Triathlon Doctor Busts Training Myths

This podcast is brought to you by Trivalo Coaching, where we help triathletes and cyclists like you train smarter to race faster. I'm your host, Jordan Donnelly, and on my left is former Australian Ironman champion and head coach of Tribalo Coaching, Gerard Donnelly. Today's guest is someone who sits at the perfect intersection of science and sport. Jeff Sankoff is not only a seasoned triathlete, but also an emergency physician and the host of the Tridoc podcast, which is a we're very grateful to be on recently. On the podcast, he brings a sharp evidence based perspective on what really keeps endurance athletes healthy and performing at their best. Whether it's understanding new supplements or busting dangerous myths we hear all the time in triathlon circles, he's here to help us separate fact from fiction. Jeff, a very big welcome to the show.

Oh, thank you so much. It's really a pleasure to be here and to continue what I thought was just a great conversation that we had on my program.

Totally agree. And we're going to dive right into some of your fun philosophies on training and racing, especially from a medical perspective, and try and bust some myths that get casually thrown around in the triathlon industry. But first of all, the Giro d' Italia just finished. You're a cycling fan, we love discussing cycling and we wanted to get your opinions. Especially on that last stage, we were thinking, what the hell? And I think you were thinking the same.

Yeah, it was crazy. So my son is a huge tattoo Pikacha fan, and every year, since he was probably 10 years old, every July, we sit down, we watch the Tour de France every day. It's a. It become. It became a real bonding thing for us. And I think that's how I sowed the seeds for him to get really into cycling, which has been reaping rewards anyways. He's become more and more into cycling, where he watches all of the big races now. And he really got into the Giro this year, telling me every day like, oh my gosh, are you so not doing well? And this kid Del Toro, he's coming out of nowhere. And so I was hearing all about Del Toro before I even knew who Del Toro was. I was getting all the updates from my son, and the more I kind of got into it and started watching, I was like, wow, this kid is really something else. And when Carapaz really started attacking in the later stages and just could not shake this Del Toro kid, I thought, he's the real deal. This is actually going to happen. And so here they go into this last stage, 20, the penultimate, the Queen stage, is all the different euphemisms. And it just seemed like it was a done deal and this was going to be the day for Carapaz to, you know, do or die. And when they started tearing up that climb and EF education, not the strongest team, but just shattered the GC group immediately until you had just the four of them left. It was really very impressive. And so you had Carapaz and Del Toro and Yates and G Canadian, obviously happy to see Derek there, and the four of them just battling it out in just an epic, epic stage. But what I could not understand is how Del Toro, who seemed invincible to that point, just lets Yates go. I mean, I understood him not wanting to necessarily go too early and pull Carapaz along, thinking, maybe, you know, I'm going to burn too many matches. Carapaz is then going to break away from me and I'm going to lose the Giro. But at some point, it's like, well, you're losing the Giro to Yates. You've got to do something. And this whole cat and mouse thing where the two of them were, like, almost coming to a standstill, and, I mean, you have to figure that Del Toro just didn't have the legs to go, or it was just weird because he clearly had the legs to go with every single attack that Carapaz did.

Exactly.

But yet all of a sudden, when Yates starts pulling away and away and away, he's not doing anything. And to what end? Because he's worried about Carapaz. I mean, at some point, you have to worry about yourself. And, I don't know. I said to my son Adam, I was like, this is not what Pogacha would do. Like, Pogacha would never sit back and let someone take the race to him. He would be the attacker. And listen, the kid's 21. Obviously sign of immaturity, a sign of not understanding. But, I mean, what was his race director yelling into his ear at the same time? I mean, and then after the race was over, it was very odd, too, because the interviews were weird. I didn't see Carapace. I didn't see Carapaz get interviewed. I'd love to know what his thoughts were, because Carapaz just seemed disgusted. And I was like, I. I'm not sure what he has to be disgusted about. I mean, he tried everything he could to shake Del Toro. He couldn't shake Del Toro. The fact that Del Toro wouldn't go after Yates is like, I mean, what is Carapaz upset about. I didn't really understand what he had to be mad about. But I I Del Toro's response of oh, I'm just so happy to be in white and I'm so happy to finish second. I'm like, dude, really? You were like in pink for the whole race. This was your chance. This was like, you are going to regret this for years. I mean, there are cyclists who go their whole career. I mean, look at what Yates, right? What? Since 2018, he's regretted not being able to get another big victory and then it just got handed to him on a platter. Now listen, his attack was amazing. And, and to have wout waiting for him on the downhill, I mean, this guy Van Art, like the whole con, the whole comparison of Van Art to Vanderpoel is fine, but Van Art is, I think just leagues ahead of Van der Poel. In a Grand Tour, like in a one on one, on a one day race, Van der Poel clearly is the better rider. But when it comes to these Grand Tours, I mean, you never see Van der Poel go up in a breakaway. You never see him being up there able to do what Van Aert can do. I mean, he single handedly won Vingegaard the Tour de France and he single handedly gave Yates the win yesterday. I mean, the guy is an incredible asset. Clearly Jumbo visma or visma. Lisa bike knows that. I mean, they gave him so much money to keep him forever, so good for them. I just, yeah, it was, it was such an entertaining and perplexing stage at the same time. I could, I could just talk about this like the whole time, right?

