Triathlon
Shawn F. Kane
Fred H. Brennan Jr
TRIATHLONS
A triathlon is a unique multidisciplinary event, consisting of sequential swim, bike, and run legs. The concept was initially developed as an alternative to standard marathon or 10-km training programs. In 1974, members of the San Diego Track Club hosted a first of its kind swim-bike-run event in and around the waters of California’s Mission Bay. That three-event race was called a triathlon, and to this day, the triathlon remains one of the most popular participation and spectator endurance events worldwide.
John Collins, a veteran of the first Mission Bay Triathlon, was influential in the further development of the sport. He is responsible for combining three endurance events — the Waikiki Rough Water Swim, the Around-Oahu Bike Ride, and the Honolulu Marathon — into one of the world’s most recognized and demanding competitions, The Ironman.
Popularity and growth led to the establishment of the International Triathlon Union and the inaugural World Triathlon Championship competition in 1980. International recognition resulted in the continued growth of the sport through the 1990s into the new century, with inaugural triathlon competitions in the 1994 Goodwill Games in Leningrad, 1995 Pan Am Games in Argentina, and the 2000 summer Olympic Games in Sydney.
□ The popularity and growth of triathlons continue. USA Triathlon (USAT) recorded a sixfold rise in membership from 1999 to 2009 and now reports 115,000 members. The International Triathlon Union has 122 member nations, and Australia alone has over 160,000 Australians participating annually in the sport (12).
Triathlons are a unique sport that encompass all fitness-related variables: cardiorespiratory endurance, body composition, muscular strength, endurance, and flexibility.
Triathlon governing bodies recognize four standard race types based on distance (17). The races are sometimes listed by the total number of kilometers (e.g., Ironman is a 225.8).
Sprint (0.75-km swim, 22-km bike, 5-km run)
Olympic (1.5-km swim, 40-km bike, 10-km run)
Half-Ironman (1.9-km swim, 90-km bike, 21-km run)
Ironman (3.8-km swim, 180-km bike, 42-km run)
The popularity of the sport has led to the introduction of short- or fun-distance triathlons, usually about half the distance of a sprint triathlon (12).
VOCABULARY
Like all sports, triathlons and triathletes have a unique vocabulary. A few of the more common terms are included here to aid in the understanding of these athletes.
Bonking — a reference to when a competitor begins to lose the ability to concentrate, feels disoriented and overly fatigued, and at times, is unable to continue on in a race. Bonking occurs when energy intake does not meet energy expenditure and glycogen stores are depleted. The regular intake of carbohydrates during prolonged competitions can prevent this condition from occurring.
Transition zone — an area of controlled chaos where athletes change from swimmer to cyclist and from cyclist to runner (T1 and T2, respectively).
Traumatic tattooing — skin discoloration resulting from debris that was deeply embedded in the skin following an abrasion from skidding on pavement.
Brick (Bike-Run-Ick) — a training method or workout used to simulate race conditions. It involves training on the bike and running in the same day and is used to simulate the bike-run transition, which many feel is the toughest part of the race.
INJURY EPIDEMIOLOGY
Triathletes compete and train in three distinct events, each of which predisposes the athlete to its own set of injuries. Injuries specific to an individual component event of the triathlon will be covered in that specific chapter.
Theoretically, it is possible that triathletes would have fewer overuse injuries compared to other one-sport endurance athletes because triathletes spend much of their time cross-training. The contrary may also be true; triathletes suffer from the cumulative effect of three
distinct injury-producing events and are susceptible to more injuries (7).
Injuries are defined as any musculoskeletal problem that causes a cessation of training for at least 1 day, a reduction in training mileage, the taking of pain medication, or the seeking of medical aid.
Cycle and run training may have a cumulative stress influence on injury risk. The tendency of triathletes to modify the training regimen by increasing the load in another discipline from that which the injury occurred rather than stop training when injured increases the risk of injury recurrence and the time until full rehabilitation (27).
Research has demonstrated injury rates among triathletes to be anywhere from 37% to 90% annually, with roughly 50% of injuries occurring solely during the preseason, 37% occurring in-season, and the remainder overlapped between seasons.
Overuse injuries are the primary reason for triathlete injury and comprise 68% and 78% of the injuries sustained during preseason and in-season, respectively. Acute injuries due to trauma make up the difference.
Injury incidence: 2.5-5.4 injuries per 1,000 hours of triathlon training and 4.6-20.1 injuries per 1,000 hours of triathlon competition have been reported. These rates are higher than the reported incidences of 3.9 and 2.5 injuries per 1,000 hours of training for track and field and marathon running, respectively (5,6,7,12).
