In 5 days time I will be running my very first 50km Ultra Marathon. I'll be local, I'll be unassisted (except for a mercy dash food and water drop off at halfway) and I'll be on my own.
No crowds, no co-runners, and no medical aid.
I'll be running the trails near where I live (as I know these well, though a 25km stretch is pretty unfamiliar to me). So what could possibly go wrong?
There are the common usual problems you need to think about, as well as a few you might not realise; along with some of the more serious ones to consider. If, like me, you are not a seasoned long distance trail runner, then to go out (especially unsupported) you should consider all of these as they can do everything from slow you down, end your challenge, or create a real medical emergency.
I have seen many of these challenges first hand when training for and completing my 100km continuous ultra hike, and have encountered a few of the lesser ones training for what I am about to do.
1. Navigation Fails
The last thing you want to do is get lost on your route. Most well organised events have a well signposted route, but solo efforts do not. If you can get your hands on a gpx file for the route and upload into a map app on your smart phone then when you're uncertain you can check. Nothing worse that finding yourself heading in the wrong direction for a mile or so and having to get back to the route. It burns time and and energy, and pisses you off.
On unfamiliar routes it is surprisingly easy to find yourself off course. Especially when you get tired. I did this when hiking the 100 in 2019 and added a couple of K around the 70km mark. Wasn't my finest moment.
You also need to let someone know your route and rough times you expect to reach. Having a phone (that's charged) is a must for me, but if signal is terrible then you need to let someone know where you are likely to be at what point. Some trails are barely used. If you don't reach a marker to check in with someone by a comfortable time then someone needs to know it. If they know the route then people can work back from where you were meant to be but didn't arrive.
2. Blisters
Your blister pack is an absolute must have. Chances are that with doing all the right things you will get them. It is one of the widest discussed subjects in the community and having suffered some extraordinary blisters a couple of years back on a 45km hike I've learned some valuable lessons and tested a few different approaches.
I'll include losing toenails in this as that is also common (especially trail running long distances). Created by friction and heat It's something that will make your challenge miserable, could end it, and deserves it's own post which will follow shortly.
I'll also mention lost toenails in this section. Shoes that tighten as your feet swell up (size up!), too small a toe-box for your foot in the shoe, and not lacing correctly for hilly courses (descents can wreck toenails on uneven routes and paths - look up how to 'lock-lace' to reduce your foot sliding forward on descents). Prevention is keeping all toenails cut short, having a slightly bigger shoe than normal, lock lacing, and putting some medical grade lambswool into the end of your shoe (a ballet dancer taught me this trick as they use this in their blocks to protect their toes).
Another point to talk about here is Chafing.
In ultra events, chafing is VERY common. Especially when wearing cotton underwear, if you have large thighs, cotton t-shirts (think bleeding nipples )
When it kicks in, it is no joke. You can chafe to the point of bleeding and infection easier than you think, and it can end a challenge.
The best solutions I've found are:
- Technical fabric underwear (e.g. Runderwear).
- Compression shorts/tights (if you have thighs that are likely to rub together)
- Taping up your nipples
- Anti-chafe stick (a life saver!) which you should also put between your arse cheeks (trust me on this!)
A friend had his challenge ended through some of the most severe chafing I'd heard about. It's no laughing matter, especially when it get's in your backside. Having to keep that clean to avoid infection is priority one, the pain associated with doing that is indescribable. I once chafed raw in my ass a couple of years back, and the only solution to keep it clean was hand sanitizer while out and about. I almost passed out. It brings a whole new meaning to the phrase 'ring sting'.
3. Energy Crash aka 'Bonking'
When it's gone, it's gone. I talk about energy levels in more detail in an earlier post here and getting your energy strategy wrong will end your challenge. I've seen it happen. I've witnessed people drop to the floor halfway up a hill and then tumble down it, others poleaxed into bushes, or simply passed out on a table at a rest stop. Everything you hear about the dreaded 'bonk' is true. This is where you need to make sure you carry enough fast calories and sugar to keep your glycogen stores topped up, and you must pace yourself. This is where fat adapting helps, but all the adapting will be for nothing if you set off too quickly and empty the tanks too fast. Once they are empty is takes hours to recover. On a 24hr + challenge you need to eat often. Something every hour at the least. This is easier said than done. After about 8 hours on your feet your stomach doesn't work so well. A lot of the blood is taken from your stomach and used in your legs. This means you don't feel like eating. In fact you can feel very sick. This is where easy to digest food with high calories that get energy to your body quickly helps the most.
