Changes

The table below lists some of the possible problems you may encounter during an ultramarathon, along with possible causes, treatments and preventions. Continuing a race when you have a problem entails some degree of risk, and these problems can impair your judgment, so use caution. This list is not comprehensive, and is expected to change over time. With all these suggestions, never forget [[The Golden Rule of Racing]], "Never do something in a race you have not practiced in training". <!-- __strippedalt__ __stripped__ -->=Diagnostic Test=Try the Jimbo Test. Picture three things in your mind; a cold drink, a cheeseburger, and a slice of cake. * If the cold drink appeals, then you're probably thirsty/dehydrated. (Remember, drink to thirst as over-hydration kills.)* If the cheeseburger appeals, then you're either after fat or salt.* If the cake appeals, then you'll probably have to some carbohydrate.You can vary the items to suit your taste. For instance, if a doughnut generally appeals more than cake, then think of a doughnut instead of cake. This test is not foolproof, but it is a good, simple way of evaluating want your body probably wants.=Nausea or vomiting=See [[Nausea]]. {| class="wikitable"!Symptom!!style="background-color: #8A713B; color:#FEFFF2;" |'''Possible Causestripped'''!!Possible Treatment!!Possible Preventionstyle="background-color: #8A713B; color:#FEFFF2;" |'''Action'''

|rowspanstyle="8background-color: #E7E8D8;"| Nausea/Vomiting/Stomach acheOverheating| style="background-color: #E7E8D8;" |* Slow down and cool off. Once you've become overheated, it can be tricky to cool off enough to recover. Slowing down or stopping is normally required to reduce your heat production. Cold fluids pored over your head, neck and body can help, as can ice. Lying down with your feet elevated can also help.'''Prevention'''* [[Heat Acclimation Training]].* [[Running in the Heat]].|-| style="background-color: #FEFFF2;" |Overeating| style="background-color: #FEFFF2;" |* Reduce calorie intakeand only eat what appeals.* Ginger or mints may help.|'''Prevention'''* Eat what appeals.|-| style="background-color: #E7E8D8;" |Going too fast| style="background-color: #E7E8D8;" |* Slow up, possibly dramatically until things improve.'''Prevention'''* Better pacing.

|Going too faststyle="background-color: #FEFFF2;" |Too little fluid intakeEven without dehydration, if you're not drinking enough to maintain urine production then you may become nauseated. This is because the hormone that reduces urine output also causes nausea.| style="background-color: #FEFFF2;" |* Slow upRehydrate, possibly dramatically until things improvebut try to drink to thirst. Remember that over-hydration kills. |'''Prevention'''* Better pacing[[Practical Hydration]].

| style="background-color: #E7E8D8;" |Excessive fluid intake/too little saltOne of the symptoms of [[Hyponatremia]] is nausea. | style="background-color: #E7E8D8;" |* Reduce fluid intake.|* Increase salt intake.* If it appeals, a little salty broth may help.'''Prevention'''* Drink to thirst.* Take enough salt to maintain thirst.

| style="background-color: #FEFFF2;" |Too much saltIt's unclear how likely this is to happen in practice.| style="background-color: #FEFFF2;" |* Restrict salt intake.

|'''Prevention'''* Balance salt intake with fluid intake.* Avoid [[Electrolyte Capsules]].

|style="background-color: #E7E8D8;" [[NSAIDs_and_RunningNSAIDs and Running| NSAIDs]]|* Avoid NSAIDsstyle="background-color: #E7E8D8;" |

| style="background-color: #FEFFF2;" |Infection| style="background-color: #FEFFF2;" |

|'''Prevention'''* Careful hygiene, including keeping all your drinking containers sterile

| style="background-color: #E7E8D8;" |Change in intestinal bacteria (due to traveling)| style="background-color: #E7E8D8;" |

| style="background-color: #FEFFF2;" |Constipation<ref>It's unusual for constipation to cause nausea, but it can happen</ref> .| style="background-color: #FEFFF2;" |* Higher fiber [[Fiber]] intake.* Stay hydrated.|* Higher fiber intake

| style="background-color: #E7E8D8;" |Tight waist band| style="background-color: #E7E8D8;" |* Loosen anything around your waist or pressing on your abdomen. (Waist packs for carrying drinks are a particular problem.)|}* Avoid whatever caused the pressure=Fatigue and sleepiness={| class="wikitable" ! style="background-color: #03476F; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #03476F; color:#FEFFF2;" |'''Action'''

|rowspanstyle="3background-color: #DFF1F2;"| Fatigue/sleepiness|Low blood sugar| style="background-color: #DFF1F2;" |

