On a recent trip to visit family in Utah, I went on an early morning recovery run and wound up in the ER. After a long day of travel and a poor night’s sleep, I arose early to run and found myself struggling to maintain an 11:00/mi pace (for me, that’s very, very easy under normal conditions). Initially, I rationalized that I was probably dehydrated from the flight, and that I was now running at 5,000 ft elevation when I live and train at sea level, and that I was tired from not sleeping well. All of those factors were valid reasons as to why I’d struggle, so I pushed on, trying to shake off the extreme fatigue. However, I only made it around the block before deciding to stop and walk back. During that 5 minute run, my heart rate had skyrocketed and I had to sit down on the curb 3 different times just to catch my breath.
Something wasn’t right. And I knew it.
As endurance athletes we are hard-wired to push ourselves when we’re tired. To ignore fatigue, and to keep on going when our body is telling us to stop. We are expert at ignoring pain and testing our limits. Even those who aren’t athletes are good at pushing themselves past the point of discomfort as they exercise. So how do we know when to stop our activity and when to push through? What are the signals we should listen to and what can we effectively ignore without getting into serious trouble?
Here are 4 rules that can help us understand our body’s response to hard workouts, and us realize when to stop an activity:
Out of the ordinary- Most people have a history of how they respond to certain activity levels. Even if you’re not a serious athlete, we all know what it’s like to do a hard ride, run, or other challenging workout. We know how it feels to push our legs, our lungs, and our bodies and how we respond. For serious athletes, we have data points that can help: power numbers, pacing, and heart rate can all be used to help us determine if any discomfort we are feeling is ‘normal’. I’ve told many clients, being a triathlete is about ‘becoming comfortable being uncomfortable’. However, when that discomfort becomes not normal, meaning you’re feeling different then you normally feel during a similar workout of the same intensity, you might want to back off. Nausea, extreme fatigue, dizziness, etc. are outside the realm of normal. If you feel these symptoms or anything out of the ordinary for you, it’s a good time to stop.
Acute pain - this goes without saying, but it bears repeating. If you suddenly experience sharp, shooting, or acute pain, this is your body’s alarm bell and you need to listen. General discomfort from aching muscles and accumulating blood lactate is normal during hard workouts; sharp pain is not. If you’re not sure if the pain is acute or general, here’s a post I wrote a while ago about injuries that can give a bit more direction.
Extremes- this is similar to recognizing things out of the ordinary, but more dramatic. If there is anything during the workout that causes a person to go from one extreme to another, this is a sign to stop immediately. One example is heat exhaustion/heat stroke- when the body is unable to cool its core temperature by sweating and the person overheats. Initially an athlete may be sweating profusely, then over time, they stop sweating all together. This falls under the ‘extremes’ rule. In this instance, the athlete can no longer produce sweat to cool the body and they will overheat and go into heat stroke unless they stop and seek medical attention immediately.
Listen to your gut- this is probably the most subjective rule, yet the most accurate. If something tells you to stop, even if you can’t point a finger on it, you need to listen. Even if you’re in the middle of a group run, or out on a ride with your training partner, listen to your gut. On that run, I knew something wasn’t right, even before I checked my HR and pulse. I knew something was wrong. And I was right.
During my early morning run, I had gone into atrial fibrillation (A-Fib), a condition where the upper chambers of the heart quiver erratically and don’t expel all the blood from the heart. This causes an irregular heartbeat, and if left untreated can lead to a blockage in the heart (a blood clot). If undiagnosed, this has a very high likelihood of causing a stroke, when the clot breaks loose and travels to the brain.
Luckily, I recognized something wasn’t right. It wasn’t the altitude, (I’ve run in Utah countless times over the years and understand how my body responds to the change). It wasn’t a lack of sleep (need I remind any of you I have two toddlers and haven’t slept well in 4 years). It wasn’t dehydration (I’m used to being slightly dehydrated on runs). Something was definitely wrong. I walked back to the house, had my wife check my pulse and she confirmed it was erratic. I texted a client who’s husband is an ER doc. She relayed the message and he called me immediately and confirmed it sounded like A- Fib and told me to hang up and go straight to the ER. After a battery of tests they determined the best thing for me to get my heartbeat back on a regular rhythm would be to shock me, just as they would to someone in cardiac arrest. After sedating me, they did so, and my heart rate returned to its regular rhythm.
This was an important reminder to me to pay attention to what your body tells you. Understanding the difference between danger signals and the body’s normal response to hard workouts are paramount in helping everyone, athletes and non-athletes alike, train safely and successfully. In my case, it was critical that I recognized that something was wrong and I’m certainly glad that I did.