ultra running

What does my physio think about ultra running?

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What does my physio think about ultra running?

Do you ever wonder what your physio thinks about your favourite forms of exercise or whether your health or lifestyle choices are a good idea? In the third of a series of blog posts entitled “What Does My Physio Think…?” we’ve asked our physios what they think about ultra running.

What is Ultra Running?

Ultra running is defined as running any distance longer than a marathon (26.2 miles). Classic distances for ultra events are 50km (32 miles) and 100km (64 miles) but every year there are more events at almost any distance over 26.2 miles, including 100+ miles. Most events are trail events but some are held on tarmac or even on 400m atheltics tracks!

Is Ultra Running good or bad for me?

Emily, our soft tissue therapist, triathlon coach, athlete personal trainer, comments:

“For ultra distance, athletes usually work at low intensity, aerobic pace: it’s not uncommon to adopt walk/jog/run combinations. In that sense, there’s less stress on the joints and cardiovascular system than in shorter distance running. As long as the athlete gradually increases mileage during training, listens to their body (and their physio / trainer / coach), human bodies can adapt to many things that “modern human beings” find “impossible”.”

Our spinal specialist Physio Shari says:

“Whilst this isn't my expert area, my personal opinion is that I would be concerned about the long term effects on the person's joints. However, I will support my patients with their ventures and help to get them in the best form possible to compete in ultra running as long as it isn't aggravating existing injuries/issues. Complementing the ultra running with cross training and strength/stability training is really important as well.”

Physio Paul, who specialises in shoulder & elbow, hip & groin and sports injuries, says:

“As with any exercise, build gradually into something as demanding as ultra-running. Not everyone is designed for it but if you are, take a long term plan to build up to distances you would like to reach. Whilst increased volume will mean increased load on joints, the impact of this might be spread out if you build up sensibly.”

And Nick, another of our sports injuries specialist physios, recommends specialist training for ultra events to avoid injury.

NoviceRunnerNik's Top Tips On How To Crew For An Ultra Runner

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NoviceRunnerNik's Top Tips On How To Crew For An Ultra Runner

Our NoviceRunnerNik, who’s been running for quite a few years now (we probably ought to give her a new nickname!), has crewed for her husband and other friends competing in ultra marathons and here are her words of wisdom about supporting your ultra runner.

What is an Ultra Marathon?

Ultra marathons are any running races over marathon (26.2 miles) distance. 50k, 50 miles, 100k and 100 miles are all common distances but some races are even longer: The Spine, for example, is the length of the Pennine Way - 268 miles.

Runners at the start of the 2019 Arc of Attrition 100 mile coastal run.

Runners at the start of the 2019 Arc of Attrition 100 mile coastal run.

Who Are These Ultra Runners?

Ultra runners are a curious breed. They will pay a lot of money to run ridiculously long distances all in one go, through daylight, night, daylight and night, with little or no sleep, often in terrible weather conditions and usually over very tough terrain. They will spend hundreds of hours running hundreds of training miles, often alone. They will also spend a lot of money on running kit: taped seams jackets, anti-chafe running underwear, ultra light-weight hydration vests, tens of pairs of running shoes. During the actual ultra race they may hallucinate, dehydrate, vomit and cry. After the event they are likely to lose toe nails, sleep and eat for England and never stop talking about their epic race. Their lives are running!

And Crewing for Ultra Runners?

Some ultra events allow for runners to have crews to support them throughout the race (normally friends or family who drive around the route feeding, watering and generally tending to a specific runner). This helps both the runners as they can carry less food, water and gear and it helps the organisers as it means the welfare of many of the runners is managed by other people.

The first of many shoe changes.

The first of many shoe changes.

NoviceRunnerNik's Top Tips On How To Crew For An Ultra Runner

If your friend / partner / colleague asks you to crew for them for an event you need to be prepared for all of the above, so here are my top tips for crewing:

  1. As always, preparation is key. Ensure you have a meeting with your runner and co crew to talk through what your runner’s expectations are. Look at and agree locations for crew support points. If your runner is very information driven, make sure they prepare the information for you so that you have it to hand on the day – this could be expected arrival times at crew support points, distances between crew support points, distances between official check points etc. Print several copies – you’ll run into other crews and they’ll love the information too, you’ll lose a copy out of a window at some point. Guaranteed. Don’t be tempted to just wing it, unless your runner is very, very laid back.

