Training Archives * Page 3 of 14 * Senior Triathletes

Can I Do Triathlon With Afib?

Terry VanderWert on October 31, 2023

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.

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How To Build Confidence For Triathlon

Terry VanderWert on August 16, 2023

confidence in triathlon comes from crossing the finish line and completing a triathlon

Triathlon is much more enjoyable when we approach it mentally prepared and with confidence.

I’m sure that New York Yankees Hall of Fame catcher Yogi Berra would agree. Undoubtedly, had he been a triathlete, Yogi would have confidently said, “Triathlon is 90 percent mental. The other half is physical.”

Confidence is Part of Mental Toughness

In multi-sport endurance competition, confidence is an athlete’s belief in their ability to perform well and successfully complete the physical and mental challenges of the sport. Confidence includes the self-assurance and positive mindset that carries an athlete into and through the event.

An athlete’s confidence not only affects their performance but also their overall experience. Athletes who approach a race with confidence are more likely to perform at their best. They are ones who push through challenges and derive more satisfaction from their efforts, regardless of the outcome.

In short, confident athletes perform better and have more fun.

Assessing Your Confidence

In The Champion Mindset: An Athlete’s Guide to Mental Toughness, Dr. Joanna Zeiger shares personal lessons about the mental component of sports competition. Beginning from her rocky start as a seven-year-old swimmer, she describes how mental toughness has been key to her experience as an amateur, later professional triathlete who finished fourth in the triathlon at the 2000 Olympic Games.

If you are interested in getting an assessment of your confidence today, take Dr. Zeiger’s free Sisu Survey. Your answers to the questionnaire will be used to measure your confidence and seven more components of mental toughness.

How Can Senior Multi-Sport Endurance Athletes Increase Confidence?

If you want to improve your confidence, here are several ways to accomplish it. Some ways may apply to you, while others may not.

Prepare Physically

This is the belief in one’s physical fitness and training preparation. Athletes who are confident in their physical abilities are more likely to believe they have the stamina, strength, and conditioning to endure the demands of the event. From my experience, consistent, structured training leading up to a race is a real confidence builder.

If, like many triathletes, you have a weaker leg that causes some anxiety before a race, make sure you train to improve it. For example, my weakest leg has always been the run. For this reason, I have spent more time reading about run training and training for the run than on training for the swim and bike. Of course, I regularly swim and bike. However, the time spent running, including after a bike workout, is about twice that spent on the others.

Two keys to getting the most from your physical training are:

Train wisely to avoid injury. Set realistic expectations, increase training stress gradually, get enough quality rest, and eat well.
Keep a training diary or log. Documenting your training progress will build confidence. It may also show when you need to rest or when other things in your life are affecting your training. Remember, your body treats all stress the same. Your total stress on any day is the sum of stress from physical activity, mental tasks, and emotional challenges.

Have the Right Attitude

How do you feel about being able to handle the psychological challenges that come with multi-sport endurance events? You can feel more confident when you have set and managed your expectations for the race and learned to manage discomfort, fatigue, and self-doubt.

Thoughts are the most effective weapon in the human arsenal. . . [I]t is powerful to realize that goals are reached primarily by establishing the proper state of mind.
David Miller, AWOL ON THE APPALACHIAN TRAIL

For every one of the community of triathletes over age 50 who train for winning in triathlon, many more train to complete their triathlon. Sure, we all like to win. However, our greater desire is to remain physically active, benefit from the social aspect of the sport, and grow mentally as we learn something new.

According to Experiences of Older Adults Preparing for Their First Triathlon: “A Qualitative Study of the Participation in an Endurance Training Intervention”:

“In Scandinavia, there is a general tendency for . . . older adults today to exercise and compete in sports including triathlon. [F]or most active people today, endurance exercising is more about ‘completing’ than ‘competing’.“

Weekend-warrior athletes can feel perfectly comfortable setting their primary goal to complete the triathlon.

Plan Your Race

You will be more confident entering a race if you have a clear plan for pacing, nutrition, and hydration. You will also be more confident if you are sure that the gear you will use is in good condition and comfortable. The adage ‘Never use something for the first time on race day’ is solid advice.

Familiarity with the course and its conditions will also boost your confidence. My typical pre-race ritual is to drive the bike course, or better yet have my wife drive, to observe the road conditions (e.g. potholes) and its turns. Then, during the race, I will be more relaxed during the ride.

Confident triathletes are also adaptable. It helps to believe you can handle unexpected challenges that might arise during the race. Training in less-than-ideal weather conditions, which could be present on race day, is one way to increase adaptability. Practice changing a bike tire with a race mindset. You will ride with more confidence.

