Search

BACKGROUND The influence of environmental conditions on marathon running performance and pacing has been widely investigated among professional runners. However, environmental conditions' influence on recreational marathoners' pacing is less known. OBJECTIVE The aim of the present study was to investigate whether environmental conditions such as temperature, barometric pressure, humidity, precipitation, sunshine, cloud cover, wind speed and dew point are associated with the pacing of recreational marathoners for men and women. METHODS A total of 668,509 (520,521 men and 147,988 women) runners' records from ‘Berlin Marathon’ races between 1999 and 2019 were considered for analysis. Correlations and Ordinary Least Squares (OLS) regressions between time-adjusted averages for temperature, barometric pressure, humidity, precipitation, sunshine, cloud cover, wind speed and dew point, and race times and paces were investigated for performance groups in intervals of 00:30 h:min for race times between 02:30 h:min to 06:00 h:min and longer. RESULTS Both increasing temperature and decreasing humidity during the day were negatively related to running speed in recreational marathoners competing in the ‘Berlin Marathon’ where men were more affected than women. OLS showed, however, that the model can only predict 10% of the race pace with weather factors as predicting variables. CONCLUSIONS The susceptibility to temperature and humidity grew as the race progressed. Although weather affected running speeds and results, it was not a significant predictor of pacing. These findings can be used by coaches and athletes to better plan and control their hydration and running pace considering weather conditions. CLINICALTRIAL

BACKGROUND Several single race events (5 km, 10 km, half-marathon, marathon, ultra-marathon) have been analyzed in multiple studies. It is known that 5 km and 10 km races attract many athletes with a focus on women and that the top finishers are getting faster in 10 km races, while younger runners were the fastest. Regarding half-marathon and marathon races there is a focus on male participants, with less but faster marathoners compared to half-marathoners. Across years, the sex difference in performance decreased in both races. In ultra-marathon, an increase in participation numbers as well as in performance has been detected, with a focus on male finishers. The performance gap between men and women seems to be stable. In summary, we have a lot of single study results, but not the running trends for several running distances over 20 years and in a whole country. OBJECTIVE The aim of this study is therefore to examine 5 km, 10 km, half-marathon, marathon and ultra-marathon races by age, sex, participation numbers and performance during two decades (1999-2019) for one country (Switzerland). METHODS We analyzed 1,172,836 finishers (370,517 women and 802,319 men) competing between 1999 and 2019 in 5 km, 10 km, half-marathon, marathon and ultra-marathon running races held in Switzerland. We used online available data about the athletes and examined total finishing numbers, sex, age and performances. In ultra-marathons, we performed a linear model as sensitivity analyses for change in running speed. Do-not-finishers were excluded. RESULTS The most frequented race was the half-marathon (33.1% of finishers), the less frequented was the ultra-marathon distance (8.5% of finishers). In most recent years, only the number of finishers in ultra-marathon, especially in trail runs increased. In total, there were more male finishers (68.4 %) than female finishers (31.6 %) and only in 5 km races, more women finished than men (55.3%). Men were faster than women and both sexes were running slower in all race distances across years. Athletes in 10 km races had the best performance within the five analyzed race distances. Median age increased with longer race distance and decreased in ultra-marathon in recent years. CONCLUSIONS In summary, finishing numbers especially in ultra-marathons increased with a focus on trail runs, female and male athletes had a declining performance across years in all race distances and men ran faster than women. Median age increased with longer race distance and showed a downtrend only in ultra-marathon in recent years.