That is an absolutely brilliant breakdown. That is as good as you can get. And Dad, I was waiting for you because I know you have a lot of thoughts. I just want to let you jump in.

I'm almost lost because you summarized it unbelievably well. Jeff, some of the points you raised and I think when I look back at what Del Toro was doing, a he wasn't the lead rider. You know, he kind of stepped up when their lead rider was actually in really bad form. And I just don't look, in normal, normal racing, this kid is a racer and if he had the legs, I reckon he would have tried to go with Yates. But he was, I think, really worried that he didn't have the legs. So he was playing a little bit of poker and trying to get Carapaz to do the work whilst he still wasn't in a losing position. So that was kind of Intriguing to watch him. How long is he going to. I think he was bluffing. I don't think he had the legs to actually do anything but follow. Even though it looks like on telly, you know, he doesn't have to chase Yates. I don't think he could. And he was hoping Carapace was.

What irritated me was his sprinting at the finish. I was like, that was such an immature kind of, you know, like, what was he doing? Like they were coming in together after he clearly had blown it. And now in the last couple hundred meters, he's making this big show of sprinting across and the commentators were making, oh, he's honoring the jersey. And I'm like, no, he's not. He's showing up Carapaz. He's showing up Derek G. Who really, really worked hard on this stage. I thought it was pretty not okay.

And look, when you, when you look at Del Toro, whenever Carapaz attacked Del Toro I think was emptying himself to follow and just trying to keep up and he had no ability to counter or to do anything else. I think the kid was on his limit. But that, what you say is true. When you, when you know that the person's going to give 30 seconds or 50 seconds or a minute 10 of all out effort. His mental racing attitude was, I just got to hang on here. And yeah, Carapaz can't keep doing this. And if he does four more, maybe I'm going to be blown out of the water. But, but you know, the whole tactics. I'd love to hear what the, the director sporties were saying in the car to Carapaz. And I'm sure, you know, Del Toro, if he had the ability, would not have let that happen. I just don't think he had the ability. And I think we're asking a bit much of him to, to be at that age. First Grand Tour. You know, he's been in pink for how many days? 10 or 11 days. Yeah, I think, I think that was interesting. But the W Van Art story is just another evolving story. And you know, we absolutely love Jakob in Gabritson and W. Vanata are the two most topical things we talk about in our podcast, which is hilarious for people listening. We've got this love relationship with whatever W does is gold. And your summary is great. But look, Van Der Pol has a special role in tours as well. He leads out the winners for the sprints. Yeah, yeah. And so that's just as important as, as what we does for Vinegard or for Yates. And, and so, yeah, they're both valuable in so many ways and to compare them is hard, obviously. And, and you know, Vanada's won his fair share against Vanderpoel in one one day races as well, but probably Vanderpoel's one more.

Well, you see, the reason, the reason I discount van der Poel's lead out rule role is because I'm really not a fan of Philipson. I'm just kind of like, I'm keeping that one quiet. But you and most people, it's not, it's not fair to Vanderpoel because he phenomenal lead out guy.

I'd love to. Jeff, I'd love to hear your opinions on 21 days. Whether it's the Giro, the, the welter or the Tour of riders riding at, at insane training stress scores, racing stress scores we should call it. Not tss. Rss.

Yeah, yeah, yeah.

And, and being able to back up and some people can handle it and you know, it just seems beyond belief. You know, if you've ever done a training camp yourself where you've actually ridden a little bit more than you should have days or 14 days, your legs each day are just getting slowly worse and worse. The feelings you're getting, the soreness you're getting, you're not backing up very well. What are they doing in between these? We know that they have really good nutrition now. We know they have good massage, maybe ice baths. How are they able to do this, Jeff? It's a phenomenon that I don't think is relatable in many sports.

I think that we forget that although they are all riding the distance and although they are all riding the 21 days and everything else, we forget that they're not all riding the stages at the same intensity. If you look at some of these power profiles, I'm always pretty amazed that if you're tucked into the group for some of these flat stages, these guys are riding like us, like, you know, 180 watts, 200 watts, even though they're going significantly faster, because just being tucked into the peloton is an enormous energy saver. So you have to remember that we watch them on stage 20 and we think to ourselves, my gosh, how are they able to do this at the end? And the thing is, the Giro was really interesting this year. There wasn't a whole string of real mountain stages the way they usually are now in the Tour de France last year, the Tour de France was insane. And what Pagaccia did last year was no question superhuman. But the Giro this year was like, there was a mountain stage and then there was sort of an easier. Easier, like, again, right. I mean, for you and me, impossible, but for these guys, an easier stage. And so it didn't. It meant that Del Toro, Carapaz, Yates, the guys in the gc, could take the day off in a way. They still had to ride it, but they didn't have to ride it at their maximum. They were. It was. For them, it was almost a recovery ride, because that's what they do every day, right? They're. Every day, they're riding 200k at a certain amount of intensity. That's not the kind of intensity of when they hit these mountains. The question is, is, are they able to then bounce back and do stage 20? And obviously, Yates and Carapaz and G were. And Del Toro was, to an extent, just not as well as he did previously. So I think we need to remember that, that, that while we are always amazed at what they do on those mountain stages, we have to remember, like, those guys aren't winning the sprint stages. They aren't winning the. The hilly stages. They're always in the group and they're getting sheltered, and so they're having an easy, easier day. And I think that really is important in understanding how they do it. That being said, they get to these mountain stages and it's amazing how they're able to execute. And I think that, you know, science really does play a role here. I think they're. They're getting good sleep. They. You watch them finish, and the first thing that's handed to them is a. Is a bottle of tart cherry juice. Right? You see that every time they're all drinking that red tart cherry ju. So clearly. And I've reviewed that science, and that science does show that it does seem to work. And that's one of the things I recommend.

