Specific Nutritional Needs for the Female Athlete, Part 1

A few weeks ago I was honored to be asked by Coach AJ Morrison of Multisport in Motion, and Cory Churches of the Mid-Atlantic USA Triathlon Council to help conduct a female specific endurance nutrition talk for female athletes in the Washington DC area. We held the event last week, at one of the fantastic DC libraries. It’s been been quite a while since I’ve done a power point presentation (maybe 3 years ago when I taught at Lane Community College), but I felt like this presentation warranted it.

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In the past (until maybe the past 5-10 years), the majority of the exercise and nutrition based scientific research has been designed with men as the subjects. This is not to say that researchers are sexist or were purposely ignoring us. I believe the main reason is, young men were more accessible, and researchers didn’t necessarily think that women were that much different. We all need calories, the same macro and micronutrients (in different amounts though), and our bodies are similar physiologically. That’s the sticking point-similar, not the same.

Let’s talk physiology first, then I’ll touch on macro and micronutrients in the next post. As any female, or boyfriend/husband will attest to, we have certain physiological processes that can greatly effect our body and moods. Yes, I’ll say it, I’m talking about our menstrual cycles. Not everyone’s favorite topic, but since I believe in giving the facts and talking straight to the point, I won’t sugar coat things. Both men and women have sex hormones, the difference being, women’s hormones fluctuate quite a lot more the men’s do. Women have both high and low hormone cycles that as they increase and decrease, cause changes in our metabolism, glycogen and plasma levels and how we feel and perform.

Let’s break it down:

Estrogen/Progesterone: Female sex/steroid hormones produced primarily in the ovaries

The Menstrual Cycle:

28 Day Cycle, broken into 2×14 day cycles

Follicular Phase:

  • Day 1 (first day of period) through Day 14
  • This is the low hormone phase of your cycle and has been shown to lead to improved endurance performance. Improved endurance comes from:
    • from a lower body temperature
    • decreased blood plasma (greater ability to get oxygen and nutrients to cells
    • Greater glycogen storage can occur here and less reliance on protein as a fuel source
  • Ideally, this is where you want to be for racing, but realistically, who wants to have a period during a long race like IM?
  • Try to schedule your “quality” and “key workouts” here in this phase.

Luteal Phase:

  • Days 15-28-You will have a surge in estrogen, causing ovulation, followed by a surge in progesterone-this is called the high hormone phase.
  • If you are on an oral contraceptive, you will always be in a high hormone phase, even in your placebo week.
  • This high hormone phase has some negatives. While you don’t have your period which is nice, you have:
    • An increase in your core body temperature, which can lead to greater sodium loss
    • pre-menstrual syndrome-headaches, fatigue, bloating
    • Blood plasma drops, making muscles fatigue more quickly and lessening tolerance to heat-there has been shown to be an 8% drop in blood plasma during this time. This makes our blood thicker, and harder to get oxygen to our working muscle cells.
    • Greater reliance on protein-during long distance racing and recovery
    • Some may not be able to complete their workouts as planned-fatigue more quickly, paces you normally hold are harder, etc.
    • Some research has shown decreased lactate threshold during this phase
    • Progesterone promotes protein catabolism (muscle breakdown), so making sure you’re fueling post workout/race with enough protein, in the proper window is key
  • While these are negatives, higher levels of estrogen do have a key benefit for women:
    • Estrogen has been known to reduce carbohydrate oxidation (burning) and increase free fatty acid availability. This means you can use more fat as fuel, making this a potential benefit for long distance events. So while we all like to complain about having getting our periods, the fact that we have greater amounts of estrogen vs men, makes our bodies better at handling longer distance events.
    • That being said:*During high intensity events like 5-10k’s or sprint/olympic triathlon, the opposite is true, and you might need to take in additional carbohydrates. At least 30-50g of carb per hour (for things over the 60-90min period).