BACKGROUND Ultra-marathon running is the most popular ultra-endurance competition in terms of the number of races and runners competing annually worldwide; however, no study has compared pacing and performance over a long period. OBJECTIVE The present study analyzed the pacing of successful finishers and non-finishers in multi-stage ultra-marathons worldwide. METHODS A total of 4,079 athletes (men=3,288; women=791) competing in 99 multi-stage ultra-marathon events from 1983 to 2021 were analyzed, including the number of participants, age, gender, rank and running speed of successful finishers. RESULTS The results showed a significant increase in the number of events (400%) and a significant increase in the number of finishers and non-finishers (250%) in the ultra-marathons worldwide during this period. The GLM of pacing variation showed non-significant effects for gender (F = 2.5; p = 0.127; p2 = 0.063) and age group (F = 0.6; p = 0.798; p2 = 0.367), but it showed a significant interaction (gender x age) effect (F = 2.3; p = 0.008; p2 = 0.009). Post-hoc analyses showed that men have a higher pacing variation than women in U30, U35, U45 and U50. Additionally, the fastest women age group (U35) had the lowest pacing variation. The GLM of pacing variation by gender and event distance showed significant effects for both gender (F = 18.5; p < 0.001; p2 = 0.007) and distance (F = 20.1; p < 0.001; p2 = 0.015). Post-hoc analyses showed a growing pacing variation with increasing race distance for both men and women. In addition, men had a higher variation in long events. Furthermore, there was a significant main effect for both gender (F = 33.7; p < 0.001; p2 = 0.012) and rank (F = 136.6; p < 0.001; p2 = 0.048) on performance, with men being faster than women. Pacing varied greatly due to gender (F = 4.0; p = 0.047; p2 = 0.001), with a lower (i.e., more even) pacing variation for men athletes in the top three finishers. Men non-finishers showed a higher performance than women non-finishers (F = 25.6; p < 0.001), and no difference was identified for pacing variation (F = 1.5; p = 0.228) based on gender. In addition, a weak but significant correlation (r = -0.130; p < 0.001) was identified between the average running speed and pacing variation for both women and men non-finishers. CONCLUSIONS In summary, multi-stage ultra-marathon competitions showed an increasing number of competitors and a higher performance challenge. Men have a higher pacing (i.e., less even) variation than women, especially observed in longer events. A higher pacing variation was associated with lower performance for men, women, and non-finishers. CLINICALTRIAL

This study aims to investigate the fear or failure (FoF) in Brazilian runners of both sex, performance levels and age categories, as well as to verify the relationship between FoF and socioeconomic status (SES). Sample size as composed by 916. Age, sex, body height, body weight, SES, and running pace were self-reported. The Multidimensional Questionnaire of FoF was applied in an online platform. Running pace, and SES were categorized and processed through multivariate analysis and Spearman correlations, with the p-value set at 0.05. Female runners with better performance (2.13 ± 0.74) and younger (2.16 ± 0.80), as a well as male runners with worse performance (2.04 ± 0.69) and older (2.04 ± 0.89) presented the highest values of FoF. Among women, SES was negatively associated with FoF (r = -0.144; p = 0.006), while a positive association between running pace and SES was observed among men (r = 0.290; p 0.001). Non-professional Brazilian runners presented low values of FoF.

Background Pacing has been investigated in different kinds of ultra-marathon races, but not in one of the toughest ultra-marathons in the world, the ‘Spartathlon’. Objective The aim of the present study was to analyse the pacing of female and male finishers competing in the ‘Spartathlon’ in regards to their age and performance groups. Methods A total of 2598 runners (2255 men and 343 women) finishing ‘Spartathlon’ between 2011 and 2019 were analysed. We selected 10 checkpoints with split times corresponding to important race sections. Average running speed was calculated for each participant and the average checkpoint running speed for each of the 10 race checkpoints. Furthermore, to assess the pacing strategy of each runner, the percentage of change in checkpoint speed (CCS) in relation to the average race speed was calculated (for each of 10 checkpoints). Finally, the average change in checkpoint speed (ACCS) was calculated for each participant as a mean of the 10 CCSs. Results Both women and men slowed down through the first 7 checkpoints but increased running speed towards the end of the race (reverse J-shaped pacing). Men showed a significantly greater CCS in the first and second checkpoint (p p p p Conclusions In summary, successful finishers in ‘Spartathlon’ showed a reverse J-shaped pacing curve with a decrease in running speed from the start to the 7th checkpoint and an increase in running speed thereafter. This strategy was most probably due to the profile of the race course. Men showed a more significant change in checkpoint speed in the first two checkpoints, whereas women showed a more substantial change in the last checkpoint. Age and sex did not affect average checkpoint speed, whereas this speed was different between the different performance groups. The slowest and the fastest runners showed fewer changes in average checkpoint speed than the two medium groups in men and women.

