<p>Have any of you ever had this done for yourself or your young athlete, and did you find it at all worthwhile as far as designing or adjusting a training program?</p>
<p>We wouldn’t be considering it for general performance enhancement reasons alone, but to solve a specific and potentially detrimental problem.</p>
<p>The squash team I’m on does VO2 max uptake testing (in the form of a 1.5 mile run) regularly, until all members of the team are up to standard.</p>
<p>I don’t know what kind of problems it would solve though. Unless an athlete isn’t sure whether they need to get more fit, VO2 testing is not really going to tell them anything especially insightful.</p>
<p>Well, on ordinary days my daughter can finish and even win big races, but on hot days she hits the “wall” near the end and can’t make it to the finish line. We’ve eliminated all possible medical issues, and are wondering if she’s reaching her lactate threshold sooner on hot days. She’s apparently more heat sensitive than most kids and therefore might be requiring a lot of extra energy to run under those circumstances. First her legs burn and then they turn to jello and she collapses. She isn’t dehydrated or low in blood sugar, etc. and the only thing blood tests show is acidosis–hence the idea of a lactate issue. We want to determine if better anaerobic training (especially speed work) will help her make it through her race on tougher days, or whether this is just a metabolic limitation she has.</p>
<p>Have you checked her ferratin level? Not her hemoglobin, but actual ferratin percent. Much evidence out there for fatigue caused by excercise induced anemia. We’re in the middle of this with many of the distance runners on our team. PM me if you want more info/articles.</p>
<p>Has she participated in lactate testing to determine her heart rate zones? Does she train with a heart rate monitor? The formulas used to detrmine max heart rate and training zones are averages. Using the formulas, my max heart rate is approximately 20 bpm lower than the max I have actually seen while running.</p>
<p>We are taking her to have whatever testing our new sports physician thinks she needs (Lord knows she’s had numerous tests already), and certainly I think lactate testing is a must. But no, she’s on a high school team and they don’t use monitors or forumulas or anything like that.</p>
<p>The first person I thought about when I heard you explain your D’s problem was Danielle Tauro, a national HS champion who collapsed after our Footlocker race last fall. She ended up having Rhabdomyolysis. It is a condition that can occur in athletes under strain in which muscle membranes begin to break down. This causes potassium in muscle cells to leak out into tissue spaces while sodium and calcium build up within the cells. An accumulation of myoglobin prevents the kidneys from properly filtering blood. Different than a lactate problem or a VO2 issue, but maybe something to rule out?</p>
<p>From previous posts, she appears to be a serious athlete. I would definately get her a heart rate monitor. I got my D a Nike one last year. She wanted one that had a small watch (her criteria). At the time people were having difficulty with the polar watches and having to return them. My son has had a polar watche and really likes it. I got a cheap ($25) Sigma Sports one at performance bike that I use when I run. I find my HR runs higher when it is warm and/or very humid. Monitoring your heart rate when exercising keeps you from over training. There is a good article in Runner’s World November 2007 discussing over training. Also, if you have difficulty elevating you HR during a work out you may not be fully recovered.There are alot of books on HR training and lactate testing. You can only exercise at or near your max heart rate for so long. </p>
<p>When does she see the doctor?</p>
<p>Rachacha: Yes, we paid attention to the Tauro story when it happened. When I researched Danielle’s diagnosis, the information was confusing to me. Most sources seemed to indicate that rhabdomyolysis was a secondary condition caused by some injury. Also unclear was how you treat it or prevent it. Can a doctor shed some light please?</p>
<p>GolfingMom: My D does own a heart rate monitor, but we’re uncertain how to use it in the context of a program set for her by her high school coach. I’m hoping that if the problem is determined to be training-related, then the MD can prescribe a plan that the coach will be willing to adhere to since it’s coming from a medical professional rather than a child or her parent.</p>
<p>We go tonight! I’ll let you all know what happens. Thanks to everyone for being willing to help us.</p>
<p>Hello all. Well, I wish I could say the visit was extremely helpful, but it was a mixed bag. The good doctor had no clear insight into what is going on with her. He seemed a bit flustered over the absence of any evidence of a medical problem. He half-heartedly suggested (in a tone which implied he didn’t think it at all necessary) that if we wanted to, we could take some further diagnostic measures. They seemed a little extreme to me in the absence of any indication those things might be the source of her problem. For ex., we could have her test her glucose with a glucometer before, during and after exercise.</p>
<p>At that point in the visit, I think he wanted to go home for dinner (his wife called to see where he was), but I reminded him that we came to him because his practice is billed as a sports medicine and PERFORMANCE center. Therefore, we’d like some professional advice on how to improve her performance so she doesn’t need to go to the ER after every race. He then consented to perform the VO2 max test.</p>
<p>Now we have a number, which should be helpful to her coach. Based on the test results, it does seeem like she’s an overachiever who’s trying to race beyond what her body is currently capable of.</p>
<p>That’s a tough one–telling a kid not to try so hard. Thoughts anyone?</p>
<p>To continue…
We were hoping for some specific training advice, but the doctor did not seem well-versed on how to interpret the VO2 data. He was having to look through his file at articles on VO2 max and seemed uncertain.</p>
<p>Also, when my D was running on the treadmill for the test, it seemed to her (and to me) that she was running way faster than the pace the doctor said. For ex., when she was supposedly at 6:00 minute mile pace (which is a comfortable racing speed for her for an x-c 5K), her legs were moving so fast she seemed to be sprinting. Now I did consider that maybe it just looked fast because of the optical effect of the moving treadmill, but she also felt like she was running at a 5:00 pace instead.</p>