Take away for the athlete:

  1. Try to race or schedule quality workouts while in the follicular phase/on your period-I know it seems counter intuitive-but your body is better equipped for endurance with lower body temp, thinner blood plasma and the ability to store more glycogen.
  2. If you on a contraceptive, or do not have your period/luteal phase:
    1. Increase your salt intake in the few days prior to a race.
    2. Make sure you are drinking a sports drink, or a diluted sports drink vs water. If you do not drink a sports drink, an electrolyte tab is crucial.
    3. Make sure you are recovering with protein-20-30g in the 30min post exercise. This will help prevent muscle catabolism from progesterone.
    4. If you are racing long, your body will rely more on fatty acids (you still need carbs though), however if you are racing shorter high intensity races, you need to make sure you are consuming enough carbs pre, during and post exercise.
  3. There are some female specific nutrition products on the market today. Some may have merit, others are more of a marketing ploy. If you’re curious, look at the ingredients and compare to a standard sports nutrition product. See if you see any differences, or if you don’t really see any. Following the guidelines listed above will help you succeed, no matter what products you use.
  4. Just because you do or don’t have your period for a large build week or race, should not dictate or allow you to make excuses for not having a good day. Use it as a piece of education, to start to see correlations between your energy, recovery, etc. around your period. I don’t want you thinking “oh no, I’m in the luteal phase, I’m going to go slower now.”

I’ll continue in the next blog on energy needs, plus specific vitamins and minerals females need to be more aware of. Stay tuned.

 

 

 

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9 Months Post Surgery and Decisions

It’s been a long journey here. Mentally, emotionally, physically and spiritually. When you’ve been struggling with something that no one seems to be able to help you with, you just about give up. Give up on  hope that there is light at the end of the tunnel, that one day you’ll be back to the athlete you once were. Now that is still to be seen, but I now am on the path to get me there.

9 months ago, I had hamstring surgery. The most incredible surgeon (Dr. Wolff from Washington Orthopedics) untethered the sciatic nerve from my hamstring, then re-attached the hamstring to the ischial tuberosity. It sounds easy when I say it, but believe me, this journey has been the hardest thing I have ever done. Putting that into perspective, it means that I’ve had a pretty good life. Not easy, and I work my butt off for what I have, but I’ve never had a deadly disease like cancer, I’ve never lost a parent, I haven’t been homeless, etc. In the grand scheme of things, I’ve had a pretty good life.

The past 2 years have been so crazy. Selling our tri shop in Oregon, starting a new job with PowerBar, moving across the country to Baltimore, Brett transferring colleges, and of course, tearing my hamstring. Due to the way it was torn, and the fact that the sciatic nerve became tethered to it, it made it virtually untreatable by physical therapy, injections, massage etc. I tried everything and went to 8 different doctors, and PT’s before finally finding Dr. Victor Ibrahim and Dr. Andrew Wolff. These two were the first ones to tell me that they knew what was wrong, and they could help me. I’ve heard from others around the world, who found me by this blog. They also have similar hamstring tears with nerve tethering. Most docs can’t treat this, and most don’t understand it.

One of the reasons I began writing this blog was to help others, in case someone was going through the same thing as me. That they could know to not give up, that they aren’t crazy when they say they have an incredible stabbing pain in the glutes, that radiates down their legs, they’re not lying. So, for all of the athletes that are going through this, or might go through this in the future, here is how I am, 9 months post surgery.

I “ran” for the first time on the Alter G treadmill 2 days ago, which was actually my birthday. And a wonderful present it was. It was only for .5 mile run, .25 walk, .5 run, .25 walk (60% of my weight), but it was a start. I’m also up to swimming 1 hour/3000y 2-3x a week (with only light kicking) and can easily walk 3 miles. When it comes to walking, sitting, standing, etc. I’m still in pain. I won’t lie and say I’m perfect and feel great. Most days the pain is in the 2-5/10 range. But it is so much better than pre-surgery. I’m also doing strength training-lunges, squats, step ups with heavier weights, in addition to short sets of plyometrics-20 squat jumps.