ObjectiveTo review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.DesignLiving systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.Data sourcesEight electronic databases were searched from inception to 18 March 2021.Eligibility criteriaStudies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.ResultsNineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.ConclusionLimited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.

Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16–18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race directors, and medical professionals often seek advice regarding the safety of youth athletes participating in these events, especially with regard to potential short and long-term health consequences. UER may impact key organ systems during growth and development. We propose a decision-making process, based on current knowledge and the experience of the consensus group that addresses age regulations, medical and psychological well-being, training status and race-specific factors (such as distance, elevation change, remoteness, ambient temperatures, level of medical assistance, and type of provisions provided by the race organizers) to use until evidence of long-term consequences of UER in youth athletes is available. These recommendations are aimed at safe participation in UER events for youth athletes with a proper and individualized assessment.

It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.

Objectives To cross-culturally adapt and validate a Spanish version of the Exercise-Induced Leg Pain questionnaire. Design Clinical measurement study. Participants The validity and reliability of the adapted version were assessed in four groups of 40 patients with exercise-induced leg pain, 40 physically active healthy individuals (control group), 40 athletes with other leg conditions and 40 athletes, military personnel and candidates with no history of injury (risk group). Main measure Exercise-Induced Leg Pain questionnaire. Reference measures Spanish version of the Short-Form 36 and Schepsis postsurgical classification scale. Results In patients with exercise-induced leg pain, the mean age was 24.9 (± 6.7) years and the mean score of the questionnaire was 62.8 (± 10.9). The standard error of measurement and minimum detectable change threshold were 1.67 and 4.63 points, respectively. Excellent internal consistency (Cronbach’s α = 0.942) and test-retest reliability (intraclass correlation coefficient = 0.995) were found. The exploratory and confirmatory factor analyses indicated that a one-factor solution explained 66.84% of the variance. For construct validity, 87.5% of the previously stated hypotheses were fulfilled between the total score of the questionnaire and Short-Form 36 dimensions. Concurrent validity, assessed by the Schepsis scale, was almost perfect (r = 0.92, p < 0.001). The predictive validity of the questionnaire was demonstrated using the receiving operating curve (area of 0.992; 95% CI: 0.983–1, p < 0.001). Conclusion The Spanish version of the Exercise-Induced Leg Pain questionnaire resulted in a reliable and valid instrument to assess patients with exercise-induced leg pain.

The influence of environmental conditions has been investigated for different marathon races, but not for the Berlin Marathon, the fastest marathon race course in the world. The aim of this study was to investigate the potential influence of environmental conditions such as temperature, precipitation, sunshine, and atmospheric pressure on marathon race times in the Berlin Marathon since its first event in 1974–2019. A total of n = 882,540 valid finisher records were available for analysis, of which 724,135 correspond to male and 158,405 to female runners. We performed analyses regarding performance levels considering all finishers, the top 3, the top 10, and the top 100 women and men. Within the 46 years of Berlin marathons under study, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21, cloud cover was predominant. There was no significant trend with time in any of the weather variables (e.g., no increase in temperature across the years). Overall runners became slower with increasing temperature and sunshine duration, however, elite runners (i.e., top 3 and top 10) seemed to run faster and improved their race times when the temperature increased (with women improving more than men). Top 10 women seemed to benefit more from increasing temperatures than top 10 males, and male top 100 runners seemed to benefit more from increasing temperatures than female top 100 runners. In the top three sub-group, no differences were observed between male and female correlations. In summary, in marathoners competing in the Berlin Marathon between 1974 and 2019, increasing temperatures and sunshine duration showed a different effect on different performance levels where overall runners (i.e., the general mass of runners) became slower with increasing temperature and sunshine duration, but elite runners (i.e., top 3, top 10) became faster with increasing temperatures where sex differences exist.

