Myocardial Fibrosis in Lifelong Endurance Athletes

NYTimes article with a good summary of recent literature about prolonged endurance exercise and myocardial fibrosis (scarring/thickening = generally bad).

It is associated with number of marathon events, ultramarathon events, and amount of training. Pretty good variety of evidence in healthy humans and rats, which sheds light on mechanism and suggests (but doesn't prove) causation. One could make arguments that it's an adaptation that's not necessarily deleterious in this population, as it does not specifically look at outcomes (age at death). I'd also argue, weakly, that there might be some selection in the age-matched control population: healthy non-exercising folks survived to a healthy age with a larger genetic influence, whereas the exercising folks might have done more to help their own cause. And, I'd like to know what happens to young athletes that stop training regularly, and older athletes that picked it up later in life. Finally, you or I may or may not care ("I'd do it anyway"), but the interesting part of the rat study is that it was reversible within weeks. In that respect, I do care and think there will be some interesting lessons from future study.

My take? For any "Born to Run"-style oversimplification of regular distance running being "natural," I have to also believe humans regularly chilled out for a bit (see, e.g., cave drawings, brain and social development). Chasing down antelopes is good and all, but when a nomadic tribe finds a lush, fertile valley, only a fool would keep going. And remember, the notion that healthy humans regularly ran great distances completely ignores the ~50% of the adult population that happened to bear and nurse children for years at a time, *and* happen to be specifically good at endurance events!

So, if our goal is to regularly run distance events for the rest of our lives, and to maximize the amount of this, some evidence is pointing in the direction of taking some time off. How long, how frequent, and what the actual benefits might be, are still open questions.

Update 3/21
The March 2011 issue of Trailrunner Mag has an interesting article: "Potential for atrial arrhythmias from long-term endurance training." This caused me to look further into current research on the subject. Atrial fibrillation has most certainly been associated with long-term endurance exercise in numerous studies; atrial fibrillation is most certainly associated with myocardial fibrosis in numerous studies (albeit most often in disease).

Based on some responses (including my own) here and mostly elsewhere (e.g. NYTimes comments), I wanted to make a stronger statement than my initial one: there is clear evidence that decades of endurance training most certainly can do damage to the heart. Period, end of sentence. As one paper put it:

A growing body of evidence reporting altered cardiac function and myocardial damage after arduous exercise, together with the increased prevalence of arrhythmias observed in highly trained athletes, suggests that repetitive bouts of prolonged, arduous exercise may be deleterious to long-term cardiac health. (Whyte, et al., Br J Sports Med 2008;42:304-305)


Results from studies like this are tough because the audience has a strong, vested opinion. The average person is much less likely to opine about studies involving mice or yeast, but dietary and exercise studies are much more accessible and applicable to everyone, yet complicated by individual genetic and epigenetic differences ("My grandpa smoked til he was 95").

With all that said, it may be prudent to remain aware of future developments and ways to mitigate these risks -- are there genetic susceptibilities? Dietary influences? Certain timing of training and de-training that can mitigate these risks? Can screening techniques catch abnormalities earlier, should different screening techniques be used for folks with different lifestyles?

Or it may be reasonable to accept the risks: we also know that a restricted calorie diet, with less exercise, is the best way to live the longest, but most of us are not interested in that, either. So the enjoyment may outweigh the risk, or the increased risk may be more than offset by decreased risk of other risk factors (in general) to an acceptable level.

But the main point is that there is a clear, growing, and damning body of evidence of heart damage in endurance athletes. Runners, cyclists, skiers. Post-mortem, and retrospective cohorts. Humans and rats. See for yourself if you agree or disagree.

Horsetooth Circumnavigation?

Looks like the FCTR boyz and girlz are planning a neat little event coming up in a few weekend, over at Alex's site. Hope to be there if the schedule allows.