<p>In a race, my D feels fine one second, and then the next she feels horrible. She doesn’t get more than a second of warning before she’s beyond the point of no return. Also, she tends to run negative splits, and she is experienced enough not to go out really fast. So if she’s pushing herself beyond where she should, but she can’t feel it coming on or doesn’t know how to prevent it, then she needs some clearer guidelines like: Don’t run faster than x pace for the first mile, y pace for the 2nd mile, and z pace for the last mile or you’ll collapse.</p>
<p>So, I tried to get that from him. I asked what this means for a race. Should she hold back more on the first two miles and then speed up for the last? But he said, “Oh no, in a race you have to go all out.”</p>
<p>So where does that leave her?</p>
<p>GFG,</p>
<p>It sounds like you have done an excellent job of trying to root out the problem from a medical standpoint, and the good news is that it sounds like it is probably not a medical problem.</p>
<p>I would guess the problem is her training and racing strategy. From my experience, h.s. coaches coach to one athlete (usually the #1 runner), and everyone else is expected to follow along. The truth is that every runner has different needs as far as training and racing go. I’ve never heard of the “go all out” racing strategy for x-ctry. In fact, my experience is that it is all about proper pacing.</p>
<p>I’d recommend you hire a private coach to help figure out what she needs.</p>
<p>GFG, thought I’d share a couple of ideas, although my sense is that you have covered all of these areas. First, because you are dealing with a female, I’d look at her diet–things like making sure she is replacing lost electrolytes prior to resuming training/competition. Secondly, make sure she isn’t going overboard with proteins. Metabolizing protein produces extra heat and this could make a difference on hot days. Even slight changes in diet can have an impact on competition days. The body type of most female runners makes good eating habits crucial to successful, regular competition. XC is such a grueling sport and small bodies can suffer! Another thing to try is hyperhydration which means she would consume 2-4 cups of water about half an hour before running. Suggest this be started on a training day rather than a competition day. I know a young man who greatly benefited from this small change. He was afraid he’d get sick by drinking such a short time before running, but found it helped him when coupled with regular hydration during the school day. One must do both types of hydration.</p>
<p>I’m curious if she experiences the same problems on hot days when she is training, but not competing. I firmly believe one important element of running competively that is often overlooked lies between the ears! Please understand I am not making assumptions, here! Just know how crucial the mind can be when running competitively.</p>
<p>Lastly, as I’m sure you know, some runners simply do not have the same success on hot days as they do on cooler days. No real explanation for it except that their bodies simply don’t perform as well.</p>
<p>Good luck to you and your D. I have great respect for those who pound the pavement day after day, mile after mile. Not much glory in running, but I believe it teaches so many intangibles that benefit young runners for years down the road!</p>
<p>I would suggest a heart monitor that records and catches what happens when she passes out.</p>
<p>Also, I would try to get some blood work immediately after she passes out.</p>
<p>Does your D actually pass out or feel like she is going to pass out? You might ask about a tilt table test, this tests the autonomic signals between the heart/BP/brain- when you exert yourself, your body has to adjust the blood pressure. Some people do not have the proper reaction and end up passing out or nearly so. Heat seems to be a major trigger for people with this condition. In some cases, it just takes learning your body and adapting, others have it so badly they are disabled!</p>
<p>According to the state’s athletic governing body rules, runners are not allowed to even wear watches in races. It’s unfortunate, because Granny’s right and the doctor suggested that also. If ever she runs road races in the off season she can do that, but unfortunately she can’t in high school competition. After her most recent collapse, I insisted she be taken to the hospital for immediate blood work. The EMT’s were busy, though, and so it was about 1 or 1.5 hours afterward before the blood work was done. Despite my request, they also neglected to take a rectal temperature, which is a necessity to verify heat exhaustion. They just used the fingertip method. Sigh.</p>
<p>Somemom: she doesn’t pass out as in lose consciousness, just gets weak and rubbery and breathless. Her speech gets slurred too. We’ve pretty much eliminated a vasovagal (sp?) cause, since according to the literature that type of collapse happens to runners AFTER they finish, not during the race. Is what you’re talking about related?</p>
<p>OK, now that we have a VO2 number (63) and a BP range between which her lactate shoots up from 3.3 to 5.0 (between 181 and 187) now what? Since we knew she was going to do 1200m. repeats in her workout today, she asked the doctor how this information should influence that. He didn’t give a coherent answer. With my limited understanding, I told my daughter to shoot for a BP of about 183. Does this sound good?</p>
<p>Yes, I remember all the HS rules about jewelry, same color compression shorts ect.</p>
<p>How many times has this happened? Just in races?</p>
<p>TheGFG,
are you absolutely certain that what is happening to her is not exercise-induced asthma or allergy-related asthma?</p>
<p>What distance races does she run?</p>
<p>What is the coaches goal for the repeats? Does he tell them how fast to run them? 1200 meter repeats seem long for HS CC runners.</p>
<p>Try to find someone who can interpret the data and establish training zones for your D.</p>
<p>You may waant to have the doctor rule out exercised induced asthma. My D has exercised induced asthma. It took awhile to diagnose. Many athletes go undiagnosed for along time. Humidity is a trigger.</p>
<p>this was a particularly difficult fall in our area for some of the athletes in outside sports. some had difficulties with asthma who had never before had problems. i think it was a combination of the high heat, high humidity, and the high pollen counts. mold has been high too. </p>
<p>golfingmom is right. asthma can be difficult to diagnose. there are various types…exercise-induced, viral-related, and allergy-related.</p>