November 16, 2011

Why so many deaths in triathlons... nearly all in the swimming phase?

Panic attacks. Officially, drowning, but the root cause may be panic:
“My world is anatomic,” said Steven Shapiro, Vermont’s chief medical examiner, whose office investigated the deaths of two men this year. “I can’t point to the body and say: ‘There’s the panic attack, there’s the arrhythmia.’ Once you’re in my office, there’s no panic and the rhythm is asystole,” he said, using the medical term for cardiac standstill.
Nevertheless, circumstantial evidence strongly points to panic, with the biggest piece of evidence the most obvious. Something is happening in the swim that isn’t happening on the bike or run.

“I was taken by surprise the very first time I did a triathlon,” said James A. Millward, a 50-year-old history professor at Georgetown University. “I swam about 50 yards, I couldn’t get into a breathing rhythm, I felt more and more anxious, and I thought, ‘Wow, I’m having a panic attack.’ ”

Millward has done the Nation’s Triathlon four times and has had the sensation each time after jumping into the Potomac River with scores of other racers. The overwhelming urge is to get his head out of the water. 
It's easy to see why the human body may have evolved this response.

75 comments:

DADvocate said...

My canoe and kayak club provided the safety boats for a triathlon. Especially at the beginning, the swimming was a chaotic mass of people. People getting kicked in the face, pushed under, swam over the top of, etc.

Unless you're truly competitive in the event, I recommend you do some breast stroke. Your head's out of the water much or all of the time, and it's easy.

Scott M said...

From the vantage point of my out-of-shape, overweight, 40-something self, people that can complete a triathlon are proof that superhumans do exist and I ain't one of them.

PatCA said...

I don't like extreme sports. I don't think people with families should be out cheating death just for the thrill of cheating death. It seems a ludicrous waste.

I came to that conclusion after reading Into Thin Air and then Bookreev's rebuttal to the whole Everest craze.

Expat(ish) said...

PatCA - Triathlon isn't extreme. It's just intense. I just finished the B2B half iron and it was the most intense 5:59 of my life.

Anyhow, every tri I've been to has had great water safety. Having said that, you are in a big group of people swimming rather fast. Which is why I swim a bit off to the side. And if you went under, you'd be invisible.

How many people died during the NYC marathon this year?

_XC

PS - If I had to have guessed, I'd have gone with bike wrecks. I came off my bike between 20-30mph on a turn and was pretty lucky.

Curious George said...

I had a panic attack watching the Bears beat Detroit Sunday. I couldn't get over the thought that I might run out of beer and snacks. So I ran out at halftime and supplied up.

Phew. That was close.

Shanna said...

Crazy! It seems like floating is the easiest thing in the world, although it sounds like the triathalons maybe have too many people in too little water and that could contribute.

I recommend you do some breast stroke

Seconded!

ndspinelli said...

A female triathalete I know says the swimming event is the most dangerous. Most contestants are primarily bikers or runners and they struggle and/or freak out in the swimming phase. Plus..it's the first phase so your adrenal gland is pumping, making you more prone to panic if you're not confident.

edutcher said...

If you've trained for the swimming event, you shouldn't have any real fear of the water, but what nd said is interesting.

Swimming is one of the few exercises that works all the major muscle groups (according to You Know Who) and, if most contestants are primarily bikers or runners, they may have relatively poorer upper body strength and not be as comfortable in the water as they should be or as strong.

As an old soccer player who kicks a lot better than he strokes, this can be a real issue.

Bob_R said...

Voluntary waterboarding.

Surfed said...

Try wiping out in big surf and swimming in through 20 foot waves. It's like running the hundred yard dash and then immediately holding your breath for 20 seconds while you're being rag dolled in the whitewater. Try this several times in a row as you dive to the bottom to escape potential drowning in the roiling whitewater. Nothing is more scary or fear inducing than having to abandon your surfboard and swimming to the bottom as a series of giant waves the size of a three story buildings moving at 20mph detonate in front of you. It's even worse if the hydraulics catch you, sucking you up through the back of the wave and then throwing your over "the falls" with the curling part of the wave then slamming you onto the reef/rocks, below. There's no mortal fear in a triathalon. Just panic.

