The Navigator has moved!

Today the Crickles Navigator moved to navigator.crickles.org. The links to the Navigator from this site have all been updated. If you have an old link bookmarked please replace it. Updates, including the addition of new athletes, will not be retrofitted to the previous version and I expect the old link will soon stop working.

The reason for this move is to migrate the Navigator to Amazon Web Services, which has several architectural advantages and in the short term also avoids some costs now that usage is increasing.

Relative CSS on the Navigator

The Crickles Navigator now has two new tabs: Relative CSS and Relative profile. These enable an athlete to compare their cardiac stress and its component with other athletes over the period defined by the date range (which currently defaults to six weeks).

Relative CSS ranks athletes on Crickles by total Cardiac Stress Score over the chosen period. Athletes at the high end may wish to consider whether they have built adequate recovery into their training plans, especially if they find themselves consistently accruing more cardiac stress than peers.

The obvious reason why one athlete’s total cardiac stress can be higher than another’s is that they’ve simply done more activities. However, it may also be that their activities are on average longer and/or done at higher intensity. Both duration and intensity can be explored using the Relative profile analysis. This comprises two density plots. The first chart shows the distribution of duration of the activities in the period. The green area plots this for the selected athlete, while the blue area shows this for the rest of the athletes in Crickles (excluding the athlete selected): for example, if there’s a large bulge of green over to the left of the blue area it will indicate that the chosen athlete does more short rides than the other athletes.

The second chart on Relative profile is a similar plot for intensity. This chart also has a dotted red line to highlight rides where cardiac intensity exceeds 100. This isn’t a “magic number” but large differences between the green and blue areas to the right of this will be indicative of how frequently athlete activities (in green) reach the highest cardiac intensities compared to activities of the rest of the Crickles cohort (in blue).

Using the Crickles Navigator (updated)

Anyone with a Strava account who has signed up to Crickles can see analysis of their Strava activities on the Crickles Navigator. Here’s how to use it…

First, choose an Athlete from the drop down list. Unless you asked me to change it, you’ll be identified on the list by your first name followed by your StravaID in brackets – for example, I’m Ian (301194). Your name can be reached quickly on the list by typing in the first letter of your name (e.g. “i” in my case). When you return to the Navigator (using the same device), the Athlete you last chose is remembered.

Next, if you want to navigate and compare only those athletes who share your gender or are in one of the clubs supported by Crickles you can do so by selecting it from the Groups dropdown. If you know of a club, or a group of friends, with members in Crickles whom you’d like to see as a group, or if you want to change the membership of one of the groups, please let me know. Even if you are in one of the groups, it can be useful to compare your CSS against the entire Crickles population (“All”) too.

The default page on the Navigator is now Relative CSS, which is described here. There are also several other pages, which appear as tabs. Most of the pages are incomplete until you’ve chosen an athlete. Once you do so, your activities over the past 6 weeks for which Strava has heart rate data are loaded into the Navigator.

If you want to see activities over a period other than 6 weeks, change the Date range in the left hand sidebar under Athlete. Once you get used to the date controls it’s fast to make a change. For example, if you want to set the range to start on 1st Jan, 2015 (currently the earliest available date) click in the first date field to get a widget like this:

calendar

If you click on the month/year at the top (December 2016 in this example) the widget will change to something like this:

cal month

You can hit the <<‘s at the top left to change to 2015 and then click on Jan to see a calendar for Jan 2015, from which you can select 1st Jan, 2015, as required. Play with it; it’s easy.

As you change the Date range (or indeed the Athlete) most of the results pages will update to reflect your choice.

On the CSS Map there is a dot for each activity. The size of the dot represents the duration of the activity (Moving Time on Strava) and the colour represents Cardiac Intensity. Cardiac Stress Score (CSS) is given by the vertical position on the map shows the components of CSS and the x-axis represents time.

If you want to see more detail on the activities that are shown on the CSS Map look at the Activities tab. The easiest way to explore this is to click on the column headings. For example, if you want to sort by date, click the Date heading:

cal date

Clicking it more than once alternates between an ascending and a descending sort order and the little arrows change accordingly. For example, if you see this, it shows that the table is sorted by Date in descending order:

cal date descending

You can do the same on the other columns too – for example, to find the activities with the largest CSS or HR Intensity just click on those headings until you get them in a descending sort. I’m afraid the column centring on the table isn’t great.

The This week tab shows the five most active athletes over the past seven days plus yourself (or whichever athlete you chose) if you’re not in the five most active. The athletes are colour-coded on this map and in addition activities of the chosen Athlete (typically you) appear as a triangle rather than a dot. This week does not respond to changes in Date range.

If you constantly find that your CSS values are higher than everyone else’s you might want to consider whether you’re overcooking it. It can also be interesting to compare CSS with other that of other Crickles athletes when you do the same event.

