Recovery after an Ultra
It’s been 4 weeks since the Lakeland 100 and I can finally say “I’m back to normal”.. whatever that is. I was totally prepared for this and even before the race, I had it in mind to “down tools” for the month of August. Recovery after such a physically and mentally demanding event is complex and also very individual. I do want to emphasize the “individual” aspect before I go on. At the awards ceremony after the race, it was clear to see who was suffering the most. I was hobbling along while some others flying around as if they just had a nice easy jog the day before. There are several factors that govern speeds/rates of recovery; experience/age, miles in the legs, conditioning, physiology mechanisms, massage, compression, cryotherapy, and of course nutrition. Before I discuss these points, I will say that some individuals either through experience/conditioning or just natural fast and efficient cellular recovery mechanisms (maybe call this “genetics”), don’t suffer as badly as the rest of us and recover much quicker. Ultrarunning though, especially over mountainous terrain, is arguably one of the most physically demanding sports in terms of muscle damage and fatigue. It’s also unchartered territory when it comes to research and development as it’s a relatively new sport (e.g. first UTMB was 2003). Not only that, but in terms of laboratory studies, it is impossible to replicate, simply because of the duration and also the other important variables such as terrain, weather etc. So we just don’t have much to go on and not only that but because of the magnitude of the event, there are such varied individual responses. This means that a lot of the time it’s a case of finding out what works for you. So this blog is a case of N=1 and there is still a great deal of speculation when it comes to what works and what doesn’t. Hopefully though, the information here will give you some insights about certain principles and idea’s that you can try out yourself.
So back to N=1. If you read my last blog, you will know that the day after (which was a Sunday), I could barely walk. By Sunday night, the legs were actually stinging with the pain. I then spent the next 48hrs in a vegetative state ! That meant I didn’t get much further than the couch, and the biggest challenge was getting up and down the stairs. Fortunately, one of the advantages of working for yourself is that you can “postpone” work when required, so that’s what I did. That meant that I could not worry about leaving the house to meet clients etc and also, not think too much ! In terms of the actual fatigue that I was experiencing, it’s worth trying to explain what this actually is:
This is the obvious one when you are simply depleted of glycogen. You’ve probably felt this after a hard long bike or a hard long run. You feel the “bonk” and your cells simply don’t have much available glucose to produce energy quickly. This, in general, is not the sort of fatigue that ultrarunners experience as we simply don’t run at a pace where our primary source of fuel is carbohydrate. In addition to that, because we are running more slowly, we can eat, so we are far less likely to completely empty our glucose reserves.
Ultrarunning for 100miles over mountains puts the body in a catabolic state. This means breakdown; breakdown of proteins, carbohydrates and lipids. On a macroscopic level, this means you breakdown muscle tissue, on a microscopic level, it means breakdown of cellular molecules such as enzymes and transporters. In terms of muscle breakdown, this is what causes the pain in the legs. Muscle fibres are being torn apart, waste products build up and the area becomes inflamed. The associated pain then prevents you from contracting the muscle properly which causes you to reduce pace and also put stresses on other muscle groups. So your muscles become sore, you overstress other muscle groups, this slows your pace and this potentially leads to injury. In my case (and most who did the L100 !), this was my main problem. The damage was felt most at about the 50mile mark and continued to get worse as I went on.
There are a few different takes on this. Some relate it to the build of metabolic waste (e.g. Hydrogen ions) which lowers the pH which affects muscle contraction. My interpretation relates more to the actual shut down or slowing of metabolic processes. During long duration demanding races, the body is put under a significant amount of oxidative stress. This causes an increase in the production of free radicals which want to react with and damage other molecules and structures in the cell. So things like mitochondria (the engine rooms where we produce energy) are broken down, the cell wall is damaged and various other molecules that help the cell to function are attacked. This then means that transport in and out of cells (i.e. fuel and waste products) lessens and the pathways to produce energy become inhibited.
This is all to do with the brain and central nervous system. It’s a complex subject that’s not completely understood yet so I’m not going to get into too much detail. Simply put, if the brain doesn’t work, neither will the rest of your body regardless of how fuelled up you etc. The neurological signals that are sent by the brain to your muscle fail to operate correctly and this then results in impairment of muscle contraction. This is also known Central Governor Theory and it’s been suggested to explain fatigue after prolonged strenuous exercise. Its fatigue on a sub conscious level where all the various signalling mechanisms and set-points are essentially changed so that it makes you tire and eventually stop. As I mentioned, you might feel fine energy wise but this is the body’s way of saying “you shouldn’t be doing this to yourself, stop now!”. It’s a very interesting concept and its one that definitely plays a role in ultra endurance sports.
