors, including Joan Hogan, have “slain that dragon” to go on and compete in triathlons.

How have they done this?

Approach

I asked three experienced senior triathletes who previously struggled with the open water swim how they had become more confident in open water. The three who generously and openly shared their experiences and advice, making this post as insightful as it is, are (in alphabetical order of last name):

Here is what I heard them say.

Some Discomfort With Open Water Swimming Is Normal

“You are not alone” was a common phrase I heard during my conversations with Nikki, Donna, and Paul.

The first step is to realize that some anxiety about open water swimming is normal. Truthfully, fear is beneficial when it causes us to avoid self-destructive actions and unnecessarily dangerous situations.

Donna recalled watching from a boat the swim leg of a half Ironman triathlon whose swim was in Savannah River. She was amazed to see the number of triathletes who were on their back, hanging onto a kayak (which is allowed by USAT rules), or showed other signs of struggling.

Swimming is the most technical of the three disciplines of a triathlon. While it requires fitness and endurance, the technique, which includes how your hands and arms enter the water and your posture throughout the stroke, is key to a comfortable swim.

Ways to Develop More Confidence as an Open Water Swimmer

Nikki, Donna, and Paul prove you can become a confident open water swimmer.

What is the secret? Following is the picture they painted as they related their experiences.

First, Become Confident in the Pool

The three contributors to this post each mentioned the need to become confident swimming in a pool before heading into the open water.

What this will require depends on your experience with swimming. Some, who never learned to swim as a child, will need to start from the beginning, often with lessons. (If you are starting from the beginning, the first goal is to learn proper breathing.)

Others will develop confidence by swimming with a Masters swim or triathlon club. For others, hiring a swim coach to help them develop a more efficient swim stroke or kick will be the answer.

Paul said that when he was learning to swim, putting on flippers helped him to get enough forward momentum that he could focus on coordinating his arm movement and breathing. Once breathing during the swim stroke felt natural and relaxed, he put the flippers aside and focused on kicking.

Practice Sighting in the Pool

Once you enter the open water, you will no longer have the lines at the bottom of the pool to follow. So, while you are still in the pool, begin to practice ‘sighting‘.

Sighting is an essential part of the open water swim stroke during which you lift your head out of the water to check your location and surroundings. During a triathlon, proper sighting will keep you on the shortest course to the next turn buoy or to the swim exit.

Stay Focused

Even as you develop confidence in the pool, remember to stay focused on what you are trying to accomplish in each session. Avoid daydreaming.

Whether you are learning to swim or training to improve your stroke, focus is key to becoming a more efficient swimmer.

swimming with experienced swimmers is a path to becoming a more confident open water swimmer.
Joining a swim class or group that swims together regularly will help you improve both confidence and skill as a triathlon swimmer.

Practice with race day nutrition

We often think of muscle cramps as an issue for runners. However, cramps have ended a race for many a triathlete during the swim.

While swimming in the pool, learn of any issues you have with cramps. Some people experience these in their calf or foot muscles. Others can experience them in their lower back. I remember a cramp in one of my hamstring muscles cutting a swim session short.

For most people, preventing cramps is a matter of paying attention to nutrition and hydration before a swim.

Being adequately hydrated before the swim is a must to prevent cramps. Others benefit from eating a banana (potassium) or taking an anti-cramp supplement (e.g. GU gel with electrolytes, Hammer Nutrition Endurolytes) thirty minutes before swimming.

Next, Practice in Open Water

Your next goal is to swim in the open water.

A first principle of triathlon is “never do anything for the first time on race day”. This is especially true for open water swimming.

Start with a short distance. However, aim at eventually swimming a distance at least two times that required in your next triathlon.

If possible, complete this swim in different weather and water conditions. For example, don’t swim only if the water is calm. Practice swimming with wind and more choppy weather. You should even practice sighting with the sun in your eyes, a common situation during early morning races.

If the race will be in the ocean, practice getting past the breaking waves near shore by swimming through them.

Get the Right Gear

Arming yourself with a few items can eliminate some common sources of anxiety. Others can make you more visible while you are sharing the open water with boats and personal watercraft.