DADvocate said...

ndspinelli - Your friend is probably right. My 47 year old sister started doing triathlons earlier this year. Myself and all my siblings swam competively as kids and are strong swimmers. She won the swim leg of her firt triathlon by more than a minute. Overall, she finished about 10th, which means the runners/cyclists made up a lot of ground.

Calypso Facto said...

Over time, the risk of death in triathlons appears to be about the same as for marathons: between 2 and 3 per 100,000 participants (as contrasted to 12 per 100,000 for auto accidents in the general population).

I will admit that it is extremely difficult to stay calm and focused during the swim portion of a triathlon, however. You train for hours and hours of solitary lap swimming in the pool only to take off in an adrenaline fueled, thrashing mass of competitive humanity at the race. Since I'm never there to compete for any medals, I try to stay away from the pack and concentrate on keeping my form despite the pressing natural fight-or-flight urge.

Scott M said...

Excellent descriptin, Surfed, on why I never surfed, even when stationed on the coast. I preferred to stay up on the beach and play two-man. Less undertow, but more arguments.

Original Mike said...

"Something is happening in the swim that isn’t happening on the bike or run."

Ah, yeah.

Surfed said...
This comment has been removed by the author.
ndspinelli said...

Dadvocate and edutcher, Thanks. lately I've been called a "fucking idiot", "liar", "ignorant and stupid" and I've really been down about that[tongue in cheek].

This triathlete I mentioned is primarily a runner. She has common sense and wisdom and is in her 50's. She's the type person you listen to when she speaks.

Surfed said...

@ScottM - Thanx! I left out the sharks, hypothermia and kooks getting in your way. It's a minefield out there. People die and disappear all the time.

ndspinelli said...

Surfed, I talk w/ a lot of surfers when I'm in San Diego. I get the sense the mortal fear is a big part of the attraction w/ many.

Steve Koch said...

I did the swimming part of a triathlon relay once but it wasn't remotely panic inducing. I was breast stroking so maybe that helped.

Big Mike said...

Something is happening in the swim that isn’t happening on the bike or run.

Let's see. You trained in a pool and are having trouble dealing with choppy water because you recover your arms too low? Nobody kicks you in the face when you're running or on a bike? You don't get water rushing into your nose and mouth when you try to breathe while you're too close to the kicking of somebody else?

I read the article. One guy died after wearing his wet suit for the first time in the triathlon that killed him. Put him down as died of doing something insane.

Scott M said...

@Surfed

We had a sandbar for a couple of years about 150 yards off the beach. We would swim out to it after getting knocked off the net to cool of and rinse all that damned sugar-white sand off. The sandbar didn't break the surface, but you could stand on it in waist-deep water depending on the swells. The trench in between was pretty deep though.

Swimming back to the beach once, I looked down into the trench while underwater and saw a very long, finned, torpedo shape moving along the bottom.

Panic.

Surfed said...

@ndspinelli - Surfing's not a sport, it's a sickness. William Finnegan, the Pulitzer Prize winning author on staff at the New Yorker wrote a 30,000 word article for said magazine in the early 90's detailing just what you mentioned.

Dante said...

Maybe it is related to the shock of going from being overheated to being cold. When the body is hot, it will open up vessels to the skin, so getting in cold water will have a huge impact on rapid cooling.

Also, ever jumped in a cold shower by accident? That alone causes it to be hard to catch breath.

Hoosier Daddy said...

The panic typically comes from having someone just plow into you and swim right over you. I've been pushed under water, kicked in the face, all of which throws off your rhythm and breathing. Sucking in lung fulls of water has adverse effects.

I know few triatheletes that enjoy the swim portion.

Ignorance is Bliss said...

Scott M said...

I preferred to stay up on the beach and play two-man.

Bet you're glad they repealed Don't Ask-Don't Tell so you can talk about such things now!

DannyNoonan said...

