Do Olympians Get Too Much Exercise?

Rowers in the men’s quadruple sculls closed onto the finish line in Rio de Janeiro at the 2016 Olympic Games.

Many of us watching the Olympics are feeling inspired now to exercise harder and more often. But exercise scientists have long been intrigued — and worried — by the question of whether, over months and years, someone can exercise too much. It has not been clear if there is a safe upper limit to exercise beyond which you can irreparably injure your body, and in particular your heart.

A new study of former Olympians and other athletes should help to allay some of the lingering uncertainties about the effects of long-term, intensive training. Its findings suggest that while such training can substantially change how the heart is shaped, it does not seem to cause lasting damage to the heart’s function.

The results from some past studies of heart health in serious endurance athletes have been worrying. A 2011 study, for example, of male entrants at an annual marathon cross-country ski race in Sweden revealed that the most committed participants — those who had completed the race the most times during a 10-year stretch or finished with the fastest times — were far more likely than their more infrequent or leisurely fellow racers to develop atrial fibrillation, or A-fib, during a multi-year follow-up period. Atrial fibrillation is a disruption of the heart’s natural rhythm affecting the heart’s upper chambers, the atria, and is linked to an increased risk of stroke.

The study’s authors speculated that, although they couldn’t prove cause and effect, it seemed possible that the serious athletes’ strenuous training had contributed to their subsequent heart problems.

Another, even more provocative study published in 2012 looked directly at the hearts of long-term competitive athletes. Using advanced scanning techniques, its authors mapped the shape and function of the heart muscles of 40 elite male masters athletes both before and immediately after a long endurance race, such as a marathon or ultra-marathon, and then again a week later.

The scans showed evidence of what seemed to be lingering damage to the athletes’ hearts, the scientists reported. Their right ventricles, one of the two lower chambers of the heart, were noticeably enlarged and did not function as well as the left ventricles both immediately after the marathon-style event and a week later. The right ventricles pumped considerably less blood than would be expected from a completely healthy heart.

These effects on the athletes’ hearts seemed so pronounced and persistent that the scientists decided that the condition was pathological and gave it a name, “exercise-induced arrhythmogenic right ventricular cardiomyopathy,” which basically translates as unhealthy — and probably permanent — changes to the heart caused by exercise.

The study was much discussed among exercise cardiologists, but some were skeptical of its conclusions, suspecting that the seeming damage to the heart muscle after endurance events was likely to be ephemeral, like sore leg muscles, and should similarly resolve with time.

So for the new study, which was published in May in Circulation, scientists at Saarland University in Germany decided to look at the hearts of long-term endurance athletes when they were training but not competing and compare their cardiac muscles to those of men of the same age who were not athletes.

If years of strenuous exercise and competition permanently damaged the athletes’ hearts, that damage would be visible even if they had not recently completed an event, the scientists hypothesized.

To test that idea, the researchers rounded up a group of 33 extremely accomplished older endurance athletes, including six former Olympic triathletes and rowers, a one-time Ironman world champion, a cyclist who once had almost won the multi-week Tour of Spain and a former winner of the Munich Marathon. They ranged in age from 30 to 60. These were men who had trained strenuously for years and continued to work out for about 17 hours or more weekly. (No women were included since previous studies of athletes’ hearts had focused on men and the scientists wished to be able to compare their data to past results.)

The athletes underwent a battery of tests at the scientists’ lab, including measures of their aerobic fitness and, most important, of the state of their hearts. Various high-tech scans looked at both the shape and function of that muscle.

Meanwhile, 33 men of the same ages who were healthy but not particularly physically active completed the same tests.

The results showed that the athletes had remarkably different hearts than the other men, particularly their right ventricles, which were considerably larger than among the nonathletes, just as in the earlier study of masters athletes. Their left ventricles also were relatively enlarged though not to the same extent.

