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I'm just an average age-grouper / weekend warrior blogging about Ironman Triathlon Training and this complex puzzle of juggling life, having fun and reporting on my various feats of strength and endurance adventures!

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We are entering the holiday season, which typically means fewer races, more (over)eating, and my personal favorite— race season goal setting.

The off-season is also a time for reflection on the last season or seasons of effort. At Best Bike Split (BBS) we’re doing some of our own reflections. November marks three years since we became part of the TrainingPeaks family. Our little startup race day planning and prediction application has come such a long way and grown in ways and directions we had not originally conceived.

As part of that journey I think it’s important to explain how BBS came to be, some of the ways it can be used today for better season planning, and what our plans are for its future.

The Dream

Four years ago I was a PhD student toiling away on somewhat uninteresting projects when I happened to stumble into the Cycling Aerodynamics and Performance Modeling Symposium/Webinar hosted by Jim Martin.

The presentations opened my eyes to the possibilities of applying my specific background of study to cycling. Interestingly enough, this past year I met Martin in Germany before the start of the 2017 Tour de France and was able to personally thank him for unknowingly creating the spark that led to BBS.

My first son was born on July 3, 2013, and during that next week (before the first individual time trial of the 2013 Tour de France) I worked—and helped with the baby—pretty nonstop to develop a prediction model.

Using prior years’ available data, courses, weather conditions, rider performance and any public power files, I created a physics-based model that included physiological constraints to estimate an athlete’s performance.

The night before the Tour stage I went to my wife with a list of predicted times from some of the expected top performers. The excitement on her face seven days post-baby was muted to say the least, but when times started coming in things started to change as the differences were just seconds off the model!

While this is interesting, it’s a ton of work to manually model things, and the outputs are definitely not sexy or really that useful. It wasn’t until I saw the stage winner Tony Martin’s race day plan for that specific race with every section broken down with targets and instructions that I knew what an app needed to do.

For me it’s not as much about the time prediction as much as it is about the plan: How do I race to my utmost ability on the specific course and day? With the growing prevalence of power meters it was obvious that a power plan was really the key. Knowing my programmatic and design limitations, I pitched the idea over fajitas to my longtime buddy and creative/dev extraordinaire Rich Harpel to make it a reality. A few months later he had made the first beta release of Best Bike Split.

The Meeting that Changed Everything

Its funny how reaching a goal often takes a different path than originally envisioned. We were approached by a couple companies in our first six months of existence, but one meeting with Gear Fisher, CEO of Peaksware, sealed the deal of our vision and where we thought things could flourish.

The team at TrainingPeaks is outstanding, and a meeting with Chief Marketing Officer Jeremy Duerksen sparked what is probably the most important feature of BBS. He said the application is great if you know where you are racing and what your goal is—but what about those who don’t? What if we could let users turn the dials and see the impact? The light bulb went off and we started work on what has become the Time Analysis Tool.

How BBS Can Help You Set the Right Goal

When I used to race I would hear goals thrown out all the time:

“This year I’m going to do a five- hour IRONMAN bike split.”

“If I can just lose five pounds I know my times will be so much faster.”

“I should get a new bike or new set of wheels to improve my times.”

The problem with all of these is that there is usually an unknown basis to them. Let’s say you are racing IRONMAN Florida versus IRONMAN Wisconsin; the effort level to achieve a five-hour bike split is completely different on these courses.

These type of situations are where the Time Analysis Tool is invaluable. Now, not only can you show the expected time of these different courses, but you can vary power, weight and aerodynamics to see what is needed physiologically to achieve these goals.

Using this, you can then set season FTP or weight goals, or even decide which races might benefit your strengths and hide potentially weak areas. It’s the ultimate “what-if” planning analysis.

For even more fine-tuned goals, like many of our users do with their coach, a deeper study of the Time Analysis Tool can provide insight into the best places to attack a course in a road race, where a potential bike exchange in a hilly time trial might make sense, or even goal power for various sections of a long MTB race like the Leadville 100.