| style="background-color: #FEFFF2;" |Low blood fat<ref name="fat"/>| style="background-color: #FEFFF2;" |* Consume a high fat food, such as peanut butter* Combine high fat and high carbs as this will not only boost both, but often these foods are easier to digest'''Prevention'''* Eat fat earlier* Have a higher fat pre-race meal* Don't consume only fast carbohydrates|-| style="background-color: #DFF1F2;" |You're running an ultra (what did you expect?)| style="background-color: #DFF1F2;" |* [[Caffeine]]* Short nap (5-15 min)<ref>Some runners recommend napping in a chair, short others lying down with your feet elevated. I like the lying down option as it helps my legs recover more. It can be helpful to have something to eat and/or drink before you take a nap</ref>.|* Pick up the pace<ref>I've consistently found that if I'm moving at a good pace, I don't suffer from sleepiness. Picking up the pace might help with sleepiness, though this is often impractical</ref>.

| style="background-color: #FEFFF2;" |Thinking about the time| style="background-color: #FEFFF2;" |

|}=Depression={| class="wikitable" ! style="background-color: #8A713B; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #8A713B; color:#FEFFF2;" |'''Action'''

|rowspanstyle="2background-color: #E7E8D8;"| Depression|Low blood sugar|style="background-color: #E7E8D8;" * Take something sweet or a [[Comparison_of_Energy_GelsComparison of Energy Gels| Gel]]|'''Prevention'''

| style="background-color: #FEFFF2;" |You're running an ultra (what did you expect?)| style="background-color: #FEFFF2;" |* Music<ref>There's a difference between having music playing in the background and actively focusing on music. Focusing on the music can be more effective than just having it in the background.</ref>.* Positive thinking.* Keep moving and wait for it to pass<ref>I've found that in most ultras there are various low spots. Often it's enough to just keep moving and wait for it to pass.</ref>.* Have a good cry<ref>Sometimes crying can be cathartic and release some of the mental pressure.</ref>.* Play mental games.** Don't think about how far you have to go.** Count the miles down rather than up.** Mentally hook a runner in front and let them mentally 'pull you along'.* Join up with another runner or group of runners<ref>Other runners can provide moral support and a well needed distraction. I've had some wonderful experiences running with others on races. Pacers can also help, especially as they'll focus on your race. Company can be especially beneficial at specific times on a race. The latter part of a race is an obvious time, but also sunset is another critical time.</ref>.|}=Headache={| class="wikitable" ! style="background-color: #03476F; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #03476F; color:#FEFFF2;" |'''Action'''

|rowspanstyle="7background-color: #DFF1F2;"| Headache|Low blood sugar|style="background-color: #DFF1F2;" * Take something sweet or a [[Comparison_of_Energy_GelsComparison of Energy Gels| Gel]].|'''Prevention'''

| style="background-color: #FEFFF2;" |Tight hat| style="background-color: #FEFFF2;" |* Loosen hat.|'''Prevention'''* [[The_Golden_Rule_of_Racing| The Golden Rule of Racing]]

| style="background-color: #DFF1F2;" |Lack of sleep| style="background-color: #DFF1F2;" |* Short nap|. If you have a sleep deprivation headache, I've found that nothing other than a short nap will help.

|style="background-color: #FEFFF2;" |[[Caffeine ]] withdrawal| style="background-color: #FEFFF2;" |* Take caffeine[[Caffeine]].|'''Prevention'''* Monitor caffeine [[Caffeine]] intake* Consider abstaining from caffeine [[Caffeine]] for 1-2 weeks before the race

| style="background-color: #DFF1F2;" |Overheating| style="background-color: #DFF1F2;" |* Slow down or stop.* Remove excess clothing|.

| style="background-color: #FEFFF2;" |Dehydration(only if accompanied by thirst and dry mouth)| style="background-color: #FEFFF2;" |* Drink more(but drink to thirst as over-hydration kills).* Keep salt intake high.* Slow down or stop|.

| style="background-color: #DFF1F2;" |Altitude sickness|style="background-color: #DFF1F2;" * [[Viagra,_Exercise_and_AltitudeExercise and Altitude| Viagra for Altitude]].* Descend.|'''Prevention'''* [[Altitude Training| Altitude training]]* [[Viagra,_Exercise_and_AltitudeExercise and Altitude| Viagra for Altitude]]|}=Heartburn={| class="wikitable" ! style="background-color: #8A713B; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #8A713B; color:#FEFFF2;" |'''Action'''

|rowspanstyle="2background-color: #E7E8D8;"| Heartburn|Eating 'wrong' foods| style="background-color: #E7E8D8;" |

| style="background-color: #FEFFF2;" |Stress| style="background-color: #FEFFF2;" |