Coincidentally, I ended up there Friday afternoon when J had a work meeting, giving me about 3 hours. I had read about the previous weekend's 18-mile circumnavigation (something I've done on bike but never foot), as well as Rob's Foothills route, so I winged the mileage without much thought and dropped myself off at Spring Canyon while J headed to her meeting. I stuck to the foothills trail for the most part, but overshot to the top of the hogback at Reservoir Ridge (forgetting where the last trail down to the road over to Lory was), doubled back, and then took the Valley Trails into HTMP. The advantage here is having a functioning water pump at Lory and then Soderberg.

The run was very enjoyable but I was slow, especially on some of the horse clomp on much of the valley trails. I had a backpack full with a jacket, hat, and gloves, waiting for the impending snow squalls that were promised, but mostly enjoyed a partly cloudy day that was 10 or more degrees warmer than expected. By the time I got out onto the road, J's meeting was done and we had some dinner plans, so I had to meet her back up on the hill rather than finish the run. So I have still failed to circumnavigate, and I'm guessing (via mapmyrun) I was at 21 miles with a couple to go. Oh well.

****
Most Beautiful Place I've Ever Seen
But here's the best part of the story: just over half an hour into the run, in an area I've been through hundreds(?) of times if you include bike and car, I was on the reservoir side of the road, when a male voice asked, "Can you take our picture?"

My first reaction was of slight annoyance, because I was farther up the hill than them, and I hate myself for it, because it was the split second before I had a chance to think about it, and I don't like the fact that I had the negative thought first, when I certainly appreciate the small favor when folks do it for me. It was a minor inconvenience, and I realized that on a weekday they likely hadn't seen other folks go past as much as on a weekend. And, as I slowed down, they said, "We're from out of town."

"Where are you from?"
"Omaha, Nebraska."
"Pretty nice view, isn't it?"

"Oh, yes! It's the most beautiful thing I've ever seen!"

Although I try not to take these things for granted, this was an important reminder. Here I (we) get to run in some of the most beautiful (let alone safe) places in the world, and sometimes I'm tempted to dismiss them as routine.

They handed me a disposable camera, which I had to remember to 'wind' between successive shots.

I pointed to Horsetooth Rock and told them about the park and views up there.
"Yeah, his....his baby mama lives here now, she was telling us about some place up here." (I love the frank but extraneous detail in that statement).

They thanked me and vowed to head up towards Horsetooth.

Though I initially loathed myself for the negative reaction and for having taken certain things for granted, I loved the world a bit more after that, and I'm glad that they did, too.

Leadville Mineral Belt Trail in Winter

Mineral Belt Trail
Leadville, CO
Trail run: ~7 of 11.6 miles explored


Having been busy with school the last few weekends, we snuck out for a quick getaway in the mountains. Saturday, we had a great time skiing with in-laws C&C at Copper. Rather than drive back Saturday night, we extended the weekend by staying in Leadville. To do this affordably, we tried out the fabulous Leadville Hostel for the first time, and found it to be a great place to stay. We enjoyed a quiet evening in a private room, although the place was packed with people of all ages, from kids to older adults. The hostel managers Bill and Cathy do a great job of making this a warm, comfortably place. No wonder that reservations for LT races in August are booked years in advance!

Coincidentally, our room was the only one with a LT100 poster on the door.
Was it a sign?

Yes, it was a sign that I sent in a registration check a few months ago. Huzzah!


Although we were planning on snowshoeing/skiing later in the day, I knew it would be an easy negotiation to sneak out for a run if J could sleep in. Luckily, the wind was dead calm and comfortably in the morning. I headed to Provin' Grounds for one of the most consistently perfect cups of dark roast, and a delicious fruit bran muffin (a decision I would have regretted had a gone for an even longer run).

I decided to check out the Mineral Belt trail, an 11.6 mile paved trail that surrounds the town. I've encountered it briefly during the Silver Rush 50 and some road bike exploration, but became more intrigued when Ben had mentioned a series of ski events on the trail, since the trail is groomed for classic and skate skiing in the winter. Snowshoeing is also listed as an activity, and dogs are allowed, so I figured I could try running on it as well without breaching any groomed trail etiquette. (In fact, we were surprised to find mountain bikers screaming down the Harrison Ave. hill the night before, only to learn that they were finishing the Mineral Belt Mayhem night-time race, so clearly winter biking on this trail is legit as well!)

