Endurance athletes & HCM

Posted by jkbrooks @jkbrooks, Oct 5, 2021

I had an SCA 16 years ago. I was out for a run. It was dramatic. I've got an implanted ICD. About 5 years ago I decided to make a change. The "box" hadn't gone off in 16 years and I had developed a weight problem from lack of exercise (and sub-par diet). I started back up on the bicycle. I've been riding about 4,000 to 5,000 miles/year. I tend to avoid most of the high intensity training but I live in Seattle. It's not flat. I climb lots of hills. In the first quarter I had some problems with AFIB (apparently my heart is uniquely skilled at arrhythmia.) 3 ablations & a couple cardioversions later . . . I've logged LOTS of low/slow miles over the last 4 months. But my performance isnt what it was a year ago. I met with my EP cardiologist today. His theory is that as I get older (I'm 53), my HCM is causing my heart to "stiffen" and not "refill" with blood as effectively after pushing the blood out. I get that I'm not one of the fast kids nor am I going to train myself into position to be part of that group. And, I'm interested if there are others in the same camp athletically as me. I'm interested in your experience. I'm not competitive so that's not on my goal list . . . but I do group rides & a fair amount of bike touring.

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) group.

Hi @jkbrooks and welcome to Mayo Clinic Connect. I saw that you also posted your story in a discussion about a child who developed HCM, but I am glad you shared it in your own discussion as I feel like several members diagnosed with HCM feel as though their exercising days are over.
I would like to introduce you to @fenet, @ajand, @johnbishop, @vi4, @auntsuzie33, and @zyxw who have had experience with HCM.

The AHA did a study on sudden cardiac arrest (SCA) that I thought you might like to read.
https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.114.011988
Are you happy with your low/slow miles? Is it keeping you active enough?

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Hi @jkbrooks, I would like to add my welcome to Connect along with @amandaburnett and others. I don't have HCM but do have hypertension and irregular heart beats – sinus rhythm with supraventricular ectopy. At 78 my pushing the exercise envelope days are over. I'm not able to ride a regular bike due to balance and a little fear of falling over but I do spend 30 to 60 minutes daily on my Teeter FreeStep Cross Trainer. I think it's great that you are able to do group bike rides and some touring on your own. I've thought about getting a 3 wheeler to ride around town but haven't made the plunge yet. I don't think anything can beat a nice easy going bicycle ride on a country road. I think you just have to find a balance that works for you to stay in shape and provides some fun and enjoyment doing it.

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@amandaa

Hi @jkbrooks and welcome to Mayo Clinic Connect. I saw that you also posted your story in a discussion about a child who developed HCM, but I am glad you shared it in your own discussion as I feel like several members diagnosed with HCM feel as though their exercising days are over.
I would like to introduce you to @fenet, @ajand, @johnbishop, @vi4, @auntsuzie33, and @zyxw who have had experience with HCM.

The AHA did a study on sudden cardiac arrest (SCA) that I thought you might like to read.
https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.114.011988
Are you happy with your low/slow miles? Is it keeping you active enough?

Jump to this post

Hi Amanda. Thank you for your note. I'll take a look at the study. Thank you for sharing. I'm pretty active. I'm on the bike 10-20h/wk (not including stops, stop lights, etc; just turning the cranks.) I average about 12-15h. Pre covid I was running about 10h/wk on the bike, two bootcamps, and two sessions with a personal trainer per week. Since covid I've migrated most of my activity to the bike. In q1 I had some real issues with afib/flutter. That took it out of me, made training much much harder, and left me feeling pretty beat up after the fact. But, two weeks after my last cardioversion in April I took off to do 350 miles along the SoCal coast. I did it, was happy I did/could, but it was rough. I was "undertrained" and on an antiarrhythmic at the time (which I later found out also introduced a second beta blocker.) Getting my HR up was nearly impossible and getting over the coastal range (with bags on) was a challenge. And I did it. From there I've done about 700 miles of solo, self-supported bike tours in France and about 700 miles of solo, self-supported bike tours all over Washington State & Oregon coast this past summer. I decided I'd just focus on volume and not do any intensity training (outside of the normal hills/mountains) . . . I wasn't doing any interval type training at all. Having laid down a reasonable "base" at this point of about 3500 miles (mostly low & slow), I'm shifting to doing some structured training on the indoor trainer once or twice a week. These are 60-90 minute sessions of long (5-15 minute) intervals at about 85% of max power output; they're not sprints. I dont have the guts or the desire to do 90 second "all out" repeats. I'm mostly happy with the volume I'm doing. My average speed is off a couple miles/hour from a year ago. I'm hopeful a little intensity training will bring that up some but I'll be ok if the "new normal" means I continue to plod along at my current pace. I dont really know how trainable my heart is at this point. Volume takes more time than intensity but supposedly provides more resliency which is mostly what I'm after. I'm not competing . . . but I'd like to hang with the "slow-kids pace group" I'm riding with. I'm also adding back in the bootcamp twice/week; not sure I can do a situp anymore 😉

