Classification of Exercise-Associated Muscle Cramps in Ironman-Distance Triathletes Over Three Decades

Abstract

Injuries and illnesses at ultra-endurance events are common, often requiring medical care. While these occurrences have been previously investigated in the scientific literature for initial care, the factors and characteristics of the athletes returning for medical care within the same race have not been previously reported. PURPOSE: To analyze the injury and illness characteristics of athletes who returned to the medical tent following initial care during the same race using three decades of Ironman-distance triathlon medical data. METHODS: Medical tent records from a single Ironman-distance triathlon event during 1989-2019 were reviewed retrospectively. All athletes presenting to the medical tent for at least one visit were included. Demographics, symptoms, and injury types were explored using descriptive statistics. The likelihood of athletes presenting to the medical tent for additional visits and their associated diagnoses were explored using odds ratios with 95% confidence intervals. RESULTS: Of the 10,533 athletes who presented to the medical tent, 940 (8.9%), 113 (1.1%), and 16 (0.1%) returned for one, two, or three additional visits in the same race. Female athletes (23.1%) presented for additional medical visits more frequently than males (17.5%)(T-test, p < .001). Returning athletes (12.36 hrs) had significantly slower race finishing times than those with only a single visit (11.52 hrs)(T-test, p < .001). No correlation was found between age and multiple visits. Following an initial care, the odds of returning for the same reason were particularly high for headache, altered metal status, diarrhea, abdominal pain, and vomiting (Fig. 1). CONCLUSIONS: Various initial presentations clearly show an increased likelihood of returning later in-race for the same reason. Careful surveillance of athletes with these medical diagnoses at initial presentations can optimize athlete care and medical tent resources allocation during ultra-endurance races.