Exertional Collapse in the Runner: Evaluation and Management in Fieldside and Office-Based Settings

Childress, Marc A; O’Connor, Francis G.; Levine, Benjamin D.

doi:10.1016/j.csm.2010.03.007

Cited by 16 publications

(9 citation statements)

References 35 publications

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“…[20][21][22] It is common in marathons, (59%-69% of all medical encounters at the finish line), resulting in 10.1 to 13.7 medical illnesses per 1000 runners. 23 EAC is less common during ultramarathons, representing 6.6% of all medical encounters during a multistage ultramarathon.…”

Section: Medicalmentioning

confidence: 99%

Evaluation and Treatment of Injury and Illness in the Ultramarathon Athlete

Krabak

Waite

Lipman

2014

Physical Medicine and Rehabilitation Clinics of North America

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Section: Medicalmentioning

confidence: 99%

Evaluation and Treatment of Injury and Illness in the Ultramarathon Athlete

Krabak

Waite

Lipman

2014

Physical Medicine and Rehabilitation Clinics of North America

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“…Exercise-associated collapse describes runners with postural hypotension or other collapse in the absence of serious medical illness. 24 This condition can mimic serious medical illness in that runners frequently exhibit altered mental status, temperature and other vital sign abnormalities, muscle cramps, and inability to ambulate or ingest oral fluids. Roberts 25 developed a clinical classification system based on observations of collapsed runners at the Twin Cities Marathon from 1982 to 1987.…”

Section: Exercise-associated Collapsementioning

confidence: 99%

Burden of Injury and Illness in the Road Race Medical Tent: A Narrative Review

Breslow

Giberson-Chen

Roberts

2020

Clinical Journal of Sport Medicine

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Objective: To summarize the literature relating to prehospital care at 5 km through marathon distance road races and present the epidemiology of common medical encounters, significant medical complications, and medical outcomes. Data Sources: We searched PubMed and Google Scholar for the published literature pertaining to road race medical tent encounters at 5 km through marathon distance road races from 2000 to 2018. We included English-language, original articles reporting on injury and illness incidence. Main Results: Standard medical encounter definitions have recently been formulated in response to the previous lack of uniform definitions. The incidence of medical complications at road races may be influenced by environmental conditions and race distance. Minor and moderate medical encounters, such as dermatologic injuries, musculoskeletal injuries, and exercise-associated collapse, are common. Serious and life-threatening medical complications, including exertional heat stroke, exercise-associated hyponatremia, and cardiac arrest, are less frequent. Fatalities are also rare, with rates of 0.3 to 5 per 100 000 participants reported at marathons. The ratio of hospital transports to medical encounters is low. Conclusions: On-site medical services play a key role in the safety of both runners and the community. Future research and care initiatives in this field should focus on optimizing treatment protocols, promoting injury prevention efforts and reducing host community costs.

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“…EAC is a clinical syndrome characterised by an inability to stand or walk unaided because of dizziness, light-headedness, syncope or presyncope after the cessation of intense exercise 14,16 . The aetiology of EAC is multifactorial but the main pathophysiological mechanism is thought to be an abrupt decrease in venous return when the lower limb muscles (muscle pump) cease rhythmic contraction 17 . This transient postural hypotension is associated with impaired baroreflexes immediately following cessation of exercise [14][15]18 .…”

Section: Introductionmentioning

confidence: 99%

Longer distance races and slower running pace are associated with Exercise associated collapse: SAFER XXV study in 153,208 distance runners

Naidoo

Sewry

Schwellnus

et al. 2022

J Sports Med Phys Fitness

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BACKGROUND: Exercise associated collapse (EAC) is a common medical encounter at distance running events. Risk factors associated with EAC are not well documented. The objective is to determine the overall incidence of EAC and identify risk factors associated with EAC in 21.1km and 56km runners. METHODS: A cross-sectional analysis of 153208 race starters from the Two Oceans Marathon races (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). All EACs on race day were documented by medical staff. Risk factors associated with EAC investigated included demographics, race distance (21.1km vs. 56km), running speed, race experience and race day environmental data (wet-bulb globe temperature [WBGT], humidity, wind speed). Incidence (per 1000 starters; 95%CIs) and incidence ratios (95%CIs) were calculated. RESULTS:The overall incidence of EAC was 1.50 (95% CI 1.31-1.71). Longer race distance (IR: 2.1; 1.6-2.7; p<0.0001) and slower running speed (IR: 1.3; 1.1-1.5; p=0.0017) were significant risk factors associated with EAC. The incidence of EAC was higher in female vs. male 21.1km race starters (IR=2.25; 1.47-3.46; p=0.0229). Age and environmental conditions were not associated with EAC (p>0.05) in a cool and temperate environment. CONCLUSIONS: About 1 in 667 race starters (21.1km and 56km) develop EAC. Longer race distance, slower running speed and female sex (in 21.1km starters) are significant risk factors associated with EAC. Race medical directors can identify race entrants that may be at risk of developing EAC, develop prevention strategies and better prepare medical care at these events.

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Exertional Collapse in the Runner: Evaluation and Management in Fieldside and Office-Based Settings

Cited by 16 publications

References 35 publications

Evaluation and Treatment of Injury and Illness in the Ultramarathon Athlete

Evaluation and Treatment of Injury and Illness in the Ultramarathon Athlete

Burden of Injury and Illness in the Road Race Medical Tent: A Narrative Review

Longer distance races and slower running pace are associated with Exercise associated collapse: SAFER XXV study in 153,208 distance runners

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