Injury and Illness Rates During Ultratrail Running

Abstract

This study aimed to describe injury/illness rates in ultratrail runners competing in a 65-km race to build a foundation for injury prevention and help race organizers to plan medical provision for these events. Prospectively transcribed medical records were analysed for 77 athletes at the end of the race. Number of injuries/illnesses per 1 000 runners and per 1 000-h run, overall injury/illness rate and 90% confidence intervals and rates for major and minor illnesses, musculoskeletal injuries, and skin disorders were analysed. A total of 132 injuries/illnesses were encountered during the race. The overall injuries/illnesses were 1.9 per runner and 187.9 per 1000-h run. Medical illnesses were the most prominent medical diagnoses encountered (50.3%), followed by musculoskeletal injuries (32.8%), and skin-related disorders (16.9%). Despite the ultra-long nature of the race, the majority of injuries/illnesses were minor in nature. Medical staff and runners should prepare to treat all types of injuries and illnesses, especially the fatigue arising throughout the course of an ultratrail run and injuries to the lower limbs. Future studies should attempt to systematically identify injury locations and mechanisms in order to better direct injury prevention strategies and plan more accurate medical care.

Key words

dermatological injuries - injury management - musculoskeletal injuries - trail running - ultraendurance - ultramarathon

Publication History

Received: 30 August 2015

Accepted after revision: 23 November 2015

Article published online:
26 April 2016

• References

• 1 Alonso JM, Edouard P, Fischetto G, Adams B, Depiesse F, Mountjoy M. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. Br J Sports Med 2012; 46: 505-514
• 2 Bishop GW, Fallon KE. Musculoskeletal injuries in a six-day track race: ultramarathoner’s ankle. Clin J Sport Med 1999; 9: 216-220
• 3 Caselli MA, Longobardi SJ. Lower extremity injuries at the New York City Marathon. J Am Podiatr Med Assoc 1997; 87: 34-37
• 4 Dvorak J, Junge A, Derman W, Schwellnus M. Injuries and illnesses of football players during the 2010 FIFA World Cup. Br J Sports Med 2011; 45: 626-630
• 5 Easthope CS, Hausswirth C, Louis J, Lepers R, Vercruyssen F, Brisswalter J. Effects of a trail running competition on muscular performance and efficiency in well-trained young and master athletes. Eur J Appl Physiol 2010; 110: 1107-1116
• 6 Engebretsen L, Soligard T, Steffen K, Alonso JM, Aubry M, Budgett R, Dvorak J, Jegathesan M, Meeuwisse WH, Mountjoy M, Palmer-Green D, Vanhegan I, Renstrom PA. Sports injuries and illnesses during the London Summer Olympic Games 2012. Br J Sports Med 2013; 47: 407-414
• 7 Fallon KE. Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run. Br J Sports Med 1996; 30: 319-323
• 8 Fallon KE, Sivyer G, Sivyer K, Dare A. The biochemistry of runners in a 1600 km ultramarathon. Br J Sports Med 1999; 33: 264-269
• 9 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2016 update. Int J Sports Med 2015; 36: 1121-1124
• 10 Hoffman MD. Performance trends in 161-km ultramarathons. Int J Sports Med 2010; 31: 31-37
• 11 Hoffman MD, Krishnan E. Health and exercise-related medical issues among 1,212 ultramarathon runners: baseline findings from the Ultrarunners Longitudinal TRAcking (ULTRA) Study. PLoS One 2014; 9: e83867
• 12 Hoffman MD, Ong JC, Wang G. Historical analysis of participation in 161 km ultramarathons in North America. Int J Hist Sport 2010; 27: 1877-1891
• 13 Hutson MA. Medical implications of ultra marathon running: observations on a six day track race. Br J Sports Med 1984; 18: 44-45
• 14 Krabak BJ, Waite B, Schiff MA. Study of injury and illness rates in multiday ultramarathon runners. Med Sci Sports Exerc 2011; 43: 2314-2320
• 15 Mailler EA, Adams BB. The wear and tear of 26.2: dermatological injuries reported on marathon day. Br J Sports Med 2004; 38: 498-501
• 16 Martin V, Millet GY, Martin A, Deley G, Lattier G. Assessment of low-frequency fatigue with two methods of electrical stimulation. J Appl Physiol 1985 2004; 97: 1923-1929
• 17 Millet GP, Millet GY. Ultramarathon is an outstanding model for the study of adaptive responses to extreme load and stress. BMC Med 2012; 10: 77
• 18 Millet GY, Lepers R, Maffiuletti NA, Babault N, Martin V, Lattier G. Alterations of neuromuscular function after an ultramarathon. J Appl Physiol 1985 2002; 92: 486-492
• 19 Millet GY, Tomazin K, Verges S, Vincent C, Bonnefoy R, Boisson RC, Gergele L, Feasson L, Martin V. Neuromuscular consequences of an extreme mountain ultra-marathon. PLoS One 2011; 6: e17059
• 20 Roberts WO. A 12-yr profile of medical injury and illness for the Twin Cities Marathon. Med Sci Sports Exerc 2000; 32: 1549-1555
• 21 Saugy J, Place N, Millet GY, Degache F, Schena F, Millet GP. Alterations of neuromuscular function after the world’s most challenging mountain ultra-marathon. PLoS One 2013; 8: e65596
• 22 Scheer BV, Murray A. Al Andalus Ultra Trail: an observation of medical interventions during a 219-km, 5-day ultramarathon stage race. Clin J Sport Med 2011; 21: 444-446
• 23 Schwellnus MP. Muscle cramping in the marathon: aetiology and risk factors. Sports Med 2007; 37: 364-367
• 24 Tang N, Kraus CK, Brill JD, Shahan JB, Ness C, Scheulen JJ. Hospital-based event medical support for the Baltimore Marathon, 2002-2005. Prehosp Emerg Care 2008; 12: 320-326
• 25 van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med 2007; 41: 469-480 discussion 480
• 26 van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med 1992; 14: 82-99
• 27 Vernillo G, Rinaldo N, Giorgi A, Esposito F, Trabucchi P, Millet GP, Schena F. Changes in lung function during an extreme mountain ultramarathon. Scand J Med Sci Sports 2014, doi:10.1111/sms.12325
• 28 Vernillo G, Savoldelli A, Zignoli A, Skafidas S, Fornasiero A, La Torre A, Bortolan L, Pellegrini B, Schena F. Energy cost and kinematics of level, uphill and downhill running: fatigue-induced changes after a mountain ultramarathon. J Sports Sci 2015; doi:10.1080/02640414.2015.1022870 1-8
• 29 Vernillo G, Savoldelli A, Zignoli A, Trabucchi P, Pellegrini B, Millet GP, Schena F. Influence of the world’s most challenging mountain ultra-marathon on energy cost and running mechanics. Eur J Appl Physiol 2014; 114: 929-939
• 30 Videbaek S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med 2015; 45: 1017-1026