This is just an expansion of the Oprah marathon phenomenon. Triathlons, like marathons, have become something that out of shape people decide they're going to do as a motivation to get in shape. Really, it's not the best idea, and is a recipe for disaster. People training "just to finish" are trouble. In marathons it leads to heart attacks and tons of joint injuries. In triathlons it leads to TONS of crappy swimmers training in a pool for 12 weeks and then jumping into crowded open water for the first time. This is just dumb. Leave the marathons to the marathoners. Leave the triathlons to the triathletes. If your goal is "just to finish" pick a different goal. From a fitness standpoint, it's much better for you to train to break 18:00 or break 25:00 in a 5K than it is to "just finish" a marathon. It's much better for you to train to break 1:00 in a 100 yard freestyle than it is to just finish the 1.5K or 2.4mile swim in open water in a triathlon.

Scott M said...

Bet you're glad they repealed Don't Ask-Don't Tell so you can talk about such things now!

I knew that was coming (no pun). We played four-man a lot too.

Hoosier Daddy said...

"... Overall, she finished about 10th, which means the runners/cyclists made up a lot of ground..."

That's typical. There are always some that try and go for broke in the swim and then creamed in the bike. Transition from swim to bike is the longest and the swim is the most exhausting.

Kit said...

I've considered doing tri's but the memory of a panic attack in an open water swim at girl scout camp many years ago, keeps me land bound.

Hoosier Daddy said...

"... This is just an expansion of the Oprah marathon phenomenon. Triathlons, like marathons, have become something that out of shape people decide they're going to do as a motivation to get in shape...."

This. I see this all the time and many never get past the swim or are done within the first five miles of the bike. I was pretty fit when I did my first sprint and that was tough. Training in a pool for weeks isn't the same as a lake with swells. Many will train a day on the bike then next day run. Ill do a 20 mile ride then immediately run a 5k because you have to condition your legs to go from that transition.

I'll admit my limitations and won't do a half Ironman because the swim would do me in.

Chip S. said...

the human body may have evolved this response

Not a big fan of using "evolve" as a transitive verb...

DannyNoonan said...

"That's typical. There are always some that try and go for broke in the swim and then creamed in the bike. Transition from swim to bike is the longest and the swim is the most exhausting."

Well, it's because the swim is the least important leg. Swimming is NOT the most exhausting leg by a long shot. It's the shortest and easiest, and therefore the most meaningless. The average triathlete spends 6 times as much time on the bike than they do in the water. And 4 times as much time running as swimming. The race HEAVILY favors cyclists and runners.

$9,000,000,000 Write Off said...

It's easy to see why the human body may have evolved this response.

No its not. Its easy to make up a "just so" story about it, but its not easy to actually know.

MarkW said...

I'd be interested in doing triathlons if it weren't for the churning scrum of bodies in the swim portion (and I like swimming). I know they do the swim first because they think tired people are more likely to drown, but I suspect it might be better to slot it in the middle so that the swimmers would be spaced out and not flailing on top of each other.

DADvocate said...

There are always some that try and go for broke in the swim and then creamed in the bike.

For my sister, it's simply the leg she's strongest at having swam competively for 10 or 12 years as a kid.

ndspinelli said...

The Spinelli triathlon is driving to the track, picking horses, and drinking beer. I excel in the last leg although like all athletes, my skills have diminished over time. I've improved slightly in the first 2 legs.

Gerad Hibbs said...

Makes sense to me. I imagine in a triathlon your constant thought is something along the lines of, "This hurts! I can't do this, this sucks, I need to stop!" due to the intense never ending rigor of the exercise. But, you overcome and do keep going.

When you are running and biking you can indeed just stop. No harm, no foul. But, when you are swimming you can't "just stop" or you will die. So, your brain is telling you:

1. I have to stop!
2. If I stop I will die!
3. ?
4. Panic!

wv: ancer (as in, "I just gave you the ancer.")

Hoosier Daddy said...

".... The average triathlete spends 6 times as much time on the bike than they do in the water. And 4 times as much time running as swimming..."

Which of course has little to do with physical exertion between the three events.

Swimming two miles is a helluva lot more exhausting than riding 20-30 miles.

Surfed said...