Besides a pair of good fitting goggles, including one pair with tinted lenses for those times when you are swimming into the sun, two must-have items for open water swim practice are:

While more expensive than these two items, a triathlon wetsuit is another wise investment. A wetsuit is great when the water or air temperature is cold. In addition, it adds buoyancy to keep your legs at the top of the water, making this one less thing with which to concern yourself.

Join Others to be More Confident as an Open Water Swimmer

When you first swim in open water, do so with other people. If possible, find a triathlon or swim club. If this doesn’t work because of where you live, find a place where experienced swimmers go, such as a public beach, and go with a friend.

Swim only in areas where swimming is specifically allowed. Swimming in “any old place” can mean swimming with unfriendly critters such as alligators, snakes, and jelly fish.

An ideal place to swim is at a public beach with lifeguards. According to the United States Lifesaving Association (USLA), the chance of a person drowning while at a beach protected by USLA affiliated lifeguards is 1 in 18 million.

Swim back and forth between lifeguard towers or, if there is only one, within the distance the single lifeguard covers. You can even inform the lifeguard of your situation.

Then, if possible, swim in water no deeper than that in which you can stand. This will eliminate another possible source of anxiety.

Ways to Maintain and Even Build Confidence in Open Water Swimming

Even after you have become confident in the open water, it is essential that you follow safe practices.

Nikki told me that before she heads out for a swim in the ocean or nearby Chesapeake Bay, she checks the surf forecast for the beach at which she plans to swim. In particular, she looks at the forecast for rip currents and wave height.

“I might still swim if there are waves a couple of feet, maybe more, but that changes the dynamics of the swim. I might not swim a mile but will be happy to work on my sighting, breathing, and other skills. I have actually found it to be quite fun and inspiring to see my skill level increase when swimming in more challenging water conditions.”

To learn more about rip currents, how to identify them, and how to swim in water where they are present; watch this short but information-packed video presentation by a representative of the National Weather Service.

Nikki’s comments on the benefit of swimming in different weather conditions and bodies of water (lakes, rivers, ocean) were echoed by Donna and Paul.

Other advice from the three for growing your confidence in the open water is:

  • Swim in open water every opportunity you have.
  • Continue to improve your swim fitness and technique. Learn to swim more efficiently. This does not have to mean swimming faster, but with less effort, using less energy because you are more efficient. Feeling out of breath, on the other hand, can bring on panic.
  • Finally, train yourself to mute any negative voices in your head. Some swimmers count from 1 to 100 over and over. Others sing. Do what works for you to stay calm.

“Do the thing you fear to do and keep on doing it… that is the quickest and surest way ever yet discovered to conquer fear.”

Dale Carnegie

Race Day Tips

Race day can present its own challenges. There is the almost inevitable contact with other swimmers. A race can also unleash an adrenaline-driven desire to keep up with or pass other racers.

Ways to mitigate these are:

  • If possible, swim in the open water of the race in the minutes leading up to the start of the race. This falls into the category of minimizing surprises that can come from:
    • Knowing the condition of the water in which you will walk into and swim. Are there sharp or slippery rocks on the way into the water? Are there weeds that I will touch when swimming? How quickly does the bottom drop-off?
    • Kick-starting your heart rate. If your heart rate spikes when starting fast, a pre-race swim will help prevent this.
    • Getting wet. The pre-race swim gets any shock of first entering the water out of the way before the race starts.
  • If there is a wave start, position yourself to one side of other swimmers or at the back of the pack.
  • Find and get into a rhythm as quickly as possible and stick to it. Stay calm. Nothing goes well when you tense up. This is just as true for swimming as it is for other sports.
  • Try to swim near others you can follow. As long as they stay on course, you can follow them, which reduces the amount of sighting you must do.
open water swim start at the California triathlon
Since I had arrived at the higher elevation (7,000 feet or 2,100 meters) of this race only two days earlier, I started near the back of the wave. Picture courtesy of Lefrak Photography.

Resources for Becoming a More Confident Open Water Swimmer

Nikki, Donna, and Paul told me of the resources they have found helpful in becoming and staying confident while swimming in the open water.

Thank You

Thank you to Nikki, Donna, and Paul for sharing your time and insights that are the basis for this post.

If you found this article useful, please add a Comment to thank them.

