In light of recent events that have taken the lives of 3 athletes during long distances running races, I think there are some lessons learned that everyone should consider. Obviously hindsight is always 20/20, but in the unfortunate case of Ryan Shay, his doctors told him that he would need a pacemaker. There are a few takeaways I have from this recent outburst of sports-related deaths.
1) Listen to your body. If you feel the slightest bit "off", don't go hard like its a race day. There is always tomorrow to push hard when you are feeling better. One day is not going to make or break your season.
2) Have regular check ups and physicals with your doctor. True many of these incidents are described as "rare" or "isolated", but with more and more people participating in endurance events, one has to expect the numbers to rise. What is important is that you have to listen to your doctors. If they warn you of something that may be of note, pay attention and do what you have to do so you don't risk further harm. Don't just ignore it and hope it gets better with time.
Due to the fact that we all tend to be Type A athletes, most people are stubborn and unlikely to alter their plans based on feel. I think these events are more of a wake up call to listen. No pain, no gain will only take you so far. A smart athlete is in line with their body and listens to those around to make sure you put yourself in the best possible situation to succeed.
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When I was running the MCM last weekend, at around mile 21 there was a water stop. Two Marines were joking back and forth and as I ran by yelled out (to nobody in particular other than the runner) - "If you don't drink water - then you're going to DIIIIEEE!". While I spewed my water laughing at the time (and they burst into laughter watching me spray water), there is some truth to that. In order to 'survive' these long events you have to ensure you do it smartly, otherwise you will end up face down on the pavement.*
*Btw, as an aside, it's actually much better to end up dehydrated than overhydrated. There is really squat medical professions can do with hyponatremia in comparison to dehydration (which they just stick an IV into you and call you ready to roll (dehydration)). There's a really long good article about this in the Hammer Nutrition free 72 page downloadable thingy from thier site.
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