* PreperationPreparation|}=Blisters=See [[Popping Blisters]], [[Taping]], and [[Blister Prevention]].=Are we there yet?=In ultras it's common to get the sense of not making progress, or that the miles have become longer. This is because they have, at least in time terms.{| class="wikitable" ! style="background-color: #03476F; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #03476F; color:#FEFFF2;" |'''Action'''

|Blistersstyle="background-color: #DFF1F2;" |It's an ultra|See style="background-color: #DFF1F2;" |* Run to the next aid station, not the end and avoid thinking about the overall distance. * Run to the next landmark, such as a tree, road sign, rock, etc. (repeat).* Think about time not distance<ref>If you have 20 miles to go, and you're moving at a 15 min/mile pace, think about the 5 hours rather than the distance.</ref>. * Convert to 'effective distance' <ref>If you have 20 miles to go, and you're moving at a 15 min/mile pace rather than your usual 9 min/mile, convert to time (5 hours), then work out how far that would be at your usual pace (about 33 miles). This can be depressing, but it creates a more realistic expectation.</ref>. * Listen to music, focusing on it rather than letting it play in the background. * Rest your mind, aiming for [[Blister PreventionStillness in Motion]]. Mental energy is a precious thing in an Ultra, so conserve it. * Put your head down and keep moving. |}=Bloating or gas=* [[Taping]]{| class="wikitable" ! style="background-color: #8A713B; color:#FEFFF2;" |'''Possible Cause'''* See [[Blister Prevention]]! style="background-color: #8A713B; color:#FEFFF2;" |'''Action'''

|rowspanstyle="3background-color: #E7E8D8;"| Bloating or gasOvereating|Overeatingstyle="background-color: #E7E8D8;" |

|'''Prevention'''* Eat when hungrywhat appeals

| style="background-color: #FEFFF2;" |Eating beans or other gassy foods| style="background-color: #FEFFF2;" |

| style="background-color: #E7E8D8;" |Antibiotics| style="background-color: #E7E8D8;" |

|rowspanstyle="7background-color: #DFF1F2;"| DiarrheaInfection|Infectionstyle="background-color: #DFF1F2;" |

| style="background-color: #FEFFF2;" |[http://en.wikipedia.org/wiki/Gastrocolic_reflex Gastrocolic reflex]<ref>Not The Gastrocolic reflex is the urge to defecate after eating. This is not normally diarrhea, but the strong urge to defecate</ref>| style="background-color: #FEFFF2;" |

| style="background-color: #DFF1F2;" |Too much fiber[[Fiber]]| style="background-color: #DFF1F2;" |

| style="background-color: #FEFFF2;" |Change in intestinal bacteria (due to traveling)| style="background-color: #FEFFF2;" |

| style="background-color: #DFF1F2;" |Too much isolated [[Fructose]] | style="background-color: #DFF1F2;" |

| style="background-color: #FEFFF2;" |Dairy (lactose intolerant)| style="background-color: #FEFFF2;" |

| style="background-color: #DFF1F2;" |[http://en.wikipedia.org/wiki/Ischemic_colitis Ischemic colitis]|* Stay hydratedstyle="background-color: #DFF1F2;" |

| style="background-color: #FEFFF2;" |Antibiotics| style="background-color: #FEFFF2;" |

|'''Prevention'''* Take yoghurt to help compensate|-| style="background-color: #DFF1F2;" |[[Magnesium]] supplements| style="background-color: #DFF1F2;" |* Don't take any more during the race '''Prevention'''* Magnesium Oratate does not generally cause diarrhea, unlike other forms of magnesium.* Limit magnesium in the 24 hours before the race.|-| style="background-color: #FEFFF2;" |Excessive fluid intake<ref>Drinking more than your intestines can absorb will produce inevitable diarrhea</ref>| style="background-color: #FEFFF2;" |* Drink to thirst (also helps prevent [[Hyponatremia]] and death)|}=Weak or painful legs=Other pain – ITBS, shin splints, cramps{| class="wikitable" ! style="background-color: #8A713B; color:#FEFFF2;" |'''Possible Cause'''! style="background-color: #8A713B; color:#FEFFF2;" |'''Action'''

|rowspanstyle="2background-color: #E7E8D8;"| Weak legs|[[Delayed_Onset_Muscle_SorenessDelayed Onset Muscle Soreness| DOMS]] | style="background-color: #E7E8D8;" |

|style="background-color: #FEFFF2;" [[Glycogen| Glycogen depletion]]|style="background-color: #FEFFF2;" * Take something sweet or a [[Comparison_of_Energy_GelsComparison of Energy Gels| Gel]]

* [[Caffeine ]] to increase carbohydrate absorption|'''Prevention'''