And what is it specifically?

Tart cherry juice. It's just. It's really. It's. It's got tons of polyphenols in it, and it's a recovery drink. It just helps with decreasing the inflammation and decreasing the. Helping wash out all of the toxins that you've built up during the course of the race. It doesn't rebuild anything. It doesn't help with that, but it does help in decreasing fatigue and allowing for coming back the next day. So I think that between the idea that they're not all riding the same way every day for 21 days and the idea that they just have a really good understanding of how to, like you said, nutrition Recovery and all that, I think helps make it a little more understandable. But listen, they're doing things now that they weren't doing 20 years ago, and that's because training's different than everything else, too.

You look at. There's a few outliers that I would like to get your opinion on. Like that last penultimate stage, the climb, Yates did that. I think it was three minutes faster than the previous PB. I think he rode 58 minutes instead of a 101. And we're looking at the second last day, 20. And he's able to pull out a PB. Fastest time ever on that climb in the middle of a tour. That's a phenomenal effort to do that. I want to hear your. You know, at the start, when all the EF Education riders blasted the first two minutes, I want to hear your view from a scientific exercise physiology standpoint where, what are they doing to the other riders? And. And what. What effect, in your opinion, did that have on the outcome of the climb? Because Yates didn't follow.

No, he did not. Neither did Derek G. And I think that's huge. Right? That's. That's why I think. So we have to remember that when we're climbing. And, and this is specific really to climbing, you. You'll often hear, like, Chris Froome used to talk about this all the time. He was very, very drilled into his power numbers. He wouldn't. Couldn't exceed a certain threshold no matter what was going on ahead of him, because he knew if people were exceeding that threshold, they were going to blow up and he. They were going to come back to him. He just had to keep doing what he was doing because as long as he stayed below that red line, he was going to be fine. And I think that's how Yates approached yesterday, is. Is he saw these guys going up the road. He knew it wasn't sustainable, and he just had to keep himself within his threshold so that he would be able to bring them back to him, which he did. And when he did explode, when he did do the attack, he hit that number probably for two minutes just to get away. And then he came back down and he kept himself at this regular pace and just pulled away. G was a really good example of a guy who kept yo yoing because he wasn't surging at all. He just kept his number exactly the same. And as the guys ahead of him would, would need to recover, he would just come on back, pass them, and then they would surge again and pass him. And then we just Keep going back and forth. But at the end, G was with them at the finish. So I think we need to remember when we climb. And I was explaining this to my son today, who came with me for his first time on a big mountain climbing ride. I told him, because he went out in the first four miles and he just, like, crushed it. And I was like, oh, my gosh, if he's able to ride like this, he's good. I'm not gonna be able to ride with him. But very quickly, he realized that he couldn't sustain that. And I told him, I said, listen, when we're descending, you will recover, but you will never get back what you've already put in. So the whole term of burning matches, it's this idea that you have a book of matches. The matches you burn will stop burning as you're descending. You'll have a chance to kind of catch your breath, but they don't get restored. You've still got that same. Whatever matches you have left in the book, that's what you've got. They're not coming back. So we have to remember. And that's exactly what I think these guys are facing. And as triathletes, we see we have the same thing. I tell my triathletes all the time, I had a conversation with an athlete tonight. He was asking me, what's this whole thing about vi? And I was trying to explain to him. I'm like, vi, is this idea that your normalized power is predicated on how much you're surging on the hills and how much you're coasting on the downhills? People who sur on the hills to try and, I don't know, look like a hero or try to make up something on the uphills, and then try think that they're going to recover on the downhills, you ain't getting anything back. So what ends up happening is your VI looks terrible because your average power is going to be low because you're coasting so much. And your normalized power is going to be high because you're surging so much. And there as your normalized power and your average power drift apart, that's burning matches. And when you get to the run, your matchbook is empty. So you need to work really hard as a triathlete to make sure that your normalized power stays close to your average. Keep that matchbook dry. Keep it. Keep those matches ready to go for when you get to the run.

I think really, you know, cyclists don't believe that that's an integral part of their arsenal. And you just look at what happened at the Giro. You know, the exact example you gave with Derek G. Riding his numbers, Yates doing the same, but just doing one effort. And then the third example is the guys just riding completely over and then under recovering get over. And eventually that. That gets less and less. That over gets less.

Right.