Is There More You Need to Know to Become a Confident Open Water Swimmer?

What questions do you have? Are there other tips you have learned for becoming a more confident, open water swimmer?

Or, have you found other resources for developing confidence in the swim leg?

Comments: Please note that I review all comments before they are posted. You will be notified by email when your comment is approved. Even if you do not submit a comment, you may subscribe to be notified when a comment is published.

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Planning For A Triathlon At Higher Altitude

How can you prepare for racing in a triathlon or other multisport endurance event that is at a significantly higher altitude than where you live and train?

While crossing the USA to complete a triathlon in every state, I have raced in western states, where the altitude on the courses was between 4,000 and 7,000 feet above sea level. Having trained in areas well below this, between sea level and 1,000 feet, I felt the effect of the altitude on race day.

Related post: Triathlon Across the USA: State #22 – New Mexico

Santa Fe, New Mexico sits at around 7,000 feet elevation. This picture was taken in the city’s art district.

What Happens When We Travel to Higher Altitude

As pictured in the chart below, the most important change is that the amount of oxygen in the air effectively decreases with altitude.

The people at APEX (Altitude Physiology Expeditions) describe it like this:

“At real altitude (in the mountains), the barometric pressure of the atmosphere is much lower than sea-level environments. The result is that oxygen molecules are spread further apart, lowering the oxygen content of each breath.”

While each air molecule contains the same amount of oxygen no matter the elevation, the density of air molecules decreases with altitude. This effectively reduces the oxygen content.

In other words, we draw in fewer air molecules with each breath at high altitude compared to a lower one. Each breath provides less oxygen for our muscles to burn fuel and create the power to move us through the water or along the road.

The result is that for a particular rate of perceived exertion (RPE), we will have less oxygen with which to power our muscles. We aren’t able to swim, bike, or run as fast as we are with more oxygen.

information about effective oxygen content with altitude for a triathlon at higher altitude
Effective Oxygen Content vs. Altitude (Data Sources: Mile High Training, Altitude Dream.com).

How I Selected the Altitude Range For The Graph

The 106° West Triathlon, first (and apparently only) held in 2016, was touted as the ‘Highest Triathlon in the World’ held at an elevation of 9,156 feet (2,791 meters). This race included quarter and half distances of the IRONMAN 140.6.

Let me know in the Comments (below) of any triathlons held at an altitude higher than this one.

Dealing With Altitude: Acclimatization and Adaptation

Two words – acclimatization and adaptation – are used to describe what happens when we travel to a higher altitude.

Acclimatization

Acclimatization refers to the immediate and short term (up to two weeks) changes that occur with altitude.

This process begins immediately upon arriving at the higher altitude. The effect we recognize as breathing harder is called ‘respiratory alkalosis’.

Within a day, the hemoglobin concentration increases. We do not have more red blood cells at this point. However, the liquid component of our blood, the plasma, decreases to normalize the oxygen content in our blood. Lower oxygen content divided by lower plasma volume equals normal oxygen concentration (but not volume) in the blood.

Acclimatization continues over about two to three weeks.

Adaptation

Adaptation describes the longer-term effects, ones that take place over several months.

With extended time at altitude, our body will produce additional red blood cells through the production of the erythropoietin (EPO) hormone. Increasing the number of red blood cells increases the amount of oxygen available to our muscles and other organs.

It takes months, typically eight months according to what I have read, for the body to produce all the additional red blood cells and for adaptation to be complete.

‘Sleep High, Train Low’

There is evidence that the ideal adaptation comes from sleeping at high altitude (between 6,600 and 8,200 feet, which is equal to 2,000 and 2,500 meters) and training at or near sea level.

Sleeping high leads to an increase in hemoglobin. Training low allows for more intense training to increase the key parameter for endurance, VO2max.

How Does Age Affect These Changes?

As seniors in the multi-sport community, we know that age changes the way we train compared with our younger competitors. But, does altitude give us an advantage or create a disadvantage on race day?

Altitude may be one of the few factors that are on our side. According to a report titled Effect of High-Altitude Exposure in the Elderly, age does not seem to be a factor in adjusting to the higher elevation. According to the authors of this study:

“Fortunately, the elderly appear to acclimatize well and after 5 days of acclimatization were physiologically almost indistinguishable from sea level. Thus, aging does not appear to impair the physiological adaptive response to either acute or chronic hypoxia, even in the presence of substantial comorbidity.”

