As part of testing a new product I had a few tests done this week which seem to have helped me come full circle in my quest to understand my recurring lower leg problems particularly around the ankles, posterior tendons and metatarsals.
The test measured various cardiovascular metrics and as expected both my normal blood pressure and my central aortic systolic pressure (CASP – the pressure at the root of the aorta next to your heart) were just on the positive side of average whereas my Radial Augmentation Index came in at 93%. Now while this sounds good, it is actually bad as this figure is 10% worse than the average results for even the 70-80 age group.
Radial Augmentation Index
The RAi is a measurement which has seen a lot of research (try Google it) and it is described in those as “a useful and easily obtainable parameter for vascular aging”, “Raid unmasks premature coronary artery disease in younger males” and generally is an indicator of the stiffness of your arteries.
In addition, the testers looked at my waveform which showed up as extremely erratic rather than the normal “high hill followed by low hill”. There is “flutter on the line” so to speak and the comment was made to me that it is often seen in people with diabetes.
In my case, however, both the RAi and the arterial pulse waveform were likely associated to the light inflammation in my ankles on the day of the test as this causes tension to build up in the arteries.
This lead me to down a route of inquiry which finally seems to confirm what I have suspected for some time about my injury: It is a form of tenosynovitis (usually linked directly to rheumatoid arthritis). Dr. Patrick Leahy and my physio John Murphy already confirmed this in separate tests and what leads me to believe that all my lower leg pains are of that nature is the following:
- I got a mild flare-up in the first week of training
- Ultra-sound scans clearly showed no tendon damage and sufficient blood-flow to all areas just the week previous
In short: There is nothing wrong with my tendons, the pain comes from an inflammation of the fluid-filled sheath around my tendons (called synoviums). As this form of aggressive over-reaction by the body is a form of auto-immune response, it is likely brought on by sub-optimal diet (and may have been brought up initially by the serious stomach infection I carried for most of 2010, and possibly parts of 2009, which is common in rheumatoid arthritis).
This is not the only cause of the very high RAi figure but explains some of the performance issues I have been seeing in present years such as the inability to push harder due to pressure around my chest despite legs still not being flooded with acid. This has also manifested in a failure to reproduce my previous max HR of 198 in subsequent tests.
My arterial stiffness would simply cause too much pain and discomfort to push into the truly maximal area of heart beats per minute I could exert myself at in 2007 and 2008. Long-time readers will remember I had a barrage of tests done at the Blackrock Clinic last year to find the root cause, but they failed to find any. Interestingly they did not perform any testing for arterial stiffness.
I would need to get the test confirmed with a doctor for absolute certainty but the medical device used is certified by AAMI and the European Society for Hypertension and has a reliability over 99.17% compared to the traditional method of inserting a catheter into the aortic root (auch!). To boot, the test was conducted thrice.
As far as I am concerned all the pieces of the puzzle seem to fall together and all point in the same direction: I must address my health first and reverse the premature aging of my cardiovascular system as well remove all food-groups causing the inflammation that sets on after certain levels of rigorous exercise.
Several studies have shown that removing products such as dairy and bread from your diet can completely reverse the symptoms of rheumatoid arthritis and other auto-immune conditions. I confirmed this with myself when I entered the Paleo-Diet ahead of having my best spell of improvement (meteoric in fact) in early 2008. Both injuries and performance-plateau returned or worsened once I returned to a traditional diet.
Back to the purpose of the test: A new product has been brought to market heavily backed by good scientific research which purports to be able to provide all the benefits of the Paleo-Diet, and reverse cardiovascular stiffness. I will be testing this on myself for the next quarter and hope to have more tests done to collect evidence of the efficacy. Health is often seen at the bottom of the fitness pyramid, below even aerobic endurance, and the last day’s experiences brings back to me just why it is the true foundation on which you build your athletic performance.