So as a cyclist, on particular events, such as long climbs, we're not talking about criterions where it's. It's, you know, it's important just to follow the wheels. But in an event where you may have to ride at your threshold for over 20 minutes and some of them a riding, you know, that was an hour's climb. And so you can't afford to burn those matches on these climbs. So cycling still has the same riding at your numbers concept. And I think a lot of cyclists need to hear that. And they just think that we don't ride like that. Well, you should ride like that if you want to get better at being a cyclist. Yeah.

And I mean, you hope to have a Wout van Aert waiting for you because getting on the wheel of a wild van Art, because they showed us Simon Yates's numbers as he was trailing wout and he was pushing 320 watts, which was exactly what he was pushing going up the hill. He was pushing up the hill 327 watts, and he was pushing 320 behind Wout. And I told Adam, my son, I said, that means that Wout van Art is probably pushing 400 watts right now.

It was 450. They should have.

Yeah. Simon is getting a nice little break, a windbreak from Wout, who's doing all of the work now to drag Simon along. And Simon gets to keep himself below his threshold. Threshold and. And just push himself as long as wout can drag him. And then he's on his own for the last, like, 15 minutes or so. And that's exactly what happened. And it was. It was textbook, right?

Yeah, yeah, it was. It was 450 or 470 watts for 13 minutes.

Watts Pool, which is just amazing.

Phenomenal. Absolutely phenomenal. But you're exactly right. I was. I was laughing in the races as the Carapaz and Del Toro would. Would surge and attack. And. And after each one, you just see Derek G. Just come into the picture and coast past them. And they. It was like a clown show where it happened six or seven times. And I just kept going, go, G, go. Because he just. He's doing exactly how. How we want triathletes to ride. That's exactly what we're talking about with the variable variability index, with the surging over and under, we try and convince our triathletes that's the way to go about it. So very, very good analysis from you.

How long do you guys find it takes? Because I have athletes like I. Most of my athletes, it takes two or three races before they buy into it. How long do you guys find you're doing?

Well, because sometimes it takes two or three minutes and they get it. And then sometimes it's a real work in progress where it might take a year's worth of. And look, when they start doing it, they just. They're almost. Their first sentence to us is, it's impossible to do. No one can do this. And then we've got so much evidence to show how athletes always start like that. And then the person who can get onto that philosophy the quickest is going to have the most fun in races.

Yeah, I had an athlete who just raced Victoria, which is a pretty hilly course up in Canada, and we were looking at his data after the race, and his VI was 1.12. And he swore up and down, no, I kept my power in check and blah, blah, blah. I'm like, look, the numbers don't lie. And I said, here's my numbers from when I did the race in 2019, where I was, you know, I was faster, but that's neither here nor there. My VI was 1.07. And I said, so it's doable. It's just a matter of being really disciplined and understanding and learning. And I don't expect anybody to do it the first time out. It is not easy. And I think the hard part for people to really understand is to push power going downhill. I think it's easier to get people to restrain themselves going uphill, although with men it's harder because they see people go by them and they're like. But it's easier to get people to restrain themselves going uphill, but it's harder to get people to push the pedals going downhill.

Yeah, for us, it's a matter of being able to prove that data. And we're slowly, over the years, we're collecting more and more data from around the world. Exactly what you've just said, around more courses. And it doesn't have to be the same course, but we can now show athletes of a course with similar elevation or similar courses profile and say, here's an athlete that rode the same elevation that you're doing and their variability index is under 1.05, you know, and so if they can do it, you can do it. And sometimes it does take that proof to. Because the athlete will swear it's not possible. And it's just. It is just a practice thing.

So now I feel shame because I was 1.07 on that course. It's okay. You're right to call me out.

Very good. So we want to move from that into. Yeah, we had a great discussion on your podcast about some of our core training philosophies, and we really want to dive into your philosophies, coming from that medical background and perspective. And your tagline is really brilliant. It's train hard, train healthy, and spend wisely. And that's referring to making sure you're spending your money on, I'm guessing anything you're spending your money on, making sure it's not a dupe, making sure it's not just hype or marketing, and it's something that's actually going to benefit you. So we wanted to open up the floor and start with some of your own training principles and philosophies that. That based on that motto, you wish more triathletes or endurance athletes would understand.