But the scientists saw no signs that these differences affected the hearts’ function. Unlike in the earlier study, the athletes’ right ventricles pumped just as much blood as would be expected and otherwise behaved normally and, in some ways, better than normal. The athletes in general had very low resting heart rates, which is considered a sign of cardiac health, and no symptoms of atrial fibrillation.

The heart scans also revealed no scarring in the athletes’ heart muscles, which would indicate long-term damage.

Over all, “we found no evidence of lasting damage, pathological enlargement or functional impairment of either the right or left ventricle in the athletes who had been doing long-term, intensive, elite-level endurance exercise,” said Dr. Philipp Bohm, a sports medicine physician and researcher at Saarland University who led the study.

He and his colleagues suspect that their results differ from those of the 2012 study because that experiment examined athletes’ hearts immediately after a draining race, when their muscles were still exhibiting race-related wear and tear.

The new study intimates that any such harm is likely to be short-term and not worrisome.

But Dr. Bohm and his colleagues also said that much more research is needed to settle the issue of just how much exercise is safe. Their study was small and focused on a highly specialized group of athletes, who might somehow be lucky or genetically blessed. Much larger, long-term experiments are needed before researchers can know whether everyone’s hearts respond similarly to Olympic-level exercise, he said.

It’s also important to know that being fit does not immunize anyone against heart disease or sudden cardiac arrest, Dr. Bohm said. If your chest hurts during exercise, see a cardiologist.

The Speed Training Track Workout for Everyday Runners

Watching Olympic track and field stars run at insane speeds, jump to seemingly unreachable heights (and lengths), and hurl just about everything except the kitchen sink—what exactly is a discus, again?—makes them appear superhuman. And while their talents on the track put them in a category all their own, even everyday runners can take something away from their training.

No matter if you’re “the fastest man alive” Usain Bolt training for the 100-meter dash at the Olympics or if you’re just looking to PR your next 5K at the local park, when speed is the name of the game, training at the proper pace, and knowing how to budget your energy is something runners of all levels can do to see results, says Andrew Kastor, consulting coach for ASICS America.

Kastor, who is also an exercise physiologist and the head coach of ASICS Mammoth Track Club in California, has spent his running career training athletes at all levels—his wife is an Olympic medalist and American record holder for the marathon if that tells you anything. He says that if you want to beat your previous 5K or 10K time, all you need to do is run quicker than your goal pace. Sounds obvious, right? Well, Kastor says the biggest mistake most runners make when it comes to speed training is thinking they need to start off in a dead sprint. Slow down and practice running as fast as you hope to be on race day—even if it’s not for very long at first. “When an athlete practices at race pace, they continue to ingrain those motor patterns into their nervous system,” he says.

And don’t think that just because you want to improve your speed means that longer, slower runs are off the training schedule. Nope, quite the opposite, says Kastor. “It’s important to run the entire ‘running spectrum’ throughout the week,” he says. (This includes a wide range of paces and efforts, meaning running at a low intensity well below your race pace, as well as shorted relaxed sprints or “strides” at about 80-90% of your max speed.) Kastor says you should aim for an ideal 80/20 split for the week with 80 percent of your weekly runs at lower intensity endurance training miles, and the other 20 percent at high-intensity short sprints (a.k.a strides) with hard, sustained effort throughout.

You might notice Olympians like Usain Bolt and USA’s Justin Gatlin performing a handful of those strides right before a race, and Kastor says they aren’t wasting any energy; these pre-race rituals are all part of their strategy. “By doing these strides, athletes recruit all the muscle tissue they are going to need, and this facilitates putting all the joints in the legs through their full range of motion, which is important just prior to the start of a hard workout or race,” he says.

To help you with your week’s last 20 percent of hard runs (and to help you practice those strides for race day), Kastor developed a speed-training workout anyone can do to shave off some time.


