Ultramarathon Running Injuries

Scheer, Bernd Volker; Murray, Dave

doi:10.1007/978-3-642-36569-0_216

Cited by 15 publications

(11 citation statements)

References 49 publications

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“…Hip injuries can often present as a diagnostic and therapeutic challenge due to the vague and non-specific presentations and signs. Typical running-related hip injuries include iliotibial band syndrome (ITBS), bursitis, sports hernias, hip osteoarthritis and great trochanteric pain syndrome (GTPS); however, rarer and more serious causes such as stress fractures need to be considered 6–8. This is in line with the initial diagnosis of GTPS received by our patient when first presenting to the A&E department.…”

Section: Discussionsupporting

confidence: 72%

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Transient osteoporosis: an unusual presentation of hip pain in a trail runner

Scheer

2019

BMJ Case Rep

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We present a case of transient osteoporosis of the hip in a 38-year-old recreational trail runner. Shortly after a trail running competition, he developed acute hip pain, functional disability and an antalgic gait. Diagnosis was made with MRI showing bone marrow oedema, plain radiographs demonstrating osseous demineralisation and bone scintigraphy showing uniform radioactive uptake. Treatment included off-loading of the anatomical site for 6 months until symptom resolution, analgaesia, Vitamin D, bisphosphonates and pulsed electromagnetic field therapy. He recovered fully and returned to running activities 8 months after initial presentation. Transient osteoporosis of the hip is rare but benign, self-limiting condition; however, awareness and exact diagnosis are important as runners often present with hip pain and other more serious pathologies such as avascular necrosis or stress fractures need to be excluded.

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Section: Discussionsupporting

confidence: 72%

“…Trail running is a popular sport4 and common running-related injuries are well described 5 6. Hip injuries can often present as a diagnostic and therapeutic challenge due to the vague and non-specific presentations and signs.…”

Section: Discussionmentioning

confidence: 99%

Transient osteoporosis: an unusual presentation of hip pain in a trail runner

Scheer

2019

BMJ Case Rep

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“…Training for an ultra-marathon and ultra-marathons per se usually result in a damage to the musculo-skeletal system (Khodaee et al, 2015 ; Scheer and Murray, 2015 ), with the extent of damage depending on the length of the ultra-marathon (Kim et al, 2009 ). The damage is generally only of minor importance (Vernillo et al, 2016 ) and beginners are more often affected than experienced ultra-marathoners (Videbæk et al, 2015 ).…”

Section: Musculoskeletal Problems In Ultra-marathonersmentioning

confidence: 99%

Physiology and Pathophysiology in Ultra-Marathon Running

Knechtle

Nikolaidis²

2018

Front. Physiol.

219

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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“…Popularity in ultramarathon (UM) running has increased over the years and includes race distances in excess of the traditional marathon distance of 42.195 km (Scheer, 2018). They are often held in challenging environmental conditions, testing the limits of human endurance (Scheer et al, 2015). Considerable research has focused on the medical and physiological aspects of UMs (Millet et al, 2000, 2011a; Scheer and Murray, 2011; Millet and Millet, 2012; Costa et al, 2013; Hoffman et al, 2014; Scheer et al, 2014; Vernillo et al, 2017a), but up to now, controversy remains on the role of running economy (RE) in UM running (Vernillo et al, 2017b).…”

Section: Introductionmentioning

confidence: 99%

Changes in Running Economy During a 65-km Ultramarathon

et al. 2018

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Purpose: Running economy (RE), expressed as oxygen cost (O2 cost) and energy cost of running (Cr) is important in ultramarathon (UM) running as it can help predict race performance. Controversy remains if RE increases, decreases, or remains stable in UM running. We examined RE before, during, and after a 65-km UM.Methods: 15 male UM runners (mean age 45 ± 5.7 years) completed a standard exercise test (mean VO2max 48.8 ± 3.4 ml⋅kg-1⋅min-1) for determination of the individual testing speed (60% VO2max: mean speed 9.4 ± 0.7 km/h). This was followed by a 65-km UM (elevation ± 1093 m) consisting of three laps (each 21.7 km). Pre and post indirect calorimetry measurements at individual running speed on the treadmill at UM-specific slopes (average percentage of positive and negative elevation) at -3, +3%, and level grade were performed in randomized order on a motorized treadmill in the laboratory for calculation of RE. Additionally after each lap, testing at +3% took place.Results: The O2 cost, Cr, and RER increased significantly pre to post UM (p < 0.01). During the uphill running, a main effect of distance indicated a gradual, linear increase in O2 cost, F(2,28) = 5.81, p < 0.01, ηp2 = 0.29, and Cr, F(2,28) = 5.96, p = 0.01, ηp2 = 0.30.Conclusion: O2 cost and Cr increased significantly pre to post UM in all testing conditions as well as during the uphill testing throughout the UM. This is the first study to demonstrate a consistent increase in O2 cost and Cr among a range of different slopes, at individual running speeds and race-specific slopes giving further evidence that these measures of RE increase in UM running.

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Ultramarathon Running Injuries

Cited by 15 publications

References 49 publications

Transient osteoporosis: an unusual presentation of hip pain in a trail runner

Transient osteoporosis: an unusual presentation of hip pain in a trail runner

Physiology and Pathophysiology in Ultra-Marathon Running

Changes in Running Economy During a 65-km Ultramarathon

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