5 Life-Saving Signs of Heart Trouble Every Cyclist Should Know

Riding a bike is indisputably good for your heart, but it doesn’t make you immune to heart disease. Here’s what one heart surgeon who rides wants everyone to know.

By selene yeager February 1, 2016

Listening to your body isn't just about avoiding injury—it's also about recognizing it. Photograph by Philip Choi/Flickr

In some ways, we health and fitness reporters are a bit to blame for misconceptions about our favorite topics. We get so excited about all the health benefits of cycling, and all the ways riding a bike strengthens and protects your heart and prolongs your life, that it’s easy to think riding makes you immune to heart problems. That assumption can lead you to brush off some serious symptoms.

“You see it all the time: Men in their 40s and 50s who are healthy and recreationally active, like cyclists and triathletes, make the assumption that because they’re active, heart disease won’t happen to them. That’s not necessarily true,” says Larry Creswell, MD, a triathlon enthusiast, heart surgeon, and author of the Athlete’s Heart Blog. Creswell admits to having had similar thoughts when he took up endurance sports. “I was really surprised when I started swimming and running and cycling in my 40s how many of the folks I trained with either had a heart problem or knew someone with one—pretty much everyone! Exercise helps strengthen your heart and is good for cardiovascular health. That is a certainty. But there’s obviously no guarantee that everyone who exercises will be forever immune to heart disease."

The good news is that because you are physically active and in tune with your body, you’re likely to see the signs before they become serious. You just need to recognize and heed them. We tapped Creswell to share five key symptoms that your heart could be in trouble—signs many riders (especially men) ignore.

Chest pain or tightness: Seems like a no-brainer, right? “I can’t tell you how many guys who have had a heart attack or other cardiac event say that they had some chest pain and/or tightness and ignored it or figured it was something else,” says Creswell. “That is the one thing that always surprises me.” To be fair, Creswell concedes that everyone feels pain differently and if you’ve never felt chest pain and you’re a healthy cyclist, it’s easy to think it must be something else like acid reflux or a pulled muscle. “The defining characteristic is that it is brought on by exercise and it subsides when you rest,” he says. “It is generally very reproducible in character." If you feel intensely during exercise and it subsides when you're at rest, get to the doctor ASAP.

Abnormal heartbeats: Heart palpitations are another symptom that you should never ignore. “Pay attention anytime you have the sensation of having an abnormal heartbeat,” says Creswell. It could be pounding in your chest or a light, fast fluttering. If something doesn’t feel right, that’s a sign that it isn’t. “This is where your heart rate monitor can really help,” he says. “If your heart is suddenly zooming along at 210 beats per minute for no good reason, that’s a sign to get checked out. Same thing goes if you’re at home going through your data file and you see episodes where your heart rate is pushing 200 or so when you felt like you were going along at 125.”

Mysterious shortness of breath. If you’re a cyclist—no matter what your level—you know what your breathing pattern is like when you’re riding. When it doesn't feel normal for the exertion level you're at, particularly if you’re cruising along fairly easily and suddenly working to catch your breath, something is wrong. This is another easy one to blow off as something else, says Creswell, and indeed it might be. “You could be fatigued or coming down with a cold or virus. But it’s a warning sign and if it’s unexplained, you need to get it checked out,” he says.

Unexplained fatigue. This one generally shows up off the bike. You’re just run down and hunting for a quiet place to nap for no good reason. “It also can show up as a performance decrement that is unexplained,” says Creswell. “If for no good reason, you’re tired on the bike and not progressing or you’re even regressing, it’s a warning sign.” 

Nearly blacking out. This is a big red warning flag. If you are nearly blacking out—or worse, actually blacking out—while you’re exerting yourself, it’s really dangerous for a few reasons. One, you could crash. Two, you could suddenly die from a serious underlying heart problem. Get it checked pronto.

Women take note, your heart problems may not present so obviously, particularly in the chest pain department. “Chest pain presents differently in women. It may be less severe or be more difficult to pinpoint where the pain is coming from,” says Creswell. “The other symptoms I mentioned should still demand your attention, especially since you may not have the same early warning in the form of chest pain.”

One last crucial heart care tip: Get a regular check-up from a primary care doctor. “This is where women are often at an advantage. They tend to go to an OB/GYN regularly, so they get their blood pressure checked; they get some blood work done," says Creswell. But guys? "There are men who are healthy and in their 40s, maybe even their 50s and they don’t have a primary care doctor. They’ve never had their blood work done, and can’t remember last time they had their blood pressure checked. If you’re going to spend all that money on a nice bike and bike computer and maybe even a power meter and a coach, get yourself a doctor, too! It’ll cost a fraction of all that and take less than an hour out of your year!” 

Advice For Aging Athletes

Build your core and leg muscles to stay strong and steady over time.