I brought microspikes, but ended up not using them. Instead, I plodded along on the far edge of the trail, opposite the classic tracks. The trail was wide enough so that I didn't interfere with skate skiing, either.

I mostly explored the eastern section, miles 2-9 (map), which are marked by individual signposts on the trail, in addition to interpretive signs. The snow was firmly packed but the lack of traction going slightly uphill slowed me down a bit, and I took a sample mile pace at 10:00. Then I ignored the watch the rest of the time and enjoyed the views. As the trail climbs to the East, you lose sight of town and instead enter quiet, dense forests with occasional vistas of mountains in either direction, as well as historical mining equipment. For being a town recreation path, the ability to get out into the woods within minutes is quite amazing, especially on a free and groomed trail. (By 7AM, there were already no traces of the previous night's bike race).



I had plenty of fun running on this trail, but wouldn't hesitate to recommend it for XC skiing (classic or skate) and snowshoeing, either -- even as a destination for those activities.

In short, Pbville is a great destination year-round, as Brandon can better attest, though I missed him running around town on the same morning. The town has great amenities for all the basics (coffee, bars, restaurants, trails, lodging), but doesn't have the pretentiousness of the larger Summit County towns, as I still saw my fair share of surly older guys with tobacco-stained mustaches, one-eyed dogs and stray cats, and the silliness of night-time bike races and closing main street in favor of setting up snow jumps for a skijoring course.

Mayflower Gulch Snowshoe/Ski

Mayflower Gulch Snowshoe/Ski
~4 miles RT, ~580ft to upper cabin at Boston Mine
2 hrs leisurely pace






After staying overnight in Leadville, J and I had chance to check out the Mayflower Gulch trail between Leadville and Copper Mountain. About 6 miles south of Copper, and 17 miles from the edge of the town of Leadville (next turnoff just north of Clinton Gulch Reservoir), Mayflower Gulch has a big bang for its buck in terms of easy terrain with scenic beauty.

The hike is a steady 2 miles on a road along Mayflower Creek, heading directly southeast as it climbs to treeline. Out of the trees, you are treated to breathtaking views in a basin surrounded by Atlantic Pk, Fletcher Mtn, and Drift Peak. Old cabin and mine ruins dot the landscape below these 13ers, affording great photographic opportunities and a chance to visit Summit County history.




Unfortunately, despite numerous gorgeous pictures online on sunny days, we did not have the classic Colorado bluebird skies, but still enjoyed an otherworldly white landscape on a calm day.



We only hiked to the cabins themselves (which are surrounded by flat or low-angle terrain in the immediate vicinity), and enjoyed the views. This is a great all-season option, as wildflowers are abundant in summer and the peaks would be more accessible. The winter trail, without recent snow, was densely packed and tracked up to the lower cabins, so shoes with traction or even skate skis would have worked on a day like this, but flotation (skis or snowshoes) is advisable anywhere past there, as my poles routinely sunk as far as I would let them. Extended tours go up further in the bowls above the cabins, or on the corniced Gold Hill to the West, both of which have more avalanche risk, if not to scrambling the summits themselves. In addition, tree skiing options abound as well as some mellow touring in the gulch itself.

This is a great option for a shorter excursion on snowshoes or skis. We saw a couple guys that were learning basic cross-country skiing on the trails, and it occurred to me (making a comparative list in my head) that Mayflower Gulch just might be one of the best places to learn basic ski touring and get comfortable with the equipment, with ample snow, great views, and wide, steady trails.

Ultra vs. Triathlete Video (Xtranormal)

Found this video from this blog.

I had to pause or rewind a few times when I missed some parts from laughing too hard.

Red Rocks/Dakota Ridge Loop Run: Ice and Mud

Red Rocks-Morrison Slide-Dakota Ridge Loop
(Matthews/Winters and Red Rocks Park)
~6.5M, 1500ft gain X 2



After some deliberation, got out early Saturday afternoon for trail running near Red Rocks. This is a fairly common loop, though I've seen a disparity and confusion on mileage and elevation, but I think the above estimate is accurate if not conservative.

