When we exercise too much

Nearly 20% of the population meet or exceed physical activity guidelines and the World Health Organisation suggests that we should be aiming to do more exercise for additional health benefit. While exercise is good for us, and great for the heart, sometimes too much exercise may lead to heart problems. As a result, we must understand what the impact of endurance exercise is on the heart.

Systematic review and meta-analysis results

Holsworth Research Initiative researcher, Dr Dan Wundersitz and his team of international and La Trobe Rural Health School researchers firstly investigated the effect of endurance cycling on the heart.

Dan and his team diligently sifted through the research and found that endurance cyclists have larger hearts relative to body size than non-athletes, and even when compared to participants in other active sports such as kayakers, canoeists, runners, swimmers, body builders and wrestlers this difference remained.

In addition, they found that endurance cyclists have an increased incidence of cardiac problems compared to non-athletes, but no more than other sport athletes.

MADRIDE results

When the team worked with participants in the MADRIDE, they found that recreational cyclists had a ten-fold increase in the rate of heart arrhythmias after this 21-day endurance cycling event.

Next they wanted to understand how endurance cycling influenced the heart and if this had any lasting effect (over multiple days).

Endurance exercise and abnormal arrhythmias

Recently, they completed a study assessing how heart arrhythmias change in response to a bout of high-volume exercise and to identify factors associated with abnormal arrhythmias.

This was the first study to monitor participants for nine days straight. Over this time they found 68% of participants displayed abnormal arrhythmias.

In addition, they found the proportion of participants with abnormal ventricular arrhythmias was higher on the exercise day (study under review). Now they want to understand how endurance exercise influences heart health by screening ~350 recreationally active adults. Once complete, they will look for ways to improve the hearts ability to handle the stress of endurance exercise so that people can perform physical activity safer.

You can read a promotional snippet about this work here Endurance exercise and heart health, News, La Trobe University

A call for volunteers

Dan and his team are recruiting volunteers for their next study. Are you a recreationally active adult who would like to have a FREE heart health assessment and VO2peak test as part of our next study? You will be asked to visit us once at the La Trobe University Flora Hill campus physiology clinic located in Bendigo Victoria. 

If you are interested in participating, please read this flyer to confirm your eligibility and to find out to get in touch with us.

Want to read more?

Endurance exercise and abnormal arrhythmias – Bendigo Advertiser and ABC News

Could too much cycling cause heart problems? A world-first study in Bendigo aims to find out – ABC News

Wundersitz, Gordon, Lavie, et al., Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis, Progress in Cardiovascular Diseases (2020)

Wundersitz, Williamson, Nadurata, et al., The impact of a 21-day ultra-endurance ride on the heart in young, adult and older adult recreational cyclists, International Journal of Cardiology (2019)

Wundersitz, Nadurata, Lavie, et al., Response: Arrhythmias 72 hour post strenuous exercise at a time when cardiac troponin was not elevated, International Journal of Cardiology (2019)

Collins, Kingsley, Gordon, et al., Coagulation activity and thrombotic risk following high-volume endurance exercise in recreationally active cyclists. Journal of Applied Physiology (2024)

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Miss Palmer and her supervisory team including HRI Director Professor Michael Kingsley and Human Performance Stream Leaders Dr Rodrigo Bini and Dr Daniel Wundersitz, investigated the relationship between residual neuromuscular fatigue and subsequent match and training activity in professional women’s basketball. The PhD was made possible through a partnership between La Trobe University and the Bendigo Basketball Association.

The results are in

The findings indicated that neuromuscular fatigue does influence both training and on-court activity in professional women’s basketball. More specifically,

# Players displayed neuromuscular fatigue before a 1/3 of all training sessions

# Supramaximal activity was 5.7% less during matches when players were fatigued prior to matches

# Moderate-vigorous activity was 3.7% less during matches when players were fatigued prior to matches

# When fatigued prior to training, players displayed reduced average intensity, maximal and supramaximal activity

Practical implications

Residual neuromuscular fatigue reduces the amount of supramaximal activity that professional women basketball players perform in subsequent training sessions and matches. To address this, practices should be implemented to minimize residual neuromuscular fatigue while ensuring a sufficient amount of training is undertaken to maximize physiological adaptation. Read the full paper here.

Still want more? You can read more of Jodie’s research below or follow her on Twitter @jodiepalmer08 to keep updated on future research.

# Palmer, J. A., Bini, R., Wundersitz, D., & Kingsley, M. (2022). On-Court Activity and Game-Related Statistics during Scoring Streaks in Basketball: Applied Use of Accelerometers. Sensors, 22(11), 4059.

# Palmer, J., Bini, R., Wundersitz, D., & Kingsley, M. (2021). Criterion validity of an automated method of detecting live play periods in basketball. Frontiers in Sports and Active Living, 3.

# Palmer, J., Wundersitz, D., Bini, R., & Kingsley, M. (2021). Effect of player role and competition level on player demands in basketball. Sports, 9(3), 38.

