1. bookVolume 21 (2009): Issue 2009 (January 2009)
Journal Details
First Published
13 Jan 2009
Publication timeframe
5 times per year
access type Open Access

The Recovery Phase Following a Triple Iron Triathlon

Journal Details
First Published
13 Jan 2009
Publication timeframe
5 times per year

The purpose of this case study was to investigate the recovery phase in a single athlete after a Triple Iron Triathlon involving 11.4 km swimming, 540 km cycling and 126.6 km running. Total body mass, body fat and skeletal muscle mass using the anthropometric method as well as total body water using bioelectrical impedance analysis were determined pre race, after the race and every 24 hours until complete recovery. Parameters of hydration status (urinary specific gravity, hematocrit and plasma sodium) and skeletal muscle damage (plasma urea) were measured at the same time. After finishing the race within 42 hours, total body mass was decreased and total body water was increased. Over the following 6 days, prior to returning to pre race values for plasma volume and total body water, body mass reached a peak value on day 3, plasma volume on day 2 and total body water on day 1. Clinically visible edemas of the feet persisted until day 4. Six days after the race, body mass was reduced by 2.1 kg, skeletal muscle mass by 0.6 kg and fat mass by 0.7 kg. An increase in both blood urea and urinary output post race between days 3 and 6 suggested an impairment of renal function immediately post race due to skeletal muscle damage and manifesting clinically observed edemas. For practical application, athletes, coaches and physicians should anticipate that performing such an ultra-endurance race can lead to considerable edemas of the lower limbs during the recovery phase.


Atwater W.O. Coefficients of digestibility and availability of the nutrients of food. Proc Am Physiol Soc, 1909. 30: 14-19.Search in Google Scholar

Ball S.D., Altena T.S., Swan P.D. Comparison of anthropometry to DXA: a new prediction equation for men. Eur J Clin Nutr, 2004. 58: 1525-1531.Search in Google Scholar

Beaumont van W. Evaluation of hemoconcentration from hematocrit measurements. J Appl Physiol 1972; 31: 712-713.Search in Google Scholar

Berneis K., Keller U. Bioelectrical impedance analysis during acute changes of extracellular osmolality in man. Clin Nutr, 2000. 19: 361-366.Search in Google Scholar

Bircher S., Enggist A., Jehle T., Knechtle B. Effects of an extreme endurance race on energy balance and body composition - a case study. J Sports Sci Med, 2006. 5: 154-162.Search in Google Scholar

Fallon K.E., Sivyer G., Sivyer K., Dare A. The biochemistry of runners in a 1600 km ultramarathon. Brit J Sports Med, 1999. 33: 264-269.Search in Google Scholar

Fellmann N., Bedu M., Giry J., Pharmakis-Amadieu M., Bezou M.J., Barlet J.P., Coudert J. Hormonal, fluid, and electrolyte changes during a 72-h recovery from a 24-h endurance run. Int J Sports Med, 1989. 10: 406-412.Search in Google Scholar

Fellmann N., Ritz P., Ribeyre J., Beaufrère B., Delaître M., Coudert J. Intracellular hyperhydration induced by a 7- day endurance race. Eur J Appl Physiol, 1999. 80: 353-359.Search in Google Scholar

Frayn K.N. Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol, 1983. 55: 628-634.Search in Google Scholar

Gudivaka R., Schoeller D.A., Kushner R.F., Bolt M.J.G. Single- and multifrequency models for bioelectrical impedance analysis of body water compartments. J Appl Physiol, 1999. 87: 1087-1096.Search in Google Scholar

Hiilloskorpi H., Pasenen M., Fogelholm M., Laukkanen R., Mänttäri A.T. Use of heart rate to predict energy expenditure from low to high activity levels. Int J Sports Med, 2003. 24: 332-336.Search in Google Scholar

Irving R.A., Noakes T.D., van Zyl Smit R. Metabolic and renal changes in two athletes during a world 24 hour relay record performance. Br J Sports Med, 1989. 23: 227-232.Search in Google Scholar