By William O. Roberts, MD Tuesday, January 5, 2016, 12:34 pm

Zandra asks: I am 81 and still love to run. I like to do half-marathons. But I am feeling increasingly ill at ease on the trail because I am getting slower and slower. It often feels that the trail is no place for old ladies. What do you think? 

Good for you to still love running at age 81. I hope to be like you. If "ill at ease" means you are worried about how you look because you are slower, I would say push on and have fun. But if you are uncomfortable with your strength and balance, we are talking about a different issue.

Physical activity is a use-it-or-lose-it proposition, especially in your ninth decade. A fall and fracture of the hip does not bode well for people over 65, especially women. You can improve your balance by working on your core and leg strength. There may be classes at your local fitness center or YMCA that help you with this. You may or may not be the oldest participant, but you will be an inspiration to the younger crowd.

I am also not sure what you mean by “on the trail.” Literally speaking, that would refer to trail running, which is a challenge at any age due to the inconsistencies in the surface. Exposed rocks and roots and loose debris can upset your balance and bring you to the ground. But "on the trail” can mean heading out on the roads or running path to put in some miles. At 81, I would usually recommend staying on relatively smooth surfaces with good traction.

Almost everyone gets slower with age. That is not a bad thing, just the way it is. People also tend to get weaker with age, and that is a bad thing. You will need to work on your strength to keep your balance even if you choose not to run. If you enjoy running, even though it is at a slower pace, keep it up. It is good for your heart, good for your body, and good for your soul.

Should Your Muscles Be Sore After Every Workout?

• By Tony Gentilcore

We've all been there.

The day after a brutal squat session or copious amounts of dumbbell flies and bicep curls, you're finding yourself cringing as you walk down a flight of stairs or reach up to grab your toothbrush.

You're sore and maybe cursing that last set of deadlifts from last night.

DOMS

The soreness you feel can be attributed to delayed onset muscle soreness (or DOMS as it's more affectionately referred to), and it's a phenomenon that's been well researched over the years. The feeling often manifests within six to eight hours post-exercise and peaks up to 48 hours afterward.

Some people seek out DOMS no matter what. They gauge the effectiveness of their training sessions on how much of it they can elicit, thinking the more sore they are, the more progress they've made.

Others avoid DOMS like a bad movie. For the non-masochistic, being sore isn't pleasurable. These people often find themselves wondering why they never make any progress.

So, which vantage point is correct?

Both.

What Causes DOMS?

First and foremost, it's important to understand what doesn't cause DOMS: lactic acid.

Everyone from our middle school gym teacher to our mailman used to attribute soreness with a build-up of lactic acid in the muscle. This myth was debunked decades ago.

Ironically, despite all the research, there's no clear-cut winner as to the exact mechanism. Our best guess, according to a 2013 study by Bret Contreras and Dr. Brad Schoenfeld, is that soreness comes from inflammation.

"DOMS appears to be a product of inflammation caused by microscopic tears in the connective tissue elements that sensitize nociceptors and thereby heighten the sensations of pain," the study states.

People Are Different

When it comes to soreness and whether or not it's mandatory to make progress in the gym, the answer is a loaded one.

In order to progress—whether your goal is to add muscle mass or lose fat—it's crucial to consistently challenge the body to adapt. This is done by making your muscles work—pushing things, pulling things, carrying things and doing anything else to add variety to your workout regimen.

When you try a new workout or unfamiliar exercises, your body is going to respond with some feedback on subsequent days. The common response? Muscle soreness.

Should Your Muscles Be Sore After Every Workout?

• By Tony Gentilcore

We've all been there.

The day after a brutal squat session or copious amounts of dumbbell flies and bicep curls, you're finding yourself cringing as you walk down a flight of stairs or reach up to grab your toothbrush.

You're sore and maybe cursing that last set of deadlifts from last night.

DOMS

The soreness you feel can be attributed to delayed onset muscle soreness (or DOMS as it's more affectionately referred to), and it's a phenomenon that's been well researched over the years. The feeling often manifests within six to eight hours post-exercise and peaks up to 48 hours afterward.

Some people seek out DOMS no matter what. They gauge the effectiveness of their training sessions on how much of it they can elicit, thinking the more sore they are, the more progress they've made.

Others avoid DOMS like a bad movie. For the non-masochistic, being sore isn't pleasurable. These people often find themselves wondering why they never make any progress.

So, which vantage point is correct?

Both.

What Causes DOMS?

First and foremost, it's important to understand what doesn't cause DOMS: lactic acid.

Everyone from our middle school gym teacher to our mailman used to attribute soreness with a build-up of lactic acid in the muscle. This myth was debunked decades ago.

Ironically, despite all the research, there's no clear-cut winner as to the exact mechanism. Our best guess, according to a 2013 study by Bret Contreras and Dr. Brad Schoenfeld, is that soreness comes from inflammation.

