Episode 192
Ep. 192-Swimming Induced Pulmonary Edema & How to Lighten Your Mental Load Before the Race Begins
In this episode:
Diving into the depths of psychological performance in sports, this episode of the TriDoc Podcast features an engaging discussion between host Jeff Sankoff and psychologist Dr. Jim Taylor. They explore the concept of mastering adversity as a way to enhance athletic performance, particularly in triathlons. The conversation kicks off with a humorous nod to Jeff's raspy voice, a remnant of his recent battle with a respiratory infection, which he cleverly ties into the theme of overcoming challenges. Dr. Taylor shares invaluable insights on resilience, emphasizing that the mental tools athletes develop through life experiences can be incredibly beneficial when facing adversity in sports. They discuss how athletes can prepare mentally for various scenarios during races, highlighting the importance of rehearsing potential challenges in advance. As they delve deeper, they touch upon the five attitudes that can hinder performance, including over-investment, perfectionism, fear of failure, preoccupation with results, and excessive expectations. By shedding light on these psychological barriers, Jeff and Dr. Taylor provide listeners with practical strategies to combat them, encouraging a mindset that prioritizes enjoyment and personal progress over rigid expectations and outcomes. This episode is a treasure trove for athletes looking to enhance their mental game while navigating the thrilling yet intimidating world of triathlons. The Medical Mailbag will be exploring the risk of swimming induced pulmonary edema in triathletes, and will investigate the data from studies done in Sweden to educate the audience on the risks and ways of ceasing the progression of pulmonary edema.
Segments:
[4:51]- Medical Mailbag: SIPE
[36:13]- Interview: Dr. Jim Taylor
Links
@drjimtaylor on Instagram@drjimtaylor on XDr. Jim on YouTube
Transcript
So much of my work and so much of my work, especially with these five attitudes, is about taking that weight vest off because they weigh you down and because the goal before any race is to just be free, light, liberated, just whatever you've got that day, you can give it everything you've got.
Speaker A:Nothing psychologically, emotionally is going to hold you back.
Speaker A:That doesn't mean you're necessarily going to achieve your goals, but it will enable you to do the very best you can on that day with what you have.
Speaker B: ,: Speaker B:I'm your host, Jeff Zankoff, the Tridock emergency physician, triathlete, triathlon coach and multiple Ironman finisher coming to you as always from beautiful sunny Denver, Colorado.
Speaker B:I have to apologize for the sound of my voice.
Speaker B:I have been fighting quite a terrible upper respiratory tract infection.
Speaker B:It's going to sound like this pretty much the entire program.
Speaker B:It's a little bit raspy because I've been coughing quite a bit.
Speaker B:But I assure you I am finally coming out the other side of what has been a very trying week.
Speaker B:But the better sounding voice that you heard at the beginning of the program was that of my guest today, and that is Dr. Jim Taylor.
Speaker B:Dr. Taylor is psychologist.
Speaker B:He has worked with some of the very best professional triathletes and cyclists in the world.
Speaker B:He himself is a very accomplished age group cyclists, skier and triathlete, and he is rejoining me on the program.
Speaker B:He was first here about a year ago and is actually a close friend of Dr. Kevin Stone, another of my recent guests who rejoined the program after first being here a little over a year ago.
Speaker B:Dr. Taylor is back to talk about some of the mental hacks that we can bring as athletes to our training and our racing in order to boost our ability to perform when we are doing the thing that we love to do.
Speaker B:We have a very busy program today.
Speaker B:I am not going to take up any of the time doing a monologue because of the fact that the medical Mailbag segment and the interview are quite lengthy.
Speaker B:So I will tell you that the medical Mailbag segment that is coming up in just a moment is going to be a return visit to a subject that I have spoken about previously.
Speaker B:It is swimming induced pulmonary edema or cold water induced pulmonary edema, something that I have been asked about increasingly, I think, over the past couple of years since I first discussed this subject.
Speaker B:And so I wanted to revisit the science and literature on this.
Speaker B:So Juliette Hoffman, my friend and colleague and coach at LifeSport coaching is here, as always, to discuss that with me.
Speaker B:We're gonna get into what is known about this entity.
Speaker B:Whether or not it's something you really need to spend a lot of mental energy worrying about.
Speaker B:It is, of course, not something you need to be too worried about, something you may want to keep in the back of your mind.
Speaker B:But we're gonna get into who really is at risk.
Speaker B:What are the things you can do to try and mitigate your risks when you're in cold water?
Speaker B:And think about the things that you really should spend time worrying about, because this is just not gonna be one of them.
Speaker B:Before we get into it, though, I do want to address something that my daughter, the editor of this program, raised in listening to us discuss the subject of swimming induced pulmonary edema.
Speaker B:She heard Juliet and I sadly discuss our the Winter Olympics.
Speaker B:How much we enjoyed watching the Olympic Games.
Speaker B:And Sam rightly pointed out that the Paralympic Games have just begun.
Speaker B:And that is, of course, a source of great enjoyment, if you can find them.
Speaker B:It is really unfortunate that the Paralympic Games don't get the kind of coverage, don't get the kind of celebration that do the regular Olympic Games.
Speaker B:And it's really sad because the kinds of things that we see in the Paralympics are honestly, often even more sensational than what we see in the Olympic Games.
Speaker B:So if you are able to watch them, I highly encourage that you do.
Speaker B:They are not easily watchable, certainly not in the kinds of doses that we got when watching the Olympics.
Speaker B:And Juliet and I did not mean to disparage them in any way.
Speaker B:We were just commenting on how much we enjoyed watching the Olympics on a daily basis and the amount of coverage that we got.
Speaker B:So for those of you who are big fans of the Paralympics, and I am one of them, I very much enjoy watching the Paralympic Games when I can.
Speaker B:We did not mean any disrespect.
Speaker B:So with, with that said, let's move on to the medical mailbag and swimming induced pulmonary edema.
Speaker B:We'll have that for you right after this short break.
Speaker B:It's time for the medical mailbag, which is appropriate because I sound like I need some medical help.
Speaker B:It's been a rough week here.
Speaker C:Someone put him out of his misery.
Speaker B:It's been a rough week here at Tridoc podcast headquarters, where I have been laid up with a miserable upper respiratory tract virus.
Speaker B:But I'm coming out on the other end.
Speaker B:The light is at the end of the tunnel.
Speaker B:I'm hoping it's not that of an oncoming train, but for now, I am joined by my friend and colleague Juliet Hockman for the medical mailbag.
Speaker B:How are you doing, Juliet?
Speaker B:Better than me?
Speaker C:I am, Yeah, I am fine.
Speaker C:And if you devolve into another one of those coughing fits, I'm just gonna have to post this by myself, which would be interesting for most.
Speaker B:Yeah, it's been, yeah, it's been a really sad week.
Speaker B:We came back from Toronto, of course, we had that wonderful trip off to meet a bronze medalist pole vault Alicia Newman last week in Toronto.
Speaker B:We had a really great time and I came back and within 24 hours I could feel I had caught something.
Speaker B:And sure enough, I was pretty sick most of the week and couldn't do any training, which is always sad.
Speaker B:And people who are listeners of this show know that I've done medical mailbag segments about whether or not you could train when you're sick.
Speaker B:And there is no harm in training when you're sick.
Speaker B:In fact, we just talked about it.
Speaker C:Unless you have a fever.
Speaker B:We just talked about it, Matt and I on tempo talks.
Speaker B:I was in no state to do any training.
Speaker B:My wife is constantly making fun of me for milking my illness.
Speaker B:My son likes to play snippets from the Civil War documentary people talking in old fashioned, old timey English letters home because he thinks that I milk the illness.
Speaker B:But even my wife was able to say, oh, you don't look so good this time.
Speaker B:Yeah, you can hear it in my voice.
Speaker B:But I'm here.
Speaker B:We are gonna make it through a medical mailb segment which, you know, we
Speaker C:have not spoken since the end of the Olympics because you were away.
Speaker B:You're going to bring that up, are you?
Speaker C:No, I was.
Speaker C:I actually did not bring that up with the intent of focusing on the outcome of the hockey games.
Speaker C:I was thinking more in terms of the fact that my evenings now are feeling very empty because usually I would turn on the Olympics.
Speaker C:I would look at athlete files for an hour or so.
Speaker C:I would have in the background all kinds of different sports and how amazing that was to see sports that I didn't know anything about.
Speaker C:And they would be going on the background and it was just so great.
Speaker C:And now I'm just feeling like there's this vacuum of.
Speaker C:Now I have to wait another two years before we get all of this incredible sports coverage again.
Speaker B:There's no question it's a real void.
Speaker B:I feel like we get this wall to wall coverage of all these wonderful sports.
Speaker B:What really bothers me is that it's so hard to find the replays if you just want to watch some of the stuff that you didn't get to watch live, it's really hard to seek it out.
Speaker C:Find that.
Speaker B:And it's too bad because it really.
