Are you preparing to take part in a sports event and looking for the best way to maximise your enjoyment, get the best results and recover well after the event?

In this episode of The Health Wrap, On The Move, the manager of the corporate events department at Mediclinic Southern Africa, Dr Darren Green, joins Ayanda Charlie to unpack these questions and many more. With a special interest and background in neuroscience, sports and exercise medicine, he is the perfect expert to demystify the big task of training for a sports event.

[00:00:00] Ayanda Charlie: Welcome to The Sports Series, powered by Mediclinic. I’m your host Ayanda Charlie. As a multimedia content producer with a love for journalism, I am here to ask all the questions you might have, chatting to the specialists to get real answers. Keep looking out for our future episodes as we have a great line-up of doctors and other experts to support you with all the information you need for your fitness journey, no matter what level of sports you play!

[00:00:28] Ayanda Charlie: Please note that the views shared by any of our guests in this podcast, may not necessarily reflect the views of Mediclinic, so please consult a medical professional if you have concerns.

[00:00:42] Ayanda Charlie: Today we’ll be speaking about sports events and races. Whether you’re competing as a professional athlete, looking to beat your best IronMan time, or simply entering your very first 5km fun run - you’ll want to be well prepared for the event - to maximise your enjoyment and get the best results.

[00:00:59] Ayanda Charlie: You’ll also want to know what to do on the day and, of course, how to recover afterwards! As we look at this important topic today, we will be joined by Dr Darren Green. Dr Green is a respected medical professional and you’ve probably seen him on a number of TV shows, including Medies on KykNET en Kie. Today he will be sharing his insights and expertise with us as we look at event preparation. Welcome, Dr Green!

[00:01:24] Dr Darren Green: Thank you so much. Great to be with you today.

[00:01:27] Ayanda Charlie: Now before we begin, do you mind just introducing yourself and sharing briefly about the work that you do?

[00:01:33] Dr Darren Green: Sure. Gladly. Um, well, I'm a medical doctor with a special interest and background, uh, in neurology, neuroscience, but then also, uh, more lately sports and exercise medicine.

[00:01:46] Dr Darren Green: Um, and then I've worked over a decade in emergency medicine as well. Um, you know, within the public and private healthcare sectors. Currently my role is, uh, as head and manager of the corporate events [00:02:00] department at Mediclinic Southern Africa and that sounds like I arrange tea parties, but it's not actually there all sorts of events that fall under this umbrella.

[00:02:09] Dr Darren Green: Uh, and uh, specifically we are looking at, uh, sporting events, uh, across all sporting codes. And, uh, what my department does is supply absolutely niche expertise and bespoke medical care to these various sporting codes, uh, across, across the board for the different, uh, you know, levels of sport. In other words, things like mass participation events like marathons and cycling races, uh, and then of course more bespoke sports or individual sports, uh, such as, uh, rugby, uh, and et cetera as well.

[00:02:45] Dr Darren Green: But we cater, uh, at looking at providing medical support in the pre-hospital setting, which is along the route, uh, of, of different events, as well as then that full treatment, uh, you know, uh, field hospital that gets set up. [00:03:00] So depending on where the event is and the size and magnitude of these events, my department will be providing emergency medical support along the route and then in a final field hospital.

[00:03:11] Dr Darren Green: And that could be near Metropol or it could be out in the middle of the bush as it often is with mountain biking, for example. Mm-hmm. Um, so yeah, that's what we do.

[00:03:20] Ayanda Charlie: Wow. So, so you're the perfect person to speak to today because we're looking at how best to prepare for a sports event or, or race and I mean, can you share with us what happens in your body when you push past your usual exercise routine?

[00:03:34] Ayanda Charlie: Like when you really push your limits on a physical level? Yes. For things like a first half marathon or your fifth comrades, you know, what's the psychological impact Yeah. Um, on the body as you participate in the event?

[00:03:48] Dr Darren Green: No, great question. I think many people, um, are in the category of what we call weekend warriors.