Irving R.A., Noakes T.D., Raine R.I., Van Zyl Smit R. Transient oliguria with renal tubular dysfunction after a 90 km run. Med Sci Sports Exerc, 1990. 22: 756-761.Search in Google Scholar

Janssen G.M., Degenaar C.P., Menheere P.P., Habets H.M., Geurten P. Plasma urea, creatinine, uric acid, albumin, and total protein concentrations before and after 15-, 25-, and 42-km contests. Int J Sports Med, 1989. 10: S132-S138.Search in Google Scholar

Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM. Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr, 2000. 83: 115-122.Search in Google Scholar

Kao WF, Shyu CJ, Yang XW, Hsu TF, Chen JJ, Kao WC, Polun-Chang, Huang YJ, Kuo FC, Huang CI, Lee CH. Athletic performance and serial weight changes during 12- and 24-hour ultra-marathons. Clin J Sport Med, 2008. 18: 155-158.Search in Google Scholar

Kavouras S.A. Assessing hydration status. Curr Opin Clin Nutr Metab Care, 2002. 5: 519-524.Search in Google Scholar

Kim H.J., Lee Y.H., Kim C.K. Biomarkers of muscle and cartilage damage and inflammation during a 200 km run. Eur J Appl Physiol, 2007. 99: 443-447.Search in Google Scholar

Kirchhoff E. Online-Publication of the German Food Composition Table ‘Souci-Fachmann-Kraut’ on the Internet. J Food Compost Anal, 2002 15: 465-472.Search in Google Scholar

Knechtle B., Marchand Y. Schwankungen des Körpergewichts und der Hautfaltendicke bei einem Athleten während eines Extremausdauerwettkampfes. Schweiz Z Sportmed Sporttrauma, 2003a. 51: 174-178.Search in Google Scholar

Knechtle B., Zapf J., Zwyssig D., Lippuner K., Hoppeler H. Energieumsatz und Muskelstruktur bei Langzeitbelastung: eine Fallstudie. Schweiz Z Sportmed Sporttrauma, 2003b. 51: 180-187.Search in Google Scholar

Knechtle B., Enggist A., Jehle T. Energy turnover at the Race across America (RAAM) - a case report. Int J Sports Med, 2005. 26: 499-503.Search in Google Scholar

Knechtle B., Kohler G. Running 338 kilometres within five days has no effect on body mass and body fat but reduces skeletal muscle mass - the Isarrun 2006. J Sports Sci Med, 2007. 6: 401-407.Search in Google Scholar

Knechtle B., Duff B., Amtmann G., Kohler G. An ultra-triathlon leads to a decrease of body fat and skeletal muscle mass - The Triple Iron Triathlon Austria 2006. Res Sports Med, 2008a. 16: 97-110.Search in Google Scholar

Knechtle B., Duff B., Schulze I., Kohler G. A multi-stage ultra-endurance run over 1,200 km leads to a continuous accumulation of total body water. J Sports Sci Med, 2008b. 7: 357-364Search in Google Scholar

Knechtle B., Knechtle P., Schück R., Andonie J.L., Kohler G. Effects of a Deca Iron triathlon on body composition - a case study. Int J Sports Med, 2008c. 29: 343-351.Search in Google Scholar

Knechtle B., Salas Fraire O., Andonie J.L., Kohler G. Effect of a multistage ultra-endurance triathlon on body composition: World Challenge Deca Iron Triathlon 2006. Brit J Sports Med 2008d. 42: 121-125.Search in Google Scholar

Lee R.C., Wang Z., Heo M., Ross R., Janssen I., Heymsfield S.B. Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models. Am J Clin Nutr, 2000. 72: 796-803.Search in Google Scholar

Lehmann M., Huonker M., Dimeo F. Serum amino acid concentrations in nine athletes before and after the 1993 Colmar Ultra Triathlon. Int J Sports Med, 1995. 16: 155-159.Search in Google Scholar