Speaker B:They keep that under lock and key and they really close fisted about it.
Speaker B:And I really wish, because I didn't get to see a ton of the cross country skiing, which I really enjoy watching, and even knowing who won, I don't care.
Speaker B:I would watch some of it.
Speaker B:Especially biathlon, which I really enjoy.
Speaker C:I think we watched every single cross country in biathlon race.
Speaker C:So the whole thing, 50k, it didn't matter.
Speaker C:Just turn it on and have it going on in the background.
Speaker C:It was still awesome.
Speaker B:I think they're all awesome.
Speaker B:Yeah, they're so fun.
Speaker B:And I did get to see that Norwegian guy on the hill.
Speaker B:Holy smokes.
Speaker B:The way he took off on the final hill and just left everybody for dust was so impressive.
Speaker C:Well, it's become a meme now.
Speaker C:The guy's running faster than six minute miles up the hill on skis.
Speaker C:And that hill was at the end of every single race.
Speaker C:And so you would just.
Speaker C:That's why it was worth watching the whole 50k, because you knew that hill was at the end and he was just gonna drop anybody.
Speaker C:And he did again.
Speaker C:You'd hate to be one of his competitors.
Speaker C:Like, you ski with the guy for two hours and in the last 90 seconds he's to drop you like a hotcake.
Speaker C:Talk about a different species of human being.
Speaker C:The guy was incredible.
Speaker B:We'll see him in triathlon any day now because the guy's going to need to find something else to do and he just looks like an endurance animal.
Speaker B:One of the things that surprised me coming out of the Olympics was I was really disappointed in ski mo, ski mountaineering.
Speaker B:I really thought that was going to be an exciting event to watch.
Speaker B:And they made it way too boring.
Speaker B:Like, it was so dull.
Speaker C:Yeah, well, I think they were.
Speaker C:I was surprised how short it was.
Speaker B:That's it.
Speaker B:They made it so short.
Speaker B:I know that there was no time.
Speaker B:Yeah.
Speaker B:But there's a point at which you condense it so much for television that you take away all of the aspects of the sport that make the sport enthralling.
Speaker B:Like, you need to give them time to actually climb and you need to give them time to actually handle some tough parts of the climb.
Speaker B:And then the downhill.
Speaker C:Well, it all came down to the transitions.
Speaker B:It all came down to the transitions.
Speaker B:To watch them sit there and peel the skins off and change their skis I was like, wow, basically you could have just given the medal to who was the fastest in the transition.
Speaker B:So I don't know as well.
Speaker B:It was too bad after my own parts.
Speaker C:I know.
Speaker C:But what we don't know is what skimo looks like when it's being competed at a non Olympic.
Speaker C:Like we don't know if that's the schemo sort of.
Speaker B:It's not.
Speaker B:From what I read, it sounds like this is a full.
Speaker B:Maybe not a full day, it might be a half a day, but it's certainly a longer event.
Speaker B:And like you said, they wanted to condense it down to be something that would be digestible for television viewers.
Speaker B:But look, there are some.
Speaker B:Look, that 50k cross country race was very exciting to watch.
Speaker B:Right.
Speaker B:Some of the longer races are watchable.
Speaker B:I think that schema could have been made into.
Speaker B:I just don't know that they gave it a good thought.
Speaker C:What's curious if it is, if under normal circumstances it is a three or four hour event, which is, I think what you're suggesting, then to then condense it into a three minute event.
Speaker C:That's a totally different type of world class athlete.
Speaker B:Yeah, yeah, absolutely.
Speaker C:And so it's interesting.
Speaker C:It's like how they've parsed or segmented climbing now in terms of all these different events and some are very fast and some are slower and.
Speaker C:But yeah, no, that, that's interesting in and of itself that they selected for this Olympics basically a sprint athlete, a three minute athlete as opposed to a three hour athlete.
Speaker C:So that's kind of interesting too.
Speaker C:Yeah.
Speaker B:Yep.
Speaker B:Yeah.
Speaker B:Not sure if it's going to be back.
Speaker B:It was a demonstration sport this year.
Speaker B:Not clear if it's going to be back in France.
Speaker B:Where is it in France?
Speaker B:Is it.
Speaker B:It's in the Alps somewhere.
Speaker B:I'm trying to remember where.
Speaker B:Grenoble.
Speaker B:I think that's where it is in four years.
Speaker C:I don't even know.
Speaker B:Yeah, I think it's in Grenoble anyways.
Speaker C:All right, well, no, wait, it's not back in.
Speaker C:It's not back in Salt Lake.
Speaker B:No, it's in France in four years.
Speaker B:It's definitely in France and I'm pretty sure it's Grenoble anyways.
Speaker B:All right, let's get to our subject for the medical mailbag.
Speaker B:That's what people are tuning into.
Speaker B:What are we going to be discussing today, Juliette?
Speaker C:We are bringing back the evergreen topic of swimming induced pulmonary edema.
Speaker C:And this doesn't come specifically from an athlete writing in or inquiring, but Jeff, what you shared with me is that you often get this question from athletes nervous about this.
Speaker C:Maybe they know somebody or they know somebody who knows somebody to whom it happened.
Speaker C:Obviously, every year at, whether it's Ironman or more local or regional triathlons, we will see somebody who has suffered from this or another tragic malady in the water.
Speaker C:And I think it's probably, particularly for athletes who are perhaps newer to the sport, it might be akin to coming across a shark in the middle of an open water swim.
Speaker C:Like, you never know what's going to happen and you're going to have nightmares about this thing happening to you and you have no control over it.
Speaker C:So I wonder if that's the genesis behind the question.
Speaker C:But talk to us, let's discuss this again, explain what it is you found some new sort of data which we discussed before the show, which is really interesting.
Speaker C:So remind us what it is and who it affects the most and what can be done about it, which I don't think is much, but I'll let you explain.
Speaker B:Yeah, so this is one of those things, like you said, I hear about it frequently because anytime that there's a death in the swim portion of a triathlon, immediately people begin to hypothesize, oh, was it swimming induced pulmonary edema?
Speaker B:Was it a primary cardiac event?
Speaker B:And the reality is that it's impossible to really know because on autopsy, the lungs are frequently filled with water, either because the individual inhaled water as a partial drowning or because they developed a primary cardiac problem which resulted in fluid in their lungs, or because they had cpr, which can also get fluid in the lungs, or because they actually had swimming induced pulmonary edema.
Speaker B:So the reality is that when swimming induced pulmonary edema occurs and actually causes a death, it's very hard to know if it was truly the cause.
Speaker B:And so what's happened is since this entity was recognized, it's going on now probably seven or eight years that it was first postulated and recognized among swimmers.
Speaker B:It's become kind of increasingly feared, it's increasingly talked about.
Speaker B:But the reality is, like sharks, we know it's out there, but we just don't know how often and we just don't know when it's gonna crop up.
Speaker B:And we don't know if every time we get in the water are we going to be the victim?
Speaker B:And you're right, I think it's that unknown that really results in a lot of fear and a lot of anxiety around this.
Speaker B:So let's talk about what it is.
Speaker B:Pathophysiologically and let's talk about the circumstances under which it's most frequently seen and who is most likely to have this problem.
Speaker B:There is, as you mentioned, I think we want to be straight up and say there's really no way to prevent this.
Speaker B:If it's going to happen, it's going to happen.
Speaker B:There's a couple of things you can do and we'll talk about that.
Speaker B:But if it's going to happen, you're kind of.
Speaker B:It's going to be difficult to prevent it altogether.
Speaker B:The most important thing you could do is recognize it's developing and then do the kinds of things you need to do to make sure you don't get into more trouble.
Speaker B:Okay, so let's go back to the beginning and just talk about what it is.
Speaker B:Pulmonary edema is simply fluid in the lungs.
Speaker B:The most common cause of pulmonary edema is congestive heart failure, which not a big issue for triathletes.
Speaker B:But if you have an elderly relative who has been in the hospital with water on the lungs, that's what is being talked about.
Speaker B:What ends up happening is your left heart.
Speaker B:So the heart has two sides.
Speaker B:It has a right side and a left side.
Speaker B:The right heart's job is to push fluid, is to basically bring fluid back from the body venous return and to push that fluid through the lungs and into the left heart.
Speaker B:The left heart's job is then to push blood flow to the whole body.
Speaker B:Most people have a resting cardiac output of around 4.5 liters per minute.
Speaker B:It's a fair amount of cardiac output in the ideal circumstances.
Speaker B:Your right side of your heart puts out 4.5 liters per minute and your left side of your heart puts out 4.5 liters per minute.
Speaker B:But in an elderly person who has had, maybe they've had a heart attack in the past, maybe they have very high blood pressure, maybe they have some kind of cardiomyopathy.
Speaker B:Maybe their right heart is working just fine and their right heart is putting out 4.5 liters per minute.
Speaker B:But something happens.
Speaker B:They get an angina attack, or maybe they had too much salt in their diet and therefore they have too much fluid in their blood.