  • 10-15 minutes: Start with a light run at an easy pace
  • 5-10 minutes: Stretch it out. (The Best Stretches for Runners is a good place to start.)
  • 5-10 minutes: Perform dynamic running drills, such as skipping, high knees, and butt kicks (moving along the track as you perform each move)

Main Set

Complete 16 rounds of 400m runs at or just below your goal 5K (or 10K) pace. (There are many free apps for runners that can track your pace and help you set goals accordingly.)

  • Round 12 and round 16 are the pace exceptions and considered your “hammer” reps, which means you give it all you’ve got during those two 400m runs.
  • Recovery times between runs or sets should be 1:1. (This means if you run 400m in 1:45, rest time before your next set should last 1 minute and 45 seconds as well.) Adjust this for every 400-meters.

Cool Down

  • 10-15 minutes: Slow your heart rate back down with some easy running.
  • 5-10 minutes: Light stretching. (Our 30-Day Running Challenge has five moves to stretch your hips, calves, glutes, hamstrings, and quads.)


What does it take to Compete in Iron Man?; Customized Nutrition to Reduce Inflammation

Episode 16.21 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One: Robbie Ventura from Vision Quest Coaching talks about what it takes to train for Iron Man Competition.

Robbie Ventura is the founder and owner of Vision Quest Coaching. With a talented staff of world-class coaches, VQ provides expert training programs for over 300 endurance athletes of all levels, kids and beginners to elite-level, Tour de France champions.

Robbie graduated with honors from Lake Forest College with a double major in Business and Psychology. While working toward his Bachelor’s degree, he played on the Forester hockey team, which advanced to the NCAA Tournament, and was named to the All-American Collegiate Cycling Team. In 2008, he was inducted into the LFC Athletic Hall of Fame for his accomplishments in both hockey and cycling.

Robbie was a professional cyclist for 12 years. A competitive racer on the dirt, road and track since the age of 7, Ventura amassed over 70 victories during his professional career, was a member of the U.S. World Team and rode the Track World Championships in Hamar, Norway, placing 5th in the elimination.

Segment Two: Cole Cruz from Coalition Training talks about the importance of customizing your diet to reduce inflammation.

11 Food Rules For The Ultimate Anti-Inflammatory Diet Hero Image

Related: 11 Food Rules For The Ultimate Anti-Inflammatory Diet


By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • RICE- Rest, Ice, Compression, and Elevation is widely recognized as the most appropriate immediate treatment for many sports injuries in the first hours to few days after injury
  • The recommendation is mainly based on several decades of experience from athletic trainers and team physicians but there is a surprising lack of high level scientific evidence to support the use of ice, especially in the later phases after injury
  • I still recommend RICE for young athletes in the first hours to few days after common sports injuries

The acronym RICE- which stands for Rest, Ice, Compression, Elevation- has been around football RICEanklesince Dr. Gabe Mirkin introduced it in 1978. Since then, healthcare professionals have viewed it almost as religious gospel that immediately after an acute sports injury you apply ice and light compression. I’ve never encountered a single athletic trainer or team doctor that wouldn’t recommend this, and at Sideline Sports Doc we also recommend it for young athletes in the first few days after a joint injury.

Interestingly though, Dr. Mirkin and others have recently raised questions about whether we should actually be applying RICE after injury. Dr. Mirkin states that inflammation after injury is a necessary part of the body’s healing response after injury, and that by reducing inflammation you are actually slowing down the healing process. He has changed his stance and no longer recommends RICE.

Let’s briefly have a look at a few sides of this problem

Authors from the National Athletic Trainers Association wrote a very nice review article about management of sports related ankle sprains, in which they devote several paragraphs to the use of RICE.

They note importantly that injury recovery can be divided into several phases. Immediately after injury (the first hours to maybe 3 days) can be called the “acute phase” in which the goals are to reduce pain, reduce swelling, and protect the injured area from further injury. After this comes the “subacute phase” in which inflammation is less of a factor and the focus is more on tissue and joint recovery. Finally, athletes would go through training for return to play.

They write that in those first few minutes or hours after injury: “Sports health care professionals, athletic trainers in particular, advocate the application of RICE immediately after injury and are arguably the only health care professionals who can consistently apply these interventions within minutes because they are often on site at the time of injury.”

