You may have heard our slogan that we want our Caveman trainees to train until they puke. We don’t mean that this should literally happen every time the client trains, nor is puking the primary objective of each workout. Instead, what we’re trying to say with this slogan is that in some of our programmes the client should be working at such an intense level during each session that they may puke during the first session, and some of the subsequent sessions.
What causes people to vomit during or after exercise? Your body needs both oxygen and nutrients to function, and these are transported throughout the body by the flow of blood. The demand for both increases during a workout, and your body adjusts to this increased demand by sending a greater percentage of blood to your working tissues. However, this means less blood goes to other areas, including your digestive system.
When someone is working at an intensity that they’re not used to, this decreased blood flow to the digestive system can cause them to become nauseous and perhaps even vomit. According to RW Steege, insufficient blood flow to the digestive system will cause the digestive system not to function properly. This in turn results in nausea and vomiting.
Another cause of vomiting is the build-up of lactic acid in the blood. During training (particularly when the body is using the ATP-PC and Glycolytic Systems), the body will break down nutrients to produce lactic acid in the blood. This lactic acid should be utilized by the body to create energy for the muscles to fire, but in individuals working out at a level of intensity to which they are not accustomed, the body isn’t able to process the lactic acid build-up quickly enough. The subsequent build up of lactic acid may irritate the vagus nerve, which links the brain to the digestive system. The body may then respond by vomiting.
You may also find that clients who have eaten just before a session, or have eaten foods that are not easily digestible (such as foods high in fat and/or protein) prior to a session, are more prone to throwing up. When food hasn’t been digested and is sitting in the client’s stomach, nausea and vomiting are far more likely. It is for this reason that you should advise your clients to have a small meal 1-2 hours before the session comprising moderate/slow digesting carbohydrates and protein.
With many of your clients coming into Caveman Circuit without having worked out at such a high intensity before, vomiting is likely to be a common occurrence at your training sessions. This is nothing to be overly concerned about, but you do need to understand that there are health concerns associated with your clients vomiting during exercise. For example, when your clients vomit, they will lose a significant amount of fluids, and are thus at a higher risk of dehydration and should be encouraged to replace lost fluids when they can.
With that said, as a Caveman Trainer, you’re working to instill an attitude of mental toughness and to teach your clients how to train at a high intensity. In our program, we have a “Train Till You Puke” slogan because we encourage our clients to push themselves to a level that they have never been before – but we don’t set out with the goal to train clients until they puke. However, when clients get sick during class, we never baby them. Instead, we cheer when someone has to step up to the garbage can, because it’s a sign that they’ve passed a barrier and succeeded at pushing themselves to train at an intensity that they never have before.
While we are not overly concerned when clients puke, and will even cheer them on, we don’t take it casually either. We will assign one trainer to assist the sick client and reassure them that they’ll be okay. However, once they’re finished throwing up, we stress for them to get right back into the workout. We keep a close eye on them after they have vomited. It promotes the “refuse to fail” attitude that we stress to our clients. Quitting for any reason other than risk of injury is absolutely frowned upon.
Most of our clients get sick only during their very first training session. However, it is known that vomiting due to the intense nature of the workout is likely for everyone at some point, and that we are able to recover without any long-term damage. Your client will quickly adapt to the intensity and will become better able to handle the physical stress of our Caveman Circuit Training. They get stronger and improve their VO2 max. In addition, the body quickly adapts to this decreased digestive track blood flow. However, if you have a client who keeps vomiting when they’re participating in high intensity exercise, it’s important to refer them to a doctor. It could be that they’re eating too close to workout time, as T. Kondo notes this may promote exercise-induced nausea, or they’re eating the wrong kinds of foods. However, if it happens often, it may be related to a more serious issue and the client should then be asked to seek medical advice.
Although there are no long-term negative effects of your client throwing up during the circuit, one negative effect of throwing up is that it may adversely affect your client’s work rate. Once they throw up, their work rate may be significantly lower when they get back into the session. Their work rate may drop lower than if your client had dialed it back a bit to avoid getting sick in the first place. This is acceptable, as long as your client gets back in the game, and doesn’t quit.
When clients do get sick during workout sessions, stress the importance of them eating and drinking immediately upon the end of the circuit. They will have lost a significant amount of fluids and they need to make an extra effort to rehydrate and refuel.
Kondo T. (2001) Exercise-induced nausea is exaggerated by eating. Appetite. 36(2): 119-25.
Rowland B, Frey R. Vomiting. Healthline.
Steege RW, Kolkman JJ, Huisman AB, Geelkerken RH. (2008) Gastrointestinal ischaemia during physical exertion as a cause of gastrointestinal symptoms. Ned Tijdschr Geneeskd. 152(33):1805-8.