Speaker B:Their blood pressure goes up.
Speaker B:And so all of a sudden the left heart suddenly can only put out 4.4 liters per minute.
Speaker B:That difference of 100cc's per minute has to go somewhere.
Speaker B:If the right heart is pushing four and a half liters to the left, but the left can only push 4.4 forward, that 100cc's per minute gets caught
Speaker C:in the lungs, sitting in the lungs.
Speaker C:Okay.
Speaker B:And so over time, the airways of the lungs, first, the interstitium, which is the tissue of the lungs, will get full of fluid and become very stiff, becomes hard for the person to breathe.
Speaker B:But then that fluid, because of hydrostatic pressure, will be forced out of the interstitium into the air sacs of the lungs and flood the air sacs of the lungs, resulting in the patient feeling very short of breath because they're essentially drowning from within.
Speaker C:Okay.
Speaker B:So that pulmonary edema is a very distressing situation.
Speaker B:And we have a number of things that we can do to regulate that to make the patient feel better.
Speaker B:But the biggest thing that we do is we try to get balance back between right and left sides of the heart.
Speaker B:So what we'll do is we will reduce venous return so that the right side of the heart, Instead of putting 4.5, maybe the right side of the heart will only put 4.3.
Speaker B:And then we'll fix the left side so that it can actually start pushing 4.5.
Speaker B:So now there's a net positive 200cc's per minute coming from the left to the right, and it'll start pulling fluid from the lungs, and that pulmonary edema will get better.
Speaker C:Okay, copy.
Speaker B:So that's the medical cause.
Speaker B:There are other medical causes which are toxin related.
Speaker B:Heroin, for example, A heroin overdose can
Speaker C:cause big problem with triathletes.
Speaker B:Yep.
Speaker B:Yeah.
Speaker B:The antidote for heroin, which is called naloxone.
Speaker B:Naloxone can also occasionally cause pulmonary edema.
Speaker B:Again, not a triathlon problem.
Speaker B:The point is that there are other causes, but swimming induced pulmonary edema is caused by a somewhat different issue here.
Speaker B:The issue is, most of the time, we see this in cold water.
Speaker B:So there are a number of physiologic changes that occur in cold water, the most important of which is that your body senses the cold water in the periphery and wants to keep blood within the torso to keep it warm.
Speaker B:One of our protective homeostatic physiologic adaptations to being exposed to the cold is to shut down blood flow to our extremities.
Speaker B:So what we'll do is we'll actually reduce the amount of blood flow going to the arms and legs and instead keep that blood pooling in our torso.
Speaker B:That essentially equates to an increased venous return of anywhere between 4 to 600 cc's of blood, which would normally be in our legs, is now coming back to the heart.
Speaker B:And so now what you end up doing is you overwhelm the right side, that blood flow starts pushing forward to the left and it can get caught in the interstitium and it can start getting in the interstitium of the lungs.
Speaker B:And in some circumstances, which we'll get to in a second, can be a risk factor for developing pulmonary edema.
Speaker B:So that's risk factor one.
Speaker B:You're in cold water.
Speaker B:There is this issue with increased blood pooling coming to the chest.
Speaker B:Okay, second issue.
Speaker B:And this affects people with who are older.
Speaker B:So people who have predisposing cardiac conditions, so maybe they have long standing high blood pressure, maybe they have issues related to inability of their heart to really increase their cardiac output under different signs of duress.
Speaker B:This is generally going to be older athletes who may have had already some scarring of their myocardium, be it from a previous myocardial infarction or just from fibrosis, from being an athlete for a very long time.
Speaker B:And so they too may now have a bit of a problem because we have this influx of fluid coming from the vasoconstriction in the legs, venoconstriction in the legs, and now all of a sudden you add to that, the heart can't adapt.
Speaker B:And so they have this imbalance that now develops between right side and left side.
Speaker B:Two other things we need to consider, one of them is the wetsuit.
Speaker B:So we put on a tight fitting wetsuit, right?
Speaker B:We want our wetsuit to be very tight in triathlon, for good reason.
Speaker B:We don't want water in there.
Speaker B:But that tight fitting wetsuit squeezes our legs further and also forces fluid back to our torso.
Speaker B:So now this is a problem in warmer conditions as well, Right?
Speaker B:We're wearing the same wetsuit in warmer conditions, but because in warmer water, we're still gonna push blood flow to our legs.
Speaker B:It's not as big of an issue.
Speaker B:So in colder water, it's much more important than it is in warm water.
Speaker B:But the wetsuit definitely can contribute to this development of cold water induced pulmonary edema.
Speaker B:And then the other thing is just being in a stressful event, starting in a race, you are ramped up, you're excited.
Speaker B:And then you add the anxiety of being in cold water, of being around other people.
Speaker B:Sometimes that cold water's dark.
Speaker B:All of the things that we always associate with the beginning of a race and all of those things together increase your adrenaline.
Speaker B:And adrenaline causes further vasoconstriction in the periphery, can increase your blood pressure and cause further problems with left ventricular cardiac output, which if you have more fluid Coming back to the heart can result in this imbalance between right and left cardiac outputs, causing fluid being caught in the lungs.
Speaker B:Okay, finally, there is a respiratory component when you take a large inspiration, a forceful, large inspiration, which a lot of people do when they swim, right?
Speaker B:They turn their head and they're like, this is a big great inspiration, right?
Speaker B:When you do that, you actually cause a vacuum effect because you are inhaling, you're causing a vacuum in your chest to get air into your lungs as rapidly as possible.
Speaker B:But that also causes a vacuum on your venous system and pulls more blood flow to your heart.
Speaker B:So we know that when you take forceful inspirations, you increase venous return.
Speaker B:So if you have all of these factors that are increasing venous return, and you add on top of that forceful inspiration, that can also increase venous return, overwhelm left ventricular output, and cause this cardiac output issue where you have fluid going into the lungs.
Speaker B:Okay, okay.
Speaker B:So I've given you a lot of reasons for the pathophysiology of this developing.
Speaker B:So now your question of who does this impact?
Speaker B:So a couple of really interesting studies that Nina Takeshima, our intern for this episode, came across some fascinating studies coming out of Sweden, where they have annual one and three kilometer swims in open water rivers that are in quite cold water.
Speaker B:And they have documented using ultrasound.
Speaker B:So ultrasound is the most sensitive way to really document the presence of fluid in the lungs.
Speaker B:And if you were to look at everybody's lungs with ultrasound, you could almost find some fluid in everybody's lungs.
Speaker B:So it's hard to know, like, what they're getting at here, but they found just a ridiculous amount of swimming induced pulmonary edema.
Speaker B:Now, I want to be clear, the vast majority of these cases were not clinical.
Speaker B:So it was ultrasound proven fluid in the lungs that was not causing any symptoms at all.
Speaker B:So almost two thirds of the athletes coming out of the water in a cold water swim had ultrasound evidence of water of some degree of fluid in their lungs.
Speaker B:And this was looking at 47,000 people over several years.
Speaker B:So it's a lot of people.
Speaker B:Yeah.
Speaker B:And when they broke it down, it was 64% of swimmers had some pulmonary edema on their ultrasounds.
Speaker B:Now, when they broke it down to see which kind of symptoms did people had who actually had clinically significant, like, if they had a low oxygen saturation, if they were coughing, if they were short of breath, there really wasn't anything that really was overwhelmingly positive.
Speaker B:And so it was only a bunch of things together.
Speaker B:You had to combine different clinical symptoms together to get a good sensitivity for this.
Speaker B:So it's not clear that this is clinically relevant, but I would just say that it's not unusual when you swim in cold water to have some degree of this that is not clinically important.
Speaker B:That's the most important thing.
Speaker B:But it is a very large number of people.
Speaker B:So here's where it gets really interesting as to who gets this.
Speaker B:Here is a graph taken from a paper on swimming induced pulmonary edema in cold waters.
Speaker B: wims in Sweden from the years: Speaker B:The top graphs are showing men versus women.
Speaker B:And it's astonishing.
Speaker C:Yeah, it's unbelievable.
Speaker B:Affected so much more frequently than men.
Speaker B:It is.
Speaker B:Now I want to be clear, this is not.
Speaker B:The Y axis is not very high right now.
Speaker B:If you're not watching on YouTube what we're talking about here.
Speaker B:So if you're watching on YouTube, you'll see this.
Speaker B:If you're listening to the podcast.
Speaker B: a graph that shows the years: Speaker B:And then it's broken into men and women.
Speaker B: And so for example, in: Speaker B:So 0.1% of men had this problem, clinically significant.
Speaker B:And 0.6% of women.
Speaker B: times as many women as men in: Speaker C:But out of what was the sample size?
Speaker B:Oh, it was huge.
Speaker B:It was several thousand.
Speaker B:Yeah, it was many thousand each year.
Speaker B:So it's a lot.