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Dr Emma Macdonald is a Senior Podiatrist in a regional high-risk foot clinic. Her PhD thesis investigated the adoption of mobile health foot monitoring technology in people with Diabetes Mellitus and was supervised by HRI Director, Prof Michael Kingsley and HRI affiliated researcher, Dr Byron Perrin. On her future ambitions, Dr Macdonald said that she aims to build research capacity and culture amongst allied health professionals working in regional Victoria and continue to collaborate on regional and national research projects aimed at improving clinical care and outcomes for people at risk of lower extremity amputations. Read some of Dr Macdonalds published research investigating foot health monitoring technology here and here.

Dr Samantha May is a Sport and Exercise Medicine Registrar currently treating patients at the Alphington Sports Medicine Clinic and Bounce Health in Blackburn. Dr May is also the Club Doctor for the Melbourne Vixens netball team. Her PhD thesis investigated the ultrasound measurement of gastrocnemius muscle architecture in athletes with Dr May planning to upskill in musculoskeletal ultrasound and interventional techniques in the near future. Currently completing her specialty sports medicine training with the Australasian College of Sport and Exercise Physicians, Dr May says she is passionate about promoting exercise as prevention and treatment for patients with chronic illness. Read some of Dr May’s research in gastrocnemius muscle architecture here and here.

Congratulations Emma and Samantha. We wish you luck and look forward to following your careers as they progress and collaborating with you on future research projects.

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The HRI would like to officially welcome Mr Michael Matyevich to the graduate research team. Michael has accepted an offer to complete a PhD with the HRI at La Trobe University. Michael will be investigating the influence of caseload midwifery on physiological responsiveness to stress in mothers and midwives. He will be supervised by HRI Director of Research Professor Michael Kingsley, A/Prof Brad Wright and A/Prof  Matthew Hale.

Following on from a Bachelor of Psychological Science at La Trobe University, Michael completed his Honours research in 2021 with a focus on cognitive and oculomotor performance in response to chronic workplace stress. Having worked as a behaviour support practitioner in a disability support organisation before completing his studies, Michael is driven by making meaningful changes in the lives of vulnerable people.

Michael has hit the ground running with his PhD studies by working with his supervisory team to develop the narrative for his research. We wish Michael the best of luck with his studies and look forward to bringing you updates on his research progress.

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Dr Blake Collins, the HRI Research Officer, had cause for celebration earlier this month graduating with a PhD in Exercise Science from Charles Sturt University. Blake’s research focus is on cardio-metabolic health among shift workers and the prognostic effect of exercise which perfectly aligns with the HRI Active Rural Individuals stream and the HRI research aims of optimising function and performance for all individuals and addressing the global challenges of inactivity and chronic disease. 

Blake joined the HRI in 2020 and quickly embedded himself within multiple HRI projects. In particular, Blake’s background lends itself to our Active Rural Individual projects investigating chronic disease and cardiac rehabilitation in rural adults. Blake has demonstrated a strong work ethic and broad knowledge base and has therefore, not surprisingly, become an invaluable member of the HRI team. Congratulations Blake!

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Our HRI Research Seminar Series has returned for 2022!

Representing the Human Performance stream, A/Prof Monica Maly joined us (virtually!) all the way from Canada. A/Prof Maly is the Director of the Mobilize Clinical Biomechanics Laboratory in the Department of Kinesiology and Health Sciences at the University of Waterloo. Her seminar presented on the role of exercising biomechanics to improve care in knee osteoarthritis.

A/Prof Maly has very kindly given permission for the HRI to share her presentation slides below. If you missed out on the presentation, watch it in full on the HRI Youtube channel.

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Along with Professor Damminda Alahakoon in the La Trobe Business School, Accounting and Data Analytics department, and Dr Rebeca Meiring from the University of Auckland, Professor Michael Kingsley is using support from the Holsworth Research Initiative in the La Trobe Rural Health School to develop a machine learning model to remotely monitor patients with knee and hip osteoarthritis. This work aims to enable people living with these conditions to safely increase their physical activity and improve their lives.

Volunteers needed for study

The research team will collect data from study participants who wear accelerometers, small electronic sensors that can measure intensity of activity.

To get more data, the team will recruit volunteers from Auckland and Bendigo who have lower limb osteoarthritis and are waiting for joint replacement surgery.

Help for people living with chronic disease

Professor Kingsley says:

We will use this project to show that our model works. Then we will improve the model so we can assist people who live with conditions such as cardiovascular disease, cardiac conditions, and multiple sclerosis.

Being able to monitor patients more effectively will inform evidence-based guidelines to fill gaps in the current Australian and New Zealand physical activity guidelines and better support people living with limited mobility to improve their quality of life.

We look forward to providing regular updates on this project.

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NSW Ambulance workplace fitness

Being a paramedic is a tough job. Paramedics are among the most frequently injured health professionals in Australia. The job can be even tougher in rural and remote areas.