While these micro-goals and race strategy concepts do take more planning and analysis, the tools we provide allow anyone from a first time Gran Fondo rider, to the Tour de France teams, and even the coaches of the Olympic time trial champions to fine-tune their strategies for the specific goals of the event.

How Using BBS Can Help You Dial-in Your Training

No matter the distance, every race is different. One IRONMAN can rarely be directly compared to another. The total elevation change and how that elevation is dispersed (i.e. frequency, length and grade of climbs), the wind and weather—even the number of technical turns all play a big role in your specific race.

When you don’t live and train in the conditions expected on race day, the challenge of fine tuning and conditioning your body for the challenges of the course and environment become very difficult. With BBS we have teamed with our partners at Wahoo, Garmin, TrainerRoad and Zwift to mimic the rigors of racing and training for the specific course and race day conditions on the trainer.

By loading a BBS race plan (or specific section of a race) into your indoor training platform of choice you can condition your legs to feel the power needed to race in the different wind conditions or climbing situations you will experience on race day for the estimated time it will take.

Scottish triathlete Graeme Stewart used this technique to prepare for the difficult sections of the 2015 Norseman Xtreme Triathlon. Jeff Agar was able to simulate the impact of pulling his son Johnny and a 60-pound Chariot while indoors in the cold winter months in Minnesota so that he would be prepared to do it during both IRONMAN and IRONMAN 70.3 races.

Because a race is typically not a perfectly steady-state effort, training specifically for the course on longer rides allows you to know exactly what efforts to expect and, more importantly, when in the race to expect them. Sprinkling these simulation efforts into your training provides not only a good race-pace workout, but also confidence that you will be ready for the day.

How to Use BBS to Fine Tune Your Aerodynamics

In the math-modeling world, the data going into the model must be of high quality to get optimal results. The concept of bad data in will always equal bad data out is truly apparent when you run a model and see results that are way out of scope from expectations (or previous experiences).

To this point we know that with so many variables going into Best Bike Split there are a lot of areas where inputs can be hard to fine tune. We have spent a lot of time refining our models behind the scenes to account for elevation data and weather data, but the biggest source of error for most models comes down to aerodynamic drag settings.

Without having access to a wind tunnel or velodrome for testing, coming up with a accurate drag number is a difficult task. To simplify this and allow for a more accurate model we have developed two methods for helping athletes and coaches dial in an athlete’s drag details.

The first is through modeling a previous race in BBS and comparing the model to the actual ride, in a section where you know the athlete was maintaining ideal aero form, using our Time Analysis Tool.

By setting the average power for that section of the model to that of the real ride and varying the drag slider until the times match, an athlete or coach can narrow down a better drag estimate for that position.

Our secondary method is a Beta tool we call Aero Analyzer, which analyzes the athlete’s actual ride file to determine an estimate of both an aero and relaxed position on the bike. This tool is best used with a recent race result or a test ride of 30 minutes or longer where speed and power were varied throughout the ride. As we continue to iterate the tool we expect it will allow for even more analysis and data enhancement.


The Future of BBS

Best Bike Split has come a very long way since our humble beginnings, but as a new season approaches we are just about to explore our 2018 goals. This year is about helping athletes and coaches achieve the most accurate model possible and highlighting areas of strengths and potential weaknesses.

To do this we are working toward completing our original BBS vision, which not only includes race prediction, training specifically for the course and conditions, and providing a optimal race day power plan, but ultimately completes the feedback loop post-race to enhance future performances as well.

The goals we set today will help us achieve our dream of tomorrow—which is as true for us as it is for all you coaches and athletes out there.

Black Friday Sale! Save 35% Through November 30th

Save 35% off an annual athlete or coach subscription! Sign-up for free or log-in and use the coupon code BBSBF35 to upgrade your account before November 30th.

Upgrade Today and Save!

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Champions are made in the off-season, which is maybe the most underestimated part of the training cycle. But how to tackle the off-season, that period of time before base training and long before your “A” race can be a tricky road to navigate.

