Since 2013, a group of medical professionals and researchers have come together annually to discuss the best science and research regarding ultra endurance sports. I have been fortunate to attend four of the 5 meetings (I am still kicking myself for missing two years ago in Chamonix.) On the upside, this was the first year I got to attend the meeting with JoAnn and we were having some flash backs of sitting next to each other during med school lectures at times!
This year’s meeting was held in Castellon de la Plana, Spain, about 2 hours south of Barcelona along the coast. The meeting was held here in conjunction with 2018 World Trail Running championships and the Penyagolosa trails race. FYI- the men’s race was won by one of the speakers at the meeting, Luis Alberto Hernando from Spain. The women’s race was won by Adeline Roche from France.
As usual, the meeting covered an incredible gamut of topics ranging from exercise-associated muscle cramping and exercise-associated hyponatremia to urinary issues in runners and use of new technologies to better evaluate runners and track runners during races. This was the first time I’d been to an international meeting that had translators so for many of the talks which was kind of interesting.
So a few highlights from assorted talks:
– The incidence of exercise-associated hyponatremia (low sodium) seems to be improving as runners are doing a better job of just drinking when they are thirsty instead of overly worrying about getting dehydrated. I also learned a trick that in a pinch, if I don’t have access to IV fluids, it’s worth trying about ½ tsp of salt in 100 ml of water along with some flavoring to create an oral hypertonic solution to treat mild symptomic hyponatremia (but don’t worry, we’ll still have IV hypertonic saline for emergencies).
-Also excited to be introduced to the “Athletes for Transparency” and the QUARTZ program that brings endurance athletes together to help promote doping-free sport.
-Learned about some how physiology labs use different protocols for VO2 max testing for road runners versus trail runners. We’re going to incorporate some of these protocols into our testing here in Reno for ultra runners.
-Muscle cramps are still a complex issue and that cramps should be thought of as a symptoms and not a diagnosis. The most recent literature still points to a complex central nervous system cause for muscle cramps instead of it being due to a specific electrolyte or hydration issue. Treatment with pickle juice, mustard or menthol may actually help by sort of “resetting” the system but more research is needed.
-Interesting study from the Solomon folks on foot swelling during the Tor Des Geants race. While the length of your foot doesn’t change, after about 50K and beyond in a race, foot volume can increase by 2-7%. They are using this data to help improve their shoe design.
– Also picked up some tips on gastrointestinal issues in runners. Dehydration and heat obviously cause more GI symptoms. Interestingly, probiotics likely make GI symptoms worse as well. The speakers also briefly reviewed a gut-training protocol that in their study helped running performance (e-mail me if you want to see the paper!)
– Really cool research about how Killian Jornet got ready for his Everest attempt and how he cycled in altitude training versus train low/sleep high protocols. The researcher uses a really sophisticated way to measure iron/oxygen carrying capacity to show how the various protocols increase red blood cell mass and thus improve performance
-Finally, got some interesting tips on helping athletes with temperature extremes. Once quick tip was immersing your hands in ice for 15-20 min to help cool you off in high temps
The biggest highlight for JoAnn and I was being able to sit and pick the brains of some of the lead researchers in many of these areas in between sessions. If people are interested, we’re talking about maybe having an evening session for DPMR folks to answer questions.