[00:03:54] Dr Darren Green: In other words, they've lost a bet and they get dead to take part in a sports event. [00:04:00] In other words, you lost a bet, you're feeling brave around the braai vleis fire and then suddenly someone says, okay, let's do it together as a group. We're gonna, oh, let's say ride a hundred kilometer cycle race, like the cycle tour, for example.

[00:04:13] Dr Darren Green: Uh, there's a big difference between that and deciding we are gonna do the comrades marathon. Yes. Which obviously is close closer to 90 kilometers. So, uh, we look then obviously at the preparation and the effect on the body in preparing for events such as that. So it would depend on the level at which you want to participate firstly.

[00:04:32] Dr Darren Green: So you get amateurs and then you get professionals and there's certainly a very different approach, uh, to dealing with, uh, these niche groups. But for the general layman, uh, out there, I think wanting to get involved in an event and making the decision and setting a goal in the first place is an incredibly bold and important step in your health and wellness profile.

[00:04:55] Dr Darren Green: You know, because we, we know that sitting is the new smoking. We know that sedentary lifestyle [00:05:00] and setting still is one of the biggest contributors to the non-communicable lifestyle diseases such as diabetes, hypertension, obesity, and uh, with all that, the complications of heart and stroke that we see as leading causes of death prematurely.

[00:05:16] Dr Darren Green: So there's a massive, massive move looking at the, the actual preventative benefits of physical activity in preventing these kind of illnesses. And people are then signing up to get involved with these events. So physiologically, you are asking physically what actually happens in your body when you go from.

[00:05:36] Dr Darren Green: Sitting on your butt all day and not exercising mm-hmm. To a place now where you suddenly start moving? Well, initially, uh, you are looking for some immediate reward. Like, you know, you think you can have another bite of donut to ice cream if you've exercised or ran that day. And, uh, unfortunately it doesn't work that way.

[00:05:55] Dr Darren Green: You kind of like earn the right to have a beer later on in the afternoon. [00:06:00] However, the body physically goes through incredible changes and in the sports exercise field we speak about things like the word conditioning. Uh, and I know we use the word a lot with things like our hair, for example. Yes. But when it comes to sport and eventing medicine, conditioning is the key word.

[00:06:18] Dr Darren Green: Mm. So what happens with the body is your body becomes a accustomed to dealing with an increased load or expectation on its various systems. And we all know the body, you know, contains, comprises various systems from your cardiac system, musculoskeletal system. Your, uh, you know, your brain, your kidneys, your liver, et cetera.

[00:06:39] Dr Darren Green: So putting it in perspective, all those systems undergo physical, adaptive changes when you start exercising and increasing your activity levels. Mm. Um, and that's what the magnificence is, uh, of actually starting to move. And with the goal setting of moving towards an event, you then kind of, uh, have [00:07:00] a, you know, a, an end goal and something concrete to move towards. [00:07:05] Dr Darren Green: But there are many things that can take you off that journey or act as stumbling blocks along the way too.

[00:07:11] Ayanda Charlie: Mm, yes, indeed. And maybe one stumbling block would be perhaps not going for a screening maybe before you start to push your body and seeing, you know, what weaknesses you might have beforehand. In what ways might that help, you know, for preparing for a big event, having a, a full body checkup?

[00:07:30] Dr Darren Green: Sure. In my industry of eventing mats, the word screening has got so many different aspects to it, so I'll put it in perspective first. I think the first thing is just getting a clean bill of health to start training, to get moving and to go for your, your gym session or your, your run or walk, et cetera.

[00:07:46] Dr Darren Green: Mm-hmm. So I think first out, we need to understand that you need to get a, a clear bill of health to actually commence and start your program and, you know, and, and, and looks firstly at: what is the current landscape, the state [00:08:00] quo of this meat, meat box in terms of its capabilities and its risks? And to do that, you of obviously often need a checkup.

[00:08:08] Dr Darren Green: So before embarking on a big, uh, goal journey to train for an event, you should actually consult a practitioner and, and, and be checked for things like a general health check that looks at your, your general physical state, looks at your blood pressure, looks at your sugar control, looks at your joint, uh, mobility and your muscle movement, et cetera.