@ndspinelli - I take my daughetr to the Dog Track. I'm the Finacial Officer and she's the Official Picker. The girl can hit a tri-fecta. Been that way since she was young. Scratch off Lotto card? She'll win. Long shot in the 3rd? She'll pick it. Like Napoleon said (paraphrase) "It's better to be lucky than good. If you're good someone will always come along who's better. But if you're lucky, you're lucky."

AllenS said...

Scott M said...
Swimming back to the beach once, I looked down into the trench while underwater and saw a very long, finned, torpedo shape moving along the bottom.

Always remember this: when you enter the ocean, you immediately move to the bottom of the food chain.

tim in vermont said...

One time as a child I jumped into a neighbor's pool and nearly drowned for no reason except that I was in complete, unanticipated, and overwhelming panic. It was as if I had forgotten how to swim.

The lady who owned the pool jumped in and saved me, bless her, in her dress and white pumps. (People used to dress like that.)

SpinningStar said...

In addition to things mentioned before, doing laps in a pool is nothing like swimming in a lake or ocean or even running and biking. First, in a pool, you can swim to the side and stop. Or there is a lifeguard who will pull you out. Running and biking, you can stop and be on solid ground.

In the lake, it's murky and you probably are swimming where you cannot stand up.

I'm a sailer and our club helped with the swim section of a race. It was hard seeing the people and the "swimmers" they put on our boat spent more time talking with each other. The sailers were the ones doing the "man overboard" drills of tracking distressed people and telling the kayakers to go to a specific person.

It was nerve-wracking to be involved.

Kit said...

"Swimming two miles is a helluva lot more exhausting than riding 20-30 miles."

Except the swim to bike, in a full tri is 2.4:112 miles. I'm not a naturally strong swimmer, so that leg would, by far, would be the toughest.

It wasn't Oprah that helped inspire me to run that first marathon, it was Greta Waitz, many years before. That and watching the finish of the Madison Ironman several years ago. Those guys were finishing a freaking marathon
AFTER more than 10 hours of swimming and biking. What was my excuse for only wanting to do a third of what they just finished? Sheesh.

E.M. Davis said...

Triathlons should obviously be banned. Too dangerous.

MadisonMan said...

it might be better to slot it in the middle so that the swimmers would be spaced out and not flailing on top of each other.

Then you have to pay people, or find volunteers, to watch the water for a MUCH longer time. I'd say start waves spaced every 5 minutes. Use chip timing

traditionalguy said...

Maybe murky waters swirling with splashing is an evocation of a primal panic signal built into our DNA.

The basic fear that the movie Jaws created in the 70s has worn off some from familiarity , but it once created a strong visceral reaction from people that saw it.

Hoosier Daddy said...

"... "... Except the swim to bike, in a full tri is 2.4:112 miles. I'm not a naturally strong swimmer, so that leg would, by far, would be the toughest..."

I'll stipulate that I have done my share of centuries in the saddle and still would take that over a 2 mile swim anyday.

Comparing a swimmers build to a cyclist or runner is a good indicator of the difficulty of swimming

Calypso Facto said...

I'd say start waves spaced every 5 minutes.

Most do. Starting with 50 or 500 makes no difference when you're in the middle of it.

The real problem with putting the swim in the middle, of course, is that you'd have 10 times the deaths as people's legs cramped up.

Shanna said...

But, when you are swimming you can't "just stop" or you will die.

You can tread water or float, which is pretty easy. Is it possible some of these people are actually afraid of water and pushing themselves to swin so they can check 'triathalon' off their mental list?

Leave the marathons to the marathoners. Leave the triathlons to the triathletes.

How does one become a 'marathoner' or a 'triathlete' if they are not allowed to do it? I find this whole line of thought unnecessarily exclusionary. Does it really if hurt you if their is some guy at the back of the pack trying to do a marathon?

Scott M said...

There's got to be some sort of CO2 cartridge safety device that can be worn on a belt or thigh strap, to be fired off in dire need. The resulting inflatable wouldn't have to be very big at all. Just big enough to give them something to hold on to while the safety peeps get to them. Surely they can contrive a firing mechanism that is unlikely in the extreme to be set off accidentally.

ndspinelli said...

