QANDrA - Episode 3

Welcome and thanks for joining me. I had plenty of guests planned for this month’s episode- but they’ve all been vetoed by Aimee: Prime Minister of the Magazine. Following her various edicts, there’s no questions from terrorists about “what do if you get sand in your uniform under-garment”, only genuine, no malarkey, ridgey didge triathlon queries published below…

Question One: Are there any safe pain-killers to use during a race?

Yes! Is the simple answer, and it’s paracetamol (panadol).  As medications go, paracetamol has a very small side effect profile when the dosage is kept to the recommended limits of 4grams per day (adult). There are toxic effects for the liver if this is exceeded. It acts on the central nervous system and can be taken on a full or empty stomach- making it perfect for using pre- or mid-race. It’s also useful for post race sleeping to minimise any fevers and settle restless legs- a symptom of the muscle damage resulting from of a long race.

Avoiding NSAIDs (non-steroidal anti-inflammatory drugs) is a really important point. Specifically that includes diclofenac (voltaren) and ibuprofen (neurofen) plus aspirin…which (if you want to get technical) are non-selective COX inhibitors. Now that may sound rude, but the take home is that these drugs cause a pretty powerful block to inflammation and pain. Unfortunately, they also cause blood vessels to the kidney to constrict, which can lead to damage. If you add dehydration to the mix (which is most races), then this harm is accentuated.

There’s also the long term risk of gastric ulceration (i.e. hole in your stomach lining) with abuse of NSAIDs, which means they should always been taken with food. You can’t ever guarantee that in race conditions- another reason to avoid these during races. Even choosing to use a selective Cox 2 inhibitor (Celebrex), which is supposed to reduce this side effect, leaves you at risk of ulceration. So all up, it’s a no go for using NSAIDs before or during races. A tickle of ibuprofen after the race with a meal is fine, especially in the setting of adequate hydration.

Question two: What’s the best treatment for blisters?

Blistering is a normal reaction of the skin to heat or friction. In the same way that you have tears in your eyes for lubrication, this response eases any friction between two tissue planes. Unfortunately it also attracts a pretty significant pain response and can ruin a race. Even small blisters on your feet can change the gait pattern, which makes you less efficient with your running pattern…thus slower.

So get on the front foot and try to avoid them, by: avoiding new shoes/socks in race conditions; have plenty of toe box in your race flat selection; using papaya ointment or vasoline application on areas you know are prone to blistering; trimming your nails regularly; using socks on the bike leg; and ensure your laces are loose at pressure points. You should avoid using tape of any description or bandaids, which are always prone to movement during the swim and bike legs…leading to chafe on the run. The application of these items is most often counter productive.

Post race treatment should include blister-blocks or ‘donuts’ to maintain the integrity of any un-popped blisters and take the pressure off them. This means the damaged areas have their natural protection, plus skin integrity to minimise infection. If the blister is ruptured, then use a small pair of scissors to trim the skin to its edges. An application of papaya ointment can provide a barrier to dirt/bugs, as well as invaluable lubrication against friction.

Question three: How much do I sweat?

How long is a piece of string? That’s right, it’s a very obtuse question and deserves this kind of answer! There are so many variables that contribute to sweat rate, so it’s worth understanding them before you try to get to a neat, round number in litres per hour.  Which you’re never going to get…

Everyone is different, and not just in size and shape. There are categories of modifiable and non-modifiable factors that influence your rates.

Modifiable                                                                  Non-modifiable

Training state                                                            Gender
Weight                                                                       Height
Clothing                                                                     Environmental conditions
Hydration status                                                       Age
Stress                                                                         Genetic factors

Practically, you just need to get a feel for your sweat rate by doing pre-post weighing. Try to remove the confounding errors of wet clothes by stepping on the scales in your underpants before and after a session. Take a note of the amount of fluid you have drunk (usually full bidons are 600mL (gm) or 750mL) and add that amount to the loss of weight. Then divide the loss by the number of hours spent exercising, and you have a sweat rate in L/hr.

Sweat rate (L/hr) = (weight loss + fluid ingested)/hours

Being aware of the amount you sweat is critical for success during endurance events. If you cannot replace this fluid and electrolyte, fatigue will cruel your performance.  Keep in mind that humans will voluntarily dehydrate around 2% before beginning to feel thirsty, so be proactive about drinking early.  Additionally fluid is a great way to ingest carbohydrates, also critical for exercise success.

Good luck out there! Looking forward to more questions next month.