Muscle Recovery from Extreme Endurance Events

     

MUSCLE RECOVERY FROM EXTREME ENDURANCE EVENTS: THE ‘AWFUL AFTERS’ COUNTING THE COST OF A 140-MILE TRANS-SAHARA FOOTRACE

By: Dr. Bill Misner Ph.D.
Eavesdropping…Ultra heroes and heroines of the 15th Marathon de Sables murmured without shame, “What have I done to myself”…,”It is totally fricken’ loony out there…,” “I couldn’t breathe, you have to live to race another day, it’s not worth dying over”…, or as one summarized it all…”I just went to hell and back!” There is a reason why they call it “the world’s toughest footrace.” The blisters on top of blisters, sunburn, windburn, sand blaststing, sore aching muscles, swollen feet fingers, and puffy faces, sunken eyelids, peeling-flaking skin, raw ruby-red rash on body parts too private to mention on the family channel are unwanted trauma troupers which will only be only a fading memoir in 3-5 days.

But the worst malaise from a 140-mile 6-day desert outing are yet come, the “AWFUL AFTERS”, a consortium of ultra-lingering “LOWS” resulting from extraordinary cellular-substrate metabolic stress from hyperthermic exposure. The mood-altering depression seems to cling
without thought of dissipating for days and weeks.

Ultramarathon Runners call this phenomena the “Post-Race Marathon Blues”. The “Lucky” ones may be those whose race experience ended prematurely. Lisa Smith’s saddening drop-out due to an asthmatic reaction, probably from breathing too many airborne allergens in the great dunes sandstorm, intensified by exercise -induced stress to her immune system, will likely be training again within 7-10 days after she gets home. Quokka Sport’s Felicia Wilkerson’s ITB-disabling knee pain, resulting in race organizers pulling her from the race may take only 21-42 days physical therapy, rest, stretching, and anti-inflammatory medications, before she returns to pain-free running, but those who actually finish the race today, in fact, may actually be the most traumatized of all. The glory of the moment, the hurrahs, the whoop la, and yes, elevated exercise-induced endorphins and other circulating hormonal metabolites creating a temporary “High” that lull race finishers into forgetting the hurt, pain, and agony their bodies have survived. For them complete recovery exacts a price tag worth review.

COMPLETE RECOVERY IS ONLY 72.5 DAYS AWAY…ARE YOU KIDDING ME?

Is having the “Blues” after such an event for real or just a let down from being out of the limelight away from the reveling generated by a race environment? No, it is for real, comparable to having been dismembered, losing a body part. During the 7-day ultramarathon ordeal, an average runner’s conservative macronutrient estimate expense is at least 15,000 calories, 9000 from body fat stores[nearly 2.5 pounds of body fat], 4500 calories from muscle and liver glycogen stores[1.33 pounds], and 1500 calories recruited from lean muscle mass amino acid pools[nearly 1/2 pound of muscle]. Imagine losing a hand, foot, or any body part weighing 4.33 pounds, predictably it follows that one naturally grieves over loss of a body part literally for months after such a loss.
This solid weight loss does not account for a 5-12 lbs. water weight daily fluctuation in the typical 70 kg. runner each racing day. What then is the difference between losing a 4-5 pound body part in 6 milliseconds or 6 days?

At each day’s stage end, each ultrarunner attempts to recompense their losses by aggressively force-feeding, rehydrating, taking electrolytes, supplements, and medications. Approximately 70%-85% of the fat stores, muscle glycogen, fluid levels, and electrolytes lost, are restored in the 24-hours time-lapse between stages. Complete lean muscle mass amino acid resynthesis and several micro-metabolites are not completely restored, tending to specific store depletion proportionate to duration, distance and/or intensity. It has been suggested that one day rest is required for each mile raced for complete cyclic recovery prior to full-course training. Whoa, that is 145 days or so!

Perhaps not quite that long, since each stage imposes a daily mandatory “rest” break, a divisive factor of 2 lowers the 145 day figure to 72.5 days, assuming each runner does not return to arduous training prematurely before down-deep cellular recovery is complete.
But why does it take so long to recover from an event lasting only SIX DAYS?