[00:08:29] Dr Darren Green: And also then gives you the assurance. Uh, as to how you should commence in a progressive way. Mm-hmm. You know, your, your exercise program, which I'm sure we'll talk about a little bit more later mm-hmm. But just understanding that checkup initially for the health screening component. Uh, a simple example, Ayanda.

[00:08:47] Dr Darren Green: If you look at someone's blood pressure, most people don't know that when you start exercising as a novice, uh, your blood pressure goes up. So if you have high blood pressure and you didn't know about it, and [00:09:00] it's often referred to as the silent killer, cuz you don't have any symptoms of high blood pressure.

[00:09:04] Dr Darren Green: Mm. Initially what happens then is you'll see that this would lead to the blood pressure going up when you start training initially, and that could, could have risk factors involved that affect you down the line. However, if you do check your blood pressure and you get it under control before starting to exercise and applying a decent exercise program, you know that you can do so in a gradual safe way.

[00:09:26] Dr Darren Green: Uh, but down the line, the benefits of exercise, for example, in the cardiovascular system is actually lowering the blood pressure. It's one of the lifestyle interventions to get you off pills and, uh, to actually look at targeting, lowering your blood pressure from different angles. Mm-hmm. Which is quite magnificent in its own way.

[00:09:45] Ayanda Charlie: Mm-hmm. Now, let's say I've got a clean bill of health, as you say, right? Okay. I know I'm fine, right? Um, I walk, I'm, I'm, I'm pretty active and I'm like, you know what? I'm gonna, I'm gonna hit the, the, the five kilometer for the first time, and I'm just [00:10:00] gonna, I'm just gonna hit the streets. I'm not really gonna try and prepare and overdo it.

[00:10:04] Ayanda Charlie: Too many people say, you know, it's, it's, maybe I commit better when I, when I commit last minutes to things. What happens to me if I don't prepare and I just go straight to the race? [00:10:13] Dr Darren Green: Haha! Under-prepared. Well, I remember I spoke about that whole word conditioning and conditioning means, uh, gradually increasing the demand from this physical meat box, the body and its muscles and bones and joints.

[00:10:27] Dr Darren Green: Uh, and then obviously improving your ability to handle increased load. Load in terms of the intensity, the frequency of your exercise, the. Type of exercise as well and obviously how fast you exercise and the times you want to achieve. So if you, if you have a mismatch of your body adapting to handle that load and you just.

[00:10:48] Dr Darren Green: You know, pummeling on the load too quickly. What happens? Ask anyone that wants to New Year's Day. What do we all do on New Year's Eve? We hit the gym tomorrow. I'm hitting the gym. Yep. Gonna undo all these bad choices over [00:11:00] December. And then we hit January, businesses booming at the gyms. And then what happens?

[00:11:04] Dr Darren Green: People hit it hard to ease their conscience. Mm-hmm. And to try and undo the damage. And what happens? They can hardly walk after that. Mm-hmm. They have typically within 48 hours a medical condition called DOMS. Now this has got nothing to do with the Afrikaans word, ‘dom’, which means to be foolish. DOMS is delayed onset of muscle soreness, which often arises from over training overreaching or going, uh, into an activity and a load that is too high too soon.

[00:11:33] Dr Darren Green: Mm-hmm. In terms of your conditioning, uh, process And that is what we need to obviously be aware of as people that go and take on, uh, large amounts of load or exercise without having done the prep before that. Mm-hmm. There will be consequences. You might not be able to walk, ask anyone that does a big legs day in terms of weights in the gym as well, and they can hardly walk up the stairs the next, uh, you know, after 48 hours.

[00:11:58] Dr Darren Green: Mm-hmm. So those kind of [00:12:00] things. And then the increased risk of injury is probably the most important thing to mention. So if you want to maintain momentum in moving towards a goal, whether that goal be weight loss, whether that goal be competing at an event, and actually making a to race day to take part in that event, you need to consider that you, you run the risk of being injured prematurely by putting too much strain and load on the body for the adapting phase and process during exercise.

[00:12:28] Dr Darren Green: Mm. And then you're gonna drop out and you're gonna have a major complex around not even pitching on race day. Which is what we don't want. We wanna look at how we can optimize you, I almost said living your best life, optimize you running your best race. You know, that's what we want.