Like the CSS Map and Activities, the Fitness tab is also blank until you choose an athlete. When you do so it will chart the Crickles’ estimate of your (or the chosen athlete’s) Functional Threshold Power (FTP) and Lactate Threshold Heart Rate (LTHR) over the Date range. FTP only appears to the extent that you have cycling activities with power readings on Strava – no FTP, no green power line. LTHR is calculated from any activities (not just cycling) for which you’ve used a heart rate monitor – no HR, no red LTHR line. The Fitness tab will be re-drawn whenever you change the Date range. The earliest date for which Fitness can be shown is also currently 1/1/2015. (At the very start of this period the estimated FTP and LTHR values may not be reliable until sufficient athlete data has been captured.)

The Seasonal tab is (currently) up to eleven charts for the chosen athlete, reflecting the time spent in each HR zone for each three month season since early 2015. Like This week, Seasonal responds to the Athlete that you choose but not to the Date range.

Newer tabs give (1) a picture of your relative All-in position, as described here:

“All-in” analysis on the Navigator

and Summary values, together with a comparison of how each such value compares with the overall Crickles population or a chosen group, as explained here:

New Summary tab for the Navigator

Activities are read from Strava every few hours so may not be up to the minute with your latest uploads. The time of the last upload is shown in the side panel.

Please let me know if you should see anything wrong or missing.

If you’ve signed up to Crickles but you don’t want your activities to appear on Navigator also let me know and I’ll take them off; I’d rather you didn’t but it’s always your data!

Coffee

Last week there was a letter in cycling weekly by a chap called Barry Jones. He had developed atrial fibrillation during a ride. It had been blamed by him and by the medics on coffee. I think it’s an example of “attribution bias”. This is when you look for the reason you want, rather than the real reason, to explain away a problem

For many years, doctors were taught that caffeine led to heart rhythm problems. Doctors have been counselling patients to avoid caffeine when they present with palpitations. There is no doubt that in overdose, caffeine can indeed cause heart problems.

But, “normal” caffeine consumption and the risk of heart rhythm problems has now been looked at in several large populations. The bottom line is that, for most people who drink only moderate amounts of coffee, caffeine intake is not related to heart rhythm problems, including atrial fibrillation (AF). Caffeine can also improve performance. As a cardiologist with an interest in heart rhythm problems and exercise, I have had to change what I advise over time.

Sadly, there is growing evidence that AF is related to exercise. The risks of developing the condition are many times higher in athletes, and there is an apparent relationship between exercise volume and intensity, particularly in men. I see many cyclists and triathletes who develop this problem in middle age. It is incredibly frustrating for them. The story of an athlete’s heart rate monitor showing high heart rates for long periods of time (not just the brief spikes we all see) along with a drop off in performance is classic.

It is possible, as with everything in life, to have too much of a good thing. Overall, exercise appears to be beneficial to health, at least in moderation; the upper limits aren’t well defined yet. I keep exercising (moderately) with adequate recovery. Life is all about balancing risks. But don’t blame the coffee when your heart rhythm goes haywire. It’s probably a consequence of your epic suffer score. And do seek medical attention – there is lots we can do, and lots you need to know.

Some references, for those who are interested:

Coffee

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579587/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859368/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200095/

Exercise

https://www.ncbi.nlm.nih.gov/pubmed/27830772

The Haywire Heart

There is little doubt that some exercise is good for you. Many studies have suggested that exercise improves many aspects of our lives, including delaying ageing, living longer and improving quality of life.

Exercise causes the heart to change. The heart rate slows, the right side of the heart enlarges and the left side of the heart thickens. Medicine doesn’t quite understand all the changes yet, and the limits of what is normal and what is not are gradually being worked out.

In recent years, there has been a vogue for more extreme exertion – look at the popularity of ironman events and ultramarathons. As a doctor, it’s a bit odd. Either patients seem to do nothing, or want to run the Sahara. There is no in-between.

As with everything in life, exercise brings its own issues, not only aching legs and torn muscles. There is little doubt that, like everything else, extremes carry their own risks. And, I don’t think we know precisely what those risks are, or the level of exercise at which those risks occur.

As a cardiologist, I see problems frequently. The most common situation is the middle-aged man who sometimes can’t keep up on the hills any more, and who has noticed his heart rate is off the scale at those times. Atrial fibrillation is a common heart rhythm problem which hits performance and appears to be associated with endurance exercise.

Pheidippides (Phidippides) was the famed courier who inspired marathon running (and died). His name lives on in cardiology. Phidippides cardiomyopathy describes a pattern of scarring in the ventricle which occurs after extreme exertion in some. The scarring can affect heart function and cause heart rhythm problems. The last definite case I saw was a man who completed the Paris-Brest-Paris randonneur event. 1200Km in 90 hours.

Chris Case (athlete), John Mandrola (cardiologist) and Lennard Zinn (athlete) have written a book – the Haywire Heart. The title is alarming, but get beyond this, and the book is good. It presents a balanced (well, reasonably) view of the pros and cons of more extreme exertion. It explains how the heart works, the problems that can occur and puts them into context. It doesn’t quite deliver on its promise on telling you how to protect your heart though. But I don’t think anyone knows how to do this yet.

