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Authors: Gerard Hartmann

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“Medics are on the way,” someone shouts.

“No, no, I'm okay. I'm okay. Just give me some time.”

Next thing I know, I'm in the helicopter ambulance high in the sky, one eye half glancing down over the prairie, the other eye fixed on the blue-gowned medic preparing to inject me. There's an oxygen mask over my face, and between the painkillers and sedation all I can hear is my mind telling me, “Gerard, focus now, the last one-mile interval to do….”

I woke up in the North Florida Regional Medical Center, feeling less than half alive and completely unaware that I had left part of myself, Gerard Hartmann, the champion triathlete, out there on the Paynes Prairie, on Highway 441 in Gainesville, Florida.

Triathlon and Ironman can give you so much, but can also potentially rob you of everything you've got. All sport, all recreational activities – from golf to tennis, from marathon running to rowing – has a definite health and fitness benefit. My involvement in sport not only changed my life for the better, but it made my life. I could never imagine what my life would be like without sport. So many people influenced my life along the way for the better: the Olympic athlete Valeri Borzov, who I never met, and Mary Peters, who I met many years later on November 16, 2000 in Buckingham Palace, where I was a guest the day she was honoured and titled Dame Mary Peters by the Queen. In 1992, exactly twenty years from the time he ignited a flame in me while I watched his performance in the 1972 Olympics on a black and white TV, I got to meet the great Finn Lasse Virén at the Barcelona Olympics. Words could not relay to him how much he had impacted on my life. These are just some of the people who motivated me, and there were many others who gave up their time and money to support my dream, most of all my parents, who must still wonder what they did to deserve such a dynamo in their lives.

Nobody in sport can make it on their own – support from people makes a difference. You cannot do the Hawaii Ironman alone. The Ironman is all about support from your family, your friends, your training buddies, your sponsor, your physio and your bike mechanic. On Ironman day, when you're out on the road praying you'll have a great day, you are not alone. There are 7,000 Ironman volunteers, working all day to make your dreams happen.

All that explains why I believe every child should be given the opportunity to participate in sports. They should have easy access to facilities, good physical education teachers and coaches, and competitive structures suitable for their age and ability. Sport brings out the best in people. It is one of life's great teachers. The downside to our technically advanced society is that, not alone are many of today's youth unfit, but many are very unhealthy. I know how close I was to being that overweight, unhealthy, troublesome boy who, because he was tall and goofy with two left feet, was shelved as not being fit for sports. Every child deserves a chance, not just a chance to play sport, but to make a team, to win a game and to find their true self; a chance to be happy and fulfilled. A healthy body in a healthy mind works across society, and can solve many of our so-called social health problems.

Every day, I see the benefits of recreation and sport. I also see the misery and destruction caused by unfulfilled dreams, and by alcohol and drugs. If it were not for sport I know I could easily have been influenced to take the wrong option. Young people can be vulnerable, through curiosity to experiment, through peer pressure, or in seeking to escape from pain and depression. I strongly believe sport and recreation is the alternative, and not only the best way forward, but the solution.

The benefits of sport are great all around. People go out for a recreational game of golf as a means of de-stressing or unwinding, of breaking the mundane routine of a nine-to-five. It is an outlet, and a healthy outlet. A father-of-two starts cycling two or three times each week, to lose the pot belly, to stave off the middle-age spread or to cheat the onset of old age. The novelty of something new and exciting, a challenge, a physical feat of endurance, the finisher's medal – these are all worthwhile because they are meaningful, and give status and kudos among family and friends.

But moderation in everything is key. The top-end high performer, the young twenty-something-year-old athlete with talent – of course they must certainly use their talent, explore it and maximise it. I know all about that, and how unique and special that feels. But to the professional career man or woman, with responsibilities to themselves and to their families, a word of caution. An obsession with anything can be dangerous, and sport can consume you. It can take over your life without you realising how badly bitten you have become. You might deny it, but, for those who are obsessed with training and participation, go to your shed and see the two or three bikes and the indoor trainer taking centre stage. Go to your wardrobe and see it crammed with running and cycling apparel. You have enough running and cycling shoes, goggles, kick boards and necessary pieces of sporting equipment to open a sports shop. Your food press is full of energy bars, gels and powders and the cupboard is full of vitamin supplements.

Like so many sports, triathlon and Ironman can become addictive. Perhaps sportswriters such as Paul Kimmage and David Walsh are right in their appraisal that all athletes are on drugs, in the sense that they are addicted to their pursuit. The more you get involved the more you want. Triathlon can consume you to the point that nothing else matters. You train, you eat, you train again, eat and sleep. Your work life, your career – that which puts bread on the table – becomes only a means to an end. It pays for the new bike and the travel and entry fees to the races. Your partner and children know you, but you don't know them. You are too self-absorbed. Your partner and children won't love you any more for winning a race or any less for not finishing a race, but they will struggle if your obsession robs them of their partner and parent.

