Solutions for preventing stitch during a triathlon

" I was wondering if you have any advise on possible solutions to avoid getting the stitch off the bike. My daughter is 15, and this problem is occurring about every 3^rd race. Basically she can either not finish the race or  virtually crawls home , and this totally destroys the result and is causing much distress, and she can almost not breathe or move, with all that effort in training wasted. The stitch rarely occurs in a run on its own. Everything tried has failed. "
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Gary:
There are a number of possibilities.  I will only list the ones I think are most relevant to your daughter:

• Using a drink or gel that is upsetting the digestive tract.  Try plain water or a heavily diluted drink.
• Drinking too much while on the bike causing the stomach to stretch and slosh under the weight while running.  Try drinking less.
• Gulping water, consequently getting air into the intestines.  Try not to swallow air while sucking/gulping.
• Spasm of the diaphragm. During intense cycling, this breathing muscle works very, very hard and may go into spasm from the effort.
• Abdominal muscle spasm.  If, during intense cycling, she is pulling excessively with the arms, the transverse abdominals may be over-worked.  Running is an intense transverse abdominal workout.
• The solution to the previous two possibilities is to join a cycle club and get experience at bike racing with the pros. Race-hardening is the solution.

Please read the advice in this article here: http://blog.garymoller.com/2011/02/how-to-slash-your-times-in-coast-to.html  It is likely, as well, that there are significant nutrient deficiencies associated with a high carbohydrate athlete diet, complicated by the enormous nutrient demands of puberty.  A Hair Tissue Mineral Analysis would be appropriate as an investigative tool.

Please follow the link at the end of this article to read the draft section about "Stitch" from the new and improved E-Book "Running or Walking a Marathon" that will be released in a few months from now.  The information and advice is relevant.

Leppin Squeezies for cycling and running: Stomach upsets, vomiting and diarrhoea

"Now the trouble starts, got advice from someone to use the Leppin Squeezies for energy so hoover down my second one before Little River with some water. Set myself a good pace upto Hilltop and felt good til 1K from the top, then my guts started turning over and I lost the lot all over the road on the next climb.

The result was I could feel my legs dying so I had to drop the pace with a real sore gut, and watch a couple of small bunches go by without the energy to hold em."

(Excerpt from a cyclist's race report - Le Race 2010).
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Gary comments:

Energy gels, of which Leppin is just one, are heavily promoted to endurance athletes.  What we seldom hear about are the downsides of consuming carbohydrate gels when exercising close to our limits of intensity and endurance.

Far from being steady state, cycle racing is more akin to a constant succession and micro sprints, full-on sprints and the occasional rest while going downhill or heading into a corner.  This kind of exercise steadily builds the body lactate levels to near intolerable and pushes the heart rate to maximum.

Problem with stomach acid, bloating, leaden legs and loose bowels while mountain biking

"Hi Mr Moller Looking for a bit of advice on a problem I am experiencing while mountain biking.

Photo. Why we love to mountain bike: Alofa and Ioasa Kosena mountain biking the Wairarapa coast

I start my rides generally at a pace of about 20km on reasonably flat terrain and then after about 5km start heading into hills and reasonable climbs. The problem is after about 30mins of reasonably hard riding my stomach turns to acid,bloating occurs and legs etc turn to lead and sometimes end up vomiting. The next day my bowels are very loose and rather smelly. This does not happen all the time but is very frustrating when preparing for an event or in one as it usually means the rest of the ride or event is real struggle."
"W"

In response to questioning from Gary Moller:

"Drinking water before and during ride and as the case yesterday usually had a couple of plain mixed grain rolls about 30 mins before setting out.

The rides are usually about 2 to 2 ½ hours long
My age is 48yrs,75kg and am 1.7m tall.

My health is excellent as recently had a checkup and am on no medication of any kind.

Tea the night before was plain pasta,lunch that day was three plain mixed grain rolls and breakfast was 3 pieces of plain toast and interspersed with 1 pear and 1 apple.

Fluids were about 2 litres of water and 3 cups of tea with 2 spoons of sugar in each and sneaked in small bar of chocolate. Am careful of my food as regards preservatives and try to avoid to many processed foods also.

Not a vegetarian but do not eat a lot of meat perhaps twice a week.

Just plain pasta as in straight out of the packet with a home made sauce made of tomato and onion. Toast with no topping .

Have a theory of my own would like your opinion on. Could it be build up of lactic acid from the exercise and my body not being able to deal with it?
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Gary Moller advises:
I doubt very much if the problems you describe are due to lactic acid build-up. The most likely cause is a poor diet that is mostly devoid of nutrients. Of course, I am making these statements based on the snap-shot you have given; but I will make the comment that a healthy person, let alone a 40+ year old doing 2-3hr mountain bike rides, needs a consistent daily infusion of thousands of different nutrients. While other days that are nutrient rich may be around the corner, there is a real danger that your diet is leading down a path that will only result in very bad health crash.

The feelings of acidity and vomiting that you describe could be explained by your poor diet. Let me explain why:

Your liver produces bile which is a bitter liquid that is used by the body to emulsify and help digest fats in your diet. The liver produces a steady dribble of bile that is stored in the gall bladder. When a fatty meal is consumed the gall bladder is stimulated to release the bile. If you are on a low fat diet, which you appear to be, then one must ask what happens to the bile that builds up in the gall bladder, especially overnight? Well, it just sits there and does nothing except accumulate more and more. Then you go out riding - heart racing, lungs pumping, smashing your way downhill - and that bile just sloshes about. Eventually, like a child who fails to get to the toilet in time - it releases and you end up with a gut full of bitter bile, some of which is regurgitated because it has no useful purpose at the time. this is a recipe for an eventual health disaster and action must be taken to correct things.

My advice is to consult an experienced nutritionist in your area to help you work out a suitable diet that suits your lifestyle and personal dietary tastes. I will offer the following general comments:

Fat is good for you. You can not live without fat. As an athlete you need more fat in your diet - not less. Fat is also essential for the supply and absorption of many nutrients including the fat soluble vitamins - A, D, E and K. Without these you get sick and die.

Pasta and bread made from white flour are not good for you in anything other than small amounts. There is little nutritional value in them and they only serve to gum up the digestive tract. It is the ingredients that go on them that is nutritious - butter, olive oil, tomato, meat fish, cheese, onions, garlic, peppers etc, etc - all in copious amounts. So go easy on the bread and pasta and big on the toppings.

Sugar and honey are simple sugars that should only be consumed in very small amounts. Too much may set you up for increasing insulin resistance and even type II diabetes. This warning applies, as well, to a diet that is excessively rich in bread and pasta. Digestion is such that the starches in these foods are converted to simple sugars almost from the moment they are mixed with saliva. For carbohydrates, you should seek a wide mix of sources, including root crops such as kumara, taro, pumpkin, bread fruit and potato.

Get more protein (along with fat) in your diet every day. Your body needs protein for a myriad of jobs, including repair following your rides and for building strong muscles.

Get more fresh vegetables and fruit in your diet. Pears and apples are kind of ok; but there must be more variety including plenty of the brightest, greenest and reddest. Berries, peppers, carrots, brocolli and so on. Fresh is best and lightly cooked or raw.

Drink only as much water as you require to replace body weight lost during a ride. Please read my many articles and E-Publications on endurance training which explain the importance of hydration without excess.