Any endurance athlete who is interested in their heart should read this.

I’m still working (slowly) towards the Exmoor 70.3.

Links (some medical):

The Haywire Heart: https://www.velopress.com/books/the-haywire-heart/

Phidippides Cardiomyopathy: http://onlinelibrary.wiley.com/doi/10.1002/clc.20994/full

The Amount of Exercise to Reduce Cardiovascular Events (Hint: Almost 42): http://www.sciencedirect.com/science/article/pii/S0735109715075452

 

Mark

Dr Mark Dayer is a consultant cardiologist with a long-standing interest in the physiology of exercise. He last ran a marathon in 2001.

Z2 Challenge – results so far

I thought the Z2 challenge would be easy. To date, four of us have done it and it seems not to be. Here’s how it stands with Mark in pink, Sean in gold, Stuart in blue and me in green (all based upon the last 50 minutes of the session):

z2-challenge

Conveniently, we all chose target heart rates that were far enough apart to generate largely non-overlapping distributions.

There are a few ways to measure the tightness of the distribution (other than by eye). The metric that I’ve chosen is to sum the absolute value of beat-seconds away from the mean heart rate over the period. When divided by 3,000 (50 minutes), this gives 2.0 for Mark, 2.5 for Sean, 3.0 for Stuart and 1.4 for me (lower is tighter/better). That’s an average in my case of 1.4 beats away from the mean. Of my 3,000 second-by-second HR samples fewer than 25% were bang on my target value of 140 bpm.

A few more of you have said that you plan to have a go at this (and I foresee a couple of re-tries from us four). Come on, people someone has to nail this!

How to quantify “Exercise dose”

Exercise has unparalleled efficacy in the prevention of a broad range of diseases and ailments associated with aging. There is, though, increasing concern that our generation of endurance athletes is the first in which so many people have systematically engaged in such punishing exercise activity so frequently over so many years. The consequence of this appears to be an increasing prevalence of arrhythmias in middle age: if exercise is a drug, our dosages may be dangerously high.

Cardiac Stress Score (CSS) is a metric that quantifies exercise dose. As well as looking at the absolute level of CSS, it is worthwhile to look at its components: Heart Rate Intensity and Exercise Time. Typically, in the off season we aim to spend a relatively high amount of time at a relatively low level of intensity. For example, here’s how the intensity and CSS of my own rides (I was only cycling) changed in the months from March to July in 2015:

2015_season

On the chart each vertical oblong represents a month, given in the header; each green point represents one activity; point size reflects the CSS; and position on the HR Intensity/Hours plane shows the components of CSS.

In March all but one of the rides is at low intensity (<0.6) although the exercise time ranges up to 5.5 hours. Over the next few months the intensity and number of rides both increase until by July the intensity is consistently over 0.8, even for longer rides.

This illustrates how CSS and its components of HR Intensity and Exercise Time can be used to plan and track cardiac stress, both in absolute level (CSS) and intensity (HR Intensity squared). The same information is also available (not shown) as a listing, giving the CSS and other attributes for each activity recorded on Strava.

Here’s how the year to date activities map out for several of our test cohort (each athlete is shown in a different colour in their own mini-chart):

time-v-hrint_sq

As expected, no one has gone mad yet: last year we collectively managed almost 20 activities with CSS of over 500, with the highest at almost 800. This year we have so far only accrued six activities with CSS over 300 and the highest level yet is under 400.

The activity profiles of the athletes vary. For example, Simon L is riding at a consistent intensity of around 0.9 over a wide range of times (one to four hours), while Paula has notched up many rides and runs within a narrower time band at a wider range of intensities.

Speaking for myself, the high-intensity bike rides reflect hard efforts rather than high power. In fact, it feels as though I’ve been over-reaching since Christmas and for the next few weeks I’ll be backing off a little, keeping my Garmin on but not looking at the screen. I’m happy to let the CSS rise but through longer, easier rides. On the chart, these may be of reasonable size but displaced to the left.

Z2 Turbo Session Challenge

It’s hard to be motivated for a low intensity base-building turbo session. Here’s a challenge to add some interest and focus…

Pick a day between now and next Sunday for a turbo/spin session; with the temp still ~0 it’s a good time for it. Set a personal target HR. For a Z2 effort I’d suggest 85% of your current LTHR (I can give you my estimate of your current LTHR). Do an hour on the turbo and try to stick to the target HR. When you’re done let me know and I’ll analyse your ride. The aim is to get the tightest HR distribution around your target level. In the calculation, I’ll discard the first 10 minutes of the hour so you can set your Garmin going straight away.

Visually, you’re looking for the histogram, which will look something like this, to get as narrow as possible:

z2-hr

Top tip: Although this isn’t a power challenge, using a power meter will cause your Garmin to sample more frequently so you’ll get a more sensitive, less blocky HR reading.