  2. Use the largest vehicle you can sensibly drive around the route. A camper van would be ideal but a van, estate car or similar will give you lots of room for kit and for having a lie down/sleep if you or your runner need it.

  3. Have a second crew member if you can, particularly if your runner is also your partner – you have company, help with navigation, you can sleep in shifts and a third party might mean that you and your runner are on your best or at least better behaviour.

  4. Pack your kit for all eventualities. Your runner will have thought long and hard about their kit for the event and you should do the same about yours. You could be out in horrible conditions for 36 or more hours. You might not sleep. You are probably more likely to get cold / hypothermic than your runner. For me essential UK kit includes thermals, full waterproofs, walking boots, full change of clothes, waterproof gloves and hat, head torch, sleeping bag, sleep mat, blanket, food, drink, a kettle, phone, phone charger, music, books, binoculars, paper maps, change for car parking, a deck of cards, first aid kit, running kit (I always try to get out for a run in between stops if I can) - be prepared for boredom!

  5. Keep your kit and your runner’s kit separate then there’s no way that you’ll accidentally eat the very thing they are craving at Mile 90. But be prepared to give your runner (or another runner or their crew) anything from your food or kit store. Pack things into separate plastic crates or boxes so everything is found easily and doesn’t roll around the back of your van. Have a bin bag or crate / box ready for wet clothes and shoes.

  6. If you can’t always get your vehicle right up to where you’ll meet your runner, for example at checkpoints, get your runner to pre-prepare a kit bag with all the essentials they might need – spare clothes, powerbank, spare socks, extra food etc so that you can just grab the bag and arrive prepared.

  7. Have a spare waterbottle filled and ready to be swapped out when your runner arrives to make restocking them simple. Knowing what your runner will need when they arrive at your next meet point speeds things up.

  8. Keep cheery but avoid too many questions that require decisions being made by your runner. It’s really obvious but your runner is going to get more tired as the event progresses, as are you. Get on and do stuff without them having to ask.

  9. Sleep if you can and set an alarm on your phone if you need to make sure you’re awake. I’ve been in check points where runners have come in and their crews aren’t there. It’s devastating for them.

  10. Mobile phone / data reception can be really poor in areas so don’t rely only on Google maps for directions and bear this in mind if you’re following your runner on a tracker website.

  11. Be prepared to do some grim jobs, such as cleaning your runner’s feet or applying BodyGlide…

  12. Make sure your runner supplies you with fish and chip (or other takeaway of your choice) money! Check that your expected fish and chip shop is actually open. I’ve learned this the hard way!

  13. Plan your journey home from the event. From someone who has both crewed for and run ultras: you’ll get as tired crewing as you would do running but you’ll recover more quickly than your runner and keep your toenails. If you’re driving home after the event this could be just as dangerous as if your runner drives home (and runners are normally required to have a driver to get them home) so make sure you’ve taken this into consideration.

  14. Don’t get carried away and enter an ultra yourself the day after you’ve caught up on your sleep! Give it quite a bit of consideration before you commit. The hours and hours lost to training, the cash lost on kit and race entries, the toenails lost to the god (or other deity) of running. Remember the bad as well as the good!

One of the less fun support jobs, particularly at 2am!

One of the less fun support jobs, particularly at 2am!

Finisher and his crew!

Finisher and his crew!

Words and images by NoviceRunnerNik.

Patient News: We're Supporting Extreme Adventurer Alex Flynn

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Patient News: We're Supporting Extreme Adventurer Alex Flynn

We're excited to be supporting extreme adventurer Alex Flynn in his challenging new project happening later this year. More on that soon! Meanwhile we’ve asked Alex to introduce himself. Here’s his story so far:

About Me

Hi, my name is Alex and I’ve had Parkinson’s disease for 11 years now. I was diagnosed at the age 36. That’s young by most people standards but it isn’t. The youngest ever diagnosed with Parkinson’s disease was a two -year-old boy. I’ll let that just sink in for a second. Two years old! What kind of life is that little boy going to have?

