Thomas J Whipple - The Endurance Paradox: Bone Health for the Endurance Athlete

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The Endurance Paradox

The Endurance Paradox

Bone Health for the Endurance Athlete

Thomas J. Whipple
Robert B. Eckhardt

First published 2011 by Left Coast Press, Inc.

Published 2016 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright 2011 Thomas J Whipple and Robert B Eckhardt

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data:

Whipple, Thomas J.
The endurance paradox : bone health for the endurance athlete / Thomas J. Whipple and Robert B. Eckhardt.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-59874-617-4 (hardcover : alk. paper)ISBN 978-1-59874-618-1 (eISBN)
1. Athletes--Nutrition. 2. Physical fitnessNutritional aspects. 3. Stress fractures (Orthopedics) 4. Bioenergetics. I. Eckhardt, Robert B. II. Title. [DNLM: 1. Physical Endurance. 2. Bone and Bones. 3. Fractures, Stressrehabilitation. 4. Nutritional Physiological Phenomenaphysiology. QT 255]
TX361.A8W45 2011
613.2'024796--dc22

2010052552

ISBN 978-1-59874-617-4 hardcover

Cover design by Piper Wallis

Contents

, Margot Putukian

, Nicholas Romanov

, Bernd Heinrich

It is widely accepted that endurance exercise is beneficial to our health and well-being. However, it has also become fairly well known that extreme exercise can have negative effects on nutrition, hormonal balance, and ultimately bone health, and that these effects may not be reversible. As a former athlete and coach, and now as a physician, understanding the science behind how exercise can affect healthand how health can affect exercise performancehas always been one of the most interesting and important aspects of sports medicine and one that has always engaged me. Understanding that exercise is medicine and seeing how different medical conditions can play a role in exercise performance and health is what led me to pursue a career in primary care sports medicine and to my work as a team physician.

How can exercise promote health, well-being, and strong bones, but in the extreme lead to fatigue, poor performance, stress fractures, and premature osteopenia? This book provides the answers and shows how athletes can implement changes to optimize bone health, and ultimately overall health and performance.

The Endurance Paradox is a tremendously useful resource for athletes, coaches, and strength and conditioning coaches, as well as for the wide variety of people who care for athletesparents, athletic trainers, physical therapists, physicians, and other health care providers. Authors Thomas Whipple and Robert Eckhardt use a scientific approach to each topic and incorporate the most recent research on endurance athletes. They present this information in a format that is easy to understand and apply; each chapter is a guide that athletes can use to improve their bone health as well as their overall health and performance.

As a sports medicine physician, I welcome this resource for the sports medicine community. It speaks directly to athletes and those around them in a manner that is refreshing and honest. I congratulate the authors and editors for a job well done.

Margot Putukian, MD, FACSM
Director of Athletic Medicine, Head Team Physician, Princeton University
Associate Clinical Professor, Robert Wood Johnson, UMDNJ
Past President, American Medical Society for Sports Medicine

This book is useful as a fundamental training guide for endurance athletes of all levels. The information it offers is increasingly urgent because, as the authors pointed out, athletes are experiencing skeletal ageing and premature bone loss at accelerating rates. This book can help athletes reverse that trend and decrease their risk.

Richard Feynman has said, A paradox is not a conflict with reality. It is a conflict between reality and your feelings of what reality should be like. This perspective applies to the field of endurance, in which a paradigm of cardiovascular development has become so dominant that it is leading to the deterioration of health and performance. What athletes were trying to achieve by emphasizing their endurance performance came at the cost of athleticism elsewhere.

At the beginning of the running boom of the 1970s, neither athletes nor coaches were paying enough attention to strength development for runners. To get better at running, they thought, you just have to run more. Instead of providing for the overall development of the human organism, they focused on the cardiovascular and respiratory systems as the keys to enhanced performance. High volumes of training, they believed, would improve these systems and result in faster marathon performances. However, the results were not faster times, but generations of broken runners. The combination of high mileage along with poor technique and the absence of strength training was a formula for disaster.

By the end of the 1970s, a fractional group of enlightened coaches began to rethink strength training and started recommending weight programs for their runners. While mainstream runners are still behind this trend, the efforts of leading scientists and coaches are being acknowledged and the value of strength conditioning for achieving endurance running results has been undeniably proven. The authors of this book are among those scientists who clearly understand the value of strength training for endurance athletes. Their literature review does not leave any doubt about the importance of strength training and provides you with noteworthy guidance in this direction.

But the book covers much more. The curious reader will find other enlightening information and will learn how quality training programs should be supplemented with technique, diet, and other program mainstays. The book leads readers to a profound understanding of it and makes recommendations for solving them. It covers a very wide spectrum of aspects of training and wellbeing, from strength training and nutrition to metabolism and rehabilitation. I think it is an invaluable source of information for everyone interested in endurance performance.

Nicholas Romanov, PhD
Founder of the Pose Method

Life is a challenge of compromises. One thing more here usually means something less there. If that isnt sobering enough, consider a paradox: you might be investing everything in order to achieve a desired result, only to find out later that this effort actually reduced rather than increased your chances of reaching your goal.

Endurance athletes are painfully aware of the problematic payoff game: we are nurtured on the dual dogmas of innate talent on the one hand, and the idea that our allotted payoff will be pretty much in direct proportion to our physical effort on the other. These dogmas keep us going sometimes until we dropliterallyor end up with poorer performance, and injury, and maybe in the long-term with accentuated frailty of the bones. Meanwhile, we see someone who appears to put half as much heart into the enterprise achieve twice the glory.

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