Keeping an Older Car on the Road while Improving its Performance
by Kim Baumgartner, David Conover, Dr. Jonathan Yager
Given the opportunity to have a few wishes granted I’m sure many triathletes would ask for new equipment to help improve race times and enhance their overall training and race experience. Not unlike wishing for a new car – a model that is faster, more comfortable, has more power and gets better fuel mileage. Recalling a statement I heard years ago - that bike speed is 97% engine – equipment and gear, which is important in order to complete a tri, can only go so far in helping athletes achieve PRs. With that in mind you might then ask - how can I improve my triathlon experience (e.g. faster, more comfortable, more power and better outcomes for less energy and physical as well as mental stress)? Then after a few (or more) years that question morphs into another far more important one – how can I continue to compete (or dare I say improve) as I get older? Using the car example –at any given point in time there are many ages and models out there. But as time goes on all models get older and need more care and service to at least stay on the road much less continue to be competitive. So can an ‘older car’ (ala episodes of Leave it to Beaver or Father Knows Best) triathlete not only keep competing but even consider getting ‘better’ with age?
My experience, after 71 years ‘on the road’ and 30 years training for and doing triathlons, bears out that as the car ages it needs more TLC and the ‘owner’ may need assistance keeping it on the road. For those approaching (or currently enrolled in) Medicare qualification or who have received that ‘welcome to AARP’ mailer, it becomes much more relevant to engage professionals to provide that assistance. That assistance can be provided by medical professionals (e.g. doctors) and triathlon professionals (e.g. coaches). They are two of the most important tires on the car – the other two being the athlete and the equipment. Hopefully this article will help athletes, especially those driving older cars, better understand the reasons to establish a relationship with these professionals.
With a background in swimming (and never running even for free beer) I was introduced to triathlon in 1990 when I was 40 – the introduction being what doing a triathlon entailed. Needless to say the hurdle was to be able to run farther than across the street. I worked at it by myself (along with biking and swimming) and felt comfortable signing up for my first triathlon. Once I had done one triathlon I was hooked. I self-trained with advice from relevant print media, signed up for local races and over time made great friends in the tri community and improved to what some might call a ‘pretty decent middle of the pack’ triathlete. My medical needs were met through an annual physical from my GP and at the time I really was not aware of the availability of triathlon coaching. In short my car ran pretty well, had what I thought were enough tires (athlete, gear and annual medical support) and was getting older. In August 2005 the car had a major breakdown that caused me to enhance the ‘medical tire’.
Thirty minutes after completing the Timberman Half in New Hampshire and really pushing the run the last mile I experienced some sweats, thirst, nausea and very minor pain at my sternum. I went to the medical tent where they said all my vitals were OK, but I opted to go to the ER. I was observed for six hours in the ER and they did a number of tests, said I was OK (my symptoms had gone away) and released me. I felt fine at the time and went out to dinner with my wife and son (who had also competed that day). Over the next few days any increase in my heart rate would bring back that mild sternum pain. When I arrived home (VA) three days after the race I visited my GP. He suggested I see a cardiologist (Jonathan Yager of Cardiac Care in VA), who in turn took an EKG, looked at the EKG from the hospital ER and my historical EKG from my GP. The cardiologist said I had had a mild heart attack. I received a stent the following day (my arteries were OK, however, my sprint at the end of the run caused some plaque in an artery to rupture and a clot formed at the point of the rupture) and was sent home. Four days later I was diagnosed with a pulmonary embolism (PE) – attributable to a reaction my body had to the heparin I was given to address the heart issue (my road ID now says ‘heparin allergy’). The PE was addressed through an alternative medication (Argatroban) to thin my blood. The PE went away and starting with cardiac rehab I got back into shape and raced again eight months later. At this time I also gained a pulmonary doctor on my team, who it turned out was also a triathlete.
The story continues over four years with a deep vein thrombosis (DVT) that lead to another PE as well as treatment for prostate cancer (seed implants), and a case of shingles. During those years (2006 to 2010) I was always able to train and get in a race or two and continued to have numerous visits and treatments from my medical team. I still have the same cardiologist, a new GP and a hematologist on my medical team who are fantastic in keeping the car on the road. As I noted above, a very important tire on the car is the medical profession. My suggestion, even if you are a newer model, is to make sure you keep up with your medical checkups, listen to your body (e.g. read the dashboard data) and be proactive in addressing your health. Doing that cannot guarantee you will never have a breakdown but it certainly can minimize such an event and more importantly build a robust medical history that may be important one day.