Some people end up taking too long to get back into training, whereas other never take any time off, and instead enter the base phase fatigued and often injured.

Here is a guide to helping you understand the entire triathlon off-season, from the moment you cross that final finish line of the year to how (and when) to successfuly transition into your pre-season training.

End of Season Phase

Most athletes will finish the season with a significant race, the IRONMAN World Championship in Hawaii in October or a late fall marathon such as the New York Marathon. Many will have chased a PB, trying to leverage on mileage and form accumulated over the summer.

Hopefully the last race is an “A” race, so you can ease into some real time off and enjoy life as a normal human being, immune to illness caused by overexertion. Should the race not be up to your expectations, well, then you need this break even more. This is because you likely over-exhausted yourself during the long months of training and racing. In any case, everyone, pros and age-groupers alike, need a quality break from their most favorite addiction, one that lasts three to four weeks in total.

The best recipe is two weeks of active recovery and two weeks of doing almost nothing.

This does not come easy to some athletes. We are, after all, creatures of habit. Many athletes get restless and all too worried that they will lose the form, put too much weight on, get lazy, and so on.

Losing some form is actually desirable in this phase—if you want to build a taller building, you need to strengthen the foundation! And to do so, you need to knock down a couple of levels.

By “doing nothing” you give all systems quality time to relax, restore and replenish. Your joints and tendons need a break, as well as your nervous system. The mental recovery is very important too; it is time to do and think about something other than “swim-bike-run.” It’s also a good time to stop controlling and monitoring your form, food, HR, TSS etc.

You have to step back to expand your response capacity to positive adaptation triggers so you can take a larger step next season. “Doing nothing” does not, of course, mean being totally sedentary. You just don’t do anything specific to your sport and you do not follow a training plan—for just four weeks! Go with the flow, exercise when you feel like it and try to move your body in different ways: Walk, rollerblade, skateboard, climb, play volleyball or just go to the sauna and spa.

Pre Season (Transition Season)

No matter what you call it (I think transition season is the best descriptor), this is the training phase after your time off following your last big race of the season. If your end-of-season phase was four weeks in length, plan on your transition season being between six and 10 weeks long.

Transition season is about preparing you for the specific training of the main season. It lays the overall fitness foundation and has the following objectives:

Improve foundational strength and stability by general training
Sustain and improve cardiovascular endurance
Improve strength & conditioning of sport-specific moving muscles
Develop technical skills (focus on swim and bike) and range of motion.

The strategies to achieve the above 4 objectives are the following:

1. Transition season is the functional strength season.

I am a big supporter of functional training throughout the season and recommend approaching it as 4th discipline, if you are a triathlete. Meaning, there is a periodized yearly plan for strength and condition training, with the transition period being the high-volume part of it.

We start with general conditioning training for all big muscles groups and work on general mobility. The number of repetition is high (15 to 20 reps per set) and the load is easy. We use predominantly drills with our own weight and over time add some additional weight to our exercises.

After three to four weeks of doing this general training, we make functional training a bit more sport-specific: we engage specific moving muscles, reduce the number of reps and increase the weight. The end result is progression in strength, increased mobility, motor control and balance. Two, hour-long strength sessions per week are ideal.

2. Transition season is swim season.

The foundation for a good triathlon performance is the swim. We pay for a weakness in the first discipline by low energy on the run. So swim, swim, swim—this will build your endurance, power and fatigue resistance—all in a low impact, injury-free way.

Start with “baby-swims,” mini-sprints of 10 to 15 meters, many reps, build it out to longer sprints, more “cruising” intervals, swimming with paddles, buoys, etc. If you have any deficits in your swimming technique and form, address them now, work with a coach or go to a swim camp.

Transition time is swim time, and the cold and darkness outside are quite conducive to warm, well-lit swimming pools indoors. Swim at least three times per week if you can. If you can, swim more. Only good things come from swimming for endurance athletes.