The attraction was getting to trails with only a half hour drive (still hate driving to run), but I was worried about crowds enjoying the nice weather. The crowds were there compared to what I'm used to, but quite manageable at this time of year. And once I started moving on the trail, my mood improved considerably, and of the folks that were there, I enjoyed brief chats, waving to kids, and playing toss with a dog that brought a branch to my feet (guess I looked like I wanted to play).

I decided to start from the Matthews/Winters and do a counterclockwise loop, followed by a clockwise loop. It was warm enough that I enjoyed the luxury of stopping at the car mid-run to take a swig of water and ditch the shirt.



Beginning with the clockwise run, after a short, flat, rolling section, that trail dipped and climbed into shaded switchbacks, a nice section of roller coaster through the snow. Without traction, I definitely had to focus on short, choppy steps on the hilly sections. After this, there's an option to continue on the Red Rocks trail, or take the Morrison Slide option instead, which is ~0.4 miles longer and also climbs more. Easy choice, as the Morrison Slide trail has a fun climb up to a gorgeous, broad plateau. I definitely enjoyed the scenery here as much as any foothills trail, especially being able to look out at the rolling ridges of Green Mountain. I like being on top of stuff and looking at other stuff I've been on top of, even in the foothills.

Next comes the downhill that you earned, again on switchbacks, which is just barely technical enough to make you pay attention but mostly a fairly clean descent. At the bottom, you're back to roads for a bit, or you can loop back on the Red Rocks trail and stay within Matthews/Winters. Otherwise, the signs help guide you to follow the Red Rocks trail further, a couple more road crossings, to Dakota Ridge.

The Dakota Ridge section is just over a couple miles, but is an entirely different world of rocky, technical climbing, with some landscaped stairs that ended up forming a ramp of solid ice in the winter. At the top, the rolling climbs keep continuing, with some off-camber slabs and rocks that force you to pay attention. (Reminds me of some sections of Devil's Backbone). Despite having views of civilization, it's still a nice perch. Of the folks that weren't walking up here with dogs, many of the rest were walking with mountain bikes instead.

Finally, the descent back down to Matthews/Winters is a less-technical blast down switchbacks (I overran a couple switchbacks, not because of speed, but because many other people have overrun them so the trail generally continues a few feet past each corner), which leads back to Hwy 93 across from the parking lot.

These trails give a good selection of whatever-you're-in-the-mood-for. Both parks allow mountain biking as well as hiking. It's a great loop, but sort of an odd one for mountain biking (though it seems to be popular to do both), since there's so much disparity in the technical nature on either side of the road. I wouldn't consider it a destination mt. biking area unless you lived nearby, or were a technical perfectionist that wanted to clean all of Dakota Ridge. But the interior park roads are also quite nice and had a decent number of cyclists on them, so I could imagine a fun day for many riders could include some road miles as well.

I was quite happy with an early season snow and mud romp. I bet I encountered much less mt. bikers than I would in just a few months, especially since the mud in Matthews/Winters was utterly unrideable. As for the loop, I enjoyed both directions for different reasons, but was surprised on the return clockwise trip, when I saw impressive, glowing red rock formations that somehow I completely missed on the way out (daylight/sun angle also had an effect there). Predictably, the shady areas of the descent on Morrison Slide were really slick and sloppy on the way back.

Finally, when I saw another runner in the parking lot, I asked him,
"Do you think we'll get in trouble for being dirty?"

Wild Basin Ouzel Falls Snowshoe and Ski

Ouzel Falls Snowshoe/Ski
7.4miles RT, ~4hrs





Since we were in town for the long weekend, we looked to get out to the mountains without driving I-70 if possible. Despite fairly common predictions of high wind, we headed out to Wild Basin in RMNP. I've enjoyed the trails there in the winter before, but hadn't taken Jessica there, and hadn't been there in about 3 years. This ended up being a fantastic choice.