PROTEIN RESYNTHESIS IS A KEY TO UNLOCKING POST-RACE DEPRESSION

Every 180 days, 98% of all human soft tissue structures are replaced during the extremely complex DNA-RNA replication process, exchanging aged cellular structures for brand new ones! Depression or negative mood-swings may occur during “Normal” periodic amino acid depletion recycling, much less when one has superimposed a 6-day 140-mile run in a furnace. Two major neurotransmitters are involved in preventing depression, serotonin, which is converted from the amino acid L-tryptophan and norepinephrine, which is converted from the amino acids L-phenylalanine and L-tyrosine. With inadequate amino-acid conversion, neurotransmitters are no longer produced in sufficient amounts, a deficiency that causes “emotional” symptoms, such as severe depression. During each and every mile run 10-15 amino acid calories are recruited for the energy cycle. Taking away 1450-2200 lean muscle amino calories in 6 days will dramatically stress the amino acid pool by which most of us avoid “The Blues”.

Even by taking daily amino-acid supplements for resupplying our regenerating amino-neurotransmitter
precursors, time is required proportionate to depletion effort, age, gender, fitness levels, and familial genetic gifting.
Hormones imbalances related to amino acid loss “take a beating” as well. Extreme endurance training stress elevates specific hormonal levels before an event, anticipating their expected demise during a prolonged endurance event.

The baseline hormonal state in 1000 kilometer ultramarathoners is quite different from normal athletes. Resting serum conjugated catecholamines–epinephrine(E), norepinephrine(NE), dopamine(D), free E and free D, Adrenocorticotrophic hormone (ACTH)–have been reported to be significantly ELEVATED above the norms. What happens after the race begins?
The effect of the racing on serum catecholamine levels elevates further free and conjugated norepinephrine (NE).
Other catecholamines, free and conjugated, also remained seen to be elevated above the normal means. Adrenocorticotrophic hormone (ACTH) remains elevated, but IR-beta EP within the normal range, without significant change. A significant increase in
growth hormone (GH), prolactin (PRL), and cortisol also occurs.[1]

As a model of chronic physical stress, ultramarathon runners demonstrate a significantly altered baseline hormonal state as reflected in the primary mediators of the stress response, the catecholamines and the hypothalamic-pituitary-adrenal axis.
Their response to severe exercise is distinct from that of untrained individuals in whom conjugated catecholamines decrease and ACTH increase. This may represent a prolonged hormonal adaptation from prolonged stress related to depression as linked to depleted muscle amino acid pool loss. While this is merely my own theory at this point in time, since little has been demonstrably concluded regarding the biomechanics of lonely long-distance ultramarathoners biochemistry. It appears that what dramatically reduces in short order our blood biochemistry hormones and lean muscle amino acids pools may be the basis for the time-required rebound from such extreme exposure to a traumatic event.

BUT THEY LOOK HEALTHY ON THE OUTSIDE…INSIDE IT IS A MAJOR CELLULAR DISASTER!

After a 1600-kilometer Ultramarathon, biochemical changes related to muscle breakdown, hepatic damage, hyponatraemia, and a number of other variables in the blood serum of ultramarathon runners was analyzed. Significant DECREASES were found during or at the conclusion of the event: globulin, uric acid, and cholesterol. Significant INCREASES were found during or at the conclusion of the event in plasma volume, sodium, chloride, urea, alkaline phosphatase, gamma-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, bilirubin, total protein, albumin, glucose, calcium, and phosphate.[2]

Previous research of blood profile changes from ultramarathon running, these researchers reported, changes in haematological parameters and iron metabolism observed during a 1600-kilometer ultramarathon. DECREASES in haemoglobin, packed cell volume, mean red cell volume, percentage lymphocytes, percentage monocytes, serum iron, total iron binding capacity, and percentage transferrin saturation occurred, while INCREASES were found in plasma volume, total red cell count (day 4 only), total white cell count, percentage and absolute numbers of neutrophils and reticulocytes, absolute numbers of lymphocytes and monocytes(day 4 only), absolute numbers of eosinophils (day 11 and race end), absolute numbers of basophils (race end only), platelets, ferritin, haptoglobin, and bilirubin (day 4 only).[3]

It is reported that after 12.6 miles of racing, athletes produce more C-reactive protein levels than it can metabolize. Prior to 12.6 miles, no increased serum C-reactive protein[CRP] levels is observed, while CRP increases proportionately to duration and distances run.[4] C-reactive protein increase is also reported excessive during minor heart attacks and in certain muscle cell death[disease disorders]. With all these biochemical and hormonal markers in stress, what should an ultramarathoner do to enhance complete full recovery for return to training?

PRACTICAL APPLICATIONS FOR ENHANCING RECOVERY AFTER EXTREME ENDURANCE EVENTS

[A]-Consume 1.4-1.7 grams COMPLETE PROTEINS per kilogram bodyweight from Whey Protein, Soy Protein, Egg-White Protein, or a combination of grain, vegetable, seed, and nut protein ideally from raw food sources.