3. Transition season is time to play around with other sports.

To prevent mental fatigue and also to add some fun to our training, we use alternative sports to work on our endurance, motor skills, balance and strength. MTB is great for max power and bike-handling skills, indoor climbing will make your core, arms and shoulders stronger, which is perfect for the swim.

Rollerblades and skateboards are great for balance, quads and core. And if you are lucky enough to live close to snow and mountains, then cross-country (Nordic) skiing is the best alternative sport ever. It is endurance, functional training, VO2max, balance and coordination training—all in one!

Did your know that VO2max records for both genders are held by Nordic skiers? One longer session of an alternative sport, like two hours of mountain biking or cross-country skiing per week would be ideal.

4. Transition season is time to save your running legs.

Running is rough on the body. This is because on average every runner has one running injury per year, from a minor tear to a serious overload injury. So we should try to save our running legs for all the miles of training waiting for them in spring and summer time.

Instead, try to load running muscles by plyometric drills developing hip strength. It is in the hips where your true running engine is located and you need to learn how to engage it better to create a more propulsive running motion.

Try “dry running” in the gym, using light weights and cords to simulate running movement. And since you will be in the pool a lot, it is also a good idea to add 20 minutes of aqua jogging to your session. So, very little running, only short runs and progression via number of runs per week and a slight progression in their duration, with pretty much zero progression in intensity. Intensity is hidden in plyometric and functional training. You will it feel the benefits later, I guarantee it.

Enjoy your well deserved vacations from a structured training for a month, and then get back on the horse with smart, versatile and progressive transition training to set a foundation for a successful 2018 racing season!

You can purchase my full transition season plan here, including a free, one-week sample plan. Good luck and have fun!

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In the final installment of our ongoing series on developing race-day mental skills, we explore how to focus on being dynamic instead of perfect in your performances.

Perfectionism can be both and asset and a disadvantage for athletes. The big problem for athletes who are perfectionists is that you can sabotage your own performance in races when taken to an extreme.

A perfectionist athlete is an athlete who strives to be perfect in whatever she does, always focusing on the mechanics rather than working toward the flow of the event’s requirements.

Perfectionism can hurt your performance in events and your ability to improve in training. When you always expect perfection in your training and racing just as you planned it, you leave no room for being adaptable, which is a must for racers.

Below shows how perfectionism in sport can be both an advantage and a disadvantage:


High motivation and a strong desire to succeed
Strong “work ethic” that supports motivation
Highly committed to goals and improving
A functional mindset for training
Ability to analyze performance in training to improve


Focus on the end results instead of the current moment
Anxiety and tension in events
Stuck in a training-mode mentality, which makes it hard to have trust in events
Strict expectations for performance
Lack of confidence in events
Wanting so badly to succeed, which often leads to anxiety
Impatient with results in events, which makes it easy to give up
Care too much about what others think

Are You a Perfectionist Athlete?

What are the signs or signals of perfectionism?

Do you generally perform better in training than you do in an event?
Do you attempt to have a perfect event?
Do you want to win so badly that you suffer from performance anxiety?
Do you worry about what other people will think about you?
Do you view your performance as either good or bad?
Do you become easily frustrated with your performance?
Are you stuck in a training mindset?
Do you have a hard time performing freely and with trust?

How To Improve Your Mindset for Events

The following six strategies will help you overcome perfectionism and allow you to focus on the particular demands of race day in a more healthy way:  

Train for greater trust in training so you can transfer that feeling to race day. Many athletes use their training time to improve their technique—and they should. But you want to spend half of your training time in trust mode by letting go of the technique and performing the way you normally do in events. For example, when you go out for a bike ride and do 20-minute intervals, be in race mode during those intervals.

Give yourself permission to encounter challenges. Accept that the race will evolve and challenges will happen from time to time. Be prepared to encounter challenges during an event, such as equipment problems. However, if you encounter a challenge during the race, it is in the past, focus on getting back into the flow or the current section of the course.

