The Interaction Between Stressors What the studies cited in this article did not examine was how the combination of factors work together to influence drop out rates. Anecdotally, while a runner may not drop out from a race if their only difficulty is a few blisters on their feet, if combined with gastrointestinal distress and mild dehydration, it would be more likely that a runner would decide to pull out. While there is no evidence to directly support this hypothesis in ultramarathon races, we do see a significant effect of the interaction of challenges on an athleteâ€™s likelihood of finishing other ultra-endurance events such as ironman and triathlons (Gublin & Gaffney, 1999; Baker, Cote & Deakin, 2006; Pfeifferet al., 2010). The priority for the coach should therefore be to look at the full range of common stressors that runners are likely to encounter during an ultramarathon and develop a strategy that aims to minimise all of their effects. The combination of factors may explain why pre-existing injuries are so strongly correlated with higher levels of dropout. Runners may feel capable of completing the race when only dealing with a mild ongoing injury that they have experienced throughout their training, but
The interaction between factors [a combination of stressors on the runner] was greater than any individual variable for predicting dropout
Hoffman & Foggard
when combined with other challenges that arise on race-day (e.g. gastro-intestinal distress and exhaustion) the physical distress is exacerbated and the likelihood of dropping out is increased. Ultimately, it appears that that there is not one individual stressor that is likely to cause a runner to drop out, but the effect of multiple stressors working together. The coach needs to prepare their runner in training for each of the most common stressors and develop raceday strategies that can assist management of symptoms if they occur during the race. The next section of this article will look at how the coach can assist prevention and management of these issues.
Medication Usage in the Ultramarathon One of the more striking findings from Hoffman and Foggard
However, the authors advise against the use of NSAIDs during
was the high usage of medication reported during ultra-
ultra-endurance events unless specifically recommended by
a medical professional. NSAID usage increases the risk of
71.3% of all finishers self-reported using medication during the race, with a significantly higher proportion of finishers
exercise-induced hyponatremia (see Athletics Coach 1 / 18 for more information) and may restrict vasodilation.
using medication than non-finishers. Of those who took
Irritation of the gastrointestinal tract has also been shown to
medication, the vast majority (over 80%) took nonsteroidal
be correlated with NSAID usage (Rainsford, 1999) and may
anti-inflammatory drugs (NSAIDs), usually for pain relief or
partly explain the high levels of nausea reported among ultra
to reduce the symptoms of mild tissue injury in the form of
aspirin or ibuprofen.
It is strongly recommended that coaches direct their runners
It would be tempting as a coach to see the data and conclude
to their primary care physicians prior to a race to discuss
that because there is a correlation between NSAID usage and
NSAID usage, and if recommended by a doctor, to trial usage
the likelihood of finishing, that runners should be encouraged
of medication during a training run.
to take NSAIDs as a means of reducing pain or discomfort.