With these medical crises addressed I was ready to get back to racing in earnest in 2011. Aging up into the 60’s and feeling good I continued my self-taught training, tweaked things (especially transitions where valuable time can be saved) and for the most part maintained a status quo of racing (defined for me as five or so races per year – primarily sprint and Olympic distance - and trying not to get slower and not letting my heart rate get too high). As they say you have good days and bad days. In 2019 at Nationals in Cleveland I had a good race and with the age up rule was fortunate to accept a spot on Team USA. The thought of going to Edmonton in 2020 to compete in the Olympic distance race suggested I make further tweaks to the car – in this case finding a coach.
As it turns out a new USAT Competitive Rules Official (CRO) I had recently officiated with (Kim Baumgartner) was also a USAT certified coach. I contacted her and after a briefing on what she would provide through FIV3 Coaching in Virginia I signed up for coaching. I’ll not delve into COVID or postponement of Edmonton in 2020 and cancellation in 2021 (and the associated disappointment). What I’ll say is the cloud had a silver lining. After two years (and counting) of coaching this 1950 car now has four solid wheels and is operating more effectively, efficiently and comfortably. It’s really fun to drive. Times are faster, I’m much more comfortable while training and competing and I have objectives to go after (rather than just putting in swim, bike and run training time). Another notable by-product I attribute to coaching is my heart rate (HR).
Prior to coaching I had no connection with power numbers on the bike (but I did know about turnover and spinning fast the last few minutes of the bike). I trained and tended to opt for the easier gear when faced with increased effort. Now I’m more able to stick with a challenging gear and ‘power on’ averaging in the low 20’s mph in 2021 races; noting that it is very rare that my heart rate (HR) on the bike is over 140 (my numerical maximum of 220 minus age puts me at 149, although the cardiologist feels I can exceed that by 5% for short periods). I can also maintain a higher turnover of my arms in the swim while keeping my stroke smooth and efficient. Again, my HR stays relatively low. The most notable segment is my run. When I was self-coaching and training it was not unusual for my HR to hit or exceed my numerical max. My run pace was decent but not what I would have considered fast for my age. Through coaching with strength training and specific speed and distance workouts and recognizing for the first time the importance of running cadence my run times are faster. More importantly when a fairly hard run would send my HR soaring it now takes heat, humidity and 200, 400, or 800 speed work to get my HR to hit my numerical maximum. Now an easy run is in the mid-9 minute pace, high 160’s cadence with a HR in the 120’s. My 5K pace in a triathlon has been in the low eight minute pace while my HR stays in the 140’s. Recovery (the drop in your HR after a hard workout) is typically 40 after two minutes rest. Suffice it to say, considering my age I have had my best triathlon year in 2021 and looking forward to 2022 and beyond. I firmly believe the medical and triathlon professionals I am so fortunate to work with are the reason.
Who knows how or when my triathlon ‘career’ will end (luckily it did not end over 15 years ago in New Hampshire at Timberman). My pre-2005 efforts likely helped improve the outcome of my medical issue after completing Timberman. Beginning in 2005 I had a reason to start seeing different medical professionals (and still do in maintenance). My desire to improve after Nationals in 2019 (which required confidence that that 1950 car could ‘take it’) resulted in my training under the guidance of a coaching professional. I started with a question - how can I improve my triathlon experience (e.g. faster, more comfortable, more power and better outcomes for less energy and stress)? I’ll add to that my quality of life and simply my overall health. Numbers don’t lie – being able to improve on your race stats and have your HR during exercise go down while you are feeling ‘better than ever’ is possible even for a 1950 vintage auto. Whether your car was put on the road in 1950, 1975 or 2000 it is never too soon to make sure your car has solid medical and coaching ‘wheels’.
Coach’s Notes: Working with older athletes can be very rewarding not only seeing their performance improve but also helping them keep a positive attitude. As a High School Track Coach, one of the things I tell my kids trying to make it to the collegiate level is to be “coachable.” In order to gain the most out of their coach/athlete relationship, athletes need to have as an open mind and be willing to try new approaches or ideas to help them train and race. From something as simple as focusing on different aspects of each discipline to a major change like transitioning to power based training on the bike, athletes who are able to place their trust in their coach and commit, whether a new triathlete or one competing for over 30 years, can unlock untapped potential and have fun while training and competing.