The “Berlin Marathon” is the fastest marathon racecourse in the world and has witnessed 11 world records (WRs; eight in men and three in women). Weather conditions can have an important impact on race time and we therefore examined the influence of environmental conditions (i.e., temperature, sunshine, precipitation, barometric pressure, and cloud cover) on WRs and elite (i.e., winner, top three and top 10 finishers) marathon performances of men and women at the “Berlin Marathon” between 1974 and 2019. Average world record marathon times in men were 2:03:52 ± 0:01:19 h:min:s and 2:25:05 ± 0:08:25 h:min:s in females (p < 0.05). Male competitions were held 44 times (mean winning time: 2:09:48 ± 0:09:15 h:min:s) and female competitions 41 times (mean winning time: 02:30:35 ± 0:19:09 h:min:s; p < 0.05). World record performances were set at mean temperatures of 18.61 ± 2.59°C for men and 13.07 ± 4.01°C for women (p > 0.05). The ideal environmental conditions for world record performances for men were temperatures of 18.61°C (p > 0.05), sunny, mostly dry days, with higher atmospheric pressure and little cloud cover (all p > 0.05). In women, ideal conditions for world records performances were temperatures of 13.07°C (p > 0.05), with low atmospheric pressure (p > 0.05), but significantly more rain (p < 0.05), and with no sunshine (p < 0.05) and cloud cover (p < 0.05). With elite performances, the ideal temperatures were of 17.36 ± 4.33°C for men and 17.93 ± 4.07°C for women (p > 0.05), with little to no rain, and moderate cloud cover and sunshine (p > 0.05). In summary, novel findings are, that environmental conditions in world records performances differ between men and women, with women obtaining world records in bad weather (with rain, cloud cover, and no sunshine) and men in good weather (sunny, mostly dry days, with little cloud cover). Larger sample sizes are needed to examine sex differences and environmental conditions on world record marathon performances.

The effect of different environmental conditions such as temperature, wind, barometric pressure, and precipitation has been well investigated in elite marathoners, but not by age categories (i.e., age group marathoners). The aim of the study was to investigate the potential influence of environmental conditions such as temperature, precipitation, and atmospheric pressure on marathon performance in age group marathoners competing in the ‘Berlin Marathon’ from 1974 to 2019. A total of 869,474 valid finisher records were available for analysis, of which 711,136 correspond to males and 158,338 to females. The influence of temperature, atmospheric pressure, and precipitation on marathon race times was investigated in age group marathoners grouped in 5-year-intervals. Within the 46 years of Berlin marathons under investigation, there was some level of precipitation for 18 years, and 28 years without any rain. Sunshine was predominant in 25 of the events, whilst in the other 21 years, cloud cover was predominant. Marathon race times were significantly and positively correlated with age (i.e., older runners were slower than younger runners) where the correlation was higher for males than for females. Marathon race times were significantly and positively correlated with both the hours of sunshine and the daily maximum temperature. The fastest marathon runners (meaning the minimum times) achieved the fastest race times on race days with higher maximum temperatures (i.e., 15–30°C). Daily maximum temperatures showed an influence on age group marathoners from age group 35–40 years and older. Higher precipitation levels impaired performance across most age groups. In summary, higher daily maximum temperatures (i.e., >15°C) and higher precipitation levels impaired performance of master marathoners (i.e., 35–40 years and older) competing in the ‘Berlin Marathon’ in the last 45 years. Master marathoners should start in marathon races with temperatures < 15°C and no precipitation in order to achieve a fast marathon race time.

(1) Background: Recent studies analyzed the participation and performance trends of historic races such as the oldest ultra-marathon (Comrades) or the oldest 100-km ultra-marathon (Biel). One of the toughest and historic ultra-marathons in the world is the ‘Spartathlon’ (246-km ultra-marathon from Athens to Sparta). The present study aimed to analyze the trends in participation and performance of this race. (2) Methods: Different general linear models were applied as follows: the first model was a two-way ANOVA (Decade × Sex), with separate models for all participants and for only the top five finishers in each race, the second model was a two-way ANOVA (Age Group × Sex), the third model was a two-way ANOVA (Nationality × Sex). (3) Results: Between 1982 and 2019, 3504 ultra-marathoners (3097 men and 407 women) officially finished the Spartathlon at least once. Athletes from Japan were the majority with 737 participants, followed by far by runners from Germany (n = 393), Greece (n = 326), and France (n = 274). The nations with the highest numbers of athletes amongst the top five performers were Japan (n = 71), followed by Germany (n = 59), and Great Britain (n = 31). Runners from the USA were the fastest in men, and runners from Great Britain were the fastest in women. Female and male runners improved performance across the decades. The annual five fastest women and men improved their performance over time. Runners achieved their best performance earlier in life (20–29 and 30–39 years) than female runners (30–39 and 40–49 years). Runners in age group 30–39 years were the fastest for all nationalities, except for Greece. (4) Conclusions: Successful finishers in the Spartathlon improved performance in the last four decades and male runners achieved their best performance ~10 years earlier in life than female runners.