Even though I'm fat adapted now, I'll be taking in carbs throughout my challenges. Every hour, in my drink, in high energy snack bars, a few energy gels and emergency dextrose tablets for the latter stages, where I know I'll need the fast energy hit the most.
Ultra's are often described as eating competitions. If you are not used to doing these types of challenges then heed this advice if you want to finish your challenge.
4. Bodily Functions
I speak from experience here when I say you need to be prepared. A few dog poo bags and wet wipes need to be in your kit list. If your stomach gets into distress it can be shocking. It cost me almost two hours sat in a portaloo making sure I was 'empty' a couple of years ago.
Immodium eventually helped, but the big problem was electrolytes. I was sweating more of my body's salts out more than I was taking in. Eventually my body just disagreed with this approach and punished me. It turned an event that was already hard enough, into pure hell for a few hours until I got those levels back again. It will also dehydrate you, and that is very bad indeed.
5. The Weather
Depending upon time of year, and where you are, the weather can be a big challenge. Make sure you check the weather report and have an emergency plan for if something happens en-route. You may well feel warm after 10km running in 5C temperatures, but bust your ankle in the middle of nowhere, and it starts raining and you could find yourself in trouble much quicker than you realise.
You need good waterproof kit, that's lightweight, that you've tested in bad conditions, and something to keep you warm if you are forced to stop or slow down. Wind and rain can rapidly drain your body heat and reduce your core temperature faster than you realise, until it is a problem you can't fix very quickly. You could be stuck somewhere hard to reach for a while and that can lead to hypothermia. Conversely, if the weather is warm and hot, you can easily get sunstroke, or dehydration if you aren't careful, so a hat/cap is essential, and sunscreen. I forgot my sunscreen and sunhat going into the second day of my 100k hike as the weather was meant to be cool and cloudy... it wasn't. I burned and struggled, using my cooling towel to wrap around my head in a makeshift bandana. It was a very unpleasant few hours and slowed me down for sure. If it had been a hotter day, it would have finished my challenge.
6. Hypothermia / Dehydration
Hypothermia, carrying on from my last point about weather, is very serious. Even getting it mildly can fuck you up. It creeps up on you as you expend body heat without realising that your body can't replace it. Ensuring you stay warm throughout is important, as well as keeping your energy levels up. Don't let yourself cool down. When you stop, add a layer, put some gloves on, etc just to keep heat in and around your body.
The other situation you are more likely to encounter is dehydration. No matter the weather, just because you aren't thirsty doesn't mean you don't need fluids. The easiest measure of this is how often you need to go to the toilet. If you go for more than 3 hours without needing a call of nature, then you are dehydrated. Water and electrolytes are essential. The warmer the weather, the more you need.
Dehydration that can become very bad, also leads to a couple of nasty complications which I'll mention in a bit - Hyponatremia and Rhabdomyolisis. Both can be life threatening.
Electrolytes are very easily forgotten and they make a huge difference. To your stomach, to your muscles, to your energy and to your hydration levels. You will sweat. You need to put those salts back. DO NOT ignore taking electrolytes throughout your entire challenge.
When you are only out for 3-5 hours, these are not issues generally. However, when you are out for 12-24+hrs they are very real risks
7. Injury Risks
Having rolled (and fractured) my ankle while jogging a trail path I know these things happen much easier than you realise. When you are tired you lose a bit of form and coordination, and injury risks go up. The biggest ones to think about are ankle sprains, twisted knees, calf tears, groin strain, quad strain, hamstring strain, etc. Keeping muscles warm, hydrated and well fed will help.
For any accidents I keep a 5m roll of KT Tape to patch up (AND SCISSORS TO CUT IT WITH!). I am prone to ankle sprains so always tape up my weaker ankle for support before I start long trail runs (as well as run trails in mid trainers with a bit of ankle support). I also run with lightweight carbon poles, which are very handy if you pick up an injury and have to keep moving. They have also saved me from nasty sprains a few times! The tape will help support strains and sprains (just make sure you practice how to tape for the most common problems).