To put this into context, I’ll just explain what I went through. As I said, the first problem I encountered was the muscle soreness and pain. As the race progressed, downhill running become almost impossible due to the damage it caused. Mentally, I felt pretty strong, I never for one moment considered stopping. Energy wise, I was also fine, nowhere near bonking. I did feel a different type of fatigue, just had nothing really in the legs, partly due to the muscle soreness and maybe partly as a result of metabolic fatigue. At the finish, after 25hr51mins, again, I didn’t feel depleted of energy, I could have actually kept going ! What was preventing me from functioning properly was the muscle soreness and damage. I could barely bend my legs. As a result of damage, I put additional stress on my hip flexor which has been tight/stiff ever since and I’m still trying to shake it off. It’s not a serious injury, more of an “overuse” injury but it confirms to me how other muscle groups/connective tissue are put under strain when certain specific areas become thrashed (in my case, my quads). The following couple of days were spent nursing very sore legs and swollen feet. The swollen feet is caused by inflammation which causes fluid to seep into muscle and under the skin. As I mentioned, I also spent those days in an almost “vegetative” state where I moved and did very little. I think this was the metabolic and central fatigue kicking in. On the Wednesday (3 days after the race), I went out on the bike for a 1hr easy spin. The muscle pain was more or less gone at this stage and I was able to walk up and down the stairs normally ! However, they were nowhere near fully recovered so I decided to not run until they were. I cycled again on the Thursday and Friday, just really easy spinning, 90mins this time. On the Saturday, I did long group ride (3hrs) and the Sunday another group ride (2hrs). I did not feel good on either of these rides. Also, I was a lot more hungry than normal both during and after the rides. This was maybe as a result of the Metabolic Fatigue whereby I wasn’t producing energy as efficiently as usual. Thus, I wasn’t fuel efficient and certain pathways (like fat metabolism) were not working as good as usual. I then (8days since the race) finally went on my first run on the Monday. This was a 30min off road flat run. It was a trot and the legs were still a bit sore. The next day I then went out on a 2hr group ride and actually felt pretty good. I started to realise how damaging running was to your cycling ability as the rest from running had finally given me back my “cycle legs”. It was also a sign that both the Metabolic and Central Fatigue was finally coming to a halt and I was returning to “normal”. On the Wednesday, I did another easy 30min run, and the legs started to feel okay.
So 10days later, I was over the main obstacles, muscle healed, swelling down, metabolism and brain almost back to normal function. I then made a trip back to Dublin for a few days for some work. Going home to Dublin is never just solely for business and with me “downing tools” for the month of August, I intended on meeting up with a few friends for “some” drinks. To cut a long story short, the “some” turned into “many”, I also thought it would be a good idea to cycle in and out of town. Needless to say, my cycle out of town was drink fuelled resulting in me careering off the road and crashing into a traffic island ! In my inebriated state, I didn’t land to well and took most of the hit on my face. I was carted off to A&E to get patched up and received a few stitches just above my lip for good measure. I’m sure you’re having a good chuckle to yourself now (and so be it!) but I was furious with myself. Here I was, just recovered from the most physical and mental damage I’ve ever put myself through, applying all my science and nutrition knowledge to the process, now back in hospital getting stitched up, battered and bruised ! And it was my own entire complete fault ! Anyways, lesson learnt but this meant I had put my body through further stress that it now needed to heal and recover from. This took another week where I continued to do easy runs and bikes but felt pretty shit. I think I may have even got a little infection as my wounds were dirty and no matter how much I cleaned them, there was still bits of dust and dirt visible. So anyway, after about a week, most of the cuts and grazes had healed up and my body was coming to the end of its “phase II” of recovery. Into week 4, and I decided to pick the training back up a bit. I started doing longer runs and also did my first high intensity sessions which consisted of some intervals with my running club. I also did a few harder bike rides. I even managed my first swim session. You might ask why I hadn’t been swimming since the beginning as it is obviously the least stress on the legs. Well, the main reason is how ridiculously early the sessions are. They start at 6.45am and the fatigue I was experiencing for the first couple of weeks just meant that I could not get up early. Secondly, I just don’t really enjoy swimming, I’m not a good swimmer so it just doesn’t appeal to me. I do it simply for the cross training benefit and the satisfaction that I get when I’m home before 8am knowing that I’ve actually done a training session ! So now we’re into week 5 since the race and I’m finally back to normal. I’ve done a few 2hr runs and the legs and fuel efficiency are good. I’m back to training twice most days and I’m putting in some tempo and speed sessions. I’ve also started back doing some resistance training. Apart from the muscle, brain and metabolic fatigue, the physical changes to my body are as follows: I now weigh 2Kg lighter (68.5Kg to 66.5Kg). My body fat has reduced by about 1% (skinfold measure) which equates to just under a kilogram. So I’ve lost just over a kilo of muscle in addition to the fat. This was to be expected given how catabolic the event was. Your body just breaks itself down and the strenuous nature of the event means that you strip down muscle. So that’s it, 4 weeks later (delayed by a little accident), over 1Kg of muscle loss and just under 1Kg of fat loss. That’s how long it has taken me to recover and what it did to my body.
