Monday, February 1, 2016

Larry Creswell, M.D.

Swimming Off the Beaten Path - Bosphorus Cross-Continental Swimming Race

I recently returned from Istanbul, Turkey, where I swam in the 6.5-km Samsung Bosphorus Cross-Continental Swimming Race. Sometimes it’s fun to try something different. I had a terrific time and thought I’d share the tale.

Heart Questions from the EC Campers

I had the opportunity to attend the recent Endurance Corner training camp in Tucson. For me, one of the highlights of the week was the chance to give an after-dinner presentation one evening on triathletes and heart health. I shared stories from the past year that had caught my attention and illustrated some important points.

Good News for Athletes' Hearts

Here’s some good news for triathletes on the “too much exercise” front. A recent report in the International Journal of Environmental Research and Public Health takes a look at the heart health of recreational triathletes. The study deserves our attention.

Swim Safe in 2014

From a safety perspective, the triathlon swim can be very unforgiving. As we know, there are a few athletes who die each year in the United States during the swim portion of multisport events. That’s really just the tip of the iceberg, though. Many other athletes require rescue because of serious medical problems or just because conditions on race day were too tough to handle.

Heart Rate Variability - Part 3: Available Tools

Now that we’ve covered what heart rate variability (HRV) is and how to interpret it, let’s take a look at some of the hardware and software tools that are available to help you make use of HRV data.

Heart Rate Variability - Part 2: Application in Endurance Sports

In previous columns I wrote about resting heart rate and heart rate recovery and more recently about the basics of heart rate variability (HRV), where we developed some basic definitions and terminology. This column looks specifically at the use of HRV in endurance training. I’ll share how and when to measure HRV and how HRV might be used to help guide your training.

Heart Rate Variability - The Basics

In a previous column, I wrote about the resting heart rate and heart rate recovery and how they can be used as indicators for monitoring athletes’ training status. At least two other heart rate-related indicators are also used for that purpose. I’ll leave the discussion about exercise heart rate to Alan Couzens, our resident Endurance Corner physiologist, but I wanted to introduce the concept of heart rate variability (HRV).

Triathletes and Doping

Recently, an interesting study caught my eye. In the November 13, 2013 issue of PLOS ONE, a group of investigators from Germany reported on the prevalence of physical and cognitive doping in a group of nearly 3,000 age-group triathletes who took part in the Ironman Frankfurt, Ironman Regensburg, or Ironman 70.3 Wiesbaden events last summer. The study was simple and the results were perhaps surprising.

Athlete Heart Advice for Coaches

I get a bunch of inquiries from athletes about various heart issues. Surprisingly, though, I get relatively few inquiries from coaches. But when I do hear from coaches, they generally ask one of two questions:

1. Can I get my athlete to talk with you about a potential heart issue?
2. What do I need to know about…?

Both are great questions. The first question is easy. I’m generally happy to talk with athletes about heart issues and help point them in the right direction to find help.

Today, let’s deal with the second question.

Going Long in the Swim

I’ve had my eyes open for a longer distance swim race (10km or more) for a couple years. Around this time last year I came across the Henley Bridge-to-Bridge Swim, a 14.1-km swim in the Thames River from the town of Henley to the town of Marlow, about an hour’s drive west of London. Given that I’m not particularly fond of ocean swimming, I figured with this race there’d be no marine life like jellyfish or sharks, no alligators like the typical Mississippi triathlon, and I wouldn’t be more than 75 yards from shore in case my ambition exceeded my abilities on race day.

I registered right away. I didn’t want to be left out.

From the Athlete's Heart Mailbag: Blood Donation

We invited readers to submit heart-health questions for Dr. Larry Creswell. Periodically through the coming months, Larry will devote his column to answering questions that should be of interest to triathletes and other endurance athletes.

In this edition, Larry answers a question about blood donation and exercise.

From the Athlete’s Heart Mailbag

We invited readers to submit heart-health questions for Dr. Larry Creswell. Periodically through the coming months, Larry will devote his column to answering questions that should be of interest to triathletes and other endurance athletes.

In this edition, Larry answers a question about cardiac screening to determine risk for sudden cardiac death at triathlon.

Any Questions About Sport and Health?

Many athletes have health-related questions, but they aren't sure where to go for answers or -- all perhaps more commonly -- they forget to ask at their annual physicals. Endurance Corner's Larry Creswell, M.D., a cardiac surgeon and Associate Professor of Surgery at the University of Mississippi Medical Center in Jackson, Mississippi, the author of The Athlete's Heart blog and a co-author of the recent USA Triathlon Fatality Incidents Study is here to help.

Have a question about a recent health issue that impacts your training or racing? Have a personal experience that you think will benefit others but you're not sure how to translate it into a larger message for the triathlon community? Contact Larry via e-mail at to share.

Mediterranean Diet: The Best Ever?

Can a diet with more fat really be healthier for your heart? Well, it may be true! Let’s talk about a recently published scientific report on the Mediterranean diet and heart health. The findings are remarkable and have implications for athletes and non-athletes, alike.

Does the Heart Get Tired?