Speaker B:This is a tiny number of people who actually developed this.
Speaker B:And again, none of them died.
Speaker B:It was clinically significant as like they were short of breath and that was about it.
Speaker B:Them needed to be hospitalized.
Speaker B: In: Speaker B:So eight times as frequent.
Speaker B:And this just goes on.
Speaker B: And the worst of it is in: Speaker B:So really just astonishing discrepancies between men and women.
Speaker B:And then the lower graph is by age and you could see that it just marches upwards very dramatically.
Speaker B:So in the lower age groups, like 18 to 30, it's almost, it's not detectable.
Speaker B:And then by the time you get into the over 60s, it's pretty high.
Speaker B:It's over 1% some years.
Speaker B:Most years it's in the 0.8%.
Speaker B:But it definitely, it just marches straight up in most years.
Speaker B: With one outlier in: Speaker B:I think the age makes sense.
Speaker B:Right.
Speaker B:Because I mentioned before, cardiac dysfunction plays a big role here.
Speaker B:And people who have hypertension, people who have had some kind of cardiac dysfunction, they're gonna be at risk for developing this.
Speaker B:So the age part makes sense.
Speaker B:Sure, the sex discrepancy is a little bit harder to explain, but what has been theorized is that women, by virtue of their smaller lung volumes compared to men, by virtue of their smaller alveolar size, their smaller airway size, are at greater risk for developing this with smaller amounts of fluid.
Speaker B:And so they don't need nearly as much discrepancy between left and right cardiac output, not nearly as much fluid overwhelming the heart before they will get into trouble.
Speaker B:So that is why, at least it's been theorized.
Speaker B:There's no way to actually make a trial to determine that, but that's the theory, and it makes intuitive sense.
Speaker B:So I think that's probably what's going on here.
Speaker B:Okay, so what does this present as, and what can you do to prevent it?
Speaker B:If you're swimming in cold water, if this is going to come about, basically, you're just going to feel short of breath and more short of breath than you would expect for the level of exertion you're putting out.
Speaker B:And it's not going to go away.
Speaker B:If this happens to you, it's imperative that you stop swimming and that if you don't, immediately feel some kind of improvement.
Speaker B:Because, look, let's face it, we've all been in a situation when we get in cold water, we start swimming, we feel short of breath, and that shortness of breath is related to just anxiety and the fact that we're in a tighter wetsuit, and maybe it's just we went out too hard, and if we stop swimming, that shortness of breath goes away and we can start swimming again, and we're fine.
Speaker B:I will tell you, if you're listening to this, if this happens to you, the vast majority of you, that's what's going to be the issue.
Speaker B:But for a very small percentage of people, this may actually be some early pulmonary edema.
Speaker B:And so if you start swimming and you feel like the shortness of breath is not what I was expecting, and you stop swimming and it's not getting better, it's time to ask for help, because this can be treated, and this does not need to be dangerous.
Speaker B:It can be taken care of.
Speaker B:If it's caught early, and it's just a matter of oxygen and getting you out of the cold water, getting you out of the wetsuit, and this has been Shown repeatedly if it's caught, that swimmers do not die, that they do very well.
Speaker B:But it's really important that you are self aware and that you not be overly anxious going into your swim.
Speaker B:And that's where how do we prevent it comes.
Speaker C:Right.
Speaker B:So I tell all of my athletes, warm water or cold, I think it's much more important for cold water.
Speaker B:When you start a race, sometimes you can't control the anxiety levels, but what you can control is how hard you exert yourself to start.
Speaker C:Yes.
Speaker B:And keeping your adrenal levels low, keeping your cardiac output low is vitally important to avoiding this problem.
Speaker B:Not breathing super hard, not taking these huge forceful inspirations, very important.
Speaker B:So when you start swimming, I tell all of my athletes for the first one or two buoys, 100 or 200 meters, I want you to just focus on calm technique, complete exhalations on your swim.
Speaker B:So get your face in the water before you start to swim because it's really important to really get that cold reflex out of the way.
Speaker B:And then once you start swimming, it's force, it's not forceful, but it's full exhalations underwater.
Speaker B:Take a nice full breath, but not forceful when you turn your head and make sure you're just focusing on technique and good steady turnover without hitting your race pace.
Speaker B:Once you get to the first or second buoy, then you can reassess how you're feeling and then ramp yourself up to the full effort.
Speaker B:You are going to lose nothing by being cautious in that first to 200, you may actually give yourself a much better overall race.
Speaker B:Is that something similar that you share with your athletes?
Speaker C:That's 100%.
Speaker C:And particularly if athletes are anxious open water swimmers, regardless of the water temperature.
Speaker C:Same thing.
Speaker C:Put yourself maybe one wave back, walk into the water, start slowly, maybe go to the left or the right so you're not right in the pack of people, so you don't have that added anxiety of people around you maybe bumping you may be going faster than you swimming near you.
Speaker C:And just, yes, one or two buoys, just take it very slowly.
Speaker C:And then the other thing I would add to that and I remember in, I can't remember when it was maybe 20, 21, something like that.
Speaker C:Going out to 70.3St.
Speaker C:George for the May race, not the world championship race, but the May race.
Speaker C:And I had heard about halfway out I heard I drove, it was like a 16 hour drive.
Speaker C:And about halfway out I heard that the water temperature was like 53.
Speaker C:And I remember calling the individual who coaches both of Us is saying, I'm turning around.
Speaker C:I can't swim in that.
Speaker C:I'm.
Speaker C:That is way too cold for me.
Speaker C:I'm terrible in cold water.
Speaker C:I can't do it.
Speaker C:And he's.
Speaker C:Just keep driving.
Speaker C:You'll be fine.
Speaker C:But what I got out there three days early, and I got in every day, right?
Speaker C:So I got.
Speaker C:The first day I swam 200 meters, and it was a horrible shock.
Speaker C:And the second day I swam 400 meters, and the third day, maybe I swam 800 or something like that.
Speaker C:But the point is that by tricking my brain and by teaching my brain, I wasn't going to die.
Speaker C:It wasn't that cold.
Speaker C:I was going to be just fine.
Speaker C:I just had to get over the shock of it.
Speaker C:Just affirming for myself, confirming for myself that it was all going to be fine.
Speaker C:And when it came to race day, it was completely fine.
Speaker C:And so I think to the extent that an athlete can get to a race where he or she knows there's going to be really cold water early and get in every day, maybe even twice a day, and just keep, oh, I'm fine, I'm fine.
Speaker C:I swim 200 meters, I swim 400 meters, I'm fine.
Speaker C:Then they know that on race day itself, they're going to be fine.
Speaker C:So I would advocate that as well.
Speaker B:I fully concur.
Speaker B:I think that's great advice, and there's definitely something to be said about having a sense of what to expect and adapting to that in advance.
Speaker B:I just want to emphasize, again, there's not a whole lot you can do to prevent this, but what you can do is mitigate some of the factors that lead to this.
Speaker B:You can't change the wetsuit, you can't change the temperature of the water.
Speaker B:You can't change your age, you can't change your gender.
Speaker B:But what you can change is your level of anxiety, which you've just addressed.
Speaker B:You can change the level of exertion when you start your swim.
Speaker B:You could change how forcefully you breathe.
Speaker B:Those factors are really important in whether or not this comes on.
Speaker B:And then the other thing, of course, is if you start to notice that you're feeling significantly short of breath, more short of breath than you would expect, dealing with that immediately is the other thing that you can do.
Speaker B:So I don't want people to come away from this feeling more afraid.
Speaker B:The idea behind this is for people to feel less concerned about it.
Speaker B:It's just not that common.
Speaker B:It is understood why it happens.
Speaker B:And now that you have a better understanding, you should Be able to control the things that are within your control and approach swims in cold water, knowing what to expect and also knowing that this is probably, you know, it's a mountain being made out of a molehill.
Speaker B:And just be aware, that's all.
Speaker B:Just be aware.
Speaker C:Yeah.
Speaker C:And 100%.
Speaker C:And just because you have shortness of breath when you go in for an open water swim, know thyself, right?
Speaker C:If you're someone who's always nervous when you go for an open water swim, no matter how warm the temperature, wetsuit, not wetsuit, regardless of where it is in the world, if you're always that athlete who gets very, very nervous, get in the water more often.
Speaker C:Every time you have an opportunity to go and swim in the open water with a friend, with teammates, with your spouse, your family, every time you have a chance, go and get in the water and practice that.
Speaker C:I've actually even had some of my athletes who are nervous open water swimmers have them like run up and down on the beach a few times so that they get their heart rate up.
Speaker C:So you simulate that race day anxiety.
Speaker C:I'm like, okay, I'm running the water and just trying over and over again to, to teach our brains that we're.
Speaker C:If we're going to be okay, we're going to be okay.
Speaker C:And I think it is repetition.
Speaker C:So know yourself as an athlete.
Speaker C:If you're an athlete, I bet really never have anxiety about the open water.