REPLY
@johnbishop

Hi @jkbrooks, I would like to add my welcome to Connect along with @amandaburnett and others. I don't have HCM but do have hypertension and irregular heart beats – sinus rhythm with supraventricular ectopy. At 78 my pushing the exercise envelope days are over. I'm not able to ride a regular bike due to balance and a little fear of falling over but I do spend 30 to 60 minutes daily on my Teeter FreeStep Cross Trainer. I think it's great that you are able to do group bike rides and some touring on your own. I've thought about getting a 3 wheeler to ride around town but haven't made the plunge yet. I don't think anything can beat a nice easy going bicycle ride on a country road. I think you just have to find a balance that works for you to stay in shape and provides some fun and enjoyment doing it.

Jump to this post

Hi @johnbishop! thanks for your note! I'm sorry to hear about the heart issues. I imagine that's not at all fun as well as scary on occasion. Sounds like you're a dedicated exerciser! Impressive you make time to do your thing on the CrossTrainer every day! I love your idea about the 3-wheeler on a bike trail. I'm totally supportive of you making the plunge! I think hauling them can be a thing. I think I'd just give up and get a utility trailer & call it good 🙂 (rather than try to hang it off my truck or car.)

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Hi @jkbrooks and @johnbishop,

While I don't have HCM, I do have long-term heart valve problems as well as a mild form of heart failure (diastolic dysfunction), so I know a little bit about adjusting an exercise routine to meet a change in physical endurance.

If you've enjoyed a certain type of exercise the change to a slower pace or a different type of exercise can feel like a let-down and a real loss.

It sounds as if you have both made the necessary adaptations to your workout routines and are keeping as healthy as possible.

I'm wondering, how long was it before deciding on these adaptations?

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@hopeful33250

Hi @jkbrooks and @johnbishop,

While I don't have HCM, I do have long-term heart valve problems as well as a mild form of heart failure (diastolic dysfunction), so I know a little bit about adjusting an exercise routine to meet a change in physical endurance.

If you've enjoyed a certain type of exercise the change to a slower pace or a different type of exercise can feel like a let-down and a real loss.

It sounds as if you have both made the necessary adaptations to your workout routines and are keeping as healthy as possible.

I'm wondering, how long was it before deciding on these adaptations?

Jump to this post

Hi Teresa, For me the change was gradual. I still enjoyed golfing, biking and racquetball with a few friends into my mid 50s but I started slowing down into my 60s when it was harder for me to walk any distance. Then when I got into my 70s and the walking became more difficult, I found that it was easier to spend time doing exercise in my home on a recumbent bike/elliptical combination machine which I eventually exchanged for a Teeter FreeStep Cross Trainer. It's easier on the legs with a more natural walking motion and it also exercises the arms.

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@johnbishop

Hi Teresa, For me the change was gradual. I still enjoyed golfing, biking and racquetball with a few friends into my mid 50s but I started slowing down into my 60s when it was harder for me to walk any distance. Then when I got into my 70s and the walking became more difficult, I found that it was easier to spend time doing exercise in my home on a recumbent bike/elliptical combination machine which I eventually exchanged for a Teeter FreeStep Cross Trainer. It's easier on the legs with a more natural walking motion and it also exercises the arms.

Jump to this post

@johnbishop The gradual approach was probably the best way to adjust to a new exercise routine.

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