Medical advice for Ford RideLondon
Before taking part in any of the Ford RideLondon events, please carefully read the following advice from our Medical Director, Professor Sanjay Sharma.
Provided you follow these common-sense guidelines, you too should be a picture of health as you cross the Finish Line.
As you know, taking part in mass participation sports events is beneficial to your health but participants need to take responsibility for their own health by equipping themselves with the right information about such things as training, eating and drinking.
The following simple advice on how to look after your body in the last few weeks building up to the event will help you to have a safe and healthy time. We do not recommend taking part in Ford RideLondon unless you are fit and well on Ride Day.
Discuss any medical problems with your GP. The advice in this article should supplement anything they say.
Fit to compete
Cycling is good for the heart in general but in strenuous endurance events, including long cycle rides, serious and sudden heart conditions may occur even in athletes apparently unaware that they had a problem.
If you have any heart-related symptoms during exercise, such as chest pain, unexpected shortness of breath, rapid palpitations (irregular heartbeat), a family history of heart attacks, heart disease, sudden death or have a high risk from high blood pressure, high cholesterol or kidney disease, we recommend that you discuss these symptoms with your GP.
Muscular aches and pains often occur after an increase in training. Try to gradually increase your training so you do not suffer prolonged periods of exhaustion. Separate days of heavy mileage with one or two days of lighter training or rest days, so that your body can refuel your muscles with muscle glycogen.
If you cannot ride at least half your total event distance comfortably three weeks before Ford Ride London, you are unlikely to safely manage the full amount on Ride Day. We do not recommend you ride on this occasion if you have not trained properly.
Illness and training
If you have flu-like symptoms, a feverish cold or a tummy bug, do not train until you have fully recovered, then start again gently and build up gradually. Do not attempt to catch up on lost mileage after illness or injury: this may set you back further. If you have a flu, it can take a few weeks to recover, so please be sensible and consider deferring your participation to ride when you’re feeling stronger next time.
Feeling unwell on Ride Day?
Do not participate if you feel unwell or have just been unwell, even if you are raising money for charity.
Most medical emergencies occur in people who have been unwell but do not wish to miss the event. If you feel feverish, have been vomiting, have had severe diarrhoea or any chest pains, or otherwise feel unwell, it is unfair to you, your family and your charity to risk serious illness and become a medical emergency.
You are unlikely to do yourself justice. There will be many other mass participation events, there will only ever be one of you. Please be sensible.
Drink what you feel you need to quench your thirst. You need to replace some of the fluid you lose as sweat but you do not need to replace it all and you do not need to drink a lot. Drinking too much fluid during or after an event can be very dangerous as it can cause hyponatraemia (water intoxication) which can lead to seizures, fits and even death.
THINK before you drink.
Individual needs vary according to your build, speed, and above all, the weather. Make sure your water bottles are full before the ride. Sip some water or sports drink in the half hour before the start so that you begin the event reasonably well hydrated.
Drinks will be available along the route at the four different Welfare Hubs. Slower cyclists do not need to drink as much as faster cyclists. If it’s a warm day you may need a little more fluid than usual, but not a lot more. On a cool day all cyclists should drink less.
Do not drink large amounts of fluid after finishing. You can rehydrate (replace lost fluids) gradually over the next 24 to 48 hours. Try to eat some salty food and stagger your drinks. This way you will not get hyponatraemia and will still replace enough of the water, salt and glycogen lost in cycling the event.
Drinking on the bike needs practice. Practise drinking while cycling on longer training rides and make sure you are used to the drinks that you will use on the day.
Do not change your normal diet drastically in the last week before the event. However, consider eating less protein (meat or plant-based sources such as tofu) and more carbohydrate (pasta, bread, potatoes, cereals, rice), especially over the last three days when you will also be markedly reducing your training (tapering). This helps to load the muscles with glycogen, which will delay you ‘hitting the wall’.
Unless you reduce your protein intake, you will not eat enough carbohydrates. Some riders find it efficient to deplete their carbohydrate levels with a long ride on a low carbohydrate diet and then replace it by carb loading, however others find this can make their muscles feel very heavy – so you should not try this for the first time in the week before the event.
Before your longer rides in the weeks leading up to the event, practise eating your breakfast at the same time you’ll eat it on Ride Day. You will then be used to eating at the right time for the event.
On the day
Wear appropriate clothes for the weather but be prepared for all conditions. Do not ride if you feel unwell or have just been unwell, even if you are riding for charity. Many medical emergencies occur in people who have been unwell but do not wish to miss the event.
At the end
Once you have completed the event, try to keep moving if you can, especially if you feel dizzy. Walking will help to keep pumping the blood back up to the head. Do not stand about getting cold. Some participants feel faint more than half an hour after finishing an event, often because they have not eaten anything. Again, do not drink excessively.
Large doses of supplementary vitamins and minerals (such as iron) are not essential and produce no benefit if you have a healthy mixed diet.
Adequate preparation for a cycle event requires appropriate nutrition, hydration and rest. Athletes often consume isotonic, carbohydrate and protein drinks as well as energy gels and bars purchased in sports and health-food shops in preparation for the event, which is considered safe practice.
However, over the last two decades there have been an increasing number of commercially available compounds that claim to enhance performance. Some have been found to contain substances banned in other countries and other products (such as steroids) that are banned for use among competitive athletes. Such products are usually purchased via the internet and should not be used by anybody training for a sports event like the Ford Ride London.
Cyclists using performance-enhancing compounds that have not been licensed and regulated properly may experience serious side effects and increase their risk of developing heart disturbances that culminate in sudden death.
There have been well-publicised cases of cyclists inadvertently using compounds such as DMAA (an amphetamine-like substance) in an attempt to help them fight fatigue during endurance events and this caused detrimental effects on their health, even resulting in their death. Do not take unregulated substances bought over the internet.
Certain painkillers termed non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, diclofenac or naproxen can cause problems with the kidneys and should be avoided within 48 hours of doing the Ford Ride London. Muscular pain during this period should be treated with paracetamol.
Professor Sanjay Sharma, BSc (Hons), MD, FRCP (UK), FESC is Professor of Cardiology at St George’s, University of London, and the Medical Director of the Ford RideLondon festival of cycling, the TCS London Marathon, The Big Half and the Vitality London 10,000.