Speaker C:You probably, after all your hundreds of races, don't either.
Speaker C:So if you were to feel it, or if I were to feel something like that, then that would be like, okay, this never happens to me.
Speaker C:This is really weird.
Speaker C:What is going on.
Speaker C:Know yourself as a swimmer too.
Speaker B:All excellent points, excellent points to finish on.
Speaker B:This has been another, I think, great and informative and interesting segment of the Medical Mailbag.
Speaker B:I want to thank all the people who reached out over the last several months and asked about this question.
Speaker B:So I'm really glad to bring it to you.
Speaker B:We have some more great questions coming down the pike because of listeners.
Speaker B:Thank you all.
Speaker B:Keep them coming.
Speaker B:It's really wonderful to get them and we know that you're listening and we are here receiving them because many of them are coming in the episodes that are to follow.
Speaker C:If you.
Speaker C:And how can people send in their questions?
Speaker B:I was just about to get there, so thank you.
Speaker B:Thank you for the lead in.
Speaker B:Yeah.
Speaker B:So if you want to send in your question for consideration for the podcast, please do so by dropping me an email@tridocloud.com youm can also reach out through the private Facebook group which is the Try Talk Podcast Facebook group.
Speaker B:You could search for it on that platform, answer the very easy questions.
Speaker B:We'll be happy to gain you admittance where you could submit your questions, you could comment on the episodes, you can join the conversations that are on there all the time.
Speaker B:We would be glad to hear from you.
Speaker B:And of course there is other ways, myriad ways.
Speaker B:You can reach out to us on Instagram, Facebook, whatever way you like.
Speaker B:We have had questions submitted in all of these different ways and they're all appreciated.
Speaker B:Juliet thank you so much once again for a great conversation.
Speaker B:I look forward to our next conversation in a couple weeks time where hopefully I will sound a little more like myself.
Speaker C:Thanks Jeff.
Speaker C:Feel better soon.
Speaker B:My guest today is another in my return visitors in the last few episodes it's been very exciting for me to welcome back a couple of guests who I had on probably a year or a year and a half ago who I really enjoyed my conversations with.
Speaker B:We had Dr. Kevin Stone on recently who came back and chatted with us about advances in orthopedic surgery.
Speaker B:But I am very thrilled to welcome back Dr. Jim Taylor who joined me.
Speaker B:Gosh, I think it was about a year ago, Jim.
Speaker B:I think it may be about a year.
Speaker B:Yeah.
Speaker B:And at that time we had a really fascinating conversation and Jim reached out not too long ago and said I think it'd be nice to have another conversation.
Speaker B:And I couldn't agree more.
Speaker B:I love it when my guests reach out and want to come back on and talk some more.
Speaker B:So you'll have to forgive me for my voice.
Speaker B:I'm suffering from this cold.
Speaker B:It's been going on for way too long.
Speaker B:My cough has really been stretching my voice.
Speaker B:So forgive me listeners.
Speaker B:I am going to be somewhat raspy through this interview, but it's Dr. Taylor who is back and I'm really excited to welcome.
Speaker B:He is considered one of the world's leading authorities on the psychology of sport, performance and parenting.
Speaker B:He has consulted with athletes, business people, military educators, medical professionals, performing artists, and parents around the world, which makes him very well suited for this podcast because I think during the course of this program we've addressed pretty much everything in that resume so far.
Speaker B:Dr. Taylor holds a PhD in Psychology and has held faculty positions at universities around the United States.
Speaker B:He is the author of 18 books translated into 10 languages and is the editor of five textbooks.
Speaker B:His blog posts have been read by more than 15 million people around the world.
Speaker B: Ironman triathlete, and since: Speaker B:But today he's rejoining me on the Tridog podcast.
Speaker B:We are going to talk about a few psychological things because they are things that I know that I have dealt with and I know many of my listeners have dealt with over the years as well.
Speaker B:But for now, Dr. Taylor, welcome back and thank you so much for coming back onto the Tridoc podcast.
Speaker B:It's a pleasure to have you.
Speaker A:Yeah, Jeff, it's always great to be talking with you.
Speaker A:We've always had great conversations and one of the most fun things for me to do is to talk about things I'm passionate about that other people are passionate about, like you, but also come from a different perspective.
Speaker A:So I learn as well as lecture, if you will.
Speaker A:So always fun to chat.
Speaker B:When you reached out to me, you sent me a list of potential topics that we could discuss and three of them really jumped out at me and I was happy that you said, oh, those were the three I was thinking about as well.
Speaker B:So that means that we are, as always, I feel, somewhat aligned.
Speaker B:And the first of them was mastering adversity, which I think is really a topic that could probably take the whole conversation and if it does, so be it.
Speaker B:But when I think of mastering adversity, I think of that as we master adversity almost every day.
Speaker B:We face adversity in our lives as professionals who are trying to get training in for triathlon.
Speaker B:We face adversity during our training sessions.
Speaker B:We face adversity in our races.
Speaker B:We have to learn to master those varying degrees of adversity in order to succeed at all of the different things that we do.
Speaker B:Is it possible to bring the same skill set to master adversity in one facet of our lives, to then be able to master adversity in all those other ways as well?
Speaker B:Or do you need to have a different toolbox?
Speaker A:A combination of both.
Speaker A:You go into it with whatever, whether it's working professionally with family, with triathlon or your sport.
Speaker A:It starts off with the attitude, the perspective you have, but at the same time the tool of.
Speaker A:I characterize it as resilience because resilience is really the tool you use to overcome adversity, which is obviously so deep and widespread in the sport of triathlon.
Speaker A:And then there are different tools for different settings.
Speaker A:So you might have different tools related to resilience and dealing with adversity in Work, family, social life, and athletically as well.
Speaker A:But at the same time, you have to start off with the same attitude regardless, because the reality is, whatever kind of adversity it is, it's all adversity.
Speaker A:And a big part of that is starting off with a distinction.
Speaker A:Is the adversity internal or external?
Speaker A:So this is a starting point I really make because it's important, because people think of adversity in triathlon as like cold, rough water hills, hot weather, cold weather, uneven surface running, things like that.
Speaker A:I always joke about how triathlon is not bowling, where, no offense to the bowlers in the audience, but it's a fairly consistent setting.
Speaker A:You're indoors.
Speaker A:I've been told by professional bowlers that each lane is unique in its own way, but it's not quite as different as triathlon, where clearly every course is very different.
Speaker A:So identifying.
Speaker A:Is the adversity you're faced with external, or is it internal in terms of your thoughts, your emotions, your preparation, your past experience, how you typically respond to adversity?
Speaker A:Because ultimately, that's what this is about, Jeff, is how do you look at adversity and how do you respond to it?
Speaker A:And that.
Speaker A:How do you respond to it?
Speaker A:That's called resilience.
Speaker B:Now, I have always felt like I have brought resilience from other aspects of my life to bear when I face adversity in whatever it is I'm facing.
Speaker B:For example, triathlon has really informed me in so many ways to face adversity in my work life.
Speaker B:Things that I have faced in my work life as an emergency physician have allowed me to face adversity with resilience in triathlon.
Speaker B:Is that what you find as well?
Speaker B:Because I find it really interesting to hear you say that resilience is how we handle adversity.
Speaker B:I hadn't really thought of it that way, but is that kind of how people are best able to master adversity, is by having this depth of resilience that they build through other aspects of their life?
Speaker A:Without a doubt, Because a big part of resilience is the belief that you can overcome it.
Speaker A:If you have no faith, no confidence, no trust that you can deal with this adversity, you are not going to put a lot of effort in to be resilient because you don't think you can succeed at it, it's much easier to just quit, stop, slow down, back off.
Speaker A:But again, there are unique things.
Speaker A:There's this overall mindset of I'm a resilient person.
Speaker A:I have the confidence, I have the experience.
Speaker A:Because the reality is I've known incredibly competent people in one area, incredibly resilient people in one area who fold in other areas because they have that confidence, maybe in their professional life, but they don't in their triathlon life.
Speaker B:Another thing about they're not adaptable enough to bring the resilience from one area to the other or they can't make the, they can't make the switch.
Speaker A:It's typically because they don't have experience in the other setting.
Speaker A:And there are unique aspects.
Speaker A:So here's the interesting thing about triathlon.
Speaker A:Let's say swimming in really cold water, very common challenge for people who are tremendously resilient if they haven't swum in cold water.
Speaker A:It's hard to be resilient in cold water.
Speaker B:Sure.
Speaker A:And so a lot of it is the experience and the perception of capability to overcome that.
Speaker B:So I think I'm making a very random sort of out there parallel here, but I think of parenting.
Speaker B:So we try very hard to help our children become resilient, but at the same time we want so much to be there for them so that they don't have to face adversity.
Speaker A:Yeah.
Speaker B:The second our kids have an issue, we tend, by our nature, we tend to swoop in and try and help them figure things out.
Speaker B:And I have realized that by, if you do too much for them, then they're unable to do anything on their own.