[00:12:45] Ayanda Charlie: Now, how far in advance should I begin training for the event?

[00:12:47] Dr Darren Green: So this would be absolutely dependent on firstly, what type of event. So remember, we, we, I. I'm involved with such a, a spectrum of events. There are one day events, like let's say you're cycling, [00:13:00] uh, 98 to a hundred kilometers in one day. Then you have multi-stage events like mountain biking events where people are on a bike for nine days, like the, the Cape Epic or the Wines to Whales cycling event where you, uh, on a bike for three days, uh, you know, and then you have a marathon.

[00:13:18] Dr Darren Green: Which is a very far long distance in one day. Uh, and then you have different other sports like rugby, netball, athletics, uh, whatever that people want to do, where they have a very short period of actual activity and demand on the, on the physical body. But everything, you know, culminates in that one moment of an hour that you spend in that moment.

[00:13:41] Dr Darren Green: So when we look at, uh, in terms of, uh, planning and so forth, I think the most important thing here is, uh, depending on the type of event is to seek guidance and advice and help from someone that is an expert in their field regarding helping you set your goals [00:14:00] realistically, uh, but also giving you an indication as to what it would require.

[00:14:04] Dr Darren Green: Before you start training. In other words, if you want to, uh, compete in a a marathon, you need to start training at least six months in advance. And depending on your baseline, you'd want to know obviously, uh, that you, that you've done well. Um, in terms of planning. A marathon might even be more than six months, uh, like the comrades marathon.

[00:14:26] Dr Darren Green: So depending on the distance and your baseline fitness, it might take a full year for someone that is, uh, sedentary and never run a half marathon, even to prep for something like the comrades marathon, in which case to prevent injury, you'd start longer in advance cause that conditioning process would mean, uh, that you would have to work on it over a longer period of time to avoid injury.

[00:14:49] Ayanda Charlie: Now, Dr. Green, let's say I wanna put together my own training program for the first time. What do I do?

[00:14:55] Dr Darren Green: I think you need to seek professional help, um, to get you, uh, into a [00:15:00] program that is safe and graded for you in terms of your level of expertise, your baseline level of fitness, and, uh, also that considers the holistic picture of your health, uh, and where you are in terms of your current conditioning.

[00:15:14] Dr Darren Green: Um, you know site and, and, and the insight rather, uh, along addressing risk factors in terms of the exercise program, takes into consideration what we call the FITT principles, FITT, the frequency of the exercise, the intensity of the exercise, the type of exercise, and then lastly, obviously the timing of the exercise.

[00:15:37] Dr Darren Green: How long should you go when you're a beginner? Um, how far should you go? Uh, at what level? If you're a cyclist, should you be setting the, the, the stationary bike if you using a what bike or a resistance bike in the gym, for example. Uh, and then, you know , the difference between walking, between lampposts, walking, running, walking, running, in terms of gradually, um, you know, [00:16:00] changing the load on the different joints, et cetera.

[00:16:02] Dr Darren Green: What we do know in terms of general health outside of eventing is that the recommendations, uh, you know, that, that, that we see by the World Health Organization for exercise and physical activity to stay healthy is 150 minutes of moderate exercise a week, all right? Or you could divide that up into 30 minutes over five days, or you could do two 75 minutes sessions of rigorous exercise, which basically means you can't talk because you don't have enough breath while doing the exercise for those that want an easy way of classifying it.

[00:16:35] Dr Darren Green: So, uh, hopefully that also helps. So I would seek out the, the, uh, the coaches that we have in the different sporting codes to advise you. Check their track record, ask your friends who have used someone to help them before. Ask about check-ins and follow up. Ask about their expertise regarding whether they take into consideration your medical condition.

[00:16:58] Dr Darren Green: If you're a diabetic, for [00:17:00] example, you'd need someone that is experienced in also navigating your nutrition with you. Uh, in terms of while you exercise, what should you be looking at in terms of your sugar levels? How do you adjust your diet, your fuel, your intake, your timing of insulin, et cetera, uh, in, in terms of those specialized coaching needs.