I know all too well. I was that person. When I broke my hip in 1991 and went from being the best triathlete in Ireland to a near cripple, who cared? I was all alone. I had nobody but myself to pick up the pieces, to question what it was all about. Don't let triathlon take you over. It can swallow you up and later spit you out, leaving you with nothing. For triathlon to be a truly healthy and purposeful pursuit, it must fit into the parameters of a balanced lifestyle. That is the challenge for each individual – to organise the training, while keeping a balance in the other important areas of your life. Because in one split second, without warning, everything can be taken away from you.

15

Athletes, Stress and Health

Some people look at sporting events like the triathlon and the Ironman and wonder how stressful competing must be on the body. Is it necessarily healthy to be pushing your body so hard, particularly day after day over a long period of time? It is an interesting and, indeed, very valid question, and one I feel justifiably qualified to answer.

Sometimes I look through my old training diaries, which I have meticulously kept every year since I was fourteen years old, and I surprise even myself at the intense level of training I did over the years. I can't even believe that it was actually me, and I wonder how such heavy training was possible: 10 to 12 miles of swimming, 12 to 16 hours of cycling and 50 to 80 miles of running each and every week – and a lot of the running was on hard roads. It certainly was a long, hard slog, and I reckon even the best old Mercedes Benz would have burned out three engines with the volume of training I did.

All the professional athletes and Olympic champions I have worked with would have pushed their bodies to superhuman levels, and that does place tremendous stress on not just the cardiovascular system, the adrenal system, the hormonal system and the musculoskeletal system, but also the immune system.

People often forget the stress that training and competing can place on the brain. When I trained and pushed my body, day in and day out, not taking a rest day for months on end, I did it while working full time, as, indeed, did many of the top athletes at that time. But can that have been healthy and have many athletes I know paid the price?

I think of my friend Ann Kearney who unfortunately died from cancer at just age 51. Ann was Ireland's first true Ironwoman – a phenomenal woman for training two and three times each day, and who also took great care of her diet and overall well-being. My good friend Grete Waitz from Norway won nine New York City Marathons and five world cross country titles. In April 2011, she sadly succumbed to cancer. Great athletes like the American distance-running greats Steve Scott and Marty Liquori also pushed themselves to record-breaking levels, but were hit by cancer. Noel Carroll was the fittest over-50-year-old I ever met, and yet died a sudden death at age 56. My good friend Kim McDonald, a 2-hour and 18-minute marathon runner, who I shared many a long run with, died of a sudden heart attack at age 45. John Walker, the great New Zealand 1976 Olympic 1,500-metre champion, was diagnosed with Parkinson's disease in his early forties, as were three athletes I know. The list goes on.

I have thought about this subject in great detail, wondering if highly motivated athletes actually push their bodies to breaking point. I know I am no exception. What is certain is that the human body is not invincible. Everyone has a certain tolerance. People are born with a particular DNA blueprint, a genetic disposition and a congenital make-up, before whatever environmental conditioning comes into play. The human body can tolerate acute stress quite well, or stress that is short-lived. But it is not designed to tolerate chronic stress – the stress that lasts weeks, months and sometimes years.

But what is stressful to one person may not be stressful to another, and that is where stress and damage to health can depend on the individual in question. Stress is not a bad thing in moderation. It keeps us alive, keeps us motivated, and keeps the passion and fire burning. Some stress is good stress. Some people prefer to work under extra pressure, to be on the go all the time at a rate and pace that would completely distress other people. Their individual blueprint and make-up can handle it.

Distress is unhealthy stress. If the body is distressed chronically over a long period of time, it will eventually rebel and cry for help. The warning signs are usually apparent, but not everyone heeds them. Stress is a silent killer. The athlete whose immune system breaks down with chronic fatigue or with a musculoskeletal injury should heed the message from their body: “Enough is enough…you are disrespecting me. Back off – you are pushing me too far.”

The body is not a machine. The athlete who trains hard day after day, without balancing this with rest and good nutrition, will soon have alarm bells ringing. These alarm bells will usually result in difficulty sleeping, when the athlete wakes up several times throughout the night, sometimes with teeth grinding or attacks of the hot sweats. Their digestive tract will be in a heap too, with symptoms such as constipation, diarrhoea, stomach pains and cramps. The stomach on a physical level will not function well and will lose the ability to absorb nutrients from food. On an emotional level, the stomach is fighting back, saying to the athlete: “I cannot stomach it anymore!”

There are other warning signs: muscles get painful and tense; the athlete keeps getting cold sores, and viral and bacterial infections; anxiety, frustration, anger and intolerance become frequent; the athlete loses focus, makes poor decisions, and can become irrational and negative and fixed into his or her way of thinking only.

When an individual is stressed, two hormones are released in the acute stage: noradrenalin and adrenalin. Noradrenalin is released when the athlete is angry and frustrated; adrenalin is released as a response to fear and anxiety. When the stress becomes chronic or lasting, the hormone glucocortisol is released. This hormone is only released in large amounts when the athlete is chronically stressed – but glucocortisol is also very damaging to the body and mind. The immune system breaks down, and a triad of health symptoms – physical, psychological and behavioural – will often result.

