Ultraendurance and Adventure Racing and Events


  • Ultraendurance and adventure races are prolonged events, usually longer than 6 hours (and some may be as long as 10 days) that usually take place in remote, austere, harsh, or extreme environments.

  • These events include challenging terrain, extreme elevation changes, weather challenges, and on-course obstacles.

  • Adventure races require participants to perform multiple disciplines that may include trail running, hiking, mountaineering, mountain biking, boating/rafting, climbing, caving, and/or orienteering.


  • More than 100,000 ultramarathoners compete in more than a thousand races held annually worldwide.

  • Adventure racing participation has increased by 211% in the last 5 years (1.3–2.2 million participants in 2013).

General Principles

Terminology/Event Types

  • Adventure races

    • Sprint (2–6-hour races): 4–8 miles on foot, 15–25 miles biking, and 2–4 miles paddling

    • Endurance (12 hour races): 6–12 miles paddling, 8–14 miles trekking, and 25–50 miles biking

    • 24-hour races: 10–25 miles paddling, 10–25 miles trekking, and 50 miles biking

    • Expedition: 400+ miles of varied disciplines

  • Ultraendurance races

    • Any running race longer than the standard marathon distance

    • Most common distances are 50 km, 100 km, 50 miles, and 100 miles.

    • 100 km is recognized as an official world record distance by the IAAF.

    • Other distances include double marathons, 24-hour races, and multiday races of 1,000 miles or longer.

    • Many events with challenges such as trails, variable terrain, altitude, weather, and variable aid and support


  • Discipline-specific (e.g., shoes, clothing, pack and tools, lights, bike, kayak, paddle, rope harnesses, compass)

  • Participants must carry/provide their own food, water, protective clothing/footwear.

  • Hydration system

  • Water purification devices (e.g., iodine tablets, filter system, ultraviolet pen)

  • Compass (GPS is usually prohibited), maps, and race directions

  • First aid kit and personal medications

  • Boxed food, water, clothing, other apparel for resupply points

  • Additional information can be found at http://www.usaranationals.com/gearlist.aspx .

Specific Training

  • Need to think about physical, mental, and skills training

  • Master the logistics of fluids, nutrition, use of equipment, and rest.

  • Plan multidiscipline, multihour sessions so that athletes know how their bodies will react and feel after extended exertions in different disciplines ( Table 98.1 ).

    TABLE 98.1


    Race Distance Total Training Hours Bicycling Running Paddling
    Sprint 5–10 2–3 2–3 1–2
    Endurance 10–20 4–5 4–5 2–4
    Expedition 20+ 5–7 5–7 4–6

Nutritional Issues

General Guideline

  • Aim for a healthy weight; avoid rapid weight loss.

  • Choose foods sensibly and consume them during training to ensure body tolerance on race day.

  • 60/20/20 split common (aim for 60% of calories from carbohydrates, 20% from protein, and 20% from fat)


  • Carbohydrate loading: load muscles and liver with glycogen (stored carbohydrates) during the week before an event

  • Consume a normal intake of carbohydrates (5–7 grams per kilogram of body weight) during the first 3 days of the taper week.

  • Increase this amount to 10 grams of carbohydrate per kilogram of body weight for the next 3 days.

  • Eat the last big, high carbohydrate meal two nights before the race.

  • Do not overeat night before race! Avoid items high in fiber or in fat, which may be hard to digest and may lead to GI distress during the event.

During Event

  • General carbohydrate needs vary but often range between 30 and 60 grams per hour or approximately 1/4 to 1/3 of body weight in pounds per hour

  • Some athletes also utilize small amounts of protein during events, up to 5 grams per hour.

  • Athletes may need up to 300 calories per hour, and it may be difficult to digest more with the demands of exercise.

  • Athletes must realize that the rate of loss will exceed rate of assimilation by approximately 3-fold during endurance events.

  • Many athletes use sports bars, drinks, and gels to replace calories on event day. Make sure to test tolerance in advance.


  • Important to replace calories, especially glucose, within the first few hours after training sessions lasting >90–120 minutes to ensure liver and body stores are replenished adequately before future training sessions

Train Low, Race High

  • Some athletes train with low carbohydrate reserves/supplies to train the body to increase oxidative enzymes and utilize fat stores and to spare glycogen use for longer periods of time (fat adaption).

  • These athletes then race while ingesting carbohydrates so