[B]-Supplementing GLUTAMINE[2000 grams] or APGL[Arginine-Pyroglutamte-Lysine][2400 grams] on an empty stomach early in the day has been shown to enhance human Growth Hormone release from 420% to 700% above baseline.

[C]-DIETARY FIBER taken in either supplemental form or from soluble fiber found in raw fruits and vegetables ranging from 35-60 grams per day with 100-120 fluid ounces of distilled water, or raw fruit juices may enhance the toxins excretory removal process.

[D]-ANTIOXIDANTS such as alpha-Lipoic Acid, Vitamins C, E, Gingko Biloba, Glutathione, N-Acetyl Cysteine, in bowel - tolerance high dosage 30-40 days post-race may enhance recovery significantly.

[E]-HOT BATHS with 8-10 ounces of food-grade H2O2 well-mixed in a hot-as-you can-stand-it soaking bath at the end of the day, followed by a full body deep-tissue MASSAGE may help your body physically remove free radical build-up, enhancing the cellular environment significantly.

[F]-SLEEP may be enhanced by taking a total of 200-400 mg. of Kava-Kava with 3-10 mg. melatonin 1-2 hours prior to bedtime. Dividing this total dose for each of 2 hours prior bedtime appears to work well for most athletes.

[G]-EXERCISE NO eccentric running during the first week after an event-[will hinder the recovery process dramatically]. Loosen up by doing concentric exercise in a pool or on a bike, workout lightly an hour, break into a light sweat, then after 7-10 days, begin short 30-60 minute jogs on a flat course every other day for 2 weeks, then 3-weeks post-race return to every day running at no more than half the weekly training pre-race mileage.

[H]-FOOD: AVOID–>Processed foods, high-sugar foods, high-fat foods, alcohol, dairy byproducts, red meat, poultry, high-sodium foods, diet products including all high-phosphorus carbonated beverages. If you cannot avoid these nutrient-empty
macro-calories, limiting to once per week. This choice will significantly increase rate of recovery, when 6/7th of the weekly dietary choices are rich in whole raw fruits, vegetables, whole grains, nuts, legumes, seeds, and organic cereals.[5]

As recovery and the hoped-for return to “Normal” transpires in time, with it some may birth the thought of return to the 16th running of the 2001 Marathon de Sables. For others perhaps this is neither a simple nor a foregone conclusion. Lisa Smith’s asthmatic reaction, creating a distinct lack of life-giving air, though a very unpleasant memory, or, Felicia Wilkerson’s disabling knee problem causing her to drag her leg like a limp tail is much more than a favorite meditation; but each of these reflections are but flaming embers, fanning the desire to tame the desert beast which has coerced today’s finishers to postpone “Counting the Cost”, facing repairs untold from the “Damages” unknown, perhaps they too will rebound in hope for another six days in the desert sun.

REFERENCES

[1]-Biochemical and hormonal changes during a 1000 km ultramarathon. Pestell RG, Hurley DM, Vandongen R,
Clin Exp Pharmacol Physiol 1989 May 16:5 353-61.
[2]-The biochemistry of runners in a 1600 km ultramarathon. Fallon KE, Sivyer G, Sivyer K, Dare A, Br J Sports Med 1999 Aug 33:4 264-9.
[3]-Changes in haematological parameters and iron metabolism associated with a 1600 kilometre ultramarathon. Fallon KE, Sivyer G, Sivyer K, Dare A, Br J Sports Med 1999 Feb 33:1 27-31; discussion 32.
[4]-Structural and ultrastructural changes inskeletal muscle associated with long-distance training and running. Kuipers H, Janssen GME, Boseman F, Frederik PM, Int J Sports Med 1989; 10:S156-S159.
[5]-Prior to employing any of these practical suggestions, athletes taking medications should always consult their licensed medical practitioner.

Dr. Bill Misner, Ph.D. is the full time Nutritionist for E-CAPS INC. & HAMMER NUTRITION, Author of NUTRITION FOR ENDURANCE: FINDING ANOTHER GEAR, Dolezal & Associates Publishing, Livermore, California, 1998. He is a former 2-time U.S.A. 50-Mile National Masters Champion. In 1998-1999, he established two “World Records” completing the first-ever 10,000 miles and 20,000 kilometers ever run in an organized footrace.

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Dr. Bill Misner, Ph.D.
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