Over time, the chronically stressed athlete gets disillusioned as his or her performance suffers and more things go wrong. It can be a vicious cycle: the harder they push, the deeper the hole they dig and eventually everything falls apart.

In 1995 Sonia O'Sullivan was on the very top of her game, the best female distance runner in the world. That summer, she won the 5,000 metres at the World Championships in Gothenburg, Sweden. She was Ireland's Golden Girl – on route to what everyone assumed was an assured gold medal at the Olympic Games in Atlanta the following year.

She trained harder and more intensively for the 1996 Olympics than she had ever done before. She felt she had to. Part of her fear was the emergence of the Chinese wonder girls, who had dominated the 1993 World Championships in Stuttgart, shattering world distance-running records along the way. Stories emerged of their mind-boggling training of up to 200 miles a week – or over a marathon a day – all the while apparently fuelled by strange foods such as turtle soup, under the command of their truly eccentric coach Ma Junren.

With that in mind, Sonia upped the ante again coming into 1996, fearful that the Chinese were about to unleash ever greater ferocity on the track. So she trained harder and harder, and dug an invisible hole for herself. Inevitably that hole got deeper and deeper, until in the end it was too late and there was no way out of it.

In the final few weeks before Atlanta, she won the 1,500 metres at the Bislett Games in Oslo, beating Kelly Holmes and breaking four minutes in the process. It was a superb run, but in the days leading up to the Olympics her severe training finally caught up with her: she developed an infection and a cold sore on her lip, and was hardly sleeping at all. Then there was the infamous “gear row” before her 5,000-metre final – where she was forced to change her vest and shorts in the tunnel just before the race, due to a sponsors conflict – and with that everything simply fell apart.

It took her over a year and a half to regain her vitality. The 1997 season hadn't gone much better, but after that she retreated to a new training base in the mountains outside of Sydney, Australia – an area known as Falls Creek. Up there at high altitude, away from ordinary life and the hustle and bustle, there was no telephone, no distractions, just a peaceful, holistic environment where she could eat, sleep and train. It was there she also found added peace with the man who would eventually become her husband, Nic Bideau.

In March 1998 she came back down to sea level with a newfound spring in her step. At the World Cross Country Championships in Marrakesh, Morocco, she won the short and long course titles on successive days, the first athlete ever to do so. Later that summer, at the European Championships in Budapest, she won a brilliant 5,000 and 10,000 metres double. In 1999 she gave birth to her first daughter, Ciara, and the year after that, at the Sydney Olympics, she ran one of the best races of her life to win a magnificent silver medal in the 5,000 metres, having been just nudged away from the gold by her old rival Gabriela Szabo of Romania.

Balance is king in everything in life. When I push myself hard, I do so to win, but in the past, in both my athletic and professional life, I sometimes pushed myself so hard that I crashed.

One such time was in 2008. It was an Olympic year and, with that, comes extra pressure and extra demands. Athletes pop up from everywhere with their injuries, looking for a quick fix. Many of the top athletes I work with want the extra edge that involves training at altitude in remote places. In early 2008 I had two work trips to Kenya. Then, as the summer drew near, I had three nine-day trips to Font-Romeu in the French Pyrenees to work with Paula Radcliffe, then two weeks in St Moritz in Switzerland working with a group of Australian athletes. Upon return, I was faced with a three-day revenue audit. I went to Kenya for two weeks to fine-tune athletes there, and then came home for three days to rest up. Then I flew to Hong Kong and on to Macau with the British Olympic team for heat acclimatisation in advance of the Olympic Games in Beijing.

Following that, on the domestic front, I was moving into my new house with my wife, who was expecting our first child at the time. Weeks later, I was the physical therapist with the Netherlands team at the World Half Marathon Championships in Rio de Janeiro, Brazil.

When I returned to normality in November, my body was in distress. I could not sleep and I had a perpetual headache for weeks on end. Fearing it was something sinister, I had a CT scan of my head, which was clear. Only time and rest would cure me. The reality was that I had pushed myself too hard for too long. I had to stand back and take stock, and learn to find balance by saying no to some opportunities.

It is in my nature to push hard, to always shoot for the top. Winners win because of their super high drive, dedication and perseverance, and also because of their willpower and extra work ethic, but there is a price to pay. For some, that can be their health and, for others, their life.

I have not got all the answers. What I do know is that balance does not happen on its own. You have to work at it. The most important thing is being true to yourself; don't bite off more than you can chew.

If your work and family life is stressful then getting to the pool for a swim, going out for cycle or run should release some stress – but it should not become another “stressor”. You can't burn the candle on both ends. If your work and family life is not stressful and challenging, and you have plenty of candle to burn, then give yourself a challenge. The good stress of a hard swim workout, bike ride or run can invigorate you, charge you up and fuel you with endorphins – and also reward you with having the functional capacity to improve and be able to enjoy your work and family life.

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