Well, I was talking to your dad just before we started recording, and he was saying how so much of your coaching is informed by your own personal experiences. And I feel very much the same way. I've been in triathlon for more than two decades, and so much of how I've developed my own coaching style is based on what I've learned through my experiences. So, for example, my communication is just based on having had different coaches and learning what I needed, what worked for me and what didn't. And so I am very, very accessible, very, very big on teaching the process. I don't want athletes to just take things that I give them on faith. I want them to really understand and ask questions. And I really encourage that back and forth. But one of the things that I am really all about is very swim forward. As much as the swim is the smallest part of a triathlon, the swim sets you up your whole day. And I tell all my athletes that, look, if you're doing a 70.3, I want you swimming three times a week. I want you swimming somewhere around 10k a week. And for many of them, that's a huge step up. And for most of them, they all kind of like their mouth hangs open and they're like, well, I can't do that. And I'm like, you can. It's just a matter of getting into the mindset of doing it. And I tell them, I said, look, it's not a matter of making you a faster swimmer. I can't promise you I'm going to take minutes off your swim time because swimming more, unfortunately, is not like running more or biking more, where we know that running more and biking more is going to make you definitely run or bike faster. Swimming more, not necessarily, but when you swim more, you become more fit with whatever stroke you have, with whatever pace you're going to swim. And there is no question that if you come out of the water feeling like that 1900 meters was not a huge effort. You get on the bike with a lower heart rate, you get on the bike feeling less fatigued, and your whole rest of your day is therefore going to be significantly improved. And so I really work hard to get my athletes to buy into that idea that, look, you don't have to be a front pack swimmer to necessarily swim more to benefit. And so that's a big thing in terms of how I work with athletes. Another big part of my philosophy in terms of training healthy is I am not big on days off. I think that rest days, days off, are a great way to get stiff, to get sore, to encourage injuries that come about when you then return to training and have taken this day where you just didn't, didn't do anything. I instead believe very strongly in the benefits of active recovery. And so I give all my athletes, depending on how old they are, the older they are, the more of these I give. But I give everybody active recovery days. So instead of a day off, it's like, hey, here's a day with an easy spin or an easy swim. And I want that to be your recovery. Because movement and blood flow are the best forms of recovery and the best ways to stay healthy. And because I'm a physician, I let all my athletes know, look, I'm not your physician, so I'm not going to treat you, I'm not going to diagnose you. But I am in a really good position to be able to understand what's going on. And so I really want to know the first signs of anything. Please just let me know right away because the second I hear that there's something, we can dive into it a little bit, I can get a better understanding of what it is. That's that this little thing is. And we can avoid it becoming a big thing. And so I take great pride in the fact that for the vast majority of my athletes, I'm able to get them to pretty Big volumes of training without having any kinds of time off for injuries because I'm very, very sensitive to overuse. I'm very, very sensitive to injuries. Now listen, if they trip and fall, if they crash their bike or something, I can't honestly do anything about that. But I am very good at like shifting and pivoting their training plans so that if they tell me, o know I felt this little thing in my Achilles today during my run, we'll explore that a little bit and I will immediately shift their training plan so that we give them a rest and they are able to shift over to bike and swim and then get them back to running very gently. And I keep in touch very closely and so I feel like I'm in a very good position to make sure that that is not an issue. And you know, I, I am, I have so many balls in the air, I am so busy and I have so many things and I have learned, learned how easy it is to make training your life. And I, my number one thing is that your training needs to fit your life, not the other way around. And so I work very hard with my athletes to learn what their goals are, what their available time is, what their partner thinks their available time is and then find the marriage between those two and then work to develop a process that helps them have the best balance between life, training and getting to the goals that they want to get to.

Really loving that summary of your own philosophies. We, we agree with all four of those and probably would be slightly less aggressive with the swimming because we think the athlete is definitely wanting more, more improvement in time. That would be our biggest philosophy on that is we can, as you said, you're probably not going to get your athlete to swim any faster, but they're going to be fresher to ride. We totally agree with that. Getting fit in the pool or in open water is really important but you know, in this day and age the athletes are really looking for improvement and spending so much time when they've only got limited time. That's a philosophy, a little bit of a variant different direction where we'd swim less and try to concentrate more on the bike and get them to get more value back. And you know, whether we agree or on the slight details, the principals still we agree with that that you want them to be fit so they can actually ride and run properly. And I think on the active recovery I could not agree anymore. And a lot of the questions we get asked and I it's good that you've said this because people say, oh, there's no rest days. And then we have to explain. Just like you said earlier, you want your athlete to ask questions and then you can explain the reasons and they'll be on board with it. We want your body to get some blood flow, to get the oxygen around to repair the damaged muscles. If you're sitting around waiting for the next session, you're going to feel very average when you start that next session in comparison to when you've actually done something. Whether it's a walk or whether it's just some walking in water or walking around the block or just rolling your legs over watching a video, it's just all really good movement to get some blood flow. And the other points about getting the balance in life and the feedback from the athlete that is crucial whether you're an actual doctor who can actually help someone or just a caring coach, they're the things we love to hear. We are so aligned. Geoff, it's really good to hear you summarize that so well.

I think the active recovery too is so much more important as we get older. And it's just, you know, it's just so easy to get stiff and sore the older you are. The hard workouts and I know for myself it's really hard to do hard workouts back to back, but if I take a day off it gets even harder and I just don't like to take days off. I just feel like moving is the best solution at all times.

So that leads to a really interesting topic that we want to touch on and get your perspective because we would really say that we're conservative coaches. I love that your kind of term around very sensitive to overuse or just sensitive to any change that might turn into something really quite negative for the athlete. We really go with a risk averse approach because we just don't want an athlete to ever have to have their training interrupted for a reason that was avoidable. But there's a lot of discussion now and a lot of hype around Zone two and we just think the term Zone two is one of the most overused and ill applied kind of hype terms of the last few years and it's been coined for some of the wrong reasons and this conversation around 80, 20 training. And so for us we have this kind of contrast and paradox of we are hyper conservative but we actually feel like we're now trying to train our athletes harder than most people realize because we just think a most age group is don't have time for such a conservative approach. That works for elite athletes who are training 30 hours a week. We also just think that age groupers can probably train a little bit harder than they realize. A lot of the approach might be you need massive recovery, especially for age groupers, especially as you get older.

That's true.