Maughan R.J., Whiting P.H., Davidson R.J. Estimation of plasma volume changes during marathon running. Brit J Sports Med, 1985. 19: 138-141.Search in Google Scholar

Milledge J.S., Bryson E.I., Catley D.M., Hesp R., Luff N., Minty B.D., Older MW, Payne NN, Ward MP, Withey WR. Sodium balance, fluid homeostasis and the renin-aldosterone system during the prolonged exercise of hill walking. Clin Sci (Lond,) 1982. 62: 595-604.Search in Google Scholar

Mischler I., Boirie Y., Gachon P., Pialoux V., Mounier R., Rousset P., Coudert J., Fellmann N. Human albumin synthesis is increased by an ultra-endurance trial. Med Sci Sports Exerc, 2003. 35: 75-81.Search in Google Scholar

Neviackas JA, Bauer JH. Renal function abnormalities induced by marathon running. South Med J, 1981. 74: 1457-1460.Search in Google Scholar

O'Brien C., Young A.J., Sawka M.N. Bioelectrical impedance to estimate changes in hydration status. Int J Sports Med, 2002. 23: 361-366.Search in Google Scholar

Ounpuu S. The biomechanis of running: a kinematic and kinetic analysis. Instr Course Lect, 1990. 39: 305-318.Search in Google Scholar

Pastene J., Germain M., Allevard A.M., Gharib C., Lacour J.R. Water balance during and after marathon running. Eur J Appl Physiol, 1996. 73: 49-55.Search in Google Scholar

Pialoux V., Mischler I., Mounier R., Gachon P., Ritz P., Coudert J., Fellmann N. Effect of equilibrated hydration changes on total body water estimates by bioelectrical impedance analysis. Brit J Nutr, 2004. 91: 153-159.Search in Google Scholar

Raschka C., Plath M., Cerull R., Bernhard W., Jung K., Leitzmann C. The body muscle compartment and its relationship to food absorption and blood chemistry during an extreme endurance performance. Z Ernahrungswiss, 1991. 30: 276-288.Search in Google Scholar

Raschka C., Plath M. Body fat compartment and its relationship to food intake and clinical chemical parameters during extreme endurance performance. Schweiz Z Sportmed, 1992. 40: 13-25.Search in Google Scholar

Reid S.A., King M.J.Serum biochemistry and morbidity among runners presenting for medical care after an Australian mountain ultramarathon. Clin J Sports Med, 2007. 17: 307-310.Search in Google Scholar

Segal K.R., Burastero S., Chun A., Coronel P., Pierson R.N., Wang J. Estimation of extracellular and total body water by multiple-frequency bioelectrical-impedance measurement. Am J Clin Nutr, 1991. 54: 26-29.Search in Google Scholar

Skenderi K.P., Kavouras S.A., Anastasiou C.A., Yiannakouris N., Matalas A.L. Exertional rhabdomyolysis during a 246-km continuous running race. Med Sci Sports Exerc, 2006. 38: 1054-1057.Search in Google Scholar

Uberoi H.S., Dugal J.S., Kasthuri A.S., Kolhe V.S., Kumar A.K., Cruz S.A. Acute renal failure in severe exertional rhabdomyolysis. J Assoc Physicians India, 1991. 39: 677-679.Search in Google Scholar

Wade C.E., Dressendorfer R.H., O'Brien J.C., Claybaugh J.R. Renal function, aldosterone, and vasopressin excretion following repeated long-distance running. J Appl Physiol, 1981. 50: 709-712.Search in Google Scholar

Whiting P.H., Maughan R.J., Miller J.D. Dehydration and serum biochemical changes in marathon runners. Eur J Appl Physiol, 1984. 52: 183-187.Search in Google Scholar

Williams E.S., Ward M.P., Milledge J.S., Withey W.R., Older M.W., Forsling M.L. Effect of the exercise of seven consecutive days hill-walking on fluid homeostasis. Clin Sci (Lond,) 1979. 56: 305-316.Search in Google Scholar

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