Speaker B:But there are clearly times when they really need your help as a parent.
Speaker B:So how do you and I feel the same way as a coach with an athlete.
Speaker B:I want them to be able to learn this resilience and gain this confidence to be able to handle things on the course?
Speaker B:So how do I as a coach, how do I as a parent know when it's time to step in and know when it's okay to back off and let either a child struggle or an athlete struggle?
Speaker A:Yeah, I think they're two different animals because when you're a parent, we're evolutionarily wired to protect our offspring because if they die, then we can't pass on the gene and propagate this, continue to propagate the species.
Speaker A:So there's a very powerful protection mechanism for our children.
Speaker A:And at the same time, there is some of that when you work, when you're a coach with an athlete, but certainly not to the same degree where your athlete struggles or fails.
Speaker A:Now, yes, sadly, in triathlon, people die periodically, but it's not a common occurrence.
Speaker A:And so it's a different kind of survival.
Speaker A:It's a different kind of protection.
Speaker A:We don't want them to fail, we want them to have great experience, they're paying us and we want to help them become successful.
Speaker A:So with kids especially, one of the biggest things for me with my kids being athletes is that I want them to learn to survive in the wild.
Speaker A:And the only way to learn to survive in the wild is to live in the wild.
Speaker A:Now I live in the Bay area of San Francisco, so there aren't a lot of saber toothed tiger, a lot of rival tribes, people around who are threatening their physical existence.
Speaker A:But nonetheless, these are different kinds of existences, if that's a word that they have to struggle with in modern times and that they're fundamentally not evolutionary prepared for.
Speaker A: ork so well in modern life in: Speaker A:It's a matter of supporting them, whether athlete or kid, but also letting them struggle.
Speaker A:Because one of my biggest things is I've wanted, as my kids have grown up and they're 20 and 18 now, I wanted them to suffer in the first world, modern day sense of suffering.
Speaker A:I want them to struggle, I want things to be hard.
Speaker A:Because then they learn how to deal with adversity.
Speaker A:They learn to develop resilience.
Speaker A:So when they get out into that big cruel world out there, they know how to handle it, versus the 40% of kids who move back home after college who aren't ready to survive out there.
Speaker B:And it's a bit of a cliche, this idea that you learn more from failure than you do from succeeding all the time.
Speaker B:But at the same time, as much as we hate to see our athletes or our kids fail, I do believe it's true.
Speaker B:I do believe that in order to have success, you really do have to go through at least one or two failures.
Speaker B:Because the lessons you learn from those failures are invaluable, first of all towards making the success feel so much richer.
Speaker B:But second of all, because it helps you achieve that success.
Speaker B:Because if you just got success right out of the gate, then it would be easy, right?
Speaker B:The reality is nothing's that easy.
Speaker A:That's the interesting thing, Jeff.
Speaker A:Yes, failure, hardship, setbacks can certainly build character and build resilience and all these kind of qualities that are necessary but not too much because then learn helplessness kicks in.
Speaker A:If you're constantly trying and you don't succeed, the natural thing is to give up because it's not working.
Speaker A:So you need to have you need to have successes?
Speaker A:But yes, absolutely.
Speaker A:I've worked with a lot of athletes who were stars when they were young, super talented, everything came easy to them.
Speaker A:But that is as much of a cross to bear as it is a benefit because it creates expectations, both internal and, and external, and it creates pressures.
Speaker A:I've always gotta be good.
Speaker A:And so it's a real challenge.
Speaker A:It's always wonderful to be the most gifted in early success and so on, but it has its challenges for sure.
Speaker B:I wanna just get back to this idea of mastering adversity for a triathlete.
Speaker B:How can the triathlete be best prepared heading into a race?
Speaker B:I always tell my athletes, spend a lot of time leading into an event running through your mind of all of the eventualities.
Speaker B:Prepare yourself mentally for all of the things that could go wrong, so that if they do go wrong, you've at least rehearsed it in your mind.
Speaker B:And then if something goes wrong that you hadn't prepared for, at least you've gone through this exercise of what will I do if.
Speaker B:And so if something comes up that you haven't actually thought about the process of how to handle it, and so it won't be quite as stressful.
Speaker B:Is there anything else that you consider worthwhile?
Speaker B:Because one of the big things I tell my athletes for the things that you can control, everything else is noise.
Speaker B:And yet still we all know that adversity comes about via just environment and everything else.
Speaker B:So what are some of the strategy or some of the tips you have for that?
Speaker A:Yeah, so resilience and preparation for strategy begins long before you start preparing for a race.
Speaker A:It is has to be in your training.
Speaker A:The best way to deal with adversity, the best way to build resilience in yourself is to train it like a muscle.
Speaker A:And I actually characterize it as a mental muscle.
Speaker A:Resilience can be weak, it can be strong, or it can be injured.
Speaker A:So if somebody has a really bad race where they didn't respond to the adversity, that their adversity muscle becomes injured.
Speaker A:But for sure, any muscle, physical or mental, won't get stronger unless it's trained.
Speaker A:So I'm constantly exhorting my clients, the people I work with, from age groupers up to some of the top pros in the world, to expose themselves to adversity as much as possible.
Speaker A:Because two things happen there if they, when they're faced with that adversity, first of all, they're forced to figure it out.
Speaker A:You get a flat tire and in race, oh, my gosh what do I do?
Speaker A:But if you've changed a tire many times in your training, then you will know how to do it there.
Speaker A:So you have the tool you need to fix that bit of adversity.
Speaker A:So it's the actual skills necessary.
Speaker A:And remember, skills, tools, they're only good if you know how to use them.
Speaker A:And the only way to learn how to use them is to do them over and over again.
Speaker A:So, like any kind of training, it's about repetition.
Speaker A:And so running in cold, training in heat, cold water, rough water, hills, flats, whatever.
Speaker A:Whatever you're going to be exposed to potentially later on, you want to practice, you want to train beforehand.
Speaker A:So it's the experience of knowing what to do, like strong headwinds.
Speaker A:That's some serious adversity in triathlon on a bike.
Speaker A:And yet how many people get crushed by it all the time?
Speaker A:So part of it is having the experience with, okay, I need to back off my power or my speed.
Speaker A:And.
Speaker A:But the thing is, Jeff, I've never been in a triathlon where it was only a headwind on me.
Speaker A:I've never been a triathlon where in the swim, it was only rough water for me.
Speaker A:So it's not the adversity that's the issue.
Speaker A:It's how you respond to it.
Speaker B:Yeah.
Speaker A:Second part of that is building confidence.
Speaker A:Hey, been there, done that.
Speaker A:I know how to handle this versus, oh, my gosh, what do I do?
Speaker A:As soon as you go like this, you're freaking out, Your physiology goes up.
Speaker A:You feel anxiety, you catastrophize.
Speaker A:And what happens then in that situation is your primitive brain perceives that your life's in danger.
Speaker A:And what does it do?
Speaker A:It does everything it can to stop you from continuing to do that.
Speaker A:So the experience of adversity in training builds not only skill sets, but also the belief that you can handle it when you get there.
Speaker A:Oh, my gosh.
Speaker A:I've been training for this for months.
Speaker A:Big deal.
Speaker A:And that is resilience right there.
Speaker B:I love it.
Speaker B:I love it.
Speaker B:That's really well put.
Speaker B:And everything always comes back to the chimp brain, the amygdala.
Speaker B:We were talking before we were recording about the amygdala and pole vaulter.
Speaker B:So I know what my listeners are saying.
Speaker B:No more pole vault.
Speaker B:Okay, let's move to the second topic that you had suggested we discuss today, and that is mental hacks to reduce fatigue.
Speaker B:Another big one that triathletes often face late in a race.
Speaker B:It doesn't have to be a long race, sometimes Olympic distance.
Speaker B:You're Pushing yourself really hard and you're getting in to the last 5k of the run and all of a sudden, despite all your training, you just feel like, oh my gosh, I'm so tired, I can't keep up this pace.
Speaker B:We certainly know much more of an issue when you're into the longer courses, but it can happen anytime.
Speaker B:So what are some of the things that we can do mentally to get through that period and all of a sudden restore our energy and continue at the pace we know we're actually capable of?
Speaker A:Yeah, so this is one of my favorite topics and I tie fatigue in with pain.
Speaker A:And again, I'm going to bring up the whole Tim thing where evolutionarily we humans are not wired to seek out discomfort.
Speaker A:Because in the Serengeti 250,000 years ago, when we first officially became Homo sapiens, if we were in pain, if we were really tired, we were going to die.
Speaker A:And so we've been wired through literally 250 million years of evolution since we climbed out of the primordial muck.
Speaker A:Is reptiles that when we felt discomfort, pain, fatigue, we'd slow down.
Speaker A:So when we do triathlons, we are resisting 250 million years of evolution.
Speaker A:But we do have that capacity thanks to our prefrontal cortex, which can override our amygdala, our primitive brain.