But from our very own experience with aging athletes and athletes well into their future 50s and 60s, they can handle a lot more than this zone to approach kind of dispels. So I'd love to know your thoughts around that.

I give really long winded responses, so get ready for another one.

We're ready. This is great.

8020 is, I think, great for beginners. Somebody who's not done any kind of training, somebody who's decided, oh, I want to do a marathon or I want to do a triathlon. I've never not got any experience doing training. And the reason that 8020 is so good in that scenario is because it's not particularly difficult. 80% of it is really easy. And then that 20% that's hard is not end up being terribly hard because their heart rate never really, their heart rate zones never really get that high because they're spending all of their time not really doing anything. And if you look at any of the discussion boards around 80 20, most people will say, I have a really hard time doing my runs or bikes and staying in zone two because the second I even put any kind of effort, my heart rate goes up to zone three. And then the responses from all the coaches is, oh no, well, you have to take it easy. You're just going to have to. And I'm like, so if you want to do 80 20, then great. I mean you're going to be a great participation athlete and you will not, you know, I mean, and that's fine. And that, that is what a lot of people want. And I feel like 8020 is great for a certain mindset of person. A person who doesn't want to push themselves, a person who doesn't want to feel uncomfortable because they're anaerobic. A person who is not particularly interested in winning. And I know what's going to happen. There's going to be somebody out there listening to this who's like, I'm an 8020 athlete and I've been on the podium and I'm like, like great. But that's not the average. Most 8020 athletes are completers are back of the pack, maybe middle of the pack type athletes. But I do think for people who are getting off the couch and need some kind of motivation because let's face it, training for a triathlon involves a lot of exertion and a lot of physical sacrifice. Right. You're sore, you're, you know, I, I just rode like two back to back days really hard and I'm fatigued. It's going to take me a couple days to get over this. Well, if I was doing an 8020 program, I wouldn't be that bad off. Right. I'd probably feel pretty good. So I think 8020 has a role for people who are not willing to really, who don't want to find themselves in a lot of discomfort but still feel like they're doing something. And there is no question if you're doing 80 20, you are training, you are doing something and good for you. I highly, you know, I don't want to take away from that. However, if you want to excel, if you want to be at the pointy end of the field, if you want to improve, you got to get out of that. Because the only way to push yourself is to start pushing yourself in training and pushing yourself to levels that are often uncomfortable. And my athletes look at, I'm sure your athletes do too. They sometimes look at their training week and they're like, there are workouts on there that make them very uncomfortable. And they'll send you a message and say, what the heck is this on Thursday? And after a little while, my athletes now look forward to those workouts because they know how beneficial they are. Yes, they know they're going to have to dig deep. Yes, they know they're going to be uncomfortable. But, but man, do they feel good when they accomplish it. And you're right, age groupers can do so much more than I think they give themselves credit for. And I think that the only way to find that out though, is to actually do it. So yes, 8020 has a role. 8020 is for certain kinds of people. But if you want to actually do well in sport, whatever your sport is, if you want to actually see yourself improve and evolve, you got to get out of it.

Jeff, can you give the listeners a little bit of an insight? Just don't go too detailed, but just they're always asking, just explain why the overload principle or pushing yourself is actually more beneficial physiologically to your body for.

Improvement rather than just it's super easy. When you push yourself hard in a workout, you are damaging your muscles. That's exactly what you are breaking at the microscopic level. You are breaking down your. That's why you're sore, that's why you fail in the workout because you get yourself to a level where you just can't do it anymore. It's because you have physically damaged the muscle fibers. And then over the next course of the next few days, your body goes through this process where it rebuilds those muscles and adapts those muscles to be stronger than. It's like the old Six Million Dollar man, which Jordy's too young to remember, but I'm sure you remember Jerry, where, you know, we're going to rebuild him stronger than he was before. That's exactly what's going on at the cellular level. The muscle fibers are now being rebuilt bigger, stronger and more able to withstand the load that you just subjected them to. Now, it won't happen after one workout, but it will happen after weeks and weeks of this where those muscles will then become adapted and stronger and better and faster. Now, does this happen at 80, 20? To a certain extent, but much, much lesser and much slower.

I'm glad you finished with that because that was gonna be my next question. And that would be one of the reasons why you would be so adamant that the average age grouper should push themselves a little bit more to get that overload stimulus. And rather than. We agree that an athlete like a pro rider or a pro triathlete can spend between 20 and 35 hours training. They can't train 20 hours at Zone 4 or Zone 5. They can't. They will actually physically fall apart.

Right.

So if they're gonna, if they've got this time to spend 20 hours plus, then they need to do a lot of zone one and two. And as a cyclist, as a pro cyclist, that is why you can actually back up 200ks day after day because you trained that way. And we always say whatever you do, whatever the requirements are of the race, you should be doing in training. So their examples are outliers. We're talking about the average age group athlete. And I think it's great what you're. The message you're getting across here is exactly what we wanted to hear, which is fantastic.

I want to move into some myth busting questions which is always exciting when got someone from a medical perspective like you. And there's some kind of low hanging fruit questions that I'm sure some people would be loved to die and hear some answers to. So look, a lot of these are just common topics that I'd love you to give either give a quick yes or no and a brief explanation as to why. And some of them might be obvious, but some of them, a lot of people might Take for granted and have never questioned. So, as always, these questions might be depends on the athlete. But do your best to give us a yes or no or to spell them myth. So the first one is a low resting heart rate in triathletes or endurance athletes is better for you.

