Medical Mechanics of Ultrarunning

Leigh Wickham
December 11,1996
Ultramarathon Running Research Paper
Professor Donald Davis(aka.captain of Don's Ultra Stars)

The medical aspects of ultramarathon running are a enormous part of what makes up the individual ultra runner. Many traumatic injuries can take place when a person gets involved in this specific sport. " It is impossible to overemphasize the importance of injury prevention and treatment to the career of a successful athlete. It has been noted that the champion athlete is very often one who has attained a high level of lay expertise and downright craftiness with regard to injuries, whereas novices seem to keep getting hurt. Very often the difference between the perennial champion and the perennial bridesmaid is just that edge: an ability to avoid and/or recover quickly from physical trauma."(Marty Liquiri) This quote made by Marty is stating the point that preventing injuries is a essential aspect that a runner has to consider. There are a limitless amount of injuries that a runner might have to deal with. Several precautions can be taken to make sure most of these injuries do not take place.

Proper stretching is a very major part of preventing injuries concerning running. In order to run any distance your muscles as well as body have to be readily prepared. There are four stretching techniques that I have learned about. The first one is ballistic stretching. This stretch activates the stretch reflex, allowing the stretched muscle to contract quickly and the runner to bob up with a lot of speed. This stretch is not a popular one and is not very useful in ultra running. The second stretch is called the passive stretching. This stretch needs a partner to apply extra external pressure to elaborate the stretch. This stretch is safest when applied to more experienced athletes and is not advised for beginners just learning the whole stretching routine. The third way of stretching is referred to as contract-relax stretching. In this stretch the muscle is allowed to contract actively while being stretched and then stretched once more immediately after it relaxes. The fourth and final stretch is considered static stretching. This stretch is positioned and held for thirty to sixty seconds. There is a gradual build up of tension in the muscle being stretched so the stretch reflex isn't activated. As the tendons are slowly being stretched the inverse stretch reflex is being activated and the tension in the muscle lessons so the muscle can be stretched even further than before. This stretch improves flexibility and allows the muscles and tendons to be stretched to the fullest extent.

Stretching is very necessary but if it is not done properly it can cause serious damage. Stretching the wrong way can cause additional soreness so it would be wise to learn the right way to perform these exercises. It is essential that a runner looks into different stretches and makes sure that they are done before each and every run. From my personal experiences I have found that stretching before a race is the most important preparation that has to be taken care of. For example ,I was at a race at my school, and I was rushing around so much I neglected to stretch properly. When my race began my muscles in my legs instantly tightened and I collapsed. This proves the point that proper stretching must be completed no matter what.

Kidney failure is a possible outcome that can occur with ultra runners. This medical trauma is a serious situation that is probably the scariest aspect of the sport of ultramarathon running. My professor, Donald Davis, has experienced this injury and spoken to all of class about the incident. In an article he wrote he explained how it actually occurred and all his experiences during his kidney failure. " The explanation for how such a healthy sport can cause such a serious problem is quite well understood. Your muscles contain myoglobin, a protein which causes the red color of the muscles and helps the muscle use oxygen. Myoglobin is primarily contained in the slow- twitch muscles which are used in low intensity exercise of long duration, and is particularly prevalent in trained athletes. When a muscle breaks down or is injured, some of this myoglobin is leaked into the bloodstream, which carries it to the kidney. There is not general agreement as to exactly how the myoglobin causes kidney failure."( Donald Davis) In this quote Davis explains how kidney failure actually formulates. One of the first signs of kidney failure is usually bloody urine. If a runner is experiencing this he should look to medical help immediately. If a runner is experiencing this symptom and does not consult a doctor than he or she may start feeling a bit ill within the next thirty-six to forty-eight hours afterwards. A headache could occur which would be a result of the major rise in the blood pressure and also retained metabolic end products caused by the actual kidney failure. To avoid having to deal with kidney failure it is advised that a runner does not ingest nonsteroidal anti-inflammatory agents during prolonged exercise. Donald Davis took 2400 mg. of ibuprofen throughout the specific race that this all took place in; because his calf muscle was bothering him. This is a possible reason to why he had experienced kidney failure. It is a very serious condition and has to be looked into immediately. I realize that some ultra runners are so involved in their running that nothing can stop them. Regardless, it would be wise to take care of the negative conditions to relieve your body from troublesome problems. Once that is done, the runner can do the best job possible on their races.

"Of the 10,271 injuries to recreational athletes treated by a large sport medicine facility during its first five years, running accounted for a greater percentage(37%) than any other sport."(article on Knee Injuries). Knee injuries occur with a lot of runners involved in distance running and a lot of runners usually feel discomfort in the knee joint after they go out running. This could be a pulled tendon caused by tension build up in the knee. This type of knee injury is referred to as "Runners Knee". This injury can usually be treated with " orthotic prescription. Running in shoes which exhibit good rearfoot control characteristics may help prevent the development of runner's knee."(article on Knee Injuries)The type of shoe you wear is an essential part of a runners priorities. When the soles of your shoes show major aging, than it is definitely time to purchase new shoes. One will usually prefer a certain name brand according to experience. Don't buy a pair of shoes because they look good, buy them because they feel good on your feet and give you the most support. Ultra runners run on very uneven grounds at times and need the support of a running shoe to protect them from foot and ankle injuries.