There are a few things that I would say if you are considering surgery:

*This was how my surgery went, yours might be a bit different*

1. If you’ve felt like you’re crazy because nothing seems to help, you’ve had the hamstring/glute pain for 1+ years and you’re giving up hope, look up proximal hamstring syndrome.

2. Once you’ve decided surgery is the only option (believe me when I say I exhausted every other options first), find a surgeon who will perform the surgery. This might be difficult because not very many surgeons will do a hamstring and nerve repair. (Dr. Wolff in Washington, DC)

3. Know that it will be the most incredible pain for the first month. But you’ll get through it, hang in there.

4. Months 1-3 you will be sitting or laying all the time. You’ll have crutches and won’t be able to do much of anything. Don’t even think you’ll be working, just getting to the bathroom and taking a shower will be a challenge.

5. Months 4-6-you’ll start to see some gains, you’ll start with therabands and you’ll start walking post crutches. You’ll build from 1 minute of walking up to 2 miles. This is where you think you should be better running again soon. Hold that thought, you’ve got more time to wait.

6. Months 6-9-This is where you’ll really think “I should be back to running, what’s wrong, why am I still in pain.” Don’t worry, it’s totally normal to still be in pain. Many days I’ve thought “what have I done, I’ve traded one pain for another.” Hang in there, it gets better. During this time you’ll be able to start doing other exercises like elliptical and swimming. You’ll move from 2-3 miles of walking You’ll also start using traditional weights (instead of just therabands) and start to feel like an athlete.

7. Lastly, how you feel about your recovery and what other people feel/think about you. It will take longer then you want it to, at least if you do it correctly. Being conservative is crucial as coming back too soon could cause more scarring or damage the nerve more. Be as patient as you can, you want your body to last a long time. While you’re in PT, you’ll see people come and go. Those with other surgeries (knee/shoulder) have a shorter recovery time. Don’t get discouraged, hang in there. And once you’ve walking normally again, and don’t look like you’re in pain or post surgery, don’t try to do more than your body is saying to do, even if people think you are fine. This is not the time to “get tough” and push through pain. As an athlete we are designed to push through pain, this is not the right attitude post surgery. And when someone looks at you and says, let’s walk around this expo for 3 hours, you’ll have to say “I’ll need to take a few breaks,” it’s ok. To an outsider you look normal, but allow yourself to sit down and take a break when you need it.

I wish I could end it here and say, “wow looking back that was such a long time ago, look at me now.” Unfortunately I am just at 9 months, so I am still in the “I’m waiting to see what the next steps are.” I’ve run once on the Alter G, and hopefully tomorrow I will run again. I can’t say when I’ll be able to run without the Alter G, and when I’ll be able to compete again. Now that I look normal, I get that question a lot. I wish I could wear a sign that “I’m still recovering post surgery, I look normal, but I’m still in a bit of pain, so please, don’t ask me when I’m racing again because I don’t know.”

It’s like a pressure that I am trying not to put on myself. I’m trying not to think about in the future and plan races. Yesterday I found myself thinking, “Ok it’s April, in 6 months will I be ready for a half ironman.” Probably not if I’m being realistic. But maybe I’ll be running a half marathon? At this point, it’s too early to say where I’ll be. As much as I want to be able to say it, I just don’t know. And that creates a lead to in to the other big decision going through my brain.

I try to keep up with social media, and what’s happening in the world, however sometimes I am a day or two behind. Today I found out that there had been an article published in Slowtwitch (a triathlon site) where the interviewer was asking the female pro triathlete about whether or not she considered aborting her baby. There has been a large upheaval and many negative responses towards the story, and that particular question. I bring this up, not to add any fuel to the fire, not to cause any controversy, but because I feel like I am going through something a bit similar.

