Lessons Learned at the Ultra Sports Science Foundation

By Dr. Andrew Pasternak, Silver Sage Sports & Fitness Lab

On May 30, 2017, I had the pleasure of attending the Fourth Annual Congress of the Ultra Sports Science Foundation in Denver, Colorado. The Ultra Sports Science Foundation was founded by three incredible docs: IMG_3243t theDr. Marty Hoffman, previous research director for the Western States 100, Dr. Volker Scheer medical director for the Al Andalus Ultimate Trail race as well as the assistant sports medical director at the University of Paderborn, Germany and Dr. Patrick Basset, an anesthesiologist, mountain rescue doctor and medical director for the International Paris Marathon, UTMB and stages of the the Tour de France.

This is my third time at the conference  (I unfortunately missed last year in Chamonix, France – still kicking myself!). This one-day conference is packed with incredible information from physicians and researchers throughout the world. I was fortunate enough to present a couple of case reports:  one on a local runner and another with Carol Lindsey from the Castle Peak 100K (so the DPMR premier race has now been presented to an international scientific meeting!).

Over the next few months I’d like to share some of the highlights of the lectures and what I’ve learned at the meeting.  We’ll start with the first two presentations today.

After a brief talk on the participation trends endurance sports (more people doing more events), the first two talks focused on nutrition. The first, by Kristin Stuempfle, PhD was entitled “Sodium Good or Evil in prolonged exercise.” Dr. Stuempfle is a PhD from Gettysburg College in Penn and has a number of publications with Dr. Hoffman including studies from WS100. She had four main questions:

  • Does sodium prevent dehydration?
  • Does sodium prevent nausea?
  • Does sodium prevent muscle cramps?
  • Does sodium prevent exercise-associated hyponatremia?

To make a long story short: Current research does not show that sodium supplementation prevented any of these issues, so there is no need to take salt caps.  She also presented a few anecdotal cases of runners who got into medical problems after pushing too much salt (over 7000mg). While these were just case reports, the idea that too much salt can cause problems is concerning.

Her bottom line is simple: If you’re thirsty: drink.  If you’re craving salt: eat something salty. As an aside, the one concern I’ve always had with salt tabs is that you don’t taste the salt. There is a thought (not completely scientifically proven) that sensation of tasting salt is as important as the salt itself.  In full disclosure, the folks at Easy Street aid station saw me try some salt tabs when I got cramps during the Broken Arrow. I’m not convinced they did anything!

The second talk was from Trent Stellingwerff, PhD from the Canadian Sport Institute Pacific, who is also a very active endurance athlete. His talk was entitled “Fueling for Optimal Ultra Performance:  from high carb to keto-adaptation.” Dr. Stellingwerff reviewed much of the data dating back to the 1925 Boston Marathon on the importance of carbohydrate intake with endurance exercise. In the 1970s and 80s, a number of studies from Dr. Edward Coyle show that carbohydrate ingestion did increase the amount of time that it took to fatigue.

Over the past few years there’s been much more of an emphasis on trying to burn fat more effectively during exercise. The rationale is that if athletes are able to burn more fat, they may not need as much carbohydrate intake during the race and may not have as many GI issues, a common reason people don’t complete races.

A few important points I learned:  to truly become ketogenic, most people had to ingest less than 50 g of carbohydrate per day for at least three weeks.  Also the data on ketogenic diets improving performance are very mixed, in part, because the definition of “performance improvement” varies so much between studies. Finally, Dr. Stellingwerff did point out our bodies are more efficient producing energy from carbohydrates than from fat oxidation.

Finally, he pointed to the diets of some elite athletes:  Kenyan marathoners get anywhere from 67-77% of their calories from carbohydrate. The famed Greek ultrarunner Yiannis Kouros, during a five-day race from Sydney to Melbourne, was able to ingest 11,000 calories a day and 95% of those calories were from carbohydrates including baklava, creamy custard and honey cookies.

His bottom line was that ultimately every person is different and we all need to experiment. Some of these differences are probably dependent on your muscle fiber type. Parts of this are also likely based on your ability to digest carbohydrates during exercise which is incredibly variable from person-to-person.  Finally, for people doing races where they are going to be exercising at higher intensities, carbohydrates are still likely the go to.

One of the exciting things is that because participation in ultra endurance events has been a fairly recent phenomenon, the research is also new and is constantly changing.

Thank you for reading and stay tuned for more updates!

 

Turning Adversity In To An Asset

**Disclaimer – this blog post was mentally crafted during a cyclo-cross sprint training session, so excuse its seeming edgy-aggressive tone.

So last year at this time I was in the throes of a torn MCL, ACL and meniscus – the result of a series of events – a couple of encounters with enthusiastic dogs, and the final blow coming at US National Mountain Bike Marathon Champs.

IMG_0702

I interviewed four ortho-surgeons, two dismissing the severity, saying, “You’re fine, carry on.” The only logical reason I can figure for this advice, is that it was a case of “Ah, she’s a 40-something and has plenty of stability to push her mini-cart down the Whole Foods isle and load the groceries into her Prius.”

Let me be clear on one thing…I do not drive a Prius :)

But honestly, the best thing these docs did for me, is underestimate me. As a result, I decided I was not quite ready to throw up the white flag and curl up in my coffin, and signed-up for surgery with a surgeon who understood and respected my lifestyle.