About Parkinson’s

What is Parkinson’s? Most people don’t fully understand what it is. It’s about rigidity. The lack of being able to move. It’s not the over abundant movement of someone flailing around like an eight-legged octopus. No, that’s just over medication; the unfortunate side-effect of taking a daily cocktail of prescription drugs to mask the effects of dwindling dopamine in the brain over many years. The product of which will take away a persons’ ability to enjoy things that most people take for granted; the ability to write, to walk, speak, have sex, not to mention the psychological impact, and many more. The diagnosis of Parkinson’s hits hard.

Many people receiving such a colossal diagnosis give up, take the medication and slowly deteriorate. I had and still have no intention becoming a shadow of my former self and neither should anyone else. So what did I do?

#KeepMoving #10millionmetres

Well, I decided to #KeepMoving by taking on a challenge called 10 million metres. My intention was to traverse 10,000 km around the planet and only the events and challenges would contribute to the 10 million metre distance. There was no master plan other than to raise awareness of Parkinson’s disease and ultimately funds towards Parkinson’s research. That was in 2008. Between that decision and the present day so much has happened. Highlights include:

  • Completing the gruelling Marathon des Sables (250 km race across the Sahara Desert);

  • Running 160 miles across the Bavarian Alps in 52 hours;

  • Running 1,457 miles from London to Rome in 30 days to meet the Pope (400 miles of which was run with a stress fractured right tibia and completing the first 20 marathons in 10 days);

  • Becoming the first person to traverse the 3,256 miles from Santa Monica to New York using four distinct disciplines. I achieved this distance in 35 days and appeared on BBC One’s One show over two consecutive nights, raising awareness to over 10 million people worldwide and realising vital donations for charity.

  • In 2013 I crossed 200km of the Amazon Jungle, climbed and ran 90 km of the Dolomites and 236 km across the Colorado Rockies, achieving all three within an eight-week period;

  • On the 24th January 2014, the 10MillionMetres Challenge was completed at the Standard Chartered Dubai Marathon.

I’d covered a distance more than 6,200 miles around the world!

And Then

In the summer of 2015, I entered the Men’s Health USA Ultimate Guy Competition, successfully reaching the final nine competitors out of over 1,000 including Special Forces and the US Marines. I was also honoured by the then UK Prime Minister, David Cameron.

2016 brought a new challenge of completing 5,566 press-ups in 22 days to raise funds and awareness of PTSD, which affects military personnel and first responders. This was extremely tough as each day the target to be achieved increased by 22 push-ups on top of that which had already been achieved the previous day. I managed to continue for 18 days reaching total of 3,762 press-ups before the right shoulder gave out.

In February 2017, I returned from the Arctic after attempting a 450 km expedition of Sweden’s Kungsleden (Kings trail) in freezing temperatures of -29°C. My participation was cut short due to ripping a tendon in my right ankle. Undeterred, I had to continue and pulled a 135lb pulk and 10kg backpack across a further 25km, including two mountain passes before the onset of hypothermia.

In 2018, I undertook the brutal and extremely challenging Lost Islands Ultra in Fiji. Two weeks after finishing the Fiji ultra, I completed the Virgin Money London Marathon, notwithstanding my medication failing to work after 10 miles and running the remaining distance with muscle cramps and pain. Lots of pain!

Last September was spent in British Columbia, Canada. I had flown there to take part in Primal Quest. As part of a team, which included five times world adventure racing Champion Mike Klosser, we took on the Primal Quest Pursuit Race. An event there would take us across 240 miles of mountainous and challenging terrain including glaciers, and white water rapids situated in big Bear country. The team completed the challenge in four days and five hours.