Raining before a triathlon. Training in inclement conditions, at least ocassionally, can build confidence for completing a triathlon in less-than-ideal weather. — Training in inclement conditions, at least occasionally, can build confidence for completing a triathlon in less-than-ideal weather.

Build on Previous Success

Success breeds success. Past successes in training and in previous races build a foundation of confidence. If you are training for your first triathlon, consider setting up a mock course representing the distance and topography. Complete this course one to two weeks before your first race.

Think hard before signing up for a race on a course with conditions that will work against you being successful. For example, is the course especially hilly but you have trained on flat terrain? Is it at a higher altitude than you live and have trained? Is the weather where the race is being held typically hotter or colder than you are comfortable?

Give yourself an opportunity to be successful under the known or most likely conditions for a race before ‘diving in’.

Within a day or two of completing a race, review its results and your experience, preferably with a friend or coach. Make note of things you did well and those for which you will better prepare for your next race.

Leverage Your Support

Having a strong support network can also enhance a triathlete’s confidence. Knowing you have family, coaches, teammates, and friends who believe in you and are cheering you on adds to one’s confidence.

What Do You Think?

Are you a confident triathlete? If so, what have you learned about confidence in your triathlon journey? What helps you be more confident on race day?

Share your thoughts and comments below.

Affiliate Disclosure

Restarting To Bike After A Crash

Terry VanderWert on July 19, 2023

A bike crash, whether it involves another vehicle or not, can be traumatizing, It can end one’s triathlon career even if the physical wounds heal.

This post is meant to answer a question from a member of the Senior Triathletes community about restarting to bike after an accident with injury.

Restarting to Bike After a Crash Can Be Physical and Emotional

One of Our Community members, Marty Hunter, knows too well how devastating a bike crash can be. She wrote the following when I asked our readers to share topics about which they would like to learn:

“[I am e]xperiencing difficulties recovering from a bike accident. Wondering what other athletes did to cope.”

Here is the background.

Training for Ironman Arizona in 2021, Marty fell on her bike while clipped into the pedals. A femur was broken in the fall, After surgery to repair it, she went through a period of walking with a cane and through many physical therapy appointments.

Even after healing physically, Marty has not recovered emotionally. She has ridden on a trainer but struggled to ride her bike outdoors on roads or trails. She told me “mentally, I’m mush”.

I am rooting for Marty to realize her dream of completing Ironman Arizona. So, I tapped into the experiences of others in our community who have been through this process of recovering from a bike crash. I am hoping their advice will help Marty return to training and racing.

Advice from Coach Jenn Reinhart

The first one to offer help was Senior Triathletes coach Jenn Reinhart. She is familiar with recovering from a bike crash having experienced a few, including being hit by a car, during her triathlon career.

Jenn and Marty spoke, after which Marty shared what she had learned from Jenn.

“Jenn found the right words to cut through my anxiety, especially my fear of being too old [to pursue my Ironman goal]. I tend to look way-way too far ahead instead of celebrating smaller but no less significant triumphs. 140.6 miles [of the Ironman] is huge. However, an 800 yard swim, 25 mile ride, and three to six mile run are totally doable. Each of these is great on it’s own. Being able to thread them together will be a mental podium finish for me.

“The basics are what I need to return to. Just get on the bike without any pressure for distance or pace at this time. Get confidence back for clipping [biking shoes] in and out. Eventually get the legs ready for power drills on the trainer.”

Advice from Other Senior Triathletes

I also spoke with two senior triathletes, Donna Maquire and Gene Peters. Both are Ironman finishers and have been injured in a bike crash.

Donna Maquire

During a triathlon in 2022, an impatient driver decided to turn when he should have waited. Because the bike course made a left turn, Donna was slowing down. These two factors – the car moving at a still low speed while accelerating from a stop and bikers slowing down for the turn – led to Donna ‘bouncing off’ the car’s side.

While her bike was undamaged, her back was fractured in three places. This was the beginning of nearly a year of back-pain as the back bones mended and aggravated discs were treated.

Within a couple of weeks of the accident, Donna was able to ride inside on the trainer. Four months after the crash, she did her first ride outside. This ride was not long and in her neighborhood where traffic is light and slow. She has continued to ride longer as time went by.

Given her experience following the crash, she does most of her training rides on a relatively flat trail near her home. She still struggles with pain when riding on hills.

Donna’s advice for Marty is to get back on a bike or trainer. When outside, never ride alone and always stay alert for cars. She uses a rear view mirror mounted on her glasses and a Garmin Varia radar that detects traffic from behind her.