Trail running is a popular sport, yet factors related to performance are still not fully understood. Lactate thresholds have been thoroughly investigated in road running and correlate strongly with race performance, but to date few data are available about the value in trail running performance prediction. We examined 25 trail runners (age 31.2 ± 5.1 years, BMI 22.2 ± 1.82 kg/m2) with an initial graded exercise test for measurement of VO2max (59.5 ± 5.2 ml.kg‐1.min‐ 1) and lactate thresholds (LT): LTAET (LT aerobic) 1.03 ± 0.59 mmol/l; 11.2 ± 1.1 km/h), IAT (individual lactate threshold) (2.53 ± 0.59 mmol/l; 15.4 ± 1.6 km/h) and LT4 (lactate threshold at 4 mmol/l) (16.2 ± 1.9 km/h). All runners subsequently participated in a 31.1 km XS trail race and 9 runners in a 21 km XXS trail race. Race performance times correlated negatively with the XS trail run (LTAET: r = ‐0.65, p < 0.01; LT4: r = ‐0.87, p < 0.01; IAT: r = ‐0.84, p < 0.01) and regression analysis showed that race performance could be predicted by: LT4: ‐324.15×LT4+13195.23 (R2 = .753, F1,23 = 70.02, p < 0.01). A subgroup analysis showed higher correlations with race performance for slower than faster runners. No correlations were found with the XXS race. Lactate thresholds can be of value in predicting trail race performance and help in designing training plans.

Purpose: Trail running is a complex sport, and performance prediction is challenging. The aim was to evaluate 3 standard laboratory exercise tests in trail runners and correlate measurements to the race time of a trail competition evaluating its predictive power. Methods: Nine competitive male trail runners (mean age: 31 [5.8] y) completed 3 different laboratory exercise tests (step, ramp, and trail tests) for determination of maximal oxygen uptake (VO2max), vVO2max, ventilatory (VT) and lactate thresholds (LT), mechanical power output, and running economy (RE), followed by a 31-km trail race. Runners had previously participated in the same race (previous year) and finished in the top 2%. Finishing times (dependent value) were tested in multiple-regression analysis with different independent value combinations. Results: Linear-regression analysis revealed that variables measured during step and ramp tests significantly predicted performance. Step-test variables (speed at individual anaerobic threshold 16.4 [1.7] km/h and RE 12 km/h in %VO2max 65.6% [5.4%]) showed the highest performance prediction (R2 = .651, F2,6 = 5.60, P = .043), followed by the ramp test (vVO2max 20.3 [1.3] km/h; R2 = .477, F1,7 = 6.39, P = .04) and trail test (maximal power 3.9 [0.5] W/kg, VO2max 63.0 [4.8] mL O2·kg−1·min−1, vVT1 11.9 [0.7] km/h; R2 = .68, F3,5 = 3.52, P = .11). Adding race time from the preceding year to the step test improved the predictive power of the model (R2 = .988, F3,5 = 66.51, P Conclusions: The graded exercise test (VO2max, individual anaerobic threshold, and RE) most accurately predicted a 31.1-km trail-running performance. Combining submaximal intensities (individual anaerobic threshold and RE) with the previous year’s race time of that specific event increased the predictive power of the model to 99%.

Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16-18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race directors, and medical professionals often seek advice regarding the safety of youth athletes participating in these events, especially with regard to potential short and long-term health consequences. UER may impact key organ systems during growth and development. We propose a decision-making process, based on current knowledge and the experience of the consensus group that addresses age regulations, medical and psychological well-being, training status and race-specific factors (such as distance, elevation change, remoteness, ambient temperatures, level of medical assistance, and type of provisions provided by the race organizers) to use until evidence of long-term consequences of UER in youth athletes is available. These recommendations are aimed at safe participation in UER events for youth athletes with a proper and individualized assessment.

