Let's face it there is a decidedly dark side to the endurance drama. However, many of the maladies suffered by endurance athletes are quite easily avoided. The following are a list of obstacles and perils of endurance sports:

Air Pollution

The total effect of air pollution on the body is greater than the effect of each pollutant individually. The two main common air pollutants you'll likely encounter during inner-city training are carbon monoxide and ozone. Once carbon monoxide from auto fumes enters your body, it combines with red blood cells and cuts off their oxygen supply. Can it be fatal? In extreme cases, yes. But even in lesser amounts, it'll shave your aerobic capacity and endurance performance. 

Carbon monoxide can have serious consequences. To preserve your health, avoid high-traffic areas and rush-hour times when running or cycling. Ozone is the primary component of urban smog. It is formed when emissions from automobiles, factories, and other pollution sources interact with sunlight. Ozone can make your eyes water, your throat burn and your breathing uncomfortable enough to limit aerobic performance.

Amenorrhea

Women serious about endurance competition once tended to consider amenorrhea a blessing: train hard, get lean and stop having your period. The freedom of not having to deal with a menstrual cycle, not having to worry about a sometimes awkward problem at the last minute on a race day was pure and simple. And what harm could it do? Everyone, it seemed, knew someone who had been amenorrheic for years, then backed off from training, resumed their menstrual cycle and had children. Big deal.

For years, the medical and scientific community felt much the same way. If amenorrhea was not exactly normal. It was widely viewed as harmless and temporary, with no lasting impact on women's biggest concern fertility.

Today, doctors and sportsmedicine experts are taking  a hard look at exercise-induced amenorrhea. Its apparent link to osteoporosis, or low bone density, a potentially crippling disorder common in postmenopausal women, has given the medical community pause. 

Ankle Sprains

You can help prevent later sprains by fortifying the weakened area. First, you can lift light weights on the end of your foot. Sit on a table with the weight on your foot and your injured leg extended and trace the letters of the alphabet, from A to Z, in the air with your foot. Second, try standing with your feet about 12 inches apart. Bend your knees slightly and alternately raise the inside and outside of your foot. Do this 20 to 30 times, several times daily. Third, and simplest, with your shoes on, walk on your toes for several minutes. Then walk on your heels with your toes in the air, again for several minutes. Finally, if you are a chronic ankle sprainer, try a tilt board. Walking on this device, a sort of round garbage can lid balanced on a center stay helps improve coordination and ankle strength.

Anorexia Nervosa

There is a dark side to this business of getting fit. There is a strong connection between endurance athletes and anorexics. Although there are no concrete figures, anorexia has made its presence known among this group. Many of the qualities associated with successful endurance athletes are also found in anorexics. Both personality types are highly driven, sometimes compulsive. Both wish to control their minds and bodies. Both also deny pain and discomfort, fatigue in the case of the athlete, hunger in the case of the anorexic. 

Asthma

Asthma is a narrowing of the breathing tubes in the lungs. As the lining of the tubes swells and the muscles surrounding them constrict, it becomes difficult to force air in and out of the lungs , a harrowing experience for anyone familiar with the accompanying gasping, wheezing and shortness of breath. Asthma can affect your performance as an endurance athlete. Do the following if you have asthma and are an endurance athlete:

• Do vigorous but gradual warm-ups before exercising
• Avoid eating two hours prior exercise
• Avoid shellfish, celery and melons
• Avoid cold, dry air
• Use a face mask in less-than-ideal situations
• Breathe through the nose
• Take slow, deep breaths
• Limit maximum effort to less than five minutes
• Keep training consistent and vigorous

Blisters

Blisters occur when friction between the skin and another surface creates heat, irritating the delicate tissues beneath the surface. Fluid then leaks out of the injured tissue, forming a bubble. If the irritation continues long enough, blood will mix with the fluid, a sign of deeper, more severe tissue damage that will invariably be accompanied by greater pain.

Bonking

Bonking is the cyclist' expression for what runners call "the Wall" that point in a marathon when muscles run out of glycogen. Triathletes use a slightly more descriptive phrase: "blow up", as in "I blew up at mile 30". 

But nothing short of personal experience can describe the feeling of reaching into your carbohydrate cupboard and coming up empty-handed. The best way to avoid the bonk in the short term is to eat a substantial breakfast before taking a long ride.