Last month an article on Slowtwitch entitled, “Heart Tired Revisited”, stimulated an online discussion among some of my triathlete friends about whether or not the heart “gets tired.” I cast a vote for NO and I’m sticking with at least a qualified NO. But the conversation got me to thinking and reading about the broader issue of exercise-related cardiac fatigue. That’s a real concept with implications for every endurance athlete.

Five Questions for Your Doctor

Readers here at Endurance Corner will know that I’m a fan of a periodic visit to the doctor for a check-up. In a previous column I discussed the rationale and the value in athletes having a doctor and on my blog I’ve offered suggestions about how to find a good primary care doctor. Today I’m sharing five important questions for your doctor that will help you get the most out of an annual visit.

10 Credible Online Health Resources

The Internet has revolutionized the way we get information -- whether it’s the news, the weather report or information about our health. But in some sense, there is just too much information. A quick Google search about an athlete’s medical problem typically yields far too many leads to track down. As I see it, the bigger -- and more relevant -- problem is that there is actually too little quality information. Here are my picks for 10 useful online and social media resources for athletes looking for information about heart disease.

Triathlon-Related Deaths - The Facts and What You Should Know

Last August I volunteered to help with a USA Triathlon (USAT) review of race-related fatalities in recent years. Since this issue has been in the news these past couple weeks with athlete deaths at the inaugural Ironman New York triathlon and again at the USAT National Championships in Burlington, Vermont, I thought I’d share my experience with the review, some data you might find interesting, and some thoughts about a path toward better race safety.

Nine Interesting Facts About the Athlete’s Heart

No catchy lead in here, just nine interesting facts worth knowing about the athlete's heart.

Athletes and Statins

In a previous article, I wrote about the general issue of serum cholesterol and lipid levels and I’ve always encouraged athletes to “know their numbers.” I'd like to extend that conversation and talk about the most common scenario I hear about: the athlete who has a high low-density lipoprotein (LDL) level and who is encouraged to take a statin medication for treatment.

Who's Got the Bacon?

Last month a group of investigators from the Harvard School of Public Health, headed by An Pan, PhD, published a report in the Archives of Internal Medicine, entitled “Red Meat Consumption and Mortality”.

The report received a great deal of media attention. But how much of what was reported in the news should concern you?

Short-Term and Long-Term Injury to the Heart with Exercise

The topic of short-term (acute) and long-term (chronic) injury to the heart with exercise has been in the news again because of a new, provocative study of endurance athletes. This is the most detailed study yet on this topic and deserves our review.

Heart Rate and Recovery... and Heart Rate Recovery (HRR)

November's theme at Endurance Corner was recovery. We heard about a variety of issues related to both workout recovery and off-season recovery.

As endurance athletes, we’re interested in measures of recovery -- and particularly those measures that are quantifiable and might help guide our training schedules. Two such measures are the resting heart rate and heart rate recovery (HRR).

Everything I Know (and Don’t Know) About Compression Garments - Part II

In part I of this article on compression garments I discussed some of the research on compression and performance/recovery. Here, I’ll cover compression, travel and your heart.

Everything I Know (and Don’t Know) About Compression Garments - Part I

I remember seeing athletic compression garments (CG) for the first time at the expo for the Ironman New Zealand triathlon in 2007. An enthusiastic salesperson wanted to show me a full body compression suit and explain the many benefits for triathletes. I also remember very clearly thinking how silly it all seemed. I’m a skeptic at heart. Now, I’m not so sure. There may well be some benefits. Here’s what I know…

Do Cyclists (And Perhaps Triathletes) Live Longer?

In his column last week, Dr. Bob shared information from some recent studies on the issue of endurance athletes and longevity and offered up some thoughts and conclusions. He’s right. The issue of whether there can be too much of a good thing when it comes to exercise is certainly a hot topic. So, more on that topic!

Normann Stadler, Heart Surgery, and You

We learned recently from news reports that two-time Ironman World Champion Normann Stadler underwent heart surgery on July 4 because of a “failing heart valve and aortic aneurysm.” On Twitter, I re-tweeted a link to one of these news reports and I was surprised to see that more than 1,200 of my Twitter followers clicked on that link to read about Stadler. In the past few days, I’ve received a bunch of inquiries about his situation and I thought I’d share some of my initial thoughts with the readers here at Endurance Corner.

You Could Be the Hero!

A couple heart-warming news reports caught my eye this month and I thought I’d share the stories -- and lessons -- with you here.

Can Too Much Exercise Harm the Heart?

Can too much exercise harm the heart? It’s an interesting question -- and probably an important question for many of the readers here at Endurance Corner. This question has received attention recently because of news reports in the popular press , so I thought I’d review the available data, offer some of my own thoughts and conclusions, and let you decide for yourself if you can have “too much of a good thing.”

Heart Attack at Tri Camp: A Story for Camp Planners to Remember

Sometimes we take for granted that being "fit" is the same as being "healthy." Larry Creswell, M.D., shares a story from a recent triathlon camp he hosted that demonstrates the value of safety planning for camps and similar events.