This study aimed to analyze the number of successful finishers and the performance of the athletes in 100-km ultra-marathons worldwide. A total of 2067 100-km ultra-marathon races with 369,969 men and 69,668 women competing between 1960 and 2019 were analyzed, including the number of successful finishers, age, sex, and running speed. The results showed a strong increase in the number of running events as well as a strong increase in the number of participants in the 100-km ultra-marathons worldwide. The performance gap disappeared in athletes older than 60 years. Nevertheless, the running speed of athletes over 70 years has improved every decade. In contrast, the performance gap among the top three athletes remains persistent over all decades (F = 83.4, p &lt, 0.001, p&eta, 2 = 0.039). The performance gap between the sexes is not significant in the youngest age groups (20&ndash, 29 years) and the oldest age groups (&gt, 90 years) among recreational athletes and among top-three athletes over 70 years. In summary, especially for older athletes, a 100-km ultra-marathon competition shows an increasing number of opponents and a stronger performance challenge. This will certainly be of interest for coaches and athletes in the future, both from a scientific and sporting point of view.

International outdoor athletics championships are typically hosted during the summer season, frequently in hot and humid climatic conditions. Therefore, we analyzed the association between apparent temperature and heat-related illnesses occurrence during international outdoor athletics championships and compared its incidence rates between athletics disciplines. Heat-related illnesses were selected from illness data prospectively collected at seven international outdoor athletics championships between 2009 and 2018 using a standardized methodology. The Universal Thermal Climate Index (UTCI) was calculated as a measure of the apparent temperature based on weather data for each day of the championships. Heat-related illness numbers and (daily) incidence rates were calculated and analyzed in relation to the daily maximum UTCI temperature and between disciplines. During 50 championships days with UTCI temperatures between 15celcius and 37celcius, 132 heat-related illnesses were recorded. Average incidence rate of heat-related illnesses was 11.7 (95%CI 9.7 to 13.7) per 1000 registered athletes. The expected daily incidence rate of heat-related illnesses increased significantly with UTCI temperature (0.12 more illnesses per 1000 registered athletes/degrees C; 95%CI 0.08-0.16) and was found to double from 25 to 35 degrees C UTCI. Race walkers (RR = 45.5, 95%CI 21.6-96.0) and marathon runners (RR = 47.7, 95%CI 23.0-98.8) had higher heat-related illness rates than athletes competing in short-duration disciplines. Higher UTCI temperatures were associated with more heat-related illnesses, with marathon and race walking athletes having higher risk than athletes competing in short-duration disciplines. Heat-related illness prevention strategies should predominantly focus on marathon and race walking events of outdoor athletics championships when high temperatures are forecast.

Background and objectives: The COVID-19 outbreak has become a major health and economic crisis. The World Health Organization declared it a pandemic in March 2020, and many sporting events were canceled. Materials and Methods: We examined the effects of the COVID-19 pandemic on endurance and ultra-endurance running (UER) and analyzed finishes and events during the COVID-19 pandemic (observation period March 2020&ndash, October 2020) to the same time period pre-COVID-19 outbreak (March 2019&ndash, October 2019). Results: Endurance finishes decreased during the pandemic (459,029 to 42,656 (male: 277,493 to 25,582, female 181,536 to 17,074, all p &lt, 0.001). Similarly, the numbers of endurance events decreased (213 vs. 61 events, p &lt, 0.001). Average marathon finishing times decreased during the pandemic in men (5:18:03 &plusmn, 0:16:34 vs. 4:43:08 &plusmn, 0:25:08 h:min:s (p = 0.006)) and women (5:39:32 &plusmn, 0:19:29 vs. 5:14:29 &plusmn, 0:26:36 h:min:s (p = 0.02)). In UER, finishes decreased significantly (580,289 to 110,055, 0.001) as did events (5839 to 1791, 0.001). Popular event locations in United States, France, UK, and Germany decreased significantly (p &lt, 0.05). All distance and time-limited UER events saw significant decreases (p &lt, 0.05). Conclusions: The COVID-19 pandemic has had a significant effect on endurance and UER, and it is unlikely that running activities return to pre-pandemic levels any time soon. Mitigation strategies and safety protocols should be established.