Next Challenge

None of the above come without impact on the body, whether caused by Parkinson’s or just bad luck. Primal Quest left me with whiplash after coming off my mountain bike a total of nine times while descending the second mountain stage. This is one of a long line of injuries I have had over the years which have been treated by Paul Martin at Physio Remedies. With Paul’s help, I intend to train harder than ever before for my forthcoming challenge this September where, as part of a team of four, I will take on the world’s toughest race.

Alex will be unveiling his next challenge very soon. Watch this space!

Words by Alex Flynn, image from Alex’s website.

The Long(est) Read: Ultra Running Tips

Colin Bathe Arc of Attrition ultra runner

The Long(est) Read: Ultra Running Tips

NoviceRunnerNik’s husband Colin ran The 2019 Arc of Attrition, a brutal 100 mile race around the Cornish Coast Path in the depths of a chilly February weekend, finishing in a Gold buckle winning time of 29 hours and 40 minutes. Billed as The South West’s Toughest Winter Footrace, The Arc has a DNF rate of around 54%, reflecting just how hard this event is.

This was Colin’s first 100 mile event and he’s shared his top ultra running tips and experience of the race with you:


1. Preparation

Preparation is key. Know what you’re taking on. Read as much as you can about the race – many people blog about races so there’s a wealth of information out there. Join the race Facebook group if there is one. Learn from other people’s experiences. Put together a training plan and try and stick to it but don’t overdo the miles and risk injury. If you are local to the event, reccie the course in sections so that you know exactly what the terrain, elevation and actual route is to reduce the risk of losing your way in the event.

Colin ran around 30 miles per week and did four long runs of around 25 miles and tapered to almost nothing in the last couple of weeks before the race. He’s fortunate enough to live local to the event and reccied the whole course, sometimes with fellow entrants and on occasion with previous entrants (picking their brains).


2. Mental Game

Getting your head in the right place on an ultra is more important than running ability. You’ll often hear that ultra running is 90% (or similarly large %) mental strength. Keeping nutrition, hydration and physical comfort in a good place for the duration of the race all help to keep your mental state there too. Being prepared will give you confidence and help your mental ability.

Colin nailed the nutrition and hydration and apart from a bit of a low, with the threat of tears, at Mile 78 when he realised he couldn’t see out of one eye (more on this later), he was in a great place all through the race.


3. Nutrition and Hydration

Ultras are actually a series of All You Can Eat contests with a bit of running in between. You have to eat and drink well all the time to keep your body properly fuelled and hydrated and this will keep your mood buoyant too. Everyone knows this but it is something that can be very difficult as your body can just straight refuse to take anything down. Eating real food, rather than gels, seems to work for many people as evidenced by the very well provisioned check points on the Arc.

Practice eating real food on your training runs to work out what goes down well whilst running and what doesn’t and try lots of things. Also practice running straight after large meals so that you can have the confidence to eat well at check points and then continue running.

Keep drinking all the time and don’t wait until you feel thirsty – it’s too late then. Make sure your fluids are easily accessible – use a bladder and hose hydration system or a hydration vest with soft bottles held at the front. You should be peeing regularly all the way around your event so practice this on your training too.

Colin ate cocktail sausages, pork pies, baby tomatoes, radishes, grapes (stolen from crew supplies!), Snickers, Bounty, mini cheddars, soup, rolls, pizza, peanuts and very high calorie flapjack with just one gel right at the end to get him up the final hill.


4. Clothing

Your choice of clothing will obviously be dependent on the expected weather conditions but again train wearing the gear you expect to wear on race day. Chafing can be a painful problem during ultra runs so run-specific underwear is worth considering.

Colin wore waterproof shorts on top of long running tights and with a waterproof running jacket, taking care not to put too many layers on his top half to avoid overheating and sweating too much. The jacket and shorts kept his core dry which meant he didn’t suffer from the dreaded chafe.


5. Feet

Looking after your feet is also really important. Make sure your shoes have plenty of life left in them whilst you train. Test methods of foot care whilst you’re training to work out what works for you to avoid the near trenchfoot condition and blisters that 36 hours of running in wet socks and shoes will afflict on you. Regular sock (and shoe) changes and feet cleans will help. If you have to run any long sections of different terrain, e.g. road / pavement when you’re running a coast path event, then consider changing shoes at the start and finish of these sections, if you can.