"DOMS appears to be a product of inflammation caused by microscopic tears in the connective tissue elements that sensitize nociceptors and thereby heighten the sensations of pain," the study states.

People Are Different

When it comes to soreness and whether or not it's mandatory to make progress in the gym, the answer is a loaded one.

In order to progress—whether your goal is to add muscle mass or lose fat—it's crucial to consistently challenge the body to adapt. This is done by making your muscles work—pushing things, pulling things, carrying things and doing anything else to add variety to your workout regimen.

When you try a new workout or unfamiliar exercises, your body is going to respond with some feedback on subsequent days. The common response? Muscle soreness.

6 Ways to Stay Fit and Sane This Holiday Season

It’s easy to derail your training over the holidays. Here’s how to stay on track.

By selene yeager

Somewhere between the parties, holiday shopping excursions, Christmas tree trimming, feast feasting, family hosting, New Year's parties—oh, and that thing called work, you may find yourself glancing longingly at your bike, wondering if you’ll ever find a moment during the holiday season to steal away for a ride. You may fret that all the fitness gains you made and body fat you shed this season will go the way of leftover eggnog: down the drain.

Easy. Everyone gets a little nuts during the holidays. You may not be able to get on your bike as much as you’d like between now and 2016, but with a little creative planning, you can maintain a consistent riding schedule that will keep you cheerfully rolling right through the holidays and ready for the riding season ahead. Here’s how.

Set up your indoor salvation station. Find a corner of the house where you can have your rollers or bike trainer set up and ready to rock, complete with iPod, TV, entertainment of choice, fan, heart rate monitor, towel and anything else you like to have on hand for an indoor training session. Lay out a pair of bibs and your shoes and slip into them Superman-style when you have 30 to 60 minutes to spare (early morning rides before the troops rally work best). Within an hour, you can be on and off your bike with a great workout in between.

Make it a HIIT sesson. Whether you’re inside or out, when time is short, make every second count with some intervals. After a warm up, try Tabatas (20 seconds full gas, 10 seconds rest, 8 times; 2 to 3 sets) or 2 to 3 sets of 40/20s (40 seconds on, followed by 20 seconds rest). Once or twice a week is all you need (and no more).

Do the Core Four. No time for even a short ride? You absolutely have 10 to 15 minutes for these full-body strength-training moves. Do squats, bird dogs, side crank planks, and push ups (one minute each), one after another with no rest. Repeat the circuit two to three times.
 • Squat: Stand with your feet hip-width apart and toes pointed forward. Push your butt and hips back as if you were sitting in a chair and lower down as far as possible while keeping your weight on your heels and extending your arms overhead. Return to the starting position and repeat.
 • Bird Dog: Kneel on your hands and knees. Keep your back straight and your head and neck in line with your back. Extend your right arm and left leg, brining them up and in line with your back, or slightly higher than your trunk, if possible. Your fingers and toes should both be pointed. Pause, squeezing your glute and back muscles to maintain balance. Return to the starting position, and repeat to the opposite side. Alternate for a full set on each side.
 • Side Crank Planks: Lie on your left side with your legs extended and feet stacked. Prop your upper body up on your left elbow and forearm. Raise your hips until your body forms a straight line from your ankles to your shoulders. Bend your top (non-supporting) arm and put that hand behind your head, elbow pointed toward the ceiling. Keeping hips stacked, slowly rotate your torso, bringing your elbow toward the floor. Rotate to start. Repeat for 30 seconds. Then switch sides.
 • Push Ups: Assume a classic push-up position, legs and arms extended and hands beneath your shoulders. Bend arms and lower chest until upper arms are parallel to the floor. Push up back to start. Repeat.

    Meet them there. Is your family heading to a holiday gathering somewhere relatively close-by? Toss a change of clothes in the car, kit up, and ride over while they drive. You’ll squeeze in a nice ride and feel better about sampling the cookies and finger foods when you get there.

Embrace creative cross-training. Yes you’re a cyclist. No there’s nothing quite like your bike. But there are many ways to get a little exercise and maintain fitness. Skip the mall and go shopping in the big city for a day (sans subway, cabs, and uber). Build a giant snowman with your kids. Go sledding, ice skating, or for a nice snowy hike.

Keep it moving. You’re bound to find yourself captive at the in-laws, in the airport, or entertaining at your own house at some point. That doesn’t mean you have to put yourself in a holding pattern of drinking beer and eating chips all day. Volunteer to help with chopping and peeling in the kitchen; take on a few household duties like dishes and laundry; putter around. Every bit of activity counts and keeps you from slipping into too much sedentary slothdom—but allow yourself a little bit of that, too. After all, it is the holidays. A little indulgence is a-okay, especially when you’re otherwise on track.