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BMJ 2004; 329 doi: (Published 01 July 2004) Cite this as: BMJ 2004;329:0407300
  1. Akbar Lalani, medical student and endurance athlete1
  1. 1Bristol

Bonking, hitting the wall, and visits to the sleep monster are all activities that endurance athletes want to avoid. Akbar Lalani explains

Training for an endurance race is similar to revising for a medical school exam--you have loads of good ideas and strategies well in advance. You then spend most of your time procrastinating and dabbling in some work. Finally, one day, you realise that time is running out and that you really better get on with things. So what is it that endurance athletes think about when training for and competing in events? Although not a natural athlete, I did manage to train for and successfully complete the world's toughest endurance race, the Marathon des Sables. Along with 700 other runners, I survived the 150 mile seven day ordeal in the Sahara desert, where temperatures peaked at 51°C.

Many endurance athletes develop borderline obsessive-compulsive behaviour patterns when it comes to their training. With so many parameters to control, life can become a series of numbers, times, weights, repetitions, sets, heart rates, calories, and hours of sleep, to name but a few. A typical week during my 18 month training schedule consisted of 30 hours training, 60 hours sleeping, 28 000 calories (117 MJ) consumed (split into six meals a day), and the odd hour or two at medical school.

The build up

A runner's most powerful tool for monitoring progress during training is the heart rate monitor. Many cardiac adaptations occur as a response to training load. Athlete's heart, a condition encompassing the simultaneous increase in the volume of the ventricles and the hypertrophy of the heart wall, can be detected in many athletes who typically spend more than 15-20 hours a week training. Other changes occur including an increase in stroke volume, and this leads to a decrease in heart rate …

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