Rest Day Discussion:
Mike Kesthely at CF Lethbridge, brought up an interesting topic today based on our posted workout. Part one of the workout today is 3 Rounds of 10 C2B Pullups and 10 Hip Smashers. An excellent performance in this one should be somewhere between 1min 10sec and 2min 30sec. Mike did it unbroken in 1min 48sec (nice job by the way). After the fact, he said he had THE WORST "blood throat" he's ever experienced. As CrossFitters, you have a coming-of-age when you've experienced THE blood throat.
That reminded Mike of a topic he just recently was reading about... someone suggested that "blood throat" is exercised induced pulmonary edema. Pulmonary edema is caused by a couple of things: either failure of the heart to remove fluid from the lung circulation or a direct injury to the lung parenchyma. The only way that I have come across to explain why exercise could cause this effect is through the inhalation of toxic gases or our inability to competely remove CO2 gas from our body due to the short quick breaths we end up resorting to mid-WOD.
If exercised induced pulmenary edmea is actually what we CrossFitters commonly call "blood throat", is it something to be concerned about? I know I've personally experienced various degrees of "blood throat". To me there are three levels: mild, moderate, and severe. Mild is the the strachy throat with an odd cough. Moderate is the strachy throat more persistant cough and alittle raspy voice. And severe.. well it sucks! I explained it to Mike as being like a really bad carpet burn in the lower 1/2 of my lungs, so bad I can't sit up straight in order to avoid expanding the lower 1/2 of my lungs, persistant cough, raspy voice, and a buring sensation ever time I swallow, eat, drink, etc.
Is there a common trend between people and WOD times in which workouts are the killers? Does everyone achieve some form of blood throat in WODs heavy in gymnastic elements? Is it the running, rowing, double unders, fast moving skills causing our blood throat? What time frame do we typically see the worst blood throats? Does the beginner CrossFitter experience the same degree of blood throat as an advanced or elite CrossFitter dispite taking more time to complete the same workout?
This could be an interesting study... Post to comments when the last time (or any time you can remember) that you experienced blood throat. WHAT was the workout? How LONG did the workout take you? Are the movements in the said workout your STRENGTHS or WEAKNESSES?
April 28, 2009 at 1:52 PM
Definatley an interesting conversation and one pertinant to all of us.
From what I've read on the Mayo Clinic it isn't that the lungs can't get rid of the CO2 it's the build up of fluids that prevent 02 in.
I am not an elite crossfitter by any means. But I have experienced it. I can't remember exactly what we did the last time I experienced it. But it usually when I truly can't catch my breath (fast, intense workouts). Funny enough though when we do fitness tests or Tabata etc. I feel pukie not "blood in the throat". Other than running hard, I can't predict the WODs that cause it.
April 28, 2009 at 3:27 PM
Great topic, Kat! I've had it happen to me on numerous occasions in varying degrees. The PWO(post-workout
)-cough, in my opinion, is exercise induced pulmonary edema secondary to high intensity metabolic conditioning. The "why(s)", well I'm not exactly sure on. My 2 cents:
* The pathophysiology lies somewhere in a transient V/Q (V/Q is the ventilation-perfusion ratio of your lungs)mismatch, exacerbated by high intensity anaerobic work. In this case, there's WAY too much perfusion (blood going to your lungs) and not enough ventilation taking place
* Short duration, high intensity met cons seem to produce EIPE more often than longer duration.
* Forgoing a "cooldown", and lying, most likely, completely supine, and doing nothing more than moaning, potentially exacerbates it also. Throw in a 250-500m row at the end of every round, and the EIPE may not happen. Why? Gives your body a chance to buffer H+ and utilize lactate.
* Buildup of blood lactate and H+ and decreased clearance via ventilation and metabolic buffering cause interstitial shifting of plasma. Perhaps through metabolic acidosis? I'm not sure.
* Actually inducing hemoptysis (coughing up of actual blood) is probably a completely different, and much more severe etiology. My cough has always been non-productive.
There's way, way more to it than that, but there's no doubt in my mind it's a ventilatory and buffering issue, coupled with intensity. The workout today induced the most severe case I'VE ever had, and coincidentally enough, was probably the shortest and most intense WOD I've also done.