[00:17:19] Ayanda Charlie: Exactly, and I'm so glad you said that because. How do I stick to a program I've tried so many times to get ready for a marathon. Yeah. And the first two weeks I'm great. Then next thing I know, it's, it's a week before and, and I, I didn't stick to my program.

[00:17:36] Dr Darren Green: And, and the thing is, you, you know, with our lives being so hectic and so there's so many unpredictable things that happen, um, that one has to be adaptable.

[00:17:45] Dr Darren Green: So you must actually allow a little bit of grace for flexibility in your training like if you have to get 150 minutes of exercise just to stay healthy into your week. If you aren't doing it for, uh, one day because you got home at 10 pm and it was too [00:18:00] early to get up at five am, et cetera, you need to realize that your average for the week is gonna be less.

[00:18:06] Dr Darren Green: And your body certainly does look at averages over a period of time. So you need to try and work that in somewhere else and also consider, uh, you know that you need to be gracious and not be so hard on yourself if you do need to reschedule your exercise.

[00:18:21] Ayanda Charlie: Now, sleeping patterns, diet nutrition. We'll surely have to, to change and kind of work in, in service of, of your goal.

[00:18:31] Ayanda Charlie: In what ways is this important, you know, as a part of the preparation process?

[00:18:35] Dr Darren Green: Sure. So what you described there are all the foundational drivers of performance in the human race. Uh, and I think you mentioned sleep, you mentioned diet, we’re speaking about exercise and activity and so forth. And then obviously the fourth component would also be something like your mental health and your, you know, your cognitions.

[00:18:54] Dr Darren Green: Mm-hmm. So let's kick off with, I think the sleeping patterns. I think how much sleep does one need [00:19:00] between seven and nine hours, and you need between four and five sleep cycles a night to optimize your performance. Okay. And there's, there are many different aspects to your physiology, to your mental health, and obviously to, to overall health and wellbeing that are essential as part of the recovery, repair, and also prepping your body for the next day's tasks when it comes to sleep.

[00:19:25] Dr Darren Green: If you think about the benefits of exercise to your body, there are smells, there are sights, there are feelings involved while you exercise. That are all incorporated into your complexity as a human being in terms of your memory, in terms of your sense of emotional wellbeing as well. And, uh, if you don't sleep, you actually rob your body of the interpretation and experience of all the benefits that you've actually, uh, put in.

[00:19:54] Dr Darren Green: To exercise and increased physical activity with all the sacrifices you're making. So the [00:20:00] role of food as fuel for your daily activity is quite important. I know many coaches that coach, uh, in terms of obesity and, and uh, looking after your physical health, they work a lot on your cognitions around before putting something into your mouth actually thinking, is this, uh, this food that I'm putting into my body for the exercise, is it.

[00:20:22] Dr Darren Green: It's contributing in a positive or a negative way to my overall health? In other words, does it have value to the muscles, the bone, and so on? When you actually start thinking about that, oh my word, you think, if I have too much of that I'm gonna cause inflammation in the body, but if I don't, I'm actually fueling it to do its work properly.

[00:20:41] Dr Darren Green: And that helps a lot of people to make some better decisions around nutrition and plan adequately.

[00:20:48] Ayanda Charlie: Well, speaking of fuel, uh, maybe let's take a quick break, fuel ourselves up and maybe talk about who fuels this podcast, which is Mediclinic. We’ll be back with Dr Green shortly! But first, we wanted to share the details of the Mediclinic 24/7 Helpline. You can call the number +27 86 023 3333. The 24/7 Helpline is no longer only for medical enquiries but can even go as far as assisting you with making a booking for the doctor. So we're back with Dr. Green and we've spoken about the buildup to the race or event, um, and the best ways to go about training and preparing.

[00:21:28] Ayanda Charlie: Now, let's consider the big day. Dr Green, what are some, you know, pre-race rituals, um, you know, warmup routines, different things that I can do to manage my mind and my body, um, and prepare it for, for good performance on the day of.

[00:21:44] Dr Darren Green: Yeah, it's a, it's a good question. I think there's some big overarching principles that I'll speak to, but remembering once again, that there's such a diverse.

