Tendon Pain - Could your diet be a problem?

Since publishing my climbing injuries book Make or Break earlier this year, this is the first important paper released into the scientific field during the year which has really caught my attention. Co-authored by professor Jill Cook (one of the tendon pain research big guns worldwide), it reinforces the idea I put across in Make or Break that looking at tendon injuries simply as ‘overuse’ injuries may at best blinker us to other important causes, and at worse be plain wrong.

In this review, Cook explores the possibility that your cholesterol profile could possibly cause tendon pain. The evidence available shows association, not causation. Nevertheless, we shouldn’t ignore the data. Not only is it known that cholesterol accumulates in tendons, that people with the disease ‘familial hypercholesterolemia’ have much more tendon pain, but several studies show that various cholesterol parameters are associated with tendon pain.

Influences such as this, if causation could be ultimately demonstrated, help to explain the apparently unpredictable individual variability in tendon injury, if you are looking at the problem solely as a result of training errors.

So if we can’t ignore the data, we get to what we should do to improve our cholesterol profile. The paper points out that increased tendon pain is associated with the same cholesterol profile as cardiovascular disease, namely a lack of HDL cholesterol and an excess of LDL and blood triglycerides. Unfortunately, the world of medicine and public health is in a big fat mess when in comes to providing evidence based recommendations for how to improve our cholesterol profile. 

If you want to learn just how messed up the situation is, read Nina’s book. Apart from teaching you a few seriously important lessons about trusting both science and government, it might even save your life if it turns out to be right. No joke. 

Unfortunately the low fat, high carbohydrate diet (as well as the problem of the oils used in processed foods) that sportspeople are still widely recommended to eat may well cause just the bad cholesterol profile we are talking about (low HDL, high LDL, high triglycerides). Diet is not the only input of course.

My personal hunch is that this line of enquiry will continue to yield evidence we should listen to. At a basic level, the idea that human tissue is unbelievably plastic, responding to training with precisely regulated growth and maintenance responses could go so frequently awry simply by doing some training does not add up. It seems likely to me that there are some things missing from the picture. This could be one of those things.

I would urge anyone serious about their tendon health, their sport performance and their long term health to go right back to basics when it comes to diet and nutrition. It’s fair to say that the whole world of nutrition and health has been blown to bits in the past five years, and pieces are still falling back to earth. Meanwhile, some of the medical world and much of the public have yet to notice. And many vested interests are desperately trying to keep it that way. Personally, I have finally wriggled free from the paradigms I learned in University about sports nutrition and stand in a confused state of optimism mixed with distrust and scepticism. The problem is, we can't wait for better evidence - I have to eat something, in two hours time! So what to eat? I’m cautious about publishing my observations on my own diet and performance just yet. I will do when I feel a bit more comfortable and educated about what the hell is going on. But, I will tell you that I feel like I’m on an exciting journey!

Review: Racing Weight

Racing Weight by Matt Fitzgerald is the first dedicated book for athletes on maintaining an optimal body composition. I first heard about it a few months ago and raced to get hold of a copy. As soon as I read it I bought a stack of them for my shop (right here) as I felt this is a must have book for any climber investing time and effort into manipulating their weight for climbing. I’ve been meaning to write this review for a while to explain why.

First off, climbers will notice that this is a book aimed at endurance athletes like cyclists and runners. Why is that important? Because their training is totally different to ours. Aerobic athletes need to burn larger volumes of calories for more hours than climbers do. But despite this, much of the book is relevant to us and even the bits that aren’t help to inform what us climbers should be doing in our nutritional regime.

Fitzgerald has all the credentials to write this book - a successful athlete (triathlon), nutritionalist, coach and professional writer. Although he references the scientific literature throughout, the text is still easy to read if you aren’t a sports scientist and is both well laid out and clear in its messages.

The discussion early on comparing the sizes, shapes and demands of many different sports was very illuminating. We are totally not alone in our challenging nutritional and physiological needs as climbers. While endurance athletes have one killer advantage in the weight loss game (that their sports use up a ton of calories), they also struggle because any caloric deficit interferes seriously with training intensity. If they don’t eat really well at all times, they get unfit.