Perform efficiently instead of perfectly. Perfectionists tend to focus too much on improving themselves for the next event instead of performing great today. We suggest you abandon the “correct” or perfect way to perform and instead get the job done. This means that you’ll fully rely on what you have learned already in training. Use the skills that you can execute with confidence today to help you perform efficiently. For example, instead of trying too hard to have the optimal FTP number, focus on being consistent and smooth.

Assess your race performance objectively. Perfectionists tend to be very self-critical and focus on only their shortcomings after events. If you do this, your confidence will take a big hit. Instead, you want to look at your event performance in an objective way. We suggest that you focus on what you did well in the race.


With a perfectionist mindset, you’ll find it has both advantages and disadvantages. You want to use the advantages to your own benefit, such as having a strong work ethic and commitment to your sport.

However, you also want to learn how to overcome the disadvantages of perfectionism. As we have discussed, perfectionists often place unrealistic demands upon themselves. Perfectionists can be highly self-critical and want to perform perfectly in all events. This leads to a lack of trust and low confidence especially in events.

To overcome perfectionism, you need to accept that you are human and you will make mistakes or face challenges so you can perform freely with whatever form or fitness you bring to the event that day.

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Are you an athlete who isn’t running to their potential off the bike? Are you someone who constantly feels weak when riding hilly courses? Are you new to triathlon and don’t know where to start? If you answered YES to any of these questions—than this is the article for you.

For the majority of athletes, your muscles will break down at some point in a race, but the stronger athletes fatigue less, or they fatigue later.

If you have put in the weekly hours of training than your cardiovascular system isn’t the problem, so when you go back to the drawing board the immediate fix isn’t to add more training volume. Instead, the key to success will be adding workouts geared toward improving your overall musculature.

Triathlon training is broken into two categories, specific training and general training. At all times you should be training both sides of the spectrum. Unfortunately, when an athlete shifts too far to one category, the ladder falls and they lose certain qualities they’ve worked hard to develop.

A good example would be if you are gearing for a hilly race that features short climbs and you spent the final eight weeks only working on your top-end threshold and speed. The good news is that you will develop a great top end, but you’ll also lose the general endurance that holds you together to the finish line.

The same could be said for the final 12 weeks in preparation for a hilly IRONMAN when you focus only on steady aerobic riding and neglect the appropriate intensity that matches the course demands. You will develop the endurance needed to complete the race, but the hills will empty your tank.

If you want to be a successful athlete, you should train more frequently in the general phase, where you’re focusing on developing your durability as well as your speed. As the race season approaches you should include race-specific workouts only once a week.

However, the majority of your workouts should be done in a bigger or easier gear than what you will be racing in. Spending most of your time developing better endurance, muscle durability and overall speed will get you to the finishline faster than others.

3 Winter Cycling Workouts for Building Muscular Strength

Here are three workouts to try to build muscular strength. If you’re looking for a more detailed plan, please check out my free, four-week starter plan HERE.

1. Biggest Gear Flat Sprints

These sprints are done in the biggest gear you have starting from a complete stop. These sprints only last 10 seconds and you are going at 100-percent maximal effort.

The first five seconds I encourage you to be out of the saddle and then sit down once you are up to full speed. Because these are done at a maximal effort, they require full recovery between each.

Start with six repetitions and three minutes of rest between each repetition. The goal of this session is maximal power! If done correctly, you will fatigue quicker when trying to reach your peak wattage as the session progresses.

These sessions are what I call “raising your ceiling” workouts. Your end goal is to is to improve your threshold and if your maximal power is relatively low to where your threshold is, your threshold potential will always remain low.

I find that most triathletes ignore these sessions as they don’t find the value, unfortunately it’s these same athletes who remain slow season after season.

2. Seated Hill Repeats

These are the bread and butter of a triathlete’s training routine and they should be repeated weekly or biweekly depending the phase of training they are in.

The intensity of these efforts should be between 105 percent and 120 percent of your threshold, and your cadence should be between 60 and 70 rpms. You should start with 10, one-minute repetitions with only one minute of rest between each.

