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Its a Deep Burn

You know that feeling you get when you're going all out during the physical ability course and the leg work is starting to make your lunch come back up?

My inquiry has to do with the nausea/vomiting that occur after hardcore or strenuous leg workouts and workouts at high elevations.

I am from Ventura County and I train right here at sea level. I run 4-5 miles per day 3-5 days per week, depending on my work schedule. Last year I was in the testing process for a department in Washoe County (Northern Nevada) and took an ability test that was very similar to the Biddle test. It consisted of Dry & Charged hose drags, extending a 35' ladder, 4 stories with a highrise bundle, equipment carries, and the dead weight dummy drag on asphalt. All this while wearing a turnout coat, helmet, SCBA, and gloves.

Almost immediately after the test, I felt the strain on my thighs from the dummy drag. It felt like the sickness I get in my stomach from doing heavy squats at the gym. I started seeing the black and white spots and everything got louder. I removed my gear and found a nice little dirt clearing away from the other testers so I could vomit for about 5 minutes. It was a horrible feeling and my lungs were burning. I felt like I hadn't trained and I couldn't catch my breath. I trained extra hard for this particular test.

The following Monday I came to work (I work in an ER) and explained my experience to one of the Doc's. His only explanation was that I had trained at sea level and the test I had taken was at 5,500 ft. Elevation and the difficulty of the test were the two factors that created the response my body had.

What's the physiology behind the sick stomach feeling and the reason the elevation has such severe effects on an athlete even if they've trained and prepared for the physical ability test?

I think this is something Dr Jen might want to field. Or anyone who has gone through this experience.


The first questions that come to mind are what and when did you eat before the event? How much time was there between your last intake and your performance? Also, what did you drink and how long before the test did you drink it? You state that you are running 4-5 miles 3-5 times a week. What intensity are these runs? Is that the only type of training that you are doing? Did you train specifically for the events that make up the test? Let me know these answers and we can try and figure this out.

Hey Runner,
thanks for the reply. I remember specifically that I was running 3-5days per week, 3-5 miles at an 8-9 minute per mile pace in heavy sweats and a sweater to prepare for the heat up there in Reno. I also ran 20 stairs on the days I did 3 mile runs. That would've been twice a week for 3 weeks before the agility test. My weight training consisted of circuit training, where I did one lift per muscle group (Bench, military press, seated cable row, etc...)
The night before the events I had 2 liters of diluted Gatorade, Spaghetti with meat sauce (big portion), and some fruit. The morning of the agility test I had another two liters of water, a granola bar, and a banana. I arrived for my test an hour early with 500mls of diluted Gatorade. Once I was in the testing facility I wasn't allowed to bring my drink with me, so I didn't drink any liquids for an hour before my test time. I only had a few sips of tap water while waiting (98 degrees in the sun) for my turn.
At the beginning of the test I felt great, but midway through I took a deep breath and felt a burn in my lungs. It was a horrible feeling. My heart rate shot up, I was breathing alot faster, and I started getting nauseated. I had felt this feeling before in high school during Hell Week in football practice. I remember I would feel that way because I hadn't ran or trained for weeks before football practices would start. This is why I was puzzled as to why I felt so out of shape when I had trained so hard for this agility test in Reno....

I think I can help with this one!!!

The body?s response is due to a lack of oxygen. The thinner air at elevation means there is not as much oxygen there as there is at sea level. While you might have trained for this, you didn?t train at the elevation of the actual event.

When someone goes up to an elevation, their body will acclimatize by making extra effort to bind more oxygen from the air. This process of accommodation takes between 3 and 7 days. If you were not at that elevation for enough time before your event, you would not have had time to get used to the event.

You body made you vomit because it was hypoxic. It was a sign that you needed to slow down or stop what you were doing. And guess what? It worked, huh?

I recently had an experience with a lacrosse team I coach that might help you. We train them at sea level, and took them to Vale, Colorado to Play in the Vale Shoot Out. Right before I left, I found this stuff at the health food store, and thought I would give it a try. It's Called Aerobic O7, subtitled stabilized Oxygen. The nurtitionist at the store told me it worked really well to help Red Blood cells bind more oxygen. I was skeptical. But, I figured it was worth a try.

I started using it on most of the players- 8 drops per bottle of water they drank- up to 4 bottles like this per day. The first day, 2 kids got Elevation sickness- headache, nausea, shortness of breath, and had to discontinue play. Neither of those kids has started the Aerobic O7 stabilized oxygen drops. The other kids were fine. They played extremely well, and even beat the home team- which no one else in the tournament could keep up with (every visiting team was low landers).

Further, I get elevation sickness- the headache and stuffy sinuses every time I go up high. I used the stuff in Vale, and felt great.

We left from there, and played in New Jersey. I stopped giving the kids the drops when we landed in Jersey because I figured they didn't need them. I think the effectiveness lasted, though. They ran the east coast teams into the ground. This is unheard of with the humidity that California kids are not used to, plus the experience and skill level of east coast kids is usually higher. But, our kids had way more energy.