Fitzgerald outlines in excellent and convincing detail how many angles we can come at these problems using the content, volume, timing and quality of our diet. I learned a great deal about all of these different components, as well as reinforcing a lot of what I had previously learnt in my own study of this subject.

I’d also read a lot of research in recent years about the tactics of appetite management, perhaps the ultimate nemesis for those permanently adrift of their fighting weight. It was fascinating to see an up to date review of all of this in one place. An excellent chapter and surely useful to just about anyone never mind just athletes.

The only place I’d like to have seen an extended discussion was that of intermittent fasting - an increasingly popular protocol in several non-cardiovascular sports that depend on low body fat percentage. Fitzgerald essentially dismisses it as unsuitable for endurance athletes due to the inability to fuel daily training sessions. This totally makes sense. But given that a lot of the book seems to be written with a wider audience of athletes or the general public in mind, I was surprised that more space wasn’t given to it. I suspect that lack of solid research on it’s effects on sport performance was the main reason. It does however leave an opening for someone else to discuss this aspect (or better still research it!) further with a greater range of sports and applications in mind. 

As a coach myself I observe climbers constantly applying bits and pieces of nutritional tactics from all kinds of sources; pseudo-scientific diet books aimed at the mass market, knowledge adapted haphazardly from other sports, out of date knowledge or simple unconscious habits. In my view, every climber who cares about training or knows their body composition could be better should read this text.

It’s in the shop here.

Glycogen dumping (and why it probably won’t work for you)

Tim just did a new E10. Looks fantastic. He mentioned in his blog post about it that he used glycogen dumping to help him close the deal on this long term project of his. He had been asking me the previous week about strategies for making yourself a bit lighter for a hard redpoint such as dehydration. It’s really hard to get dehydration to do anything other than make you feel ill. But carrying less glycogen up your route is a strategy that is occasionally useful. Talk of this ‘new’ (it’s actually very old) strategy peaked some interest and various emails asking me to explain it. It’s really simple, so I’ll explain it in two sentences.

For each gram of muscle glycogen, the body has to store 3 or 4 grams of water. If you eat less the day before your big lead you can deplete the store, lose a few kgs and maybe get a small but crucial advantage.

The explanation of why it probably won’t work for most climbers needs more words, but is really worth reading, so you don’t waste your time, energy, food and chances of sending.

The first and biggest reason why it won’t work is that people will try to use it to replace ‘real’ preparation. The real reason why Emmett climbed his E10 is because he’s Emmett. This accounted for 99% of the success, the new strategy only making up the tiny difference which was crucial in this case as it sounded truly at his limit.

That 99% - ‘being Emmett’ - is what most people should really be concentrating on; learning how to go for it without hesitation, without fear of falling, with every shred of effort you can muster. It’s the tactics of learning to know your body, mind, strengths, weaknesses, equipment, conditions etc unspeakably well through endless consideration, planning and testing over years. It’s the boring old stuff - the hours of training, the getting over the excuses that get in the way of getting the hours in.

The second reason why it won’t work for most people is that their technique, especially foot work is not good enough for small differences in weight to make a noticeable difference.

The third reason is that it won’t work if you overuse it, or use it when you aren’t already really really close to success. This technique by it’s nature depletes your energy reserves for the session. So it’s good for one, maybe two all out redpoints in the day and then a good recovery. It causes a reactive glycogen loading afterwards (indeed it’s used for carbo loading by endurance athletes) so using regularly has the opposite effect. If you are still working the route and aren’t ready for a pure redpointing session, you’ll just burn out after a short session. Depleting the glycogen store to really low levels takes much longer to recover from.

If you are thinking I’m trying to put you off, you’d be right. Used well, it can be useful once or twice a year for your career best project, and only in addition to your very best in the real methods of preparation and good tactics. The trouble with tactics like glycogen dumping is that most people use them (subconsciously) to replace real effort, real thought, real preparation. It’s such an easy psychological trap to fall into, and most the time, we do fall in.