She added, “Go slow. Increase the distance you ride a little at a time. And, be patient. As you ride more, you can expect your fitness and confidence to improve.”

Gene Peters

Gene Peters (look for his story here soon) told me of his experience while on his first ride after moving to Park City, Utah. During this ride, he collided with a car. In the accident, his back was broken in two places.

How did he get back to riding after healing?

The first time out after recovering, Gene rode less than six miles, enough to get comfortable riding.

Gene says that he is always concerned about cars, but realizes that there are some times when you can’t avoid riding with them around. This is another reason he does a lot of this bike training on the Computrainer his wife bought for him.

My Experience With Clip-In Shoes

I have not been in a serious accident with my bike. However, I have fallen twice during races, once because I was clipped in the pedals and unable to unclip quickly enough.

My first fall, at my Rhode Island triathlon, occurred because of a flat front tire.

I fell a second time, at a triathlon in Arkansas. This time, the fall was because I was not able to unclip my shoes quickly enough after the chain came off and jammed between the wheel and sprocket.

Interestingly, upon returning to the transition area after the bike leg of this triathlon, I saw another racer use traditional pedals with a toe cage (not clip-in) with his triathlon bike. I followed this example for the next several triathlons.

Besides making it easier to get in and out of the pedals, this configuration eliminates time in T2 to put on running shoes.

One qualifier: I am not sure this is valid for longer distance races. However, it can be helpful for restarting to bike after a crash.

Conclusions

A bike crash, especially one with an injury, can produce a major setback in one’s triathlon training. However, in most cases, it need not be career ending.

The concensus among other senior triathletes for restarting biking after a crash is to begin by getting on the bike for short rides. Ride in a safe area. And, if appropriate, use equipment that makes you feel safe, such as pedals and normal running shoes instead of clip-in shoes and pedals.

While you are regaining confidence riding outdoors, build your biking endurance using a bike trainer or stationary bike. Eventually, you will be able to put the bike handling and bike fitness pieces together.

Comments

What advice do you have for restarting to bike after a crash? Share your comment below.

How To Make Triathlon Training Senior-Specific

Terry VanderWert on May 17, 2023

Kurt Madden a triathlete and triathlon coach over age 60, answers a readers question about senior specific training plans.

Triathletes over age 50 struggle to find senior specific triathlon training plans. This is the major reason for partnering with Our Coaches, each who are also senior triathletes.

The genesis of this post and my conversation with Senior Triathletes coach Kurt Madden was a question from one of our readers. Linda, a new female triathlete over age 60 wrote:

“How do you change a triathlon training program that is meant for everyone, to one that works for a female over 60?”

The Senior Triathletes’ Challenge – Finding An Age-Specific Training Program

Looking back over my time in triathlon, I appreciate the challenge of finding the right training plan. What part of a training plan found in a book or online is appropriate for an older athlete, or specifically for me? Or for us as we age from 50 to 60 and beyond?

This is especially true when the mainstream endurance sports writers consider a man or woman age 40 to be an ‘older athlete’.

As you will hear, Kurt knows firsthand how the needs of a truly older athlete differ from their younger self. In this conversation, he gives us principles to use in adapting generic training information and hints for preventing injury and maintaining an active life for the long term.

Stress plus rest equals growth.
Kurt Madden, “Over 60” triathlete coach and athlete

Coach Kurt Madden’s Advice on Making Triathlon Training Specific to the Older Endurance Athlete

Recording of my conversation with triathlon coach and senior triathlete Kurt Madden about how to adapt general training plans for athletes over age 60.

Milestones in our Conversation

If you don’t have time to listen to the entire conversation now, you can download it for later listening. You can also jump to a specific point within the conversation.

1:02 – Kurt’s answer to Linda’s question begins with three principles for adapting general training and exercise programs.
3:58 – What to look for in generic training and exercise plans.
7:22 – Best ways for those over 60 to prevent injury when training.
10:51 – Nutrition: How to – and how not to – fuel your body during a training program.
15:09 – Alternatives to trial and error in adapting general training plans.
20:29 – How to develop a consistent, sustainable exercise program.
27:17 – Kurt’s tribute to three senior triathletes from age 78 to 92.

It’s Time for Your Questions and Comments

What questions do you have for Kurt?

Of Kurt’s advice, what did you find most interesting or thought provoking?

Based on his comments, how will your approach to generic training and exercise programs change?

Post your comments below. You may also contact Kurt Madden directly using the email address on his profile page.