At most sock changes, Colin cleaned his feet (or had it done for him!) of the worst of the mud using wet wipes, dried them off and then applied a new thick layer of Vaseline. It kept his feet dry and also helped with avoiding blisters. He changed socks six times and went from trail shoes to road to trail and then a second pair of trail shoes through the event. His feet were almost perfect at the end of 100 miles. Others looked as if the soles of their feet had been turned into relief maps of the whole course!


6. Crew

If race rules allow, having crew who drive round the event with you and pop up every so often for sock and shoe changes, refilling water bottles, handing out food and cheering you on makes your run easier. It means you can carry less weight in your pack and change clothes easily too. Treat them well as it’s a long and often dull job! Make sure you’re clear about your expectations and requirements from your crew. Plan where you expect to see them and communicate well. If your crew is a runner they will really understand what you’re going through.

Colin’s crew consisted of his wife Nik (a runner) and good friend Lee (an ultra runner), who they had crewed for in the Arc 2017 and 2018. There’s another blog post about how to crew for your ultra runner coming up!


7. Navigation

If the course is self-navigated, take time to work out what and practice with technology that will help you on your route finding as getting lost not only takes up valuable time, it can be really demoralising just when you need to keep your spirits up.

Colin used a Garmin Forerunner 235 watch to give him a rough map to follow so that he could check the route ahead and see if he was grossly off course or not. He also had a detailed map on his phone using the Locus Maps app and a downloaded offline copy of OpenStreetMap. He used a portable power pack to charge his phone and Garmin at check point stops.


8. Kit

Pack weight can make a difference to pace so pack carefully. If you have crew, carry the mandatory kit and leave as many of the ‘nice to haves’ with your crew, particularly if you’re seeing them very regularly.

Colin carried the mandatory safety kit (of course) but very little else. Without water and food, the carry weight was 2.1kg, around half of what some other people were carrying and he’s certain this made a difference.


9. Ultra Runner Issues

Corneal Oedema

A few miles before the St Ives Checkpoint at Mile 78, Colin noticed he had lost the vision in his right eye – all he could see was a white fog. Whilst concerned about the deterioration of his eyesight, his biggest concern was that he would have to retire when the race was going so well for him! The medics at the check point told him that Corneal Oedema, swelling of the cornea causing it to go cloudy and restrict vision, isn’t unusual in ultra runners. It is thought to be caused by dehydration, cold, wind and etc.

It had also affected around 10 other runners during the Arc. Colin was blind in the right eye for the last third of the race but it started to recover at the finish and he was 100% back to normal the next day. Some were less lucky with at least one person suffering vision loss in both eyes and having to retire from the race. More details on Corneal Oedema and Ultra Marathons are available here.


Vomiting

During the 2018 Arc of Attrition, with temperatures hovering around the freezing mark and a strong wind, many runners were struggling with constant vomiting and were unable to keep food and sometimes even water down. Being unable to refuel and rehydrate can have dire consequences for someone who still has 60 miles to run. Lee, Colin’s crew, suffered this but somehow managed to finish! It’s likely it was a symptom of mild hypothermia so getting Lee warmed up was the first thing we did. Another tip given by one of the checkpoint staff was to get him to drink lukewarm water instead of the chilled water in his pack. This is less of a shock to the stomach and certainly reduced the chances of seeing the water again - it worked a treat!


10. Stats

And because every ultra runner I know loves stats, here are Colin’s from the Arc:

  • 101 miles

  • 12,300 feet of ascent

  • 160 starters

  • 67 finishers

  • 29 hours 40 minutes 45 seconds

  • 218,000 steps

  • 11,000 calories burnt

  • 1.6kg weight loss

  • 2 very small blisters

  • 1 gold buckle

  • 1 very big smile (make that three)!


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Words by Colin Bathe and Nik Bathe. Images courtesy of MudCrew Events Ltd.