An injury that I have personally experienced more than once is known as Tibial Stress Syndrome (shin splints). This injury is caused by a breakdown of the tibia's bony surface. One will receive discomfort along the anterior or posterior side of the shin. Many runners just run through this pain, but they probably do not realize that shin splints can lead to a stress fracture which is much more severe than a shin splint. If you experience achiness in the shin area while taking a run, you should immediately relieve the calf and stop running on it. Rest it and stretch it, maybe even ice it a bit. Icing is not always necessary with shin splints, but if swelling occurs then it has to be done. If the pain gets to the point where you can hardly walk on it without excruciating pain, then it has turned into a stress fracture and a doctor should begin to treat it. A runner has to listen to his body. When pain begins to be felt, you have to consider that pain, and rest yourself before it leads to something major.

When my track season began in my senior year in high school, I had really bad shin splints. I stopped running for a few days and then began again. Once my calves were rested properly the tenderness I was feeling actually disappeared. I think my shin splints were the outcome of not being completely prepared to run my first practice of the season. My legs were used to playing soccer, which works the legs and muscles a little differently than the sport of running. Running emphasizes a certain form and routine rather than soccer which can be a variety of forms. One should be aware that shin splints can be very painful so make sure you stretch properly and take it easy when you go out running, after a break from exercising, or if your just beginning. Ultra- runners usually receive shin splints when they change around their scheduling a bit or when they increase their work load in a short period of time. You should gradually increase your workout to higher levels to avoid any injuries. " If you are running on dirt and switch to pavement, watch for signs of stress or injury. Run slower, or shorter distances at first. Proper running style should always be observed. Stay off your toes, and run tall by standing more erect."(Glover and Shepard pg.222) This comment is explaining how if your going from being used to one surface, to running on another you have to take it slow and easy always make sure your not running on your toes. This would cause to much tension on the upper foot and could possibly lead to ankle injury.

It is inevitable that every runner will experience blisters in their running careers. There are many reasons why a runner experience blisters. One reason is that the runners shoes might be to tight or to loose. For this reason it is clear that shoes are of importance in the sport of ultramarathon running. Another reason would be when a runner goes out running on thin soled shoes on very heated pavement. To avoid this circumstance make sure the soles of your sneakers are not to thin. "Beginner runners tend to get blisters because their feet are tender and need to be toughened gradually. Avoid the commercial "skin tougheners": they may be good for other sports, but not for the continuous motion of running. Foot powder or Vaseline generously applied to your feet before running usually prevents blisters."(Glover and Shepard pg.227) Blisters will heal a lot quicker if you pop them and release the fluid and tension build up from within. It should then be cleaned with antiseptic solution. Again it is important to rest the foot before you exert pressure on it. Allow it to heal throughly like all other injuries and that is what will give you the best conditions.

Getting the proper amount of sleep is of great importance in a runner's lifestyle. Since ultramarathon runners are exposed to sleep deprivation, it is imperative that they receive a certain amount of sleep daily. If someone is running in a race that is lasting several days, sleep breaks should be added into their schedules. "There are currently two popular theories about sleep. The first holds that sleep is a cormant period that serves to conserve energy; the second maintains that sleep is needed to restore certain bodily changes that occur during the awake period. For evidence now shows that marked sleep deprivation impairs athletic performance and causes behavioral and minor personality changes." (Lore of Running pg. 703). This describes the effects not enough sleep can have on a person. Your results could be worse if your body is not rested properly, and after a long while without sleep you may start to see visions that are not actually there. Hallucinations could take place. On the other hand, insomnia can occur to runners that exert too much stress and tension on their bodies throughout the day. Running is definitely putting stress and tension on your body, so runners do have to think about this problem. A way to avoid insomnia one could make sure they usually have a regulated sleep pattern. Make sure the atmosphere in which you are sleeping is dark as well as quiet. Avoid sugar, salt, and caffeine before bedtime. These are a few ways to handle the problem of insomnia; there are probably more.

Women can experience many negative qualities when they pick up the sport of running. The menstrual cycle can be severely effected because of the strenuous activity to the female body. Also when you start running , if it is constant, than a female is very likely to lose some weight which can effect the her normal menstrual cycle. "Young women weighing less than 53 kg. who lost more than 4.5 kg after they began running were more likely to develop menstrual irregularities"(Speroff & Redwine, 1980) When a woman loses weight her body is transformed in one way or another irregular effects. When the menstrual cycle is effected from athletics, it usually stops, or does not come for a long period of time. Also, in women runners, infertility can take place. In the menstrual cycle there is a phase called the luteal phase. Exercise can decrease the length of this phase. " This will effectively prevent pregnancy because it will cause sloughing of the uterine lining before any fertilized egg has the chance of becoming established in the womb lining."(Lore of Running pg. 623). So if a women has problems getting pregnant prior to the beginning of their running career they should seriously consider this topic.

In an article I read, the author, Fink, states "The preponderance of running injuries are, in fact, chronic soft tissue inflammations. The onset of these injuries is not sudden, but usually follows a history of neglect and abuse. Running injuries are caused, they don't "just happen"" (Warren Finke). Finke is pointing out that when you overlook injuries, that is when they progress and get worse. There is always reasons behind why an injury occurs, they can just appear from no where. The key to avoiding long term injury is to recognize the problem right away. " Rather than denial or fear of the loss of fitness, the runner needs to adopt a defensive posture that assumes a potential injury and treats it in an early stage." It can not be emphasized enough in the world of running, that injuries do take place and your health and well being should always be first priority.

The medical aspects of ultramarathon running should be looked upon by all ultra runners. Circumstances such as Kidney Failure can be very intense and can be caused from excessive and long lasting running. Yes, ultramarathon running is a exciting and beneficial sport, yet at the same time it can cause major dilemmas to your body. Ultra runners sometimes run for many hours, even days without stopping. If the runner is enjoying themselves and receives self- satisfaction out of this sport than I believe they should definitely take it as far as they want to, but I strongly believe that they should consider all the consequences and try to take excelllent care of their bodies.

Works cited