I mentally had this strange peace with the entire episode – injury and prospect of surgery, the journey back, and all that entailed. I saw this six-month hiatus as an opportunity to push my body’s mental and physical reset button. I also, in a very positive way welcomed this opportunity to rehab, and return to sport as a way to emotionally and physically live every minute detail, that I train and work with others to accomplish. And finally – I saw it as a challenge to return stronger than I had left sport, by placing a more purposeful emphasis on stability and mobility, basically the only things I could do for the first couple months.

Athletes that I coach will tell you, they get sick and tired of me continually emphasizing that the off-endurance work of hip activation, hip-trunk stability and global mobility takes equal billing to the sport-specific endurance work. But I am a sincere believer, because I have experienced the benefits of this consistent investment in my own athletic life.

I took this rehab opportunity as a focused period to develop and improve every little functional stability and mobility fiber of my body. I knew that if I set this foundation in place – when the time came to hop back on my bike, and start running again it would translate in to improved efficiency of power in to the pedals and foot strike, and act as my safety net to help avoid over-use as well as traumatic injuries.

pic 2

Nearly a year to the date of my decisive injury last year, I lined up for US National Mountain Bike XC Champs, and finished what I started, to take the victory. And like with all of our endeavors – the riches and lasting benefit was not on that particular day, but all that I had experienced, learned and gained along the way.

So it goes, seeming set-backs can be turned in to invaluable opportunities.

Importance of Fit for Junior Cyclists

As title sponsors of the Reno Tahoe Junior Cycling team, we have the opportunity to support the team, in their pursuit of excellence, with bike fitting, physiologic testing, as well as provide advice on training and recovery strategies. Below is a post from the team’s director, Trevor DeRuise on the importance of bike fitting for his athletes.

IMG_1719

Cyclists are very well known for going to incredible lengths to squeeze a little more speed out of their bikes. Shaving a few grams off of a competitive bicycle can literally costs thousands of dollars and deliver such marginal improvement that it’s easy to wonder if the investment is really worth it. Curiously, one equipment upgrade that so many people overlook is a professional bike fit. For a fraction of the cost of a new carbon wheelset, a professional bike fit improves performance, comfort, and protects riders against overuse injuries.

While any cyclist can benefit greatly from a professional bike fit, I would say this service is exceptionally important for junior cyclists. The reason is that junior cyclists are constantly growing. With this, their fit is constantly being altered even if nothing on the bike is actually changing. In order to both prevent injury with their young joints as well as maintain optimal performance and comfort, having fit assessed throughout a junior cyclists season is paramount.

kids3

As the 2015 season nears for the Reno Tahoe Junior Cycling team, we were privileged to have our athletes visit Silver Sage Sports and Fitness Lab for pre-season fits, with Julie Young,  before training really got underway. Having come off a 3 month off season, it was apparent that several athletes were already in need of raising their seat height. This was just the tip of the iceberg though, as every angle of the athletes body was then measured and analyzed in order to create optimal muscle recruitment through every pedal stroke, prevent overuse injuries in the knees, and provide optimal comfort for long rides.

During the fit process, other fundamental yet incredibly important things like pedal technique were also taken into consideration. Focusing on all of the small things that are often overlooked like this early in the season can help young athletes create good habits and allow them to get the most out of their training while minimizing injury risks.

I understand how challenging junior racing can be for families from a financial standpoint. With this, I’ve never been one to recommend “buying” performance in the shape of fancy carbon parts or new bikes every season. Instead, I recommend finding the potential of your rider’s current setup through a proper fit and analyses. At the junior level, the most important thing is keeping the rider safe, efficient, and letting them fall in love with the sport.

Pasternak Named Family Physician of the Year

Reno, NV (January 31, 2014) – Dr. Andrew Pasternak, owner of Silver Sage Center for Family Practice and Silver Sage Sports Performance, has been selected as the Northern Nevada “Family Physician of the Year” for 2013 by the Nevada Academy of Family Physicians.

The Nevada Academy of Family Physicians considers the Family Physician of the Year based on the following criteria:

  • Provides his/her patients with compassionate, comprehensive and caring family medicine on a continuing basis;
  • Is directly and effectively involved in community affairs and activities that enhance the quality of his/her community;
  • Family physician is a credible role model professionally and personally to his/her community, to other health professionals and residents and medical students;
  • Family physician can effectively represent the specialty of family medicine and the AAFP in public speaking;
  • Family physician is in good standing in his/her medical community;

“It’s an incredible honor to be selected as the Family Physician of the year by the NAFP,” said Dr. Pasternak. “Any award is always special, but to receive an award from your colleagues is quite humbling. I’d like think this really reflects the overall care our patients get at Silver Sage Center for Family Medicine from all of our physicians and staff.”

Dr. Pasternak founded Silver Sage in 2005. He is board certified by the American Board of Family Physicians. He is also an assistant clinical professor at the University of Nevada School of Medicine and serves on the board of directors for the Washoe County Medical Society, Access to Healthcare and the Nevada State Health Information Exchange.

About NVAFP

The mission of this organization is to promote excellence in health care and the betterment of the health of the citizens of the state of Nevada. For more information, visit http://www.nvafp.com.

About Silver Sage Center
Silver Sage Center is committed to providing high quality health care for the entire family. They treat the entire spectrum of medical conditions, ranging from simple ear and sinus infections to more complex problems like heart disease and cancer. For more information, visit http://www.silversagecenter.com.

 

###