Participation and performance trends as well as the performance differences among sexes in ultra-endurance running have been well described in the adult population; however, less information on such trends existed in youth ultramarathoners. The aim of the present study was to investigate the age-related participation and performance trends of children and adolescent ultramarathoner runners. Data on runners, younger than 19 years of age, competing from 1960 to 2018 in distance-limited ultramarathons of 50 km, 100 km, 50 miles and 100 miles, were analysed. During this period, the number of ultramarathon participation increased, most notably among boys, most runners originated from Europe, and the 50- and 100-km race distances were the most popular. Overall, male runners were faster than female runners, except in the case of European and Oceanian origin, where girls were faster over the 50-km race. The fastest male runners originated from Africa and the fastest girls from Oceania, and the average running speed has largely decreased for both sexes over calendar years. In summary, this study was the first to report details on participation and performance trends in youth ultramarathoners competing in distance-limited ultramarathons.

In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. This study investigated the effects of age, sex, and performance level on pacing in the UTMB&reg, (Ultra-trail du Mont Blanc) and aimed to verify previous findings obtained in the research on other running disciplines and other ultramarathon races. Data from the UTMB&reg, from 2008 to 2019 for 13,829 race results (12,681 men and 1148 women) were analyzed. A general linear model (two-way analysis of variance (ANOVA)) was applied to identify a sex, age group, and interaction effect in pace average and pace variation. A univariate model (one-way ANOVA) was used to identify a sex effect for age, pace average, and pace variation for the fastest men and women. In our study, pace average and a steadier pace were positively correlated. Even pacing throughout the UTMB&reg, correlated with faster finishing times. The average pace depended significantly on sex and age group. When considering the top five athletes in each age group, sex and age group also had significant effects on pace variation. The fastest women were older than the fastest men, and the fastest men were faster than the fastest women. Women had a higher pace variation than men. In male competitors, younger age may be advantageous for a successful finish of the UTMB&reg, Faster male runners seemed to be younger in ultramarathon trail running with large changes in altitude when compared to other distances and terrains.

BACKGROUND: Ultra running is popular among youth athletes (< 19 years of age), with an exponential increase in participation over the last years. If running extreme distances during such a young age has implications in adulthood is currently unknown. METHODS: We performed a retrospective survey study investigating adults that participated in ultra endurance running as youth athletes, describing running history, health and social data. Seventyeight participants (mean age of 38.0±12.0) completed the survey. RESULTS: Most participants were male (83.3%), white Caucasians (92.3%), originated from the USA (89.7%), were married (57.7%), with no children (52.6%), and had a university degree (79.5%). Age at first ultra was 16.1 years (± 2.3), with an average number of 3.7 ultras (± 5.5), predominantly over 50 km (1.5 ± 3.3) and 50 miles (1.21 ± 2.0). Musculoskeletal injuries occurred in 23.1% of youth athletes, and stress fractures in 6.4%. The main reason to stop running ultras were injuries (28.6%). The majority (93.6%) of youth athletes continued running into adulthood; however only 26.9% continued running ultras. Training load was significantly (p

We present a case of severe, acute kidney injury, rhabdomyolysis and dehydration in a 49-year-old, competitive trail runner, after a 110-km trail race in mountainous terrain. Six days after the event, he presented to the hospital with fatigue, weight gain and oedema. Biochemically the diagnosis of severe, acute kidney injury was made, with increased serum creatinine levels of 13.4 mg/dL (normal range 0.67-1.17 mg/dL). He remained hospitalised for two weeks, and improved with conservative measures, without the need for renal replacement therapy. Likely risk factors included ingestion of non-steroidal anti-inflammatory drugs prior to the event, dehydration and prolonged running in mountainous environment at moderate altitude. Renal function largely returned to baseline levels four months after initial presentation. This case highlights that severe kidney injury can occur, even days after ultra-running events, especially in the presence of associated risk factors. If repeated cases of acute kidney injury can trigger chronic kidney injury is currently unclear and further research in this area is warranted. In the meantime, efforts should be made to educate athletes, coaches and health care professionals about the dangers of acute kidney injury and associated risk factors.