Too just expand on a few of the recovery strategies I used, here goes
The ice bath thing is still an issue of debate. To cut a long story short, it reduces the pain but does not necessarily reduce the inflammation. It also can prevent adaptation so the muscle doesn’t learn from the stress. If you are in pain, I think they are worth using. Therefore, I’ll use them after hard races or really hard training sessions. I certainly wouldn’t use them on a routine basis for training. Compression garments are another issue of debate. I think the research to date so far shows that they do not improve performance and whether they improve recovery or not is still questionable. For such long hard events such as mountain ultramarathons, I think they’re useful. The quality and fit are important aspects. I used Nike compression socks, not great, as they are just a standard fit. I do however intend on getting made to measure full leg length compression tights.
In terms of standard recovery nutrition, I’m not going to re hash what I’ve already written about, you can read my article “Essential Recovery for Endurance Athletes” for all this info. What I did do which I haven’t talked about too much is that I made my nutrition very anti-inflammatory and very adapted to protein synthesis. The anti-inflammatory nutrition is to help bring down the inflammation that causes cellular damage, hormonal damage (raised cortisol) and immune system damage (which is why people get run down and ill easily post race). Anti-inflammatory nutrition is about increasing omega 3, reducing omega 6, choosing anti-oxidant rich foods and avoiding pro-inflammatory foods. I upped my omega 3 intake to 4g of EPA per day (through fish oil supplementation) and avoided omega 6 rich foods. I added things into my foods like turmeric and ginger (which have strong anti-inflammatory properties) and also kept up my intake of green tea (for its polyphenols). In terms of protein synthesis, this is the process that helps the body re-builds. Muscle is not the only thing that is built from protein. Enzymes, hormones, immune cells and capillaries are all built from using proteins too. Therefore, I ensured that my protein intake was high, particularly branched chain amino acids which trigger the protein synthesis pathway. In addition to protein, fats are also need for growth as they make up cell walls and are also pre-cursors for anabolic hormone production e.g. testosterone. So, good naturally sourced fats from meats, fish, eggs and nuts were common features of the menu. I could go on a lot more here but I just want to give a summary or else this blog will turn into a book !
Of course exercise is part of the recovery process which I have detailed above. My plan was to hang up the trainers for a while and do a bit of easy cycling. Some might say that the best way to recover from running is to run, and there is truth in that too. However, my legs were so thrashed and in so much pain that I simply couldn’t run. In hindsight, I’m glad I delayed my return to running and feel that it was the minimum amount of time off the feet needed. Generally any type of exercise that you enjoy doing and doesn’t hurt will aid recovery simply by helping blood and to just keep things ticking. Certainly, doing nothing is not advised as this will slow your recovery and even cause loss of training adaptations and fitness. Definitely doing easy exercise is the obvious choice with the intention of slowly building up the mileage and the intensity.
As I mentioned, much of the fatigue after ultras is caused by the central governor mechanism. Apart from all the other strategies I’ve talked about, simply not thinking about training and racing is for me an important part of the recovery process. Mentally preparing for a big race is a tough task and requires a lot of focus and self motivation. It’s very easy to over focus and become obsessive about your mental approach which I suspect happens to a lot of ultra runners and endurance athletes. In the case of ultra trail 100 milers, there is a lot to think about simply due to the duration, the unknowns and the challenge. There are not many experienced 100mile runners out there as a) there is only so many of them you can do in a year and 2) they haven’t been around for that long. So for many, 100miles is a new experience and even if it’s not your first, it might probably be your first time doing the particular course. So you still have mental challenges to focus on such as terrain, gradients, weather, altitude etc. All in all, big races like this are huge psychological battles and everyone has to fight for themselves. Thus, my recommendation is to switch off from them as soon as they are over. It’s one of the reasons why I wrote my race report so quickly, so that I could pack it away and not think about it any longer ! This is what I did for most of August, I didn’t think much about races, I didn’t have a structured training plan and I didn’t run much. And for me, that helped big time. Now I’m ready to roll again, I’ve entered my next race and I’m planning out my training programme as we speak. I’m also looking forward to running long again, for the first couple of weeks I didn’t want to run longer than an hour. So rest your thoughts, forget about doing what you love for a while and you’ll love it even more when you come back !!
As per usual, this blog is about 5 times longer than I expected it to be. I’ll just finish off by emphasizing what I alluded to at the start. Ultra endurance events, particularly ultrarunning, is unchartered territory for most and its putting the body in places it hasn’t been before. Much of the science behind it is still undiscovered and I’m just trying to understand it and research it myself. I’m by no means saying everything I write is gospel, because it’s not and I realise that people do things that may go against much of the theory but still get results (e.g. Mr 44 gels !!). Therefore, I’ve written this blog to help people understand the concepts and to give an indication as to how things work inside the body. Maybe you now know a bit more about why you feel tired and maybe I’ve given you a few idea’s as to what to do about it. I think when it comes to extreme ultra endurance events; there are no rights and no wrongs.