Wild Basin is the southern entrance on the east side RMNP, and is relatively lesser-traveled compared to more popular entrances to the north. This should not be so. In the summer, Wild Basin offers less-crowded backpacking destinations to several different alpine lakes, past some minor waterfalls and cascades, as well as some summit assaults on mountains deep within the interior of the park, if not some "sneak" routes of the burly group near Longs to the north. In the winter, it does get windswept, so it's important to check the Snotel readings for sufficient snow: whereas Bear Lake might be "in" in early December or even November, it's usually best to wait another month for Wild Basin to have at least 30 inches. The trails, however, have sufficient tree cover to protect from the wind. Finally, the Wild Basin entrance is usually unofficially unmanned in winter, so if you haven't renewed your RMNP or ATB pass yet, you can get a free visit and remind yourself about "America's Best Idea."

The winter parking lot is past Copeland Lake, on the left side of the often-plowed dirt road, but is still about a mile short of the ranger station and trailhead, so be sure to factor this in to your timing. After parking, proceed an easy, flat mile along the road (usually on ice or thin snow) to the TH, which has a ranger station, open restrooms, and a Warming Hut in the winter, rumoured to be stocked with hot chocolate and coffee. (The "Warming Hut" on this day was said to be open, and a sign said it was 500 feet behind the restrooms, but when I proceeded to an obvious cabin and a small shack 500 feet behind the restrooms, I found it to be locked. I did not explore the Ranger Station, also approximately 500 feet from said sign, thinking that the sign would have just said "Warming Hut/Ranger Station," but with subsequent confusing research since returning...I still don't know. But sounds like fun!)

Finch Lake
Alternatively, about a quarter mile before the ranger station is the Finch Lake TH, which has a trail that begins switchbacking in earnest on a rockier trail. I recall exploring this option and finding some good snow in sun-exposed aspen groves, and ultimately a scout camp complex, before abandoning that route in a mish-mash of social trails that didn't follow any obvious landmarks. So this is a good option for variety, but requires more route-finding and trailbreaking.

Wild Basin TH
At the Wild Basin TH, you now begin to follow the St. Vrain drainage. This trail is well-marked and usually well-trodden at least to Ouzel Falls, which is 2.7 miles. Unless there is a recent snowfall, traction such as microspikes or yaktrax would often be sufficient on the packed snow of the trail, making this a viable trail-running option. Continuing on the trail, you will pass Copeland Falls, and ultimately a bridge at Calypso Cascades. Both features in winter are reduced to trickles of water underneath ice and deep snow drifts.

The trail is a slight, even grade up to the bridge at Calypso Cascades. After this, the trail starts climbing in earnest on the way up to Ouzel Falls. Scenic views start to open up in this area, scarred by fires decades ago. (And on clear days, you will be able to see more of the higher peaks).



The corners are tighter after Calypso Cascades for skiers, but with good snow, everything is manageable with sufficient skill and caution. In fact, the downhill from Ouzel Falls to Calypso Cascades can be a downright exhilarating bobsled run! Just be sure to have visibility, caution, and pity on the snowshoers, who are not accustomed to reacting to anything other than the immediate desire to take a snack break right in the middle of the trail around blind corners. (Just kidding! Kinda).

Finally, Ouzel Falls itself is nothing more than a frozen chunk of ice and snow in the winter (shown in first picture), resembling nothing of it's summer intensity. (In fact, I have not yet seen it in summer).

We turned around here, but one can continue to a fork which leads to Ouzel and Bluebird Lake; or ultimately to Thunder Lake. These options increase the chance of trailbreaking in deep snow, and other parties on this day had turned around in a myriad of social trails in the rocky terrain above the falls. I previously had made it to Thunder Lake after much effort, but was unable to enjoy the scenic views in a snowstorm and having taken longer than I expected to break trail, so I would recommend further destinations only with an early start on bluebird Spring days.

As it was, we had a mixture of just a bit of sun but mostly light snow and clouds, but the clouds and cooler temperatures kept the snow absolutely perfect for skiing in both directions.



Although Ouzel Falls itself wasn't entirely impressive in the winter, J enjoyed all of the views and mixture of terrain, which ended up being her longest snowshoe outing by mileage. Luckily, near the TH, there was an igloo ready for her to take a break!