As your training progresses, you should add two additional interval repeats every two weeks while trying to maintain the same power output. Your heart rate will not elevate to where you’re out of breathe, but your muscles will experience heavy levels of fatigue.

This session is also very good for teaching athletes how to “feel the pedal stroke” and the correct places to apply pressure. If you are not pushing above your threshold, you aren’t going to get the benefit of this workout.

3. Low Cadence Extended Intervals

As your fitness grows, so does the length of your intervals. These intervals are what we consider “supporting sessions” early on in your training as they support the high intensity sessions you are primarily focusing on. As the racing season nears, they become the focus of your training plan. Starting these efforts at Threshold power, progressing to Sweet Spot power, and finishing them at a Tempo power is the best plan of progression. Triathlon is an endurance sport so when we get to our competition phase, doing longer low cadence sessions are the staple sessions for building the durability needed to minimize fatigue in the later stages of the race.

How To Balance Your General and Specific Training

Some athletes are born stronger than others. If you were constantly picked last for dodgeball, there is a good chance you should be focusing more of your time on Maximal Sprints and Seated Hill Repeats in the early part of your season. The athletes who are gifted with good force production have greater athletic potential than athletes with limited force production.

If you are someone who scores well on the one-minute Power Profile Chart, you should spend more time doing the Seated Hill Repeats and Low Cadence Extended Efforts in the off-season.

The best part of adding these sessions to your training routine is that they will help you run faster off the bike. Simply riding your bike in an aerobic zone does little to condition your body for the demands of your race.

The stronger your legs are, the less they will fatigue. While all of the new indoor riding programs make riding the trainer more enjoyable, they also encourage poor training habits. These programs have a place in an athlete’s weekly plan, but it shouldn’t replace the structure needed to take you to the next level.

In closing, if you have not had a professional bike fit or if you experience knee pain while doing any of these three workouts, then I wouldn’t recommend you do them without consulting a coach, or modify accordingly.

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Triathlon is an ultra-endurance event testing the boundaries of human tenacity. The overwhelming demands placed on the body across the three disciplines of swimming, cycling and running are often the main attraction to the sport.

Unfortunately, reported cases of sudden death in the triathlon have raised concerns about the safety of this event. Despite this, there remains a lack of information about the prevalence and causes of triathlon deaths.More importantly, there are unanswered questions as to if and how triathletes should undergo pre-participation heart screening.

The popularity of the sport has increased tremendously since its origin in 1920s France where it was referred to as Les trois sports (the three sports). Triathlon events and participant numbers have more than doubled in recent times.

In 2011, in America alone, there were more than 500,000 athletes competing in more than 4,000 races, compared to 276,000 participants and 2,070 events in 2006 (1).


There is only one large study on sudden death during a triathlon. Researchers in the USA studied almost 1,000,000 triathletes competing in approximately 3,000 triathlon events between January 2006 through September 2008 (2).

They gathered data from two large American registries and obtained post mortem reports from medical examiners. Overall there were 14 deaths during this period which corresponds to 1.5 in 100,000 participants.

Most deaths occurred in males (80 percent) and middle-aged runners (median age 44 years). All of the deaths happened during the swimming stage of the race, apart from one cycling fatality, which occurred as a result of neck injuries following a fall.

Only nine of the 14 deaths had post-mortem data. Cardiovascular causes featured heavily as the cause of the death (80 percent); Six had mild left ventricular hypertrophy, including one with a clinical history of Wolff-Parkinson-White syndrome, and one had a congenital coronary arterial anomaly (2).

In addition, recently released data from USA Triathlon (USAT) has provided more information on risk factors. A panel was asked to review information about fatalities that occurred at USAT-sanctioned events between 2003 and 2011.

In those nine years, nearly 23,000 sanctioned events were held, involving more than three million participants.

The overall fatality rate for competing triathletes was approximately one per 76,000 participants. Among the 43 race-related athlete deaths, five were traumatic, caused by injuries sustained in cycling crashes; the remaining 38 deaths were non-traumatic.

