Fixing problems in Ultramarathons

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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".

Symptom Possible Cause Possible Treatment Possible Prevention
Nausea/Vomiting/Stomach ache Overeating
  • Reduce calorie intake
  • Ginger or mints may help
  • Eat what appeals
Going too fast
  • Slow up, possibly dramatically until things improve
  • Better pacing
Excessive fluid intake
  • Reduce fluid intake
  • Drink to thirst
Too much salt
NSAIDs
  • Avoid NSAIDs
  • Avoid NSAIDs
Infection
  • Sorry, better luck next time
  • Careful hygiene, including keeping all your drinking containers sterile
Change in intestinal bacteria (due to traveling)
  • Sorry, better luck next time
  • Travel earlier
  • Avoid non-bottled water.
Constipation[1]
  • Higher fiber intake
  • Stay hydrated
  • Higher fiber intake
Tight waist band
  • Loosen anything around your waist or pressing on your abdomen
  • Avoid whatever caused the pressure
Fatigue/sleepiness Low blood sugar
  • Take something sweet or a Gel
  • Take carbs earlier
You're running an ultra (what did you expect?)
  • Caffeine
  • Short nap (5-15 min)[2].
Thinking about the time
  • Ignore the time of day and focus on the hours
Depression Low blood sugar
  • Take something sweet or a Gel
  • Take carbs earlier
You're running an ultra (what did you expect?)
  • Music
  • Positive thinking
  • Keep moving and wait for it to pass
  • Have a good cry
  • 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 pull you along
  • Join up with another runner or group of runners
Headache Low blood sugar
  • Take something sweet or a Gel
  • Take carbs earlier
Tight hat
  • Loosen hat
Lack of sleep
  • Short nap
Caffeine withdrawal
  • Take caffeine
  • Monitor caffeine intake
  • Consider abstaining from caffeine for 1-2 weeks before the race
Overheating
  • Slow down or stop
  • Remove excess clothing
Dehydration
  • Drink more
  • Keep salt intake high
  • Slow down or stop
Altitude sickness
Heartburn Eating 'wrong' foods
  • Antacid tablets
  • Eat what appeals
  • Avoid what triggered the heartburn
  • Avoid what triggered the heartburn
Stress
  • Try to relax
  • Visualization
  • Preperation
Blisters See Blister Prevention
Bloating or gas Overeating
  • Reduce calorie intake
  • Gas-x
  • Eat when hungry
Eating beans or other gassy foods
  • Gas-x
  • Change diet before and during the race
Antibiotics
  • Gas-x
  • Take yoghurt to help compensate
Diarrhea Infection
  • Consider Imodium[3]
  • Careful hygiene
Gastrocolic reflex[4]
  • Some foods are a stronger stimulus of this reflex, so avoid those foods
  • Avoid triggering foods
Too much fiber
  • Consider Imodium[3]
  • Carefully reduce Fiber intake before the race
Change in intestinal bacteria (due to traveling)
  • Consider Imodium[3]
  • Travel earlier
  • Avoid non-bottled water.
Too much isolated Fructose
  • Avoid foods high in fructose
Dairy (lactose intolerant)
  • Stop dairy intake (read the ingredients)
  • Avoid dairy
Ischemic colitis
  • Stay hydrated
  • Stay hydrated
Antibiotics
  • Sorry, better luck next time
* Take yoghurt to help compensate
Weak legs DOMS
Glycogen depletion
  • Take something sweet or a Gel
  • Increase carbohydrate intake
  • Caffeine to increase carbohydrate absorption
Cramping Sodium Deficiency
  • Add salt to your drink
  • Eat something salty
  • Drink pickle juice
Muscle fatigue
Chaffing Skin on skin
  • Wear something form fitting so the clothing rubs, not the skin
  • Tape both surfaces so the tape is rubbing, not the skin
  • Lubricants may help if used early enough, but often make things worse
  • Wear clothing that prevents the chaffing
Skin on clothing
  • Wear something form fitting so the clothing rubs, not the skin
  • Tape the skin
  • Lubricants rarely work
  • Wear clothing that prevents the chaffing
Monkey butt
  • Clean the area using moist wipes, making sure it's really clean. Any unwanted residue will act as an abrasive.
  • Diaper (nappy) treatment can help relieve the pain. Desitin (or a generic Zinc Oxide ointment) is recommended by some runners, but does tend to leave white marks.
  • Lubricant can help if used early enough, but if the skin is damaged and rough it doesn't help as much. One of the best lubricants for this area is 2Toms Sport Shield. You either need a roll-on dedicated to this area, or preferably use the Sport Shield Wipes.
  • Cleanliness is critical. Make sure the areas is thoroughly clean, using wet wipes if you have to go mid-race.
  • Lubricate before the race, clean and lube after you go and periodically through a longer race.
  • Compression shorts or tights that are too tight around the buttocks can hasten the chaffing
Fainting, or near fainting (light headed, dizzy) Heart problems
  • Fainting or near fainting can be a warning sign of a serious health problem and it may be the only symptom that precedes a sudden cardiac death[5].
Dehydration
  • Drink more
  • Keep salt intake high
  • Slow down or stop
Stopping suddenly[6]
  • Slow up before coming to a stop
Hypothermia
Altitude sickness

Notes

  1. It's unusual for constipation to cause nausea, but it can happen
  2. Some runners recommend napping in a chair, others lying down with your feet elevated.
  3. 3.0 3.1 3.2 Imodium (Loperamide) is an anti-diarrhea mediation, but it works by slowing the progress of material through the digestive tract. Some runners find this makes the problem worse, acting like a cork.
  4. Not normally diarrhea, but the strong urge to defecate
  5. See http://www.aafp.org/afp/1999/1101/p2001.html and http://www.jfponline.com/Pages.asp?AID=5146
  6. The calf muscle helps pump blood, so stopping suddenly can exacerbate low blood pressure.