Better for you. It's a sign of better fitness. Now that is a little dependent on the individual. So a smaller person, women, for example, a smaller woman will have a smaller heart, and so her resting heart, heart rate will tend to be. And a smaller man, too, a smaller male, will have a higher resting heart rate just because their heart is smaller. And therefore, to pump enough blood per minute, they need to pump more frequently. But in general, the more exercise you do, then the stronger your heart becomes. It's able to squeeze more blood per beat, and therefore it doesn't have to squeeze as frequently. So therefore, think about it now. Okay, I'm gonna have to back up. I'm gonna start over. So your heart needs to. Your heart needs to pump a certain amount of blood per minute. Resting. Let's. I'm just gonna make it up and let's say it's 4 liters per minute. Well, if your heart is pumping 25ccs per beat, then you could figure out how many that beats that's gonna be per minute to get to 4 liters. Whereas if you're a really fit individual who's trained your heart to squeeze 50cc's per beat, your heart's going to have to beat half as frequently. Therefore, a lower resting heart rate generally translates to somebody who's more fit.

I think the premise of the question comes from, we do see often, and maybe they're outliers, but, you know, quite fit individuals and very well trained individuals, but still with a resting heart rate of 58, 60, 62, which maybe is generally low for the population.

That is low. Yeah. That is low. Yeah. So a standard resting heart rate tends to be around 75 to 80. So if your heart rate is 50, like, if your heart rate's in low 60s, 50s, you're doing fine. I mean, it's, you know, like mine is 49, and that's not normal for athletes. Like, most athletes will tend to be in the higher 50s to low 60s, even very fit athletes.

That's great because a lot of athletes compare to the, the athletes that are 42, 46.

No, please don't. It's just, it's. There's so much individual variability, so just. It's not worth it.

That's great. Question 2. Taking painkillers like ibuprofen or I think in Australia, Panadol is a common one, but maybe I think in the US Tylenol or something similar before or during long races is generally harmless.

That is false. So ibuprofen. I actually just wrote about this in Triathlete Magazine, so if you look. Look for that or you can find the article. But. So there's two problems with ibuprofen. Ibuprofen in general has a very safe therapeutic range, which means that even though its recommended dosage is 400 milligrams, you could take a lot more times that and not cause major problems. However, ibuprofen is known to interfere with muscle adaptation to training, so it will decrease your ability to receive the adaptations from training. It also impairs the renal function, kidney function. And when you're in a race and you're becoming progressively dehydrated, there are. There is a risk of causing kidney injury. And finally, ibuprofen causes problems with the stomach and so you can get stomach upset over time. You could develop gastritis and it can be a problem. So ibuprofen over usage is very common. It is something to be avoided as much as possible. Tylenol does not work the same way. Tylenol or Panadol. Panadol, Is that what it's called?

Yeah, that's what we use, yeah.

Panadol or acetaminophen is the generic name. Does not work the same way. In fact, we don't have a great understanding of how it works. It doesn't have all of the major negative effects that ibuprofen does, but it does also seem to have some negative impacts on athletes. Athletes. If you're going to take one over the other, Tylenol is the safer drug. Just know that Tylenol has a much narrower therapeutic index. What that means is you should not exceed the recommended dose because it can get toxic very quickly.

So with that said, what are your thoughts on athletes taking it before races? If they don't. If there's no specific injury?

I would tell. I always tell athletes not to take those medications around a race. It's just not worth. I mean, it's not going to benefit you. There's only the potential for harm.

Brilliant. That's what we're here for. Cramping during racing and training is. Comes down to dehydration.

False. And that's a very long. There's going to be a very long discussion about that one. So cramping has been attributed to many things throughout time. Immemorial it's been attributed to dehydration, it's been attributed to sodium, it's been attributed to, attributed to potassium, magnesium temperature. It's been attributed to so many different things. At the end of the day, cramping is very likely multifactorial. It probably is individualized quite a bit. For some people, sodium might play more of a role. For some other people, hydration might play more of a role. But at the end of the day, cramping is probably a protective evolutionary thing that develops to protect us. And basic what I mean by that is, let's say your hamstring, you're deep into a race. You, your hamstring is you have nerves that are sensing that your hamstring is close to failure. And so by cramping, you are forced to stop. You have no choice but to stop what you're doing. And so the cramp is, is a very painful defense mechanism. It keeps you from doing what you're doing. And there may be things that lower the cramping threshold. For some people, it might be dehydration or sodium or whatever those other things are. But at the end of the day, the cramping is a protective reflexive mechanism. And that seems to be why cramping has been found repeatedly to be something that can be interfered with by a things like pickle juice, spicy things in the mouth and esophagus, like those hot shots. Those are quite effective at interfering with cramping. They won't make cramping go away completely because if you're still doing the thing that the body is afraid of, you're going to cramp regardless. But you can mitigate the cramping by those kinds of things by interfering with that reflex. So it's a, it's a very complex physiologic process, but it is not uniquely related to dehydration.