Of the 38 non-traumatic fatalities, 30 occurred during the swim, three occurred during cycling, three occurred during the run, and two occurred after an athlete had completed the race.

Several important conclusions were made by USAT. Firstly, the fatality rate does not appear to be related to race factors such as length of the race, the type of swim venue, and the method of swim start (e.g., mass, wave or time trial).

Secondly, victims appear to have included athletes from a broad range of triathlon experience and fatalities were not confined to inexperienced triathletes. Among the major recommendations put forward by USAT to athletes was to “Visit your doctor for a physical examination with an emphasis on heart health before participating.”

There are several possible reasons why the swimming portion of the race is the most dangerous. The beginning of the swim race is the most chaotic part of the event with competitors bumping into each other as they jostle for positions.

Being knocked unconscious in deep water can be fatal, even for only seconds. In addition, diving into cold water is a recognized trigger for sudden death in a condition called long QT syndrome (LQTS).

This is an ion channel disorder characterised by a prolongation of the QT interval on a heart tracing (electrocardiogram). Death is often due to fatal arrhythmias mediated by adrenaline surges such as cold water immersion.

Finally, many deaths are thought to be secondary to a phenomenon called Swimming Induced Pulmonary Edema (SIPE). SIPE is well recognized in swimmers and divers and is caused by raised pressures in the lungs as a direct result of body reflexes secondary to cold water.

The exact mechanism is not fully understood but is thought to be a combination of blood vessel constriction and pooling of blood from the peripheries to the heart and lungs.

Although there is a paucity of data with regards to triathlon, there is ample information concerning marathons. The incidence of sudden death in marathons varies widely from 0.54 to 2.1 per 100,000 participants between reports (3).

Depending on some estimates, therefore, triathlons may be considered more of a risk than marathons. In addition, the major cause of death in marathon runners is coronary artery disease, whereas this did not feature in any of the triathlon deaths mentioned above.

The ultimate question is whether triathletes should undergo pre-participation cardiac screening. Screening is a novel concept in triathlons and marathons, which attract enormous numbers of participants of varying ages and experience.

However, in professional competitive sports screening is now commonplace and even mandatory in some countries. It is endorsed by several professional sporting bodies such as FIFA and the International Olympic Committee (IOC).

Most of the documented causes of deaths in triathletes are treatable and can be easily picked up by simple tests such as a heart tracing (electrocardiogram or ECG) and a heart ultrasound scan (echocardiogram).

The yield from such testing can be increased in the presence of prodromal symptoms or a positive family history which can be gathered from a simple health questionnaire.


A widely accepted screening model based on the European society of cardiology (ESC) consists of a health questionnaire, physical examination and an ECG. Should these be abnormal, an ultrasound scan of the heart known as an echocardiogram is performed.

These simple measures would diagnose the vast majority of heart disorders(4). Additional tests such as cardiopulmonary exercise testing (CPET), cardiac MRI and genetic tests are warranted when further information is required to make a diagnosis or for the purpose of research.


The Centre for Sports Cardiology and Inherited Cardiac Diseases at St George’s Hospital, London, and the affiliated charitable organization, Cardiac risk in the Young (CRY), are committed to providing cardiac screening to all competitive athletes including triathletes.

There is very little known about the effects of triathlons on the heart. We hope to build a partnership with triathlon organizations, which will foster research into the field and ensure the safety of the sport for many years to come.

Many thanks to Dr. Ahmed Merghani (BMedSci, MBBS, MRCP) and Prof. Sanjay Sharma (MD, FRCP (UK), FESC) for their contributions to this article. Professor Sharma is the medical director for the Virgin London Marathon, Consultant cardiologist for the CRY sports cardiology clinic at St George’s Hospital, cardiologist for the English Institute of Sport, British Rugby League and the British Lawn Tennis Association. Professor Sanjay Sharma is Professor of Cardiology and Lead for the Inherited Cardiomyopathies and Sports Cardiology Unit at St George’s Hospital in London, England.

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