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NOT TAKING ANY CHANCES, triathlete Denise Chia, 10, undergoes the treadmill VO2max test at the Singapore Sports Medicine Centre. It is a measure of one's capacity to generate the energy required for endurance activities. -- MUGILAN RAJASEGERAN
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IN THE realm of endurance sports, there is a fine line between pushing the body's physical limits and self-destructing.
Knowing one's body is what keeps an athlete alive after punishing runs, gruelling bike rides and numbing swims, say experts.
'Listen to your body, and learn to judge its parameters like your heart-rate response to exercise,' said Dr Low Wye Mun, a sports physician at The Clinic @ Cuppage.
Added Adrian Mok, a 31-year-old triathlete whose achievements include five Ironmans (3.8km swim, 180km bike, 42.2km run) in the past six years:
'The beauty of triathlons lies in learning about your strengths and how to curb your weaknesses through challenging yourself.'
The two offer their advice in the wake of the tragic death of 17-year-old national triathlete Thaddeus Cheong last Sunday.
The Raffles Junior College student collapsed after finishing third in a South-east Asia Games selection trial.
He had recorded a personal best of 2hr 9min for the 1.5km swim, 40km bike ride and 10km run.
The incident sent shock waves through the sporting fraternity.
It prompted much concern over safety measures in endurance sports, particularly since they are becoming more popular.
Triathlon, for instance, has already gone mainstream.
From a mere 800 athletes four years ago, participation in the Osim Singapore International Triathlon swelled to 3,500 last year.
And all 3,800 slots have been taken up for this month's edition.
Thaddeus' death was the third endurance sport-related fatality in Singapore over the past two years.
In October 2005, Hewlett-Packard production manager Ho Wai Piew, 40, drowned in the swimming leg of his maiden triathlon after suffering a heart attack.
It was the first triathlon fatality since the event started here in 1982. It was later revealed that he had advanced coronary arterial disease.
Then came the death of Colonel Bernard Tan, 39, just 600m away from the finish line during the Singapore Biathlon in March last year. The event comprised a 1.5km swim followed by a 10km run.
This was classified as sudden cardiac death - whereby an otherwise healthy person dies owing to a heart ailment which cannot be completely prevented or detected.
Thaddeus' death was attributed to heart failure. But investigations into the cause are ongoing and will take about another month to conclude.
Such fatalities may appear to be a recent trend, but former triathlete and current president of the Sports Medicine Association of Singapore, Dr Jason Chia, said: 'In absolute terms, the risk of sudden death is low.'
According to studies recorded in the American College of Sports Medicine's Guidelines for Exercise Testing and Prescription, one death occurs for every 396,000 man-hours of jogging, and one cardiac arrest per 2,253,267 man-hours of exercise.
Notably, the recent mishaps coincided with the increase in 'initiates to the sport with less training background before their first races', said Dr Chia, an associate consultant sports physician at the Changi General Hospital and a one-time Ironman competitor.
He said: 'It's important to know that people can collapse and sometimes die during vigorous exercise for various reasons.
'Some of them are not related to the heart - heatstroke, for example.
'In instances of deaths due to heart problems, they occur as a result of pre-existing underlying abnormalities in the heart.
'To date, we have no conclusive evidence that strenuous exercise injures a normal heart.'
Dr Chia recommends that those who engage in vigorous physical activity undergo medical screening first.
Subsequent screenings will depend on the athlete's profile and medical history.
The screening should include a physical examination, full blood count, renal panel, electrocardiogram (ECG) and chest X-ray.
Both young and old should be on the look-out for musculoskeletal (muscles and bones) abnormalities, he said.
Those aged 55 and above should remain alert for hypertension, diabetes and symptoms of cardiac problems, though such screenings will not always be able to detect pulmonary artery diseases.
Less extensive screenings should be undertaken annually, which is what Parliamentary Secretary (Community Development, Youth and Sports) Teo Ser Luck, ensures he does.
Mr Teo, who has completed numerous triathlons since 2001 as well as three Ironmans within the span of a year, also stresses the importance of preparation.
'Endurance sports are long term,' he said. 'It took me almost two years of training before I had the courage to attempt the Ironman.'
Dr Low and Mok agree.
'Progressive participation in training will enable the athlete to adapt physically, physiologically and mentally to the demands of the sport,' explained Dr Low.
Noted Mok: 'Preparation is what defines how dangerous the sport is.'
Proper nutrition and adequate training, interspersed with rest periods that allow for recovery - and taking carbohydrate and protein supplements - are all ingredients for a safe race.
But the young are more at risk of unknowingly pushing themselves to the brink.
Recalled Mok: 'At 18, I was almost never tired and felt like I could keep carrying on.
'It's important for young athletes to have proper, regulated training, so they don't overdo it.'
'There are two kinds of pain. One is what one normally goes through in the course of training or competing; the other is when something goes wrong,' explained Dr Chia.
'An athlete should stop when he feels that something is not quite right.'
Thaddeus' death may have cast a pall over endurance sports, but Mr Teo said the MCYS is working with the Singapore Sports Council and the Triathlon Association of Singapore (TAS) to bring about changes in the safety measures at events.
He said: 'There will be better implementation of medical aid, and we hope to employ the improved safety measures by September's Aviva 70.3 Ironman.'
The TAS' honorary secretary, David Hoong, said the association, which sends its national athletes for medical screening, is also keen on having a collaborative programme with the Changi General Hospital.
The programme will involve sponsoring national athletes for regular medical screenings, which cost between $200 and $450 a patient.
With endurance sports - particularly triathlon and its cousins, the biathlon and duathlon - also a hit among youngsters, the TAS introduced the Osim Kids Tri Club in 2005 to give children as young as seven guidance and training by professionals.
Still, parents of young athletes are not taking any chances. Many want their children screened.
Said Dr Low, whose son is 17-year-old national cyclist Ji Wen: 'Many have been inquiring about medical check-ups at our clinic since the recent tragedy.
'I myself accept the risks and challenges of the sport. But the responsibility of ensuring that Ji Wen goes for routine check-ups lies with me.'
Tan Ai Leng, the mother of 10-year-old triathlete Denise Chia, is now 'more worried' about her daughter's safety.
She said: 'Denise has never had a medical screening, but we will take her for one before the Osim Singapore International Triathlon on July 28 and 29.
'We will be monitoring her more closely. But, so long as she is enjoying the sport, we will not stop her.'
hpeishan@sph.com.sg
THE FACTS
'In absolute terms, the risk of sudden death is low... We have no conclusive evidence that strenuous exercise injures a normal heart.'
DR JASON CHIA, former triathlete and current president of the Sports Medicine Association of Singapore
ONE STEP AT A TIME
'Progressive participation in training will enable the athlete to adapt physically, physiologically and mentally to the demands of the sport.'
DR LOW WYE MUN, a sports physician at The Clinic @Cuppage. Parliamentary Secretary for the Ministry of Community Development, Youth and Sports, Mr Teo Ser Luck, said he trained for almost two years before attempting the Ironman
BETTER HELP
'There will be better implementation of medical aid, and we hope to employ the improved safety measures by September's Aviva 70.3 Ironman.'
MR TEO. He said the MCYS is working with the sports council and the triathlon association to bring about changes in the safety measures at events
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