When tired you can stumble on loose stones, slip in mud, lose footing on a steep hill. And this is really easy to do when you get more fatigued, and as it gets dark.
Another risk, especially for the heavier challengers is nerve damage. Time on your feet can damage nerves in your feet through compression of areas such as the ankle and foot. I lost feeling in one of my big toes for over 2 months after my ultra hike a couple of years ago. It can bring on things such as Morton's Neuroma (very painful), nerve spasms (also very painful), and numbness (which is just weird). Having the right footwear (especially if you are heavier) is very helpful to avoid this. Wide toe-box, and sensible lacing make a big difference, as does going a size bigger than your everyday shoes. Your feet WILL swell up. Having a slightly larger shoe will help reduce blisters, lost toenails and nerve damage.
8. Hyponatremia
Hyponatremia is dangerous. It's where your body's sodium levels are all but gone. And that is bad.
This can happen with dehydration and sweating too long without putting electrolytes back into your body. Or from drinking too much water (overhydrating) and diluting your sodium levels in your blood too far. Your cells take on too much water. This can lead to:
Nausea and vomiting
Headache
Confusion
Loss of energy, drowsiness and fatigue
Restlessness and irritability
Muscle weakness, spasms or cramps
Seizures
Coma
It's more common than you think and, because of the time ultra marathons last, it can be more serious than you realise.
Simple prevention is not to drink too much and get your electrolytes in constantly. Again, if you are drinking a lot, but not going to the toilet, your hands/feet/calves feel puffy, and ANY of the above symptoms start to show up, then the chances are you have it. Even in mild form. Get electrolytes into you. I carry salt tablets as well as electrolytes in my drinks. I'm pretty sure the mess I got into two years ago with my stomach etc was due to this. Ever since, I've been religious about my electrolytes and I've avoided these problems on my longer training runs.
9. Rhabdo
If your urine is the colour of Guinness or Coke (or Pepsi, for that matter) then you need to address the problem quickly before you get kidney failure.
Rhabdo is something many experienced ultra marathon runners particularly pay attention to. It comes from when your body breaks down muscle protein too quickly for energy, creating too much myoglobin. This in turn blocks your kidneys, and can result in very serious complications. The high levels of myoglobin are what is seen in very dark coloured urine.
This massive muscle breakdown is from over exertion and dehydration. This is where appropriate fuelling and hydration are essential when going long distances.
This is also why you should absolutely NOT TAKE Ibuprofen if you suffer pain during a long distance run. Ibuprofen makes the Rhabdo problem much worse, and increases the risk of kidney failure.
Rhabdo is also a problem that can continue AFTER you have completed a challenge. For the 24hrs or so after your event, you need to keep your hydration high as you will almost certainly be dehydrated after an ultra, and the complications and damage can continue long after you have finished.
Here is a link to a detailed guide to prevention and the condition https://trailrunnermag.com/nutrition/race-day-nutrition/warning-signs.html
Final word
I don't say this stuff to put you off. I say it because the chances are you too will experience a number of the above things. Guranteed you will dehydrate, and have low electrolytes. And you are near certain to feel sick and get blisters and chafing. Do not for one second think you won't. It's called Ultra running for a reason. These risks are also high when hiking ultra distances. The right kit and precautions will make a huge difference and are often a contributing factor in success or failure (the dreaded DNF). Any one of these when it kicks in certainly will suck any joy of the event if they get out of control. Find yourself 5 miles with before a stop with nasty blisters and it could be fatal to your challenge by the time you get help to treat them. Give yourself the time to prepare accordingly. Get the right gear and carry the right means with which to patch yourself up en-route. Research it, and be disciplined in managing it during the event you take on. That will keep the worst of the things that can happen to a minimum.
Yes, a lot can go wrong. You will encounter at least two of the above, even with the best precautions, so expect it and deal with it. But you are taking your body so much further than it's used to if you are starting out in this sport. Pain is part of it. That's why most don't take this type of challenge on. Because it's hard.
... but that's why we choose to do it, right?
Thanks for reading...
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