It is important to note that every athlete and their circumstances are unique. At FIV3Racing, we believe in a highly personalized and interactive approach to training – no cookie cutters! One of the first things a coach of a senior athlete needs to realize is that they can’t just be treated as an older Age Grouper. To start with, as we get older, it takes the body longer to recover. As such a coach may need to take a different approach to training cycles. Many times more senior athletes simply need more recovery. Maybe they need more rest days or - maybe a completely non-standard cycle paying closer attention to alternating hard workout days with lighter days. Instead of the long bike and run being back-to-back on weekends to fit around a work schedule, try a long bike on Friday, rest day Saturday and a long run Sunday with a recovery swim on Monday. Or alternate weeks with a long ride one week, and a long bike the next. Most senior athletes tend to have a more flexible schedule which allows a coach to get creative!
So with the “less dense” workout schedule it is extremely important to focus on Quality Workouts! Working with an older athlete such as Dave we avoided packing the training plan with junk miles and lots of volume that would wear him down. Instead, we focused on fewer but more specific and sometimes intense workouts to allow him to fully achieve the quality from each workout. Basically we avoided getting to the point where every workout was just a grind. Thankfully, with a seasoned athlete, they typically have enough “base” from years of training so a coach doesn’t need an athlete to carry a high Chronic Training Load or CTL. For instance, we didn’t need to run 15 miles in prep for a 10K and that allowed us to focus on just sharpening things!
As a USAT Certified Coach I also encourage strength training for all my athletes, but especially my older athletes. In addition to the well accepted studies outlining the benefits of strength training in seniors, I find that it can add something new and different to an athlete’s repertoire to spice things up. We all know that the body adapts to its routines over time, and sometimes we just need to shake things up to bust through a plateau and the exercises and variations are almost limitless in this realm. From body weight and mobility exercises, to core and stability, Tabata, High Intensity Interval, there is a lot to work with to give an athlete something new to help them. Even just doing 5-10 minutes of body weight exercises targeting core, upper and lower body 2-3 times a week can go a long way in someone who hasn’t ever focused on that before.
Doctors’s Notes: It is a pleasure to work with patients who already know the many physical and mental benefits of regular exercise. As a result my focus as a cardiologist becomes keeping an athlete healthy and safe during training and competition. For someone like Dave who had already experienced a mild heart attack, we directed our efforts toward “secondary prevention” – essentially never letting that happen to him again. In his case this involved placing a stent in his coronary artery to keep it open, as well as continuing medications to keep his heart healthy. As he described, he has been able to not only continue his triathlon competition despite his cardiac history, but to improve his performance and outlook toward continued participation.
Just as athletes appropriately focus on orthopedic health for long term performance, it is critical to keep cardiovascular risk factors under control as well for “primary prevention” – avoiding cardiac events in the first place. This is especially true for older athletes or for anyone with a family history of cardiovascular disease. It is important that everyone “know their numbers” – specifically fasting blood glucose, cholesterol levels, and blood pressure. As Dave mentioned, it is important to have a relationship with a health care provider to help control these risk factors, including with medication if necessary.
For anyone with significant cardiac risk factors or interested in further screening, coronary calcium scoring and coronary CT angiograms are tests that can provide a direct look into the status of one’s coronary arteries – the arteries that supply blood to the heart muscle itself. These scans can identify mild to moderate, potentially vulnerable plaques (blockages) that could rupture during exercise and cause heart attacks. Vulnerable plaques are often mild enough that they do not cause symptoms, since it usually takes at least 70% blockage in an artery to cause exertional chest pain or shortness of breath. In other words, someone can have mild to moderate blockages and not be aware of it. Plaque can develop in arteries even in people with very healthy lifestyles, depending upon their overall risk factors and genetics. Identifying these early on can lead to risk factor modification, appropriate medication, or stress testing. Stress tests can also be helpful to identify cardiac rhythm disorders that can arise during intense exercise, and can be used as another screening tool to keep an athlete healthy. It is clearly preferable to look ahead and get checked out before a race, as opposed to during or after a cardiac event at a race.
David Conover is a USAT CAT 1 CRO and has been competing in triathlon since the early 90’s. He is a member of Team USA and was named USAT CRO of the year in 2020.
Jonathan Yager, MD, FACC is a cardiologist at Cardiac Care Associates. He is Board Certified in cardiovascular disease and nuclear cardiology. He is a graduate of Harvard University, did his internship and residency at the University of California in San Francisco and was in the Cardiology Fellowship Program at Duke.