Let me explain. I believe the interviewer (Herbert Krabel) asked the question as his second question, and worded it in a way that was insensitive. In reality, the question could have been left out, or worded differently if he was trying to talk about the choices and decisions female pro triathletes have to make. That being said, as a female the question of “do you put your career on hold while you have a baby, or do you continue with your career and wait to have children” is a very valid question. Depending on the profession, some females don’t miss a beat with their career, others have to take some time off. As females I believe that we have the power to do just about anything we put our minds too. Pity the day someone tells me I can’t do something, because I will be the first to try to prove them wrong. And talking about equal pay, I certainly deserve just as much as a man with the same experience and schooling.

But that doesn’t stop the fact that, as a female athlete, when you use your body as your profession/or even as a hobby that you love, in addition to carrying a child, it’s hard to do both. For a few months, impossible. So that means, one thing will be put on hold. The sport you love will take a back seat, or becoming a mother will take a backseat.

Now I am not a pro triathlete, so my career is not dependent on the timing of having children. For those females that are pro though, it must be an incredibly tough choice as, having a child means taking (give or take) a year off from your sport. Some pro’s have great success with having a child and coming back to the racing scene. But there are a lot of “what ifs” that can go through your mind. I don’t know the pro that Krabel was interviewing, however Beth Gerdes obviously thought about it and decided that being a mother was more important right now, and put her career on hold for a short while.

The decision to have children is very personal, and one that really should be kept within the family circle. So, I’m breaking what I just said, to share something that’s been on my mind over the last 9 months. Ironically, that’s the same amount of time a women carries a child. It took a lot to start this blog, as I was going through a pretty rough time and felt very depressed and anxious. But now I know starting it helped me to get through this, in addition to reaching others going through the same thing. So, talking about having children is personal, however like surgery, this issue might be something that someone else is going through. So, maybe it might help to know that someone else is going through the same thing. And maybe it will help give me more clarity for my direction.

I knew surgery was the only option, so I didn’t hesitate. I’m now two years into this “ordeal” and I’ve missed 2 years of racing, of being an athlete. It’s the spring, so a 3rd year is starting, and I’m still on the sidelines. I’m yearning to get out there and race again. Whether it’s a sprint tri, a 5 k, a fun run, anything. I just want to race again. I will never be a pro, but I do want to be good again. I believe I have the ability to do that. So where am I going with this? Brett and I first discussed children many years ago. We both want a family, but knew we had to wait till Brett finished school. That way, if I had to take some time off, or I wanted to put my career on hold to spend more time with the baby, we weren’t strapped financially. So here we are, we’ve come to a crossroads.

Brett is graduating in June, just 3 months from now. I just turned 34 years old. I’m getting older, and I can feel the fertility time clock clicking away. Brett will soon have a career, and we’ll soon be onto the next journey in life. But I’m feeling selfish and conflicted. I’ve had to be on the sidelines for 2 years, if we have a baby right now, that means I’ll be on the sidelines for another year. Or, do I continue on my path of healing and potentially have one more race season before having a baby. Baby vs Career (or for me, a passion for sport and competition). If I hadn’t been sidelined, this would be a no brainer. It’s time to have children.

I’m so torn, but at the same time, I understand that as a women, this is something that we all go through. Men can be great caregivers, fathers, spouses, but when push comes to shove, they aren’t the ones carrying the baby, and they aren’t the ones who have to put their sport or career on hold. So, while it’s not fair, that’s the way we were created and life just isn’t fair. It’s a valid question for women who use their physical abilities as their career and their child-bearing. But it’s a question that I believe should be between the two people in the relationship, not the world. So while I think Krabel shouldn’t have asked such a personal question and it’s no ones business but the couples, in a round about way, he asked what is on my mind, and must be on the mind of other females who use their body as their profession “what do I chose, a child or my career.” Or in my case, do we put off trying to have a baby so I can at least feel like an athlete again?