Going the distance can be going too far

When Pheidippides ran the 40-odd kilometres to report the Greek victory over the Persians to the people of Athens after the battle of Marathon, legend has it he collapsed on the spot and died. But it is little known that he was reputed to have run 240 kilometres in the previous two days. So the perils of ultra-distance running have been apparent from the earliest days.

The demands made on the body during an ultra-marathon are taxing in the extreme. But over the past few decades, more sophisticated training techniques have come to the fore, along with evolving medical expertise in the form of physiotherapy, biokinetics and sports science, which has mitigated much of the damage caused and the dangers posed. For the well-trained runner of today, therefore, the body can not only handle the severe punishment meted out in an ultra-distant road race, it also can recover fairly quickly.

But for the ill-prepared runner, the dangers in running ultra-distance marathons can be severe. Running in the kind of heat—and in some places humidity—typical of South Africa’s climate poses a multitude of dangers. As the temperature rises, the body is unable to evaporate the sweat it produces efficiently and any of the three recognised heat illnesses caused by dehydration can either cause the race to end prematurely or have far more serious consequences.

Heat can translate into painful muscle cramps that rarely work themselves out on their own. The runner needs to stop, drink plenty of liquids containing electrolytes, cool down with wet towels and get into the shade.

Heat exhaustion is characterised by dizziness, nausea, vomiting, headaches and weakness. Rehydration and balancing of electrolytes need to happen quickly. Other symptoms can be a lack of co-ordination, profuse sweating and cold, clammy skin with goose bumps. When this happens, one has to stop running immediately, cool the body down with wet towels, lie down, try to elevate the legs above the heart and seek medical attention.

Then there’s heatstroke. In some cases, this can be life threatening so it is classified as a medical emergency and requires immediate treatment. Symptoms include confusion, bizarre behaviour, disorientation, extreme weakness and lethargy, which can result in depressed levels of consciousness. Because heatstroke occurs as a result of the failure of the body to regulate temperature, sweating will stop and the skin will appear dry to the touch. In extreme cases, convulsions, seizures and coma can occur as the brain effectively shuts down. While waiting for emergency medical personnel to arrive, the patient needs to be cooled down with ice and water.

These race-ending emergencies can be avoided by the runner training his or her body to process a high volume of fluid and electrolytes in a short space of time.

But runners must also be careful not to overdo their liquid intake. With more people entering marathons, a condition that is causing increasing concern among sports-medicine practitioners is hyponatremia. This happens when the body’s sodium level becomes dangerously low owing to the dilution that occurs when the intake of liquids is too great.

Symptoms include a lack of concentration, co-ordination and confusion.

Other injuries occur as a result of damage to muscles, tendons, joints, cartilage and ligaments. These can range from inflammation to more serious stress fractures.

Cardiac injuries can also occur as the heart muscles take severe strain. Your kidneys can also be at risk when damaged muscles leak myoglobin into the bloodstream, which is then filtered by the kidneys and results in renal dysfunction.

Balanced training with a gradual increase in speed and distance seems to be the way to prevent injuries. Running through pain is a complete no-no.

Running will be the topic of Bonitas House Call on September 10 on SABC2 at 9am

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