Speaker A:But the challenge is it takes effort.
Speaker A:So if you think about a triathlon, it's usually the ones who can resist the pain and the fatigue.
Speaker A:The ones who achieve their goals, they don't always win, depend upon their level, but they're going to be the ones who achieve their goals.
Speaker A:So much of my work, again, from age groupers up to top pros, is their ability to manage their pain and their fatigue because the nature of pushing yourself is it hurts.
Speaker A:And yes, I used to do Ironmans, now I do short course.
Speaker A:And I can assure you that short course is more acutely painful.
Speaker A:This has been my experience, but Ironmans are more like grindingly long term moderate discomfort unless the wheels fall off.
Speaker A:And if you're in that much pain where the wheels fall off, it's not about keeping up your pace.
Speaker A:It's just a matter of maybe finishing or deciding not to finish.
Speaker A:Like you saw with.
Speaker B:I was going to bring that up because there you saw an example of where the frontal cortex did more harm than good.
Speaker A:Potentially.
Speaker A:Yes.
Speaker A: ic image of I've Ironman from: Speaker A:She's winning the race.
Speaker A:She's about.
Speaker A:I don't know, 25 yards from the finish, she falls down.
Speaker A:She.
Speaker A:Everybody starts rushing to her and she says, don't touch me, because then I'll be disqualified.
Speaker A:She gets up, she staggers, she falls down, she gets up, she staggers.
Speaker A:With about 10 yards to go, the second woman, Kathleen Kennedy, passed her and she won the race.
Speaker A:But people rarely remember her.
Speaker A:But I talked to Julie a number of years ago after the race, and she said her mind was sharp as a tap.
Speaker A:She was sending these signals to her body, and her body wouldn't listen.
Speaker A:But the fact is that rarely ever happens.
Speaker A:And this is something that I really emphasize with the triathletes I work with, with when you don't think there's any more fuel in the tank, there's almost always more fuel in the tank because if your body waited till you fell down, you probably back in the Serengeti 250,000 years ago, were going to die.
Speaker A:So early warning starts whispering, please stop.
Speaker A:This is getting harder.
Speaker A:Please stop.
Speaker A:And if you, then, if you don't listen, what's it going to do?
Speaker A:It's going to crank up the volume.
Speaker A:It starts seeing it louder and louder until it's screaming at you to stop.
Speaker A:And then I don't think all the prefrontal cortex activity in the world can stop, but you can make adjustments.
Speaker A:And our prefrontal cortex does give us the capacity to make choices and to tap into that tech because whenever we think there's nothing left, there's always something left.
Speaker A:And there's been a ton of research in human performance labs and anthropological studies of primitive people hunting.
Speaker A:That evolution has ensured that there is always fuel and tank.
Speaker A:For example, anthropologists have studied primitive cultures in other parts of the world and followed them tracking game like a gazelle out in the Serengeti.
Speaker A:And sometimes they track them for 20, 25 miles for three, four, five hours.
Speaker A:But here's the thing.
Speaker A:They had to get them home to feed the family.
Speaker A:So if there's nothing left in the tank, they die.
Speaker A:Their family doesn't get fed, they die.
Speaker A:We don't propagate the species through evolution.
Speaker A:We always keep reserve.
Speaker A:But our primitive brain doesn't want us to know that because all it knows is I'm hurting here.
Speaker A:We need to stop.
Speaker B:So what are the tricks then?
Speaker B:What are.
Speaker B:It gets back to the mind hacks.
Speaker A:First of all, it's your first realization.
Speaker A:When I tell this story, and I've heard a number of athletes I've told this to later on, said when I was really starting to hurt I thought of that.
Speaker A:Because you can't tap into the fuel in the tank unless you know there's a reserve fuel tank.
Speaker A:So just that awareness alone is, oh my gosh, there's still gas there.
Speaker A:Or battery charge if you drive an ecm.
Speaker B:So when you're on E, when you're on E, the light is on, but that you've got way more than you actually think.
Speaker A:Yes, unfortunately, it doesn't work so well with EVs because there's only like a mile or two left of the battery.
Speaker A:But the car manufactures with internal custom combustion engines, always build in 15, 20 miles or a gallon and a half or whatever.
Speaker A:Anyway, not automotive class.
Speaker A:And so just having that realization.
Speaker A:Because as soon as you engage your prefrontal cortex, your primitive brain backs off.
Speaker A:Because what you're doing is you're sending a message like, I've got this.
Speaker A:So your primitive brain looks up your prefrontal cortex and said, are you sure?
Speaker A:And if your prefrontal cortex goes, I got this.
Speaker A:The primitive brain goes, okay, I'm gonna hang out.
Speaker A:I'm gonna just hang back.
Speaker A:I'm not gonna get involved.
Speaker A:But you know what?
Speaker A:If I hear more noise, I'm stepping in.
Speaker A:So that's one thing.
Speaker A:Second of all, in a way, it's a communication battle between your body and your mind where when you start to hurt, you're tired, you're maybe not cramping fully, but your legs are hurting, it's painful.
Speaker A:We both know that experience.
Speaker A:Your body, your permanent brain, is telling your mind to stop.
Speaker A:And if your mind says, okay, you're going to slow down or stop.
Speaker A:But communication goes in the other direction.
Speaker A:Our prefrontal cortex, our evolved brain, if it tells our body to keep going, it will, because your permanent brain knows there's still fuel in the tank.
Speaker A:So that self talk is so important because if your body turns against you and your mind turns against you, game over.
Speaker A:And this is not just something you do at the end of a race, because when you're hurting, your primitive brain doesn't want you to think.
Speaker A:So it does everything it can to keep your prefrontal cortex from engaging.
Speaker A:It knows from experience what's gonna happen.
Speaker A:I'm like, I'm gonna get talked out of getting involved.
Speaker A:Plus, it takes a lot of wherewithal to go, okay, what do I need to do here?
Speaker A:And it's not like you're gonna stop in the middle of a race, although technically you can, and go, okay, what do I do here?
Speaker A:What's the best thing?
Speaker A:No, you need to Have a plan.
Speaker A:A year ago I was in the Canary Islands training and Magnus Ditlef was there.
Speaker A:This was, I don't know, a couple of months after he was third in Ironman and in Kona.
Speaker A:And I don't know if you knew this, but he and I talked about this in T2.
Speaker A:He actually sat down for four or five minutes and thought through whether he wanted to continue or not.
Speaker A:And he obviously his prefrontal cortex won and he went on once he got run and he felt better, he finished on the podium in Kona.
Speaker A:So this is really powerful hack, if you will, is just being aware of that reserve using self talk.
Speaker A:But again, going back to training and this ties back with resilience and adversity.
Speaker A:You want to train that you want to train.
Speaker A:So obviously there's all kinds of opportunity when you're training to experience adversity, to hurt and to train through it.
Speaker A:And for me, classic example is running intervals on the track.
Speaker A:One of my favorite things to do, I love pushing myself.
Speaker A:It's hard.
Speaker A:But let's say you're doing four by eight hundreds by the second two and by the first lap you're hurting a lot.
Speaker A:And so using a couple of tools, your self talk, really powerful training that.
Speaker A:So for me, if I'm trying to keep going because as soon as you lose focus or start to accept you're hurting, you're going to slow down.
Speaker A:I've actually researched this.
Speaker A:I actually slow down when I lose focus and when I have my key phrases, my keywords, what I call power words, that keeps me engaged, keeps me focused and keeps me overriding my pain.
Speaker A:So a couple of my favorite power phrases or power words are just push, push toward the end, like the last couple 3, 400 yards of meters of an interval.
Speaker A:Dig deep and then with a hundred to go, finish strong, finish strong.
Speaker A:You're distracting your body and you're tapping into that reserve.
Speaker A:And that can happen the last quarter mile of a short course or can be the last couple of miles, half Ironman or an Ironman.
Speaker A:So the self talk's key.
Speaker A:Another thing is breathing.
Speaker A:When you're hurting, you get out of breath.
Speaker A:Now maybe this is less so with long course, but certainly with short course I do.
Speaker A:I focus mostly on sprints, super sprints and mixed relay.
Speaker A:So it's pretty much full gas the entire time.
Speaker A:So I'm out of breath.
Speaker A:What does your permanent brain think when you're out of breath?
Speaker A:We're gonna die.
Speaker B:Right?
Speaker A:Simply taking control of your breathing and especially if you're almost Gasping, you can still take control.
Speaker A:That does a couple things.
Speaker A:Get some more oxygen into your system.
Speaker A:Use deliberate breathing.
Speaker A:Gets more oxygen than gasping.
Speaker A:It relaxes your body.
Speaker A:It also settles your body.
Speaker A:When you go like this, your center of gravity drops.
Speaker A:You can generate more power on the bike, on the run, not sure about the swim.
Speaker A:And it tells your primitive brain to back down.
Speaker A:So again, breathing, self talk, all really powerful.