Kit,

My brother is a chef in Boston. He learned quickly that Marathon weekend you better have 3 times the pasta on your shelf because you get slammed w/ pasta eaters.

We had a guys Boston Marathon long weekend in 1996 for the 100th. We stood just over the crest of heartbreak hill. The pain on the faces of runners is incredible. Uta Pippig won the womens. I was confused when she ran by and I saw what I thought was mud on her legs. It was a beautiful crisp day and I said what the hell is w/ that? I later read she had her period and diarrhea. One tough broad! Of course, she is German.

carrie said...

Part of it might be due to the Instinctive Drowning Reflex-- http://en.wikipedia.org/wiki/Instinctive_drowning_response This reflex kicks in when people are really drowning and it makes it hard to recognize people who are drowning. Triathalons use a lot of volunteers who probably don't know what to look for. People who are truly on the verge of drowning can't call for help and can't even waive their arms to draw attention to themselves.

ricpic said...

Aren't these guys supposed to be in great shape? A panic attack isn't fatal to a strong heart. But Pogo'll probably be along soon to tell me I don't know squat...which is true. I'm still skeptical.

Calypso Facto said...

There's got to be some sort of CO2 cartridge safety device...

I wouldn't go building your business model around the 1-9 people who die in triathlons each year. Maybe the common-by-comparison "struck by lightning" market?

Seven Machos said...

I have "competed" in two half triathlons. The swim is 1.2 miles. It's incredibly taxing mentally at the beginning.

I strongly advise that anyone doing any kind of triathlon wear a wetsuit. It's hot, but it also makes you much more buoyant. I also agree with the person who advises the breast stroke if you are feeling anything bad at all.

Also, Carrie, there is training for the lifeguards.

Scott M said...

I wouldn't go building your business model around the 1-9 people who die in triathlons each year

You're being short-sighted. You come up with a product that probably works half the time. You slap a name brand on it, jack the price up 500 percent and sell it in the correct sport-centric catalogs and websites. At the same time, you find a willing foil in Washington to put forward a bill demanding that all participants of that "awful blood sport" to be required to wear this safety device. As you're the only holder of the patent...bliss...

Scott M said...

I strongly advise that anyone doing any kind of triathlon wear a wetsuit.

Technically, when doing a triathlon, doesn't any suit you're wearing become wet?

I don't know why but that made me think of this...

"I'm the Rosa Parks of lazy people. When you think about it, though, Rosa Parks is the Rosa Parks of lazy people."

paminwi said...

Big Mike: "One guy died after wearing his wet suit for the first time in the triathlon that killed him."

My son (6'5"/200 pounds) wore a wet suit for his first triathlon and it didn't fit him properly (he rented it) and he said it scared him because the water came in through the sleeves and it weighted him down. He never participated in a triathlon where the water was so cold he had to wear a wetsuit again.

Seven Machos said...

My son (6'5"/200 pounds) wore a wet suit for his first triathlon and it didn't fit him properly (he rented it)

I guess I should add that you should obviously practice swimming in your wetsuit in safe open water before the triathlon to make sure it fits and to get used to how it changes everything (for example, you arms have less latitude and it is hot as fuck). I really shouldn't need to add that.

DADvocate said...

A panic attack isn't fatal to a strong heart.

You panic and drown. That's fatal to any heart.

Harsh Pencil said...

I've done three triathlons (two sprints, one olympic) and I've never experienced the panic, but they have all been in Minnesota lakes (no waves or current). But even my bike instructor, a triathlete who medals, has panicked in the water.

Currently training for a half iron man next summer. Not sure what to do reduce chance of panic other than lots of open water swims and start on the outside of the pack.

Eli Blake said...

I DISAGREE that having panic attacks while trying to keep your head above water in a crowded field causes death.

If that were true we'd have seen at least a couple of deaths during Republican debates this year.

Don't Tread 2012 said...

Exhaustion.

No one should exert themselves that much unless its for a beer run.

Chuck Worrel said...