[00:21:54] Dr Darren Green: Um, set of habits between the different sporting codes. So when we speak about cycling, there's [00:22:00] certain things you do, when you speak about running there's certain things you do when you speak about, uh, swimming and triathlons also different. So there's specific niche little habits that that creep into the different sporting codes that are quite useful.

[00:22:14] Dr Darren Green: But let's look at some big overarching principles I think just to kick it off and, uh, you know, if you didn't do it in your training, don't do it on race day. So a simple, simple example of that is your nutrition. So people wanna know what must I eat on the morning of the big day? I mean, we all remember Bruce Fordyce and his wonderful story about having a massive chocolate cake before the comrades every, I remember my mom used to always love using that as a motivation to make a cake and eat it.

[00:22:45] Dr Darren Green: And uh, Bruce Fordyce, for example, was a, a tremendous, uh, athlete and still is a tremendous athlete. Uh, but if you think about it, don't go and change the normal habits and the routine that you've [00:23:00] actually applied during the buildup to your race day. You train with demands that, uh, move up, you know, progressively to simulate what's gonna happen on race day, whether you're cycling, running, uh, or training for a rugby match.

[00:23:15] Dr Darren Green: For example, during training, you're training for the same period of time. You're doing the same types of exercise in terms of cardio work, endurance work, strength training, agility training, mental fatigue, uh, conditioning and mental, uh, focus and concentration, exercise, et cetera. So when it comes to race day, firstly, do the things you were doing perfectly well beforehand, and what are the things you do well?

[00:23:39] Dr Darren Green: Well, you make good decisions around discipline about going to sleep at night. You make good decisions around eating meals and food types that you normally eat at home. A lot of people are looking with their anxiety for something to boost them on race day. So what do they do? I see the effects, uh, you know, costing people, them, uh, costing their race [00:24:00] when they take things like energy gels and, and, um, these caffeine gels on the day hoping to get more energy, uh, more of a boost.

[00:24:09] Dr Darren Green: They anticipate getting tired and being, uh, you know, and being anxious about the last hill that they have to climb. Then they do things that they didn't do while they were training, and then they take all sorts of desperate, uh, supplements, uh, during the race, which costs them eventually cause then they start developing.

[00:24:28] Dr Darren Green: Uh, simple example is osmotic diarrhea from the high, high, uh, sugar content gels that they're using during these races and not having used them before. The caffeine, for example, in the energy, uh, supplements. Uh, if you haven't trained with them and don’t know what it does to your heart rate and your resting heart rate and the rhythm of the heart, suddenly you have a pulse rate of 180 even at rest.

[00:24:51] Dr Darren Green: And you don’t know why, cause you've triggered, uh, you might have a predisposition genetically to abnormal heart rhythms and irregular heart [00:25:00] rhythms. So very important, uh, in the buildup and on race day as well to consider these things. But, you know, I know the biggest mistake people make is they anticipate the pain mm, afterwards, and they wanna minimize the, the, the post event complications of, uh, you know, of muscle soreness, joint pain.

[00:25:20] Dr Darren Green: So what do people do? While running the race they actually pop pain medication for pain during the race and pain after the race. What people fail to know out there in terms of eventing medicine is that the use of anti-inflammatories has a major effect on your kidney health and can actually have dire consequences in you needing dialysis, losing your kidney function permanently down the road, and then also obviously prematurely ending your race.

[00:25:54] Dr Darren Green: So the use of anti-inflammatories in endurance events is not recommended. The damage to the [00:26:00] kidneys, especially in the absence of sufficient hydration but also the, the local mechanism of how it damages the kidney cells that also affects blood supply to the kidney are just two mechanisms that we know about already. So people need to be made aware of that.

[00:26:16] Ayanda Charlie: So Dr Green, what strategies can somebody who, you know, suffers from a lot of race day anxiety and nerves employ and maybe, you know, there's a checklist, right? That kind of covers everything that I need to cover on the day of that you can give us.

[00:26:31] Dr Darren Green: Yeah, I think, uh, importantly I think there's a physical checklist, as in to decide when should I participate or not?