Speaker A:And it's about focusing, making sure you're focusing on keeping going, not, oh my gosh, I'm hurting.
Speaker B:Simple tools, taking your mind off of the present reality that's creeping into your mind and giving you negative perceptions and refocusing on what you actually should be focusing on.
Speaker B:I think all really important.
Speaker A:But a key thing here is someone might think, oh, I just need to distract myself.
Speaker A:And people run with music, people race with music sometimes, even though you're not supposed to.
Speaker A:For me, you should never use music or podcasts if that's your thing.
Speaker A:Except for yours, of course, to distract yourself during quality training.
Speaker A:Because there's this thing called state dependent learning in psychology.
Speaker A:Whatever state you train yourself in, you learn in.
Speaker A:You need to perform in that same environment.
Speaker A:Now, the oddly funny thing is the early research had to do with getting stoned when you studied.
Speaker A:If you get a study stoned, you should take the exam stoned.
Speaker A:I'm not advocating drug use in school, but the same thing with training.
Speaker A:If you get used to listening to music when things are hard, your body, your mind, get conditioned to having that as a tool, if you will.
Speaker A:But on racing, you can't have that.
Speaker A:You need to just be right there.
Speaker A:Plus, there's been great research from a long time ago looking at elite marathoners versus non elite marathoners.
Speaker A:And what they found was that non elite marathoners, when it got hard, they tried to dissociate, they tried to distract themselves.
Speaker A:And that works to a point.
Speaker A:But our primitive brain has a tremendous capacity to get our attention.
Speaker A:It's called pain.
Speaker A:And it just ramps up the pain as it gets harder and harder and as it thinks you're getting closer to death even though you're not.
Speaker B:Yeah.
Speaker A:And after a while, your evolved brain, your prefrontal cortex, simply can't resist the distraction.
Speaker A:So what you have to do, and you already referred to this, you can't just distract yourself.
Speaker A:You have to redirect your focus onto something that will propel you forward.
Speaker A:And sometimes, no matter what happens, maybe you push a little too hard, maybe you can't keep holding that pace, but maybe it's just a matter of Keeping you going, moving along.
Speaker A:I worked with one top ironman a few years ago where he was looking at top 10 at Kona, but the wheels fell off in the marathon.
Speaker A:But you know what he decided?
Speaker A:He said, I'm still gonna enjoy this.
Speaker A:So he was high fiving everybody long, talking to people, getting cheered on by people, and the last 10 miles he was jogging, but he still had a great time and he felt like it was overall, it was a positive experience.
Speaker A:Because of that, he could have easily bailed out.
Speaker A:And I've never quit a triathlon before, but I know a lot of people have and most people regret unless there's something truly catastrophic that's stopping that.
Speaker B:Yeah, yeah.
Speaker B:No, I think that's a very valuable lesson, especially to hear a pro say that we don't have a ton of time.
Speaker B:But I really would like to hear this last subject, which is the five attitudes that kill performance.
Speaker B:Enjoy.
Speaker B:Do you think you could do that quickly?
Speaker B:Maybe just list them off or I would hear this.
Speaker A:Yes, I'll list them off and give a little bit of background.
Speaker A:So what I find is that very often I work with athletes who are pretty mentally strong.
Speaker A:They've done the mental training, they've done the exercises, but they've developed attitudes that basically ensures failure before they even begin.
Speaker A:And these attitudes, they don't choose these attitudes.
Speaker A:It often comes from emotional baggage, need to protect.
Speaker A:A lot of deeper issues that we could get into in another podcast.
Speaker A:But here are the five.
Speaker A:One is over investment.
Speaker A:And that's where your self identity, your self esteem, your goals are too tied in with achieving your goal.
Speaker A:Yeah, and for example, I'm working with a top top Ironman wants to qualify for Kona age grouper and but he's failed a couple of times at qualifying because he just gets super anxious and goes out too fast and blows up.
Speaker A:You need to care.
Speaker A:You need to be invested, but not overly invested because especially for us age groupers, if things don't go well in a race, it's not the end of the world.
Speaker A:Our kids still love us.
Speaker A:Hopefully we still have our work, et cetera.
Speaker A:So over investment.
Speaker A:Second is perfectionism.
Speaker A:Perfectionism and triathlon do not play nice together.
Speaker A:Nobody has ever had a perfect triathlon.
Speaker A:And what is perfectionism?
Speaker A:It's striving for something you will never ever achieve.
Speaker A:And when you don't achieve it, which is inevitable, you beat yourself up about it.
Speaker A:Third is fear of failure.
Speaker A:Epidemic in our culture.
Speaker A:The number one reason why parents bring their kids to me, they don't know that's the reason, but that's the underlying reason.
Speaker A:And because fear failure is not about pursuing success.
Speaker A:It's about doing everything you can to avoid failure.
Speaker A:You so you're not looking there at success, you're looking behind you and it's that saber through tiger that's chasing you.
Speaker A:But you know what?
Speaker A:It will catch you.
Speaker A:Fourth is a preoccupation with results.
Speaker A:I gotta qualify, I gotta get a certain time.
Speaker A:I have to beat people, I have to get on the podium.
Speaker A:Yes, look great thing about triathlon is it's not about results very often.
Speaker A:It's about participation for most people.
Speaker A:Now I'm not one of those people.
Speaker A:I do triathlons to compete, to push myself, to see how I stack up against the best in the world.
Speaker A:But in order to get the results that I want, I don't focus on the results because when did the results occur at the finish line?
Speaker A:I focus on what I need to do from the start of a training, at the beginning of the season or in the off season to when I'm approaching the finish.
Speaker A:So the preoccupation results.
Speaker A:And yet we live in a result or in society and it's if you haven't done an ironman, it's like you're not a triathlete.
Speaker A:What, what's up with you?
Speaker A:And the last one is expectations and pressure.
Speaker A:Imagine you're about to begin the swim of a triathlon and somebody makes you put on a 25 pound weight vest.
Speaker A:How do you feel?
Speaker B:Heavy.
Speaker A:How are you going to swim?
Speaker A:It's perfect for swimming because if you try to swim, what's going to happen?
Speaker A:You're going to sink to the bottom of the lake or whatever.
Speaker A:So much of my work, and so much of my work, especially with these five attitudes is about taking that weight vest off because they weigh you down and because the goal before any race is to just be free, light, liberated, just whatever you've got that day, you can give it everything you've got.
Speaker A:Nothing psychologically, emotionally is going to hold you back.
Speaker A:That doesn't mean you're necessarily going to achieve your goals, but it will enable you to do the very best you can on that day with what you have.
Speaker B:This was a wide ranging and very entertaining conversation.
Speaker B:Jim, thank you so much for coming back here and sharing all of this because I really got a lot out of it and I'm sure my listeners did as well.
Speaker B:I know that among the topics that I talk about on this program, to me the mental performance aspect is one of the ones that I think is most relatable and is one of the ones that I think is easiest for people to bring into their own training and racing and adapt to their own life because I think when they hear it they don't necessarily recognize how important it is and how valuable it is and just hearing it gets the ball rolling on them.
Speaker B:Starting to think about the fact that as much as they train physically, they need to incorporate the mental training as well.
Speaker B:And hearing this I think is the gateway to them then pursuing what they need to in order to get the mental training on board as well.
Speaker B:I know for me it made a world of difference when I finally started working with a mental performance coach and I always encourage athletes to consider doing the same.
Speaker B:So thank you for bringing this to the podcast yet again.
Speaker B:It was an overdue follow up conversation.
Speaker B:We will have to make sure we don't wait quite as long before I have you back again to talk about even more on this fascinating topic.
Speaker B:Dr. Jim Taylor is a PhD in psychology.
Speaker B:He talks about mental performance.
Speaker B:He coaches athletes.
Speaker B:He's just an all around successful performer in skiing, karate, triathlon, everything.
Speaker B:Jim, thank you so much for taking time out of your day to join me once again on the Trotter podcast.
Speaker B:It was really a tremendous conversation.
Speaker B:I really enjoyed it and I wish you all the luck in your current endeavors.
Speaker B:Where are we going to see you on the race course this year?
Speaker A:Three big A series races.
Speaker A:Multi Sport Nationals in Michigan in May, Triathlon Nationals in Milwaukee in August, and then World Championships in Spain.
Speaker B:That's amazing.
Speaker B:Where is it in Spain?
Speaker A:Ponte Vedra again.
Speaker B:Okay.
Speaker B:All right.
Speaker B:Good luck to you and all of that and everything else that you're doing and I will once again thank you for joining me today and we'll talk to you again soon.
Speaker A:Look forward to next time we chat.
Speaker D:What's up everybody?
Speaker D:My name is Joe Wood and I'm a proud supporter of the Tridark Podcast.
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Speaker D:You can find the show notes for everything discussed on the show today as well as the archives of previous episode@www.trydarkpodcast.com.
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Speaker D:Until then, train hard, train healthy.