NSW Ambulance wanted to help their rural teams. They ran a pilot workplace exercise program for six months across Western NSW between 2017 and 2018. They wanted the program to provide guidance on the best ways to improve their paramedics’ work-related fitness and reduce their physical injury rates.

Tailored exercise programs reduce workplace injury

Dr Jayden Hunter and his team assessed this program and reported to the NSW Ambulance on how it had worked – some of their preliminary findings were published in the Occupational Medicine journal. They found that:

• paramedics were not fitter than the general population, despite their physically demanding job, and
• rural paramedics would benefit from tailored workplace exercise programs to build their muscular strength.

This was the first study globally to investigate how a dedicated health coach can support a workplace exercise program for paramedics.

Global Challenge of Inactivity

This research fits with the Holsworth Research Initiative aim to:

address the global challenges of inactivity and chronic disease

Dr Hunter has received funding from the Holsworth Research Initiative in the La Trobe School of Rural Health so he can analyze the data from the six-month program.

He will use the funds to analyse data for a journal article to contribute to the growing body of knowledge around ways individually tailored workplace exercise programs can benefit paramedics in rural and regional areas.

He will share the results of their research with other organisations interested in using workplace exercise programs to benefit their workforce.

We look forward to providing updates on the team’s findings.

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Dr Gordon has received funding from the Holsworth Research Initiative in the La Trobe Rural Health School to investigate if dietary supplements containing caffeine and capsaicin (the active component of chili peppers) can help maintain weight loss. As he says:

It is important to identify potential treatments for obesity as we know that regional and rural areas have greater rates of obesity and more commonly poorer health outcomes. At the moment it is particularly important to manage conditions like obesity as that has been identified as a condition more commonly associated with worse outcomes if COVID-19 is contracted.

Obesity: a global challenge

This research addresses one of the key aims of the Holsworth Research Initiative:

to address the global challenges of inactivity and chronic disease

Adult weight gain and obesity are worldwide problems. Among developed countries, Australia has one of the highest proportions of overweight and obese people. Weight gain leads to an increased risk of cardiovascular disease, hypertension, type 2 diabetes, obesity-related cancers and osteoarthritis.

Can Caffeine and Capsaicin save the day?

Caffeine and capsaicin are two cost-effective and safe, natural supplements that show promise in assisting people to manage and maintain weight loss.

Further research is needed to discover the best ways that they can be used (alongside diet and exercise) to manage weight loss, maintain weight loss and ultimately reduce the risks of chronic disease.

Weight loss is hard and expensive

When people lose weight by calorie restriction and exercise the weight is almost always regained over time because the body is programmed to resist weight loss. Further, prescription weight loss drugs are expensive and can have negative side effects, so many people are turning to alternatives.

The research team hopes that this study will help understand how the body balances energy consumption and expenditure and identify the ways in which caffeine and capsaicin increase energy consumption. This will pave the way for more research in the future.

We look forward to providing regular updates on this project.

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A seat belt won’t save you if you drive a glass car

What lies behind a reported factor such as increase in anterior cruciate ligament (ACL) injury in women athletes when compared to men? Professor Nimphius argued that women athletes may not have access to top quality training in their formative athletic years, as there are less funds available for womens sport and coaches are less likely to be professional accredited than those in male sport. Structural inequities in the training for female athletes “set them up to fail” then blame them “for being female” when they get injured.

Control for the right factors

Studies that have compared men and women athletes for injury risk and performance have often not controlled for factors such as height, strength or motor experience. Once these factors are normalised the differences disappear or reduce to a value questionable in explaining injury risk. In fact, there is more overlap between men and women athletes than conclusions lead us to believe. Commonly modifiable variables likely explain the differences purposed to be sex/gender “specific”.

You run like a girl

Professor Nimphius also reinforced the role of self-efficacy in performance: athletes have to believe they are at their best in order to perform at their best. If a coach or an athlete believes there are inherent non-modifiable factors that limit athletic performance, if they believe in sayings such as “you run like a girl”, then their expectations of female athletic performance are going to be lower. This becomes a self-fulfilling prophecy.

Making broad claims about groups does not help anyone.

Professor Nimphius concluded that research, and society, need to focus on the capability of the person, rather than the gender/sex of the person. She challenged the audience to examine the language of sex/gender difference in sports research and their own assumptions about female athletes, strength and injury. So much of the debate around female athletes and injury risk is based on ‘biological sex differences’ which is simply a way of saying the injury risk is inherent and nothing can be done about it, when these outcomes may really be the result of disadvantages inherent in an inequitable training system and the methodological bias of the research studies that support these findings. We must continue to challenge historical studies and critique the methodology of sports research studies to optimise the best research to support peak athletic performance.

Session recording

If you would like to hear Professor Nimphius’s presentation in full please follow the link below and use the password x@H++v6Bl1Dh

Failing by design in understanding female athletes (97.9 MB)

Further reading

Exercise and sport science failing by design in understanding female athletes

Comparison of quadriceps and hamstring muscle activity during an isometric squat between strength-matched men and women

Biological system energy algorithm reflected in sub-system joint work distribution movement strategies

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