[00:26:36] Dr Darren Green: That one needs to know about and I think, uh, acute conditions, in other words, things that are no-nos to start. If you've got proper flu and you've got body pain, fever, for example as well, and you're coughing, you've got a productive cough a and you feel short of breath, even with minimal amounts of exercise, you shouldn't be participating on even day.

[00:26:57] Dr Darren Green: I think if you've got gastroenteritis and your gut is obviously in turmoil, you're gonna have problems with absorbing fluids, food, and balancing your fluid electrolyte, uh, you know, match during the event. So be aware of that as well. We often use a sign, which is the, what we call below the neck sign, if you've got lymph nodes as well with your sore throat, et cetera, accompanying the fever and body pains.

[00:27:25] Dr Darren Green: Then you shouldn't take part. I advised nobody on antibiotics to take part on a, on a, on an endurance event as I've mentioned. And then of course, uh, obviously also considering any form of chest pain that could be related to either the different causes, the heart itself when you exercise your develop pain like angina.

[00:27:47] Dr Darren Green: Uh, in view of possibly having blocked vessels, and then obviously the membrane around the lung, which is called pleurisy or pleuritic type chest pain with a recent chest infection. Uh, also important, uh, to not, [00:28:00] not neglect chest pain, shortness of breath, and irregular heart rhythms or palpitations. When it comes to managing just the component of anxiety and performance anxiety, before the event, a few tips there.

[00:28:13] Dr Darren Green: There are many techniques that you could use that contribute to your success. The first one being breathing techniques, and certainly there are lots of apps now that can help you with decent breathing exercises and how the breathing can relate to getting your body into a relaxed physiological state.

[00:28:30] Dr Darren Green: Then we speak about meditation and mindfulness practices, which you can practice every day for 10 to 15 minutes, even a quick exercise, um, uh, you know, to help you have what's called selective focused attention. That ties in also very nicely with another technique that I recommend to athletes, whether you're an amateur or a pro, which are, which is called positive visualization.

[00:28:53] Dr Darren Green: In other words, you sit there. While you're laying on your back and you picture yourself doing well, going [00:29:00] past the, you know, the 85 KM mark, you see yourself coming around the corner with the crowds roaring as you make it to the finish line, and you visualize successfully completion of the actual, uh, sporting code that you're doing and the event.

[00:29:15] Dr Darren Green: And that in itself has a, a hell of a lot of structural change in the brain in terms of your goal setting and positive visualization to help you overcome the anxiety, obviously, on race day.

[00:29:28] Ayanda Charlie: So, Dr. Green, what is your recommended post-race recovery plan to promote that muscle repair and reduce post-exercise soreness or fatigue?

[00:29:38] Dr Darren Green: So after the event, what actually happens is your body, like having a pregnancy for example, needs to return physiologically to its norm and how it does this is quite interesting. Uh, something that happens spontaneously without you thinking about it, but you can aid this process by making good choices.

[00:29:58] Dr Darren Green: Hydration and electrolyte [00:30:00] balance, for example, is a very important one. One of the most important things post-exercise that you need to consider. How do we know, uh, what to do? Well, firstly, are you passing urine? Are your kidneys working? Have you been to the loo after your event? How often are you going to the loo?

[00:30:16] Dr Darren Green: And more importantly, what does it look like? The color of your urine tells us so much about the condition post metabolism and post event. In other words, if your urine is dark and concentrated looking almost orange, it could be from all those vitamin tablets you've been taking for the race, the energy boosters, that the, that those vitamins are now obviously not being absorbed in the body and passing straight through, coming into the urine.

[00:30:44] Dr Darren Green: More likely it's related to concentrated urine where you just haven't ingested enough water as such to dilute all the salts and the different, uh, you know, dissolvent to solvents as I've mentioned. So thinking specifically about the [00:31:00] electrolytes as well, you must also imagine if your urine is coke colored.

[00:31:04] Dr Darren Green: It's a warning sign of other medical emergencies that you could have actually been breaking down your muscles in search for energy and a source of fuel to fuel your exercise in endurance events and the coke colored urine could show kidney failure as well as muscle breakdown condition we call rhabdomyolysis, for example, this is a life-threatening condition that could lead to, uh, serious, uh, complications, including deaths if not addressed quickly.

