Mandatory Rest Stops Improve Athlete Safety during Event Medical Coverage for Ultramarathons

Joslin, Jeremy; Mularella, Joshua; Bail, Allison; Wojcik, Susan; Cooney, Derek R

doi:10.1017/s1049023x15005555

Cited by 12 publications

(3 citation statements)

References 10 publications

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“…Four days of short term heat acclimation facilitates effective perceptual adaptations (Willmott et al, 2017 ). The adaptation to the heat can also be achieved by pauses during heat or tropical runs (Joslin et al, 2015 ). It is also important that an appropriate cooling is initiated immediately in case of suspected overheating or heat stroke (Rae et al, 2008 ).…”

Section: Exercise-associated Hyponatremia In Ultra-marathon Runningmentioning

confidence: 99%

Physiology and Pathophysiology in Ultra-Marathon Running

Knechtle

Nikolaidis²

2018

Front. Physiol.

225

235

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In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35–45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold) or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In longer ultra-marathons, ~50–60% of the participants experience musculoskeletal problems. The most common injuries in ultra-marathoners involve the lower limb, such as the ankle and the knee. An ultra-marathon can lead to an increase in creatine-kinase to values of 100,000–200,000 U/l depending upon the fitness level of the athlete and the length of the race. Furthermore, an ultra-marathon can lead to changes in the heart as shown by changes in cardiac biomarkers, electro- and echocardiography. Ultra-marathoners often suffer from digestive problems and gastrointestinal bleeding after an ultra-marathon is not uncommon. Liver enzymes can also considerably increase during an ultra-marathon. An ultra-marathon often leads to a temporary reduction in renal function. Ultra-marathoners often suffer from upper respiratory infections after an ultra-marathon. Considering the increased number of participants in ultra-marathons, the findings of the present review would have practical applications for a large number of sports scientists and sports medicine practitioners working in this field.

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Section: Exercise-associated Hyponatremia In Ultra-marathon Runningmentioning

confidence: 99%

Physiology and Pathophysiology in Ultra-Marathon Running

Knechtle

Nikolaidis²

2018

Front. Physiol.

225

235

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“…EHS can occur in various environmental conditions, but it is most commonly associated with long periods of extreme heat or solar stress alongside exposure to high humidity [29]. The diagnostic signs of EHS are collapse, aggressiveness and irritability, confusion, convulsions, and alterations of consciousness [61], and it can even lead to death in some cases [52].…”

Section: Stress Heat Stroke (Ehs) During Physical Exercise Under Extrmentioning

confidence: 99%

“…It has an estimated incidence of 1 in every 1000 athletes [62], and it is frequently observed in adventure races, climbing, hiking, cycling competitions, and ultra-endurance races [52,62]. In the latter, it is most common in marathons [14,44,45] and in ultra-marathons several cases of athletes that did not finish because of heat-related factors, as an inadequately heat acclimatization have been reported [29,35].…”

Section: Stress Heat Stroke (Ehs) During Physical Exercise Under Extrmentioning

confidence: 99%

Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations

Sanz

Nuñez

Sospedra

et al. 2020

IJERPH

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During the last few years, the numbers of competitors in endurance and ultra-endurance sports modalities have increased significantly. This type of competition is an extreme challenge for athletes. Therefore, they have an increased the risk of developing medical and nutritional problems. The aim of the work is to estimate the incidence of nutrition-related adverse outcomes in endurance and ultra-endurance sports, considering the variables that influence them. A critical review was carried out based on the PubMed database, by means of a search strategy based on keywords separated by Boolean connectors. For all the results obtained in a period from 2008 to 2019, a series of inclusion/exclusion criteria was applied to select only the studies that fitted the objective of the present study. Results and discussion: Of the 871 publications identified, 33 met the inclusion criteria. The adverse outcomes found included exercise-associated hyponatremia (EAH), heat stroke by exertion (EHS), gastrointestinal (GI) problems, dehydration, and hypothermia; the provision of misinformation to athletes about nutrient intake and hydration during competition was identified as the main cause. Conclusions: The main adverse outcomes in endurance and ultra-endurance sports modalities are EAH, GI inconveniences, and EHS. These problems can affect the performance and health status of the athlete during and post-competition. Several nutritional guidelines have been suggested that can prevent these adverse outcomes, and it is essential to individualize and adjust the nutritional intake and hydration status according to the characteristics of each competition.

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Epidemiology of exertional heat illnesses in organised sports: A systematic review

Gamage

Fortington

Finch

2020

Journal of Science and Medicine in Sport

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Mandatory Rest Stops Improve Athlete Safety during Event Medical Coverage for Ultramarathons

Abstract: Mandatory rest stops during extreme running events in hot or tropical environments, like the Jungle Marathon, are likely to improve athlete safety and improve the heat acclimatization process.

Cited by 12 publications

References 10 publications

Physiology and Pathophysiology in Ultra-Marathon Running

Physiology and Pathophysiology in Ultra-Marathon Running

Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations

Epidemiology of exertional heat illnesses in organised sports: A systematic review

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