Here's the kicker: 3 weeks later, we took them back to the east coast-to Maryland. I didn't take the drops. The kids were weak, and tired and slow. The same kids, same team... were run into the ground. They still played pretty well, but they were slow and tired. We had been training and practicing them harder over the past 3 weeks than before the Vale and NJ tourneys. There was no reason for it. Several of them asked if I had the drops, and I had to say no.

So, the morale to the story is: The strangest things will help us.... and thinking outside the box can really beneficial.

Their website is [url=][/url]
Try it- it worked for them, and it might just work for you.

Best wishes

Dr. Jen Milus, DC
This message was edited by DrJen on 8-22-07 @ 11:07 AM

Where in NJ was the tournament? It's weird how big lacross and field hockey are here. (I am from CA)

The tournament was actaully just north eats of Phili- I can't remember- this tiny little town with this high school that had like 20 fields. It was called the National Draw...
Yeah- it's a heck of alot of fun......
Dr. Jen Milus, DC

Since you asked for the physiology behind it-

Dr. Jen is completely right in that the body is becoming hypoxic. The
major stress comes from the decrease in oxygen content in arterial
blood from the elevation. This is due to a decrease in the partial
pressure of oxygen at higher elevations. The body compensates by
making you breath faster. The increased breathing makes your heart
rate speed up, which decreases your exercise capactiy.

Basically, your body is working harder at that elevation then the same
workout at sea level. So you've trained and have an idea of what to
expect from the (PAT)Physical ability test at home, but when you go to
the higher elevations your body can't perform as well as it could
before, so you go past your limits, and your body lets you know.

However, the nausea/vomiting may not be from hypoxia. I (not an
expert, but studied exercise physiology at CSUF) believe that the N/V
came from a buildup of lactic acid. When you do PATs it's an all out
race. You are utilizing your fast twitch muscle fibers and a process
called glycolysis. An end product of this process is pyruvate which,
when enough oxygen is present turns to Acetyl CoA, which can then be
utilized for producing energy. However, when there is a lack of oxygen
the pyruvate turns into lactate. This lactic acid builds up and can lead
to fatigue, nausea, and vomiting usually accompanied by pain.

I'm not saying that hypoxia didn't cause your dizziness or contribute to
the situation, but I think that this is an explanation for the pain and the

I have gone through this test myself and I know exactly how you felt. I
think everything you described can happen in Ventura where you live,
but the elevation makes all these things occur quicker and easier.

Just my theory (I've been watching a lot of house lately).

As a side note I don't think oxygen drops can have any impact on Red
Blood Cells binding oxygen because that is controlled by
chemoreceptors that monitor the partial pressures of oxygen in the
body. So unless the drops are actually liquid oxygen, its highly
unlikely that they actually work.

-sorry about the multiple posts
This message was edited by Tim21 on 12-29-08 @ 1:17 AM

This message was edited by Tim21 on 12-29-08 @ 1:16 AM

This message was edited by Tim21 on 12-29-08 @ 1:16 AM

Your work out regimen sounds good, but it doesn't sound like you've
been pushing into your anaerobic threshold. Your body seems to have
become accustomed to the long aerobic runs and stair climbs. The
agility is just the opposite. It's all out work-100% for a very short
period of time. Just like on the fire ground. When you go into that
anaerobic stage, you can only sustain it for so long. If you stay in that
anaerobic stage too long, you feel sick.

So how do increase your anaerobic threshold? Inserting intervals into
your running regimen is a good start. An interval is basically a sprint
for a short period of time or distance. Start with a short interval like 15
seconds or 50 yards and work your way up. Shoot for 3 intervals in a
work out. It's important that all 3 intervals are at the same speed or
period of time. In other words, the last interval should be just as fast
as the first, so pace yourself.

I highly recommend a heart rate monitor. You can get one for about
$50 at the sports store. If you go to a doctor and do a full fitness
medical, they will do a max stress test. This will determine your max
heart rate. An interval gets your heart rate to about 90%-100% of your
max heart rate. The rest of your run should be at about 60-80% of
your max heart rate. When you are finished running, measure how
long it takes to get your heart rate back under 120 and write it down.
If you are training correctly, your recovery time should shorten. This is
a good thing.

Another way to increase your anaerobic threshold is to do circuit
training with functional exercises. Circuit training is like the agility.
Functional training is doing exercises that mimic work (firefighting for
you) tasks. You have different events(exercises) that you go through
one after another. Try setting up a this circuit and see how you feel.

30 seconds of push ups
30 seconds of air squats
30 seconds of pull ups ( assisted if necessary, just keep moving)
30 burpees
30 seconds of sit ups
run 400 meters and do it again

Each exercise is done with max effort.

I think that if you incorporate some intervals, circuit training and push
yourself into that anaerobic stage, you will become strong as steel,
head to heel.

When you are ready for some more, go to my website:
and let me know how you do.

Al Yanagisawa
This message was edited by firefit on 7-11-09 @ 2:06 PM