[00:31:33] Dr Darren Green: So abdominal cramps, abdominal pain, and cramping in your muscles itself should get better with rest and rehydration and, and, and additional fuel sources afterwards, for example, so a lot of people laugh at me when I say they're one of the, the best things to take as a, a high protein flavored milk. You know, like our normal colored milks, like, uh, Steri Stumpy or something like that.

[00:31:57] Dr Darren Green: It's the poor man's, the poor man's [00:32:00] post event recovery drink. Uh, cuz it contains the right amount of protein and the right amount of nutrients to help you recover. But for a long distance event, obviously you would've done your pre-nutrition, your nutrition during the event, and you shouldn't have such a big deficit after the event as well in terms of nutrition because of that planning and that expertise.

[00:32:22] Dr Darren Green: So I hope that helps some people just in planning some of their post-event recovery.

[00:32:27] Ayanda Charlie: How then do I gradually return to being a human being and not superwoman back into my regular training, you know, in physical activity after completing the event to avoid injury and to allow for adequate recovery?

[00:32:40] Dr Darren Green: Absolutely. So I think one of the biggest things is not to, not to take too long to get moving again. You'll often find the marathon runners will know that the next day they're already taking a walk out, uh, and having a light run to mobilize, obviously the lactic acid out of the muscle. They go for massages as well in [00:33:00] terms of moving that muscle, getting it pliable again cuz it all locks down afterwards.

[00:33:04] Dr Darren Green: And then what you want obviously is to optimize your load gradually, as I've mentioned, uh, as well. So just a light run, getting the, the joints mobile again, getting the muscles perfused with decent blood supply as well. Uh, and then obviously while you're doing that, you then allow the, the movement oft the fluid.

[00:33:22] Dr Darren Green: If you had swelling and of blood pooling in your legs, et cetera, you'll notice the swelling start to go down. You'll notice obviously, uh, the, the, the ease and the, and the cramping become less, and the stiffness of the, of the, the muscles and joints certainly also become less. And that would then obviously lead to.

[00:33:40] Dr Darren Green: Greater mobility and the ability then to, to return to training with the lower risk, uh, of injury. That load as to how much you should do straight afterwards would depend on what you've done, the intensity of the event you've done, uh, the endurance event, et cetera. Uh, and, uh, you, you just must make sure [00:34:00] that in this post-event recovery period that you, uh, monitor your symptoms and monitor obviously.

[00:34:06] Dr Darren Green: The, the different musculoskeletal aspects in terms of your training program. And, uh, as I, as they say, you don't want to sit still and, and reminisce in the glory of completing the event while you become, uh, obviously a stiff piece of biltong before the next one. And that's, that's important.

[00:34:25] Ayanda Charlie: Dr Green thank you so much for being with us today. You've given us so much useful information, helpful insights for preparing our bodies and minds adequately before a big sports event or race.

[00:34:36] Dr Darren Green: Fantastic. I look forward to seeing you on the finish line at our next event.

[00:34:42] Ayanda Charlie: As we wrap up today’s discussion, it’s evident that success lies in the intersection of physical, mental, and strategic preparation. We’ve explored the importance of training plans, nutrition, injury prevention, and self-care. Remember, it’s not just about crossing the finish line, but enjoying the journey along the way. Embrace the challenges, savour the milestones, and stay committed to your goals. With a balanced approach, perseverance, and a supportive community, you will be well-equipped to conquer any sports event or race. So, go out there, chase your goals, and may each step be a testament to your passion and perseverance. Good luck, and happy racing!

[00:35:08] Ayanda Charlie: Thank you again to Dr Darren Green for being with me today. And to all of you who joined me in listening to this episode of The Sports Series podcast, powered by Mediclinic. If you haven’t yet done so, subscribe to our podcast channel and sign up for the Mediclinic Prime newsletter, packed with great health articles; a bi-weekly series of newsletters focused on young families – the link is in the show notes too. Until next time.