Cramps

Cramps have probably put a stop to more athletic endeavors than jobs, family  and rainy weekends. Poorly trained muscles can contribute to cramps. Endurance athletes have muscle cramps because of dehydration and a resulting electrolyte imbalance. The balance of electrolyte helps maintain the movement of fluid in and out of the cells. It also ensures proper muscle contraction.

Frostbite

Frostbite comes in one or two varieties, superficial or deep. Skiers often experience the symptoms if superficial frostbite, painful numbness on exposed cheeks and the tips of the nose and ears. Deep frostbite is far more serious, inflicting irreversible damage on underlying tissues. When circulation stops, the extremities actually freeze, and the skin turns white and hard to the touch, like a bar of soap.

Hamstring Pulls

Hamstring problems are compounded by the fact that these muscles are notoriously tight. Runners, for example, often have bow-tight hamstrings, since the muscles go through a small range of motion during running. You can increase the range of motion slightly by doing different kinds of running fast and slow, uphill and downhill but most experienced runners address the hamstring dilemma through stretching and strengthening.

Hyperthermia

Hyperthermia is the extreme elevation of your body's internal, or core, temperature. Damage from hyperthermia can range from heat exhaustion, which can seriously impair performance, to life-threatening heatstroke.

Preventing Hyperthermia:

• Drink often during training and racing. Don't wait until you are thirsty.
• Prehydrate aggressively during the week before a hot-weather race.
• Wear ventilated shade on your head
• Wear white or light-colored, loose-fitting clothing that reflects sunlight and allows air to circulate.

Hypoglycemia

Glucose is what fuels our efforts, and when it goes, so do we, which is what makes hypoglyemia, or low levels of glucose in the body, a problem for the endurance athlete who neglects his or her energy stores. If you have ever been caught short on energy supplies, your thinking turns fuzzy, your coordination is slightly off. It is because your central nervous system depends on blood glucose for energy.

Hypothermia

Hypothermia is the lowering of the body's core temperature to below 95 degree Fahrenheit, is most often associated with swimming. The best way to prevent hypothermia is to dress suitably for any condition.

Iliotibial Band Friction Syndrome

IT band syndrome is common among endurance athletes. What brings on this syndrome? In most cases, a mechanical problem in your stride shifts the band slightly and makes it rub over the bony outside of the knee. As the IT band rubs over the bone and the friction increases, the band stiffens. And so does your knee.

Avoid the following to prevent this from happening:

• Downhill running
• Sloped surfaces
• Sudden increases in mileage
• Excessive hard running
• Hard surfaces

Iron Deficiency

Iron is a big issue with athletes particularly endurance athletes and women trying to keep a low body weight. Women are at a higher risk for iron deficiency. During their menstrual cycle alone, women can lose between 0.4 and 0.7 milligram of iron. A proper diet is the key preventive measure from iron deficiency.

Obsession

It is good to start a self-improvement program but don't let it turn into an obsession. A sign of obsession is when your dream vacation is to go compete at the New York City Marathon. 

Overtraining

How much should you train? How hard? How fast? How often? What should you eat? When should you rest? Unfortunately, there are no specific guidelines, the answers to these questions are as varied as the thousands of people who ask them. Most experienced athletes fall into patterns that lead to overtraining but the trick is to recognize the symptoms as soon as they appear, then ease off and make the necessary adjustments before all your hard work goes down the drain.

Some symptoms include the following:

• Your pulse rate when you wake up in the morning is more than ten beats per minute faster than normal
• You have been suffering from recurring colds; minor cuts and scrapes that have not been healing as quickly
• Injuries keep pooping up
• Your weight drops suddenly
• Your appetite wavers
• Your muscles are sore for days at a time
• You're irritable and out of sorts
• Your arms and legs feel heavy and coordination is slightly off
• You have trouble sleeping

Shin Splints

Shin splints is a catch-all term used to describe a variety of injuries. All of them revolve around the leg's shin bone (tibia), hence the name. But the root of the problem, and the pain it brings, can stray far and wide involving the bone itself, or the muscles, tendons and connective tissues surrounding the tibia. If you developed shin splints, here is what to do, ice it right after each exercise session, icing it down for between 15 and 30 minutes. Ice minimizes the swelling and inflammation caused by muscle or tendon strains. 

Stress Fractures

Stress fractures are caused by overtraining. These are the worst kind of shin splint injuries involving s microscopic break or crack in the bone. The cure for stress fractures is to rest. It takes about six weeks for bone to heal, although this can vary. 

Reference:

Scott Tinley and Ken McAlpine. Winning Guide to Sports Endurance, Rodale Press, 1994