Beautiful mountain view with the caption 'Racing at a higher altitude can mean experiencing some of the most awe-inspiring places on this planet.'
Racing in a triathlon at a higher altitude can mean experiencing some of the most awe-inspiring places on this planet.

What Can You Do To Prepare For A Triathlon At Higher Altitude?

The audience for this post is beginner and intermediate age group athletes. Therefore, I am assuming you will not invest the time and money for training at an altitude camp for several weeks.

However, even if you do, there is no guarantee of increased performance, according to many coaches and scientists. Some people do not adapt. And, the training must be tailored to the individual for it to have significant benefit. (Continue reading for more information on high altitude training.)

Nevertheless, there are ways you can prepare for a triathlon at a higher altitude.

1. Arrive at the race altitude from 2 to 14 days before the race

In a paper titled “Timing of Arrival and Pre-acclimatization Strategies for the Endurance Athlete Competing at Moderate to High Altitudes”, authors Robert F. Chapman, Abigail S. Laymon, and Benjamin D. Levine (see the complete reference in the quotation below) conclude that arriving at the race altitude 14 days before the event is the most ideal. However, they also acknowledge that this amount of time will not be practical for most, given the cost and other responsibilities related to family and work.

Arriving the night before the competition, on the other hand, is a risky strategy. This is especially true if you suffer from any disruption in sleep, a critical component of acclimatization.

While longer is better, 2 to 14 days before the race at the altitude of the event reduces performance declines. This comes from settling into a consistent pattern of quality sleep and reducing the deleterious physiological effects of altitude, such as a reduction in plasma volume.

Performance decrement at altitude appears to decline with each day of altitude residence (up to ~14 days).

Chapman, Robert F., Abigail S. Laymon, and Benjamin D. Levine, “Timing of Arrival and Pre-acclimatization Strategies for the Endurance Athlete Competing at Moderate to High Altitudes”, High Altitude Medicine & Biology, Volume 14, Number 4, 2013, pp. 319-324.
Hungry Horse Reservoir and Dam near Glacier National Park in northwestern Montana. By the time I competed in the Montana triathlon, I had stayed above 5,000 feet elevation for over two weeks.

2. Pay extra attention to factors that degrade at altitude

This is in line with the previous point, but worth repeating.

First, stay hydrated. Along with lower effective oxygen, higher altitude also means lower relative humidity of the air. Therefore, fluid loss is greater than in higher humidity regions.

Also, the higher altitude may compromise your sleep. According to this TrainingPeaks article, getting sleep during the initial time at higher altitude can be difficult for some. Some people initially suffer from acute mountain sickness (AMS). Symptoms of AMS include headaches, nausea, dizziness, and fatigue.

Give yourself time to become rested.

3. Pace yourself on race day

According to an article in Triathlete magazine, our VO2max decreases by 7.7 percent for every 1,000 meters of altitude. If you are able, go for a swim, bike, or run before the race to get a sense of how the altitude is affecting your performance. Otherwise, plan to go out slower to avoid having your body put the brakes on unexpectedly.

Remember to ease into the altitude and pace yourself as your body becomes acclimatized.

4. Train to offset performance declines that come with altitude

As we just read, our VO2max decreases with altitude even after several days of acclimatization. However, one strategy for mitigating the decline is to increase your VO2max.

In the last weeks before traveling to the higher altitude, perform harder sessions, like hill repeats, at your typical training altitude. These will simulate the feeling of working harder that will accompany racing at higher altitude.

If you want to learn more about the ins and outs of training at high altitude, I recommend listening to this podcast from Fast Talk Labs.

Final Comments

The human body is amazing in its ability to adapt to different environments. However, the comments on various websites and in academic research papers continually remind me we are all different.

Be sure to discuss with your coach or your doctor any plans to race in a triathlon or other multisport endurance event at higher altitude.

What Has Been Your Experience With Racing At Higher Altitude?

Please share in the Comments below what you have learned about training and racing in a triathlon at higher altitude?

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