In Part 1 of Anatomy of an Injury I outlined the three categories of injuries that affect triathletes. In addition to the obvious physical problems, an injury can take the form of a chemical imbalance, the subject of this second part, as well as mental forms, which I will discuss in Part 3.

If you’re perusing this website, you probably spend a significant amount of time training and racing, and juggling work, family, and social life with triathlon. Going for a long ride is as regular as going to bed at night—if only you could only sleep as well as you used to. Maybe now it’s getting harder to get through the day, your training failing to energize you like it used to. Maybe you’re more irritable than ever. The few pounds you’ve gained, the first in some time, seem to come from an increasing appetite, including frequent cravings for sweets. Maybe you’re on your fourth cold this year.

“Luckily I’m not injured,” you tell your training partners. Well, my friend, you could very well be injured … chemically. Chemical injuries typically don’t produce pain like physical ones do (although some chemical imbalances associated with chronic inflammation can be painful). The most common characteristic of a chemical injury instead is fatigue—all too common among triathletes. In addition to fatigue, the chemically injured athlete has irritability, increased weight gain, excessive hunger, frequent colds, and insomnia to deal with.

By addressing the cause, relief from chemical injury is usually not far off

The first step is to rule out a more serious conditions like anemia, infection, or immune disorders. This is often easily done with the help of a healthcare professional who might perform blood tests, take a proper history, and perform a physical exam. Once serious problems or diseases are ruled out, however, the athlete can review lifestyle and training factors.

Maybe the problem originated when the athlete’s training schedule became too busy, on top of an already busy life. For many people this upsets the body’s ability to properly recover. And as the months go by, a recuperative deficit builds up—something most of us know better by the name “stress.” The body’s adrenal system is designed to adapt and compensate for stress, but sometimes the load is just too great. I often discuss the training equation to give athletes a better understanding of the problem: Training = workout + rest. Any time there is an unbalanced equation—any combination involving too much activity and too little rest—fatigue may result.

How do triathletes, so well educated in so many other areas of training, pave the way for chemical injuries? Perhaps it was early success in racing that led our athlete to up the ante for longer competitions. Maybe he or she increased total workout times and intensity, and then, without meaning to, started rushing through meals and dashing around between home, office, and workouts. This scenario is probably common among triathletes.

Initially, the adrenal glands tolerated the increased stress. After all, that’s their job. But like a long event you’re not trained for, the cycle of work, family and social life, training and racing got more difficult to maintain. Soon there was less time to do the things that needed to get done, and recovery was hindered. And because our triathlete attempted to keep up, eventually those same glands became less effective. At this point, the training equation lost balance. Sleepless nights—not an uncommon sign of adrenal stress—further reduced recovery.

With the body unable to keep up, other healthy bodily functions began to slip. The blood sugar became unstable, depriving the brain of the sugar it needs and inducing cravings and increased hunger. This began to affect the whole nervous system, bringing irritability and mood swings. Since the adrenal glands also influence the body’s hormone systems, the athlete’s metabolism slows, due to elevations in the stress hormone cortisol. High levels of cortisol can wake you in the middle of the night, causing the athlete’s body increase sugar burning and reduce fat burning. (Hence the weight gain and decreased endurance.) Now our athlete has to work harder to keep pace, even in training. Race results become even more frustrating, contributing to more stress. Stress also compromises the immune system and with the body’s defense system suppressed, colds begin to reoccur or last more than three days. The vicious cycle continues, all of these factors exacerbating the chemical injury.

Chemical imbalances may cause other dominos to fall, triggering a series of problems resulting in or aggravate a physical injury. A common example of a combined chemical and physical problem is chronic inflammation. Joint pain, for example, is typically the combination of a physical muscle imbalance not allowing the joint to move normally, and the eventual chemical response to that impaired movement—chronic inflammation—another common chemical injury in triathletes. While inflammation is a normal, natural part of the healing process (even an easy workout results in the production of inflammatory chemicals as part of the recovery process), when body chemistry is out of balance, as it is during chronic stress, inflammation becomes chronic too. This form of inflammation is not normal. Consider how many “-itis” signs and symptoms exist in athletes: plantar fasciitis, Achilles tendonitis, osteoarthritis, and others.

By avoiding symptom treatments and addressing the cause of the problem, relief from chemical injury is usually not far off. Additional nutritional support may be necessary, perhaps including vitamin A for the immune system or zinc for the adrenals. Unfortunately though, even a good diet may not be successful if the athlete’s schedule, which may have created the original stress, is not modified.

Stay tuned for Part 3, on the mental injuries that can befall triathletes.

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A long-time fixture in triathlon, Dr. Philip Maffetone coached many of the sport’s best—including Mark Allen, Mike Pigg, and Colleen Cannon. He’s the author of more than a dozen books on fitness and health. His latest book is The Big Book of Endurance Training and Racing, with a foreword by Mark Allen. House Calls is his column here on lavamagazine.com. Visit him on the web at www.philmaffetone.com