To be clear, we are talking about the very early phase after an injury and I think this should be emphasized.

Once an injured person gets in to the “subacute phase” after a few days, then the emphasis changes more towards mobilization and improved function. This will vary on the type of injury, whether surgery was needed, etc. but the point is that once you get in to this phase then ice is likely less useful.

Interestingly, there isn’t a lot of high quality scientific evidence to support either position- for or against use of ice in the immediate post injury phase. Much of what we advocate is based on decades of clinical experience with athletes and other injured individuals, but we should recognize that evidence might someday appear that challenges our current beliefs.

SideLineSportsDocUntil then, I’m still a believer that application of RICE for about 20 minutes out of every few hours in the first few days after a sports related injury to a joint or extremity is the correct thing to do; decades of experience has established this method as the standard of care.

Understand also that not all injuries can fit neatly into boxes and there will be a lot of individual variability. When in doubt, seek qualified evaluation from a healthcare practitioner and have them assist you with an individualized treatment plan.

Did you know that U.S. Olympian Laurie Hernandez is a tissue recipient?

Golden Child Laurie Hernandez Is the Breakout Star as U.S. Gymnasts Dominate

RIO DE JANEIRO — She led them through the dimly lit hallway at the Rio Olympic Arena, her chin high, a mischievous half-smile shining on her face. The way she looked, she could have been holding a royal flush in a game of poker.

The youngest member of the United States women’s gymnastics contingent was a picture of confidence as she cantered toward the stadium floor for the start of the team competition finals, her teammates in star-spangled leotards following behind—Aly Raisman, Simone Biles, Gabby Douglas and Madison Kocian. Yes, it was as if 16-year-old Laurie Hernandez already knew what would be confirmed two hours later: This year’s American women’s team may be the best of all time.

“Man, we were ready,” Hernandez said. “So, so ready.”

What followed was as ruthlessly dominating of a performance as there has been in the last half-century of sport—a feat every bit as impressive as what the Dream Team accomplished in 1992 in Barcelona when it vaporized the field to win basketball gold.

Consider: The American women beat second-place Russia by 8.209 points—the largest margin of victory since the 1960 Olympics in Rome, where six athletes’ scores were included in each apparatus total. In Rio, only three individual scores were tallied in each event.

“It just felt like a normal meet, not even like the Olympics,” said Biles, the only American to compete in all four events. “We were so crazy ready that we knew we just had to do what we did in practice and we’d be fine. And we were.”

A three-time world champion, Biles is the overwhelming favorite to win all-around gold Thursday, but the mantle of breakout American star at these Olympics belongs to Hernandez.

About 36 hours before the start of the team competition, Martha Karolyi, the U.S. national team coordinator, told Hernandez she would be participating in three events—the vault, the balance beam and the floor exercise. Upon hearing the news, Hernandez, the first Latina gymnast on the U.S. team since Annia Hatch a dozen years ago, felt like screaming in joy. She was selected over Douglas, the reigning all-around Olympic gold-medal winner, and Kocian, a specialist on the uneven bars.

“I’ve worked so hard for this moment, and I wanted to be out there for my country,” she said. “There was no doubt about my abilities at all in my mind.”

In the preliminary round of the team competition, Hernandez became a trending topic on Twitter after her floor exercise as she danced and tumbled her way into the imagination of fans across the globe. Nicknamed “Baby Shakira” and “The Human Emoji” for her vivid facial expressions, she engaged the crowd with a stage performer’s ease—a prodigy born to be in the bright lights.

In her final floor routine, she again dazzled spectators with her rhythmic moves—first learned in ballet lessons at the age of three. In between opening with a double layout and closing with a tucked double back, she danced like no one was looking, which caused everyone who was looking to roar.

Unable to contain her joy after sticking her final flip—a refreshing trait in women’s gymnastics—she blew kisses to the fans.