As a lifelong competitive swimmer and coach I can say without qualification that outside the category of trained competitive swimmers, people in general are lousy and dangerous in the water. It is a foreign medium and unless one has spent countless training hours, beginning at a young age (very important), they will always be at risk, particularly in open water. If a person begins training at age 8, swims for a couple of years and restarts at age 14, the early training provides an insurmountable advantage that the late starter can never overcome. Start at 20 or 25 and you will never be truly comfortable and safe in the water. Start early and you will be able to be comfortable and safe. This is why I always recommend that parents get their children into a competitive swimming program (where they do actual training as opposed to lessons) for at least a couple of years when they are young. They may not end up olympic swimmers but the early training (mileage) will make them safe forever.

Seven Machos said...

Harsh -- just remember always that the worst swim you could possibly do will result in maybe 12 minutes difference in your time.

Julie C said...

My son competed in his first open water swim just a few months ago. He's a teenager and has been swimming competitively since he was a little kid. What fascinated me was the people who on paper should be really great open water swimmers - super fit, really fast swimmers, great shape etc. - who for some reason suffered from hypothermia and barely made it out of the water. Seems like a little extra body fat is actually helpful when the water is 58 degrees. (And participants don't wear wetsuits unless they specifically swim in the wetsuit division) so you can't rely on that. From what I can see, open water swimming really needs to be trained for in something other than a pool at least part of the time.

rp said...

I am bothering to leave this comment only because it might save someone's life. Arrhythmias frequently reflect magnesium deficiency. The magnesium loss through sweating [eg, during the running and cycling parts of the triathalon] is enormous. If I were in a triathalon I would try to go into it with a serum magnesium level around 2.3 or 2.4. Hmm. I wonder if any of the military participants in the recent triathalons have suffered arrhythmias, since the standard military field diet is quite high in magnesium.

ndspinelli said...

Julie C, You're preaching to the choir on extra body fat..that's my strong point.

DADvocate said...

Here's the answer to all our surfing, triathlon, wetsuit problems: the Billabong V1 wetsuit which has a bladder that inflates using a CO2 cartridge when a cord is pulled.

Shanna said...

This is why I always recommend that parents get their children into a competitive swimming program (where they do actual training as opposed to lessons) for at least a couple of years when they are young. They may not end up olympic swimmers but the early training (mileage) will make them safe forever.

I completely agree with this. I took lesson's when I was little but it was the couple years of swim team when I was about 9 or so that really taught me to swim. I was never very good but I feel extremely comfortable in the water.

Gary said...

Panic during the swim in triathlons can be brutal. I'm a strong swimmer, but the one time it hit me I was overwhelmed. It scared me so bad I didn't go back in the water for over a year.

Gary said...

If you are in any kind of decent shape, there is nothing about a bike ride or a run that can cause panic. But the swim is different.

Simon Kenton said...

Shanna said:

"You can tread water or float, which is pretty easy."

Nope. I can just barely float when I am 15 pounds overweight. At full inhalation a sliver of my back is above water. At competitive weight, I can't do it; I have to be in continual motion to keep nose and mouth above waer. During the exhalation phase of swimming I describe an arc downward, and before inhaling, have to fight back up to the surface. My guess is that a lot of the problem for those dying during the swim phase is that they have bicyclist or weight-lifter bodies: excess muscle and bone mass.

DannyNoonan said...

"Swimming two miles is a helluva lot more exhausting than riding 20-30 miles."

First of all, no it isn't. Second of all, that's NOT the ration in triathlon. That would be a much better ratio. Ironman is 2.4mile/112mile/26.2mile. Olympic distnace is 1.5k/40k/10k.

DannyNoonan said...

"How does one become a 'marathoner' or a 'triathlete' if they are not allowed to do it? I find this whole line of thought unnecessarily exclusionary. Does it really if hurt you if their is some guy at the back of the pack trying to do a marathon?"

It doesn't hurt me, it hurts them. One becomes a marathoner by training properly with a time goal in mind. Not following the Runner's World "Just Finish" plan. I'm just saying that most people that take up the sport with the goal of getting in shape, rather than with the goal of running fast marathons, would be better served by running 5Ks and trying to get faster. They'd be much better off in a number of other activities, but for some reason, marathons and triathlons have become this be-all, end-all of fitnes in most people's minds. And they're not.