Running injuries account for 65%-78% of the total injuries, cycling injuries account for 16%-37% of the total injuries, and swimming accounts for 11%-21% of the injuries experienced by triathletes (17).
□ Iliotibial band syndrome, patellofemoral pain syndrome, and patellar and Achilles tendinosis are common injuries from running.
□ Aeroneck — neck pain and stiffness caused by prolonged sitting with the shoulders hunched, the neck hyperextended, and the arms tucked tightly in underneath the chest. This is a complaint that many triathletes have after or during the cycling portion of the race.
□ Patellofemoral pain, quadricep strains, and calf strains are common cycling injuries (2).
□ Corneal abrasions frequently result from having the goggles kicked off the face at the congested start of the swim phase (15).
Despite differences in the number of training sessions, weekly total mileage, and workout duration, there has been no reported difference in the injury prevalence, distribution, or severity among triathletes who vary in skill from elite to recreational (27).
Predictors of injury:
□ Total weekly training distance, weekly cycling distance, swimming distance, and total number of workouts (swimming, cycling, and running) per week, but surprisingly not running distance per week, are all associated with an increased incidence of running injuries (15,28).
□ The total amount of time spent running and cycling, but not total distance, negatively influences the incidence of cycling injuries (29).
□ The most significant predictor of injury in the preseason is number of years of experience in triathlons. More experienced triathletes have a higher injury rate (17).
□ The most significant predictor of injury during the season was a history of previous injury and high preseason running mileage (> 20 miles per week) (9,30).
□ Training errors, most specifically improper technique, have been frequently associated with injuries related to cycling and swimming.
Running-related injuries are the most prevalent injuries seen in triathletes. Athletes who spend greater amounts of time training in cycling and swimming are at higher risk for running-related injuries. This may be because there is less time for overall muscle recovery (30).
Specific injury rates
Cardiovascular — Cardiac muscle fatigues and is stressed while performing endurance events, similarly to skeletal muscle. Troponin T levels are elevated in 27% of Ironman Triathlon finishers, and echocardiograms have demonstrated a 24% reduction in postrace ejection fractions compared to prerace values. There are no published data concerning the rate of fatal cardiac complications in triathletes. We do know from the marathon literature that fatal cardiac complications are uncommon (1 in 50,000 competitors) (14,19). The published fatality rate in triathlons is 1.5 in 100,000, with 13 of 14 deaths occurring during the swim. Drowning was the declared cause of death in all swimming deaths, but autopsies revealed a high prevalence of cardiovascular abnormalities (15).
Gastrointestinal bleeding — 8%-30% of marathoners have evidence of intrarace or postrace gastrointestinal bleeding. Blood shunting to exercising muscles causes relative intestinal ischemia and, combined with elevated core body temperatures, leads to cellular death and gastrointestinal bleeding.
Abdominal cramping — May be associated with competitors who consume a diet high in fiber before the race. Also seen with the excess consumption of carbohydrates before or during the race.
Diarrhea (runner’s trots) — Abdominal pain and diarrhea associated with prolonged running or biking. This condition is caused by ischemic changes in the bowel due to the shunting of blood to exercising muscles. This may occur during or shortly after the completion of the race.
Nausea and vomiting — Eating 30 minutes before a triathlon is highly associated with vomiting during the swim. A diet high in fat or protein and the consumption of hypertonic beverages result in a higher rate of nausea and vomiting among competitors.
Hematology — 30% of triathletes demonstrate microscopic hematuria and 95% have a decrease in haptoglobin after an event. These numbers demonstrate that footstrike hemolysis, renal ischemia, and bladder contusions are frequent occurrences.
Infectious diseases — Fresh water swimming in high-risk areas has resulted in triathletes developing leptospirosis. Lyme disease in endemic areas may also raise the potential risk to triathletes competing in extreme-course triathlons.
Sunburn — Sun protection factor (SPF) sunscreen of at least 15, a hat or visor, SPF-rated clothing, and ultraviolet protective sunglasses are recommended to prevent the burning effects of the sun during training and competition.
TRAINING CONSIDERATIONS
Triathlons are unique and demanding events that require a dedicated, well-organized training program. Proper training will prepare a competitor for successful completion of the race and minimize the risk of injury while training and competing.
Training programs need to be customized to meet the competitors’ needs; what works for one athlete may not work for another. We recommend that novice competitors consider hiring a USAT-certified coach to learn the sport and maximize available training time. There are also training-related resources on the Web and in triathlon magazines to help develop a suitable and safe program. Advice from more experienced athletes can be helpful.Related posts:
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