Absolutely love that answer. Is endurance training, long term endurance training bad for the heart? There's a bit of a myth around this that you're working the heart too hard. Slash, can chronic training lead to irreversible heart damage?

It's like I should just put up the episodes of my podcast and answer these questions because I've answered all of these. Yeah, right. So there is something called the reverse J curve that talks about the idea that you, as you train, as you do more and more exercise, you decrease all cause mortality and morbidity related to cardiovascular disease. So if you look at a graph and you say, okay, here's the risk of mortality and morbidity on the Y axis and on the X axis is the amount of hours you train per week. You would see that that number would go down compared to sedentary people. But there's a tipping point where suddenly that number starts to come back up. I don't know why it's called the reverse J curve because if you look at it it actually looks like an actual J anyways. So that number will come back up. What's really important to understand is that the number never comes back up higher than it would be if you weren't exercising at all. All that's happening is that you're losing the benefit. So you're not not more at risk, you're just not getting as much benefit. And that number seems to be around 10 hours per week of high intensity training. And I want that to be very clear. It's not 10 hours a week of Zone 2 training. It's 10 hours a week of high intensity. So I don't know a whole lot of people that do that. Like I train a lot of volume, but I'm not training 10 hours a week of high intensity. But that seems to be the that tipping point if you're over 10 hours a week. And the reason this seems to be happening is that once you get over that, you start to get into issues with cardiac hypertrophy and various other things. Dysrhythmias and things like that.

Last one for this Ironman or endurance training weakens your immune system long term.

Not long term, just very transiently. So anytime it's not just Ironman, it's any long event. Any long event where you are putting yourself at high intensity exercise. So anything that eclipses, I can't remember what the actual number was. I think it was six hours, but it might be eight. But anything where you are pushing yourself above, I think it was 60% of your threshold for more than. I think it was six hours. Then there is a window of about 48 hours where your immune system is depressed and then it recovers. So it just makes you more susceptible to getting sick in that 48 hours. It doesn't have any long term effects whatsoever.

Absolutely lovely.

I'm sorry. In fact, exercise has been shown repeatedly to strengthen the immune system. So doing training for Ironman or anything else actually makes you less prone to infections. It's just that 48 hour window around particularly lengthy intense races or training sessions.

Thank you very much for answering those so succinctly. I know it's a hard job when we throw these kind of catchy Questions at.

Great. I could go on all day.

We have one final closing question. But before we do. Dad, was there anything you wanted to ask along this topic to kind of finish off the episode and anything you wanted to clarify?

No, I've loved the answers and the detail you're going into is.

Is terrific.

And yeah, look at the one thing I know is our immune system is compromised by training the way we do with such consistency. And you know, it's hard to be a monk and do the training and not interact with other human beings because that's obviously when your immune system's down. If you're with your grandchildren like I am and they've come from the local creche, you know, it's the diseases they're carrying, you know you're going to be putting yourself at risk and you don't want to. You know, we talked about balance and, and Jeff, you spoke about that having a balance in life, you know, you've just got to be careful. But you can't be over careful. You've just got to do your best with what's going on around you. So I love the answers you're giving and it really. Some of the things that people think are true, you've actually given some real clarity. And one of the things I was shocked and horrified at the amount of people that I soon discovered were taking medication during Ironman events. And I don't know why I didn't realize this was happening because. But once I dug a bit deeper, I was very disappointed that there is a huge amount of people using medication to get through an Ironman. And I think that really clouds the goal of endurance and you pushing yourself when you're actually reaching for something to help you get through that instead of your own preparation. And I'm really happy that you've sort of. The answer was no, I wouldn't want anybody to take medication. They shouldn't be thinking about not doing the race rather than having to reach for some medication.

Yep.

Last question I wanted to ask. Was there, is there any myth or if you could dispel one myth or topic about endurance training or athlete health forever, what would that be for you?

That there's no shortcuts. I think that our sport is surrounded by a mythology that if you take this pill, if you take this powder, if you use this tech, that you are suddenly going to turn into Lionel or Ashley Gentle or whoever. And the reality is just not that simple. At the end of the day, there is nothing out there that is going to translate into sudden gains into sudden benefits. You just have to do the work. And the reality for many of us as age groupers is that we don't have the gifts of these people and we have to be okay with that. And we also don't have the time that those people have to put into it. And we have to be okay with that too. So instead of chasing after illusory gains and spending money to get there, you mentioned my catch line about spending wisely. Don't spend money on things that promise trivial things. Spend money on yourself. Put in the work and you will find that you will feel so much better about yourself and you won't be disappointed in the fact that the things that you bought aren't doing what they say.

Thank you so much for your succinct and such well articulated answers for the episode. It's just so valuable for the listeners. And if you want to hear more of that, you can go check out Jeff on his his podcast, the Tridoc Podcast. As he mentioned, he discusses all these topics and more in such brilliant detail and it's why we're fans of the podcast. So, Jeff, thank you so much for your time and for joining us on the show and we definitely want to have you back on.

It was an absolute pleasure. I really enjoyed both of our conversations and I look forward to continuing them at a future date.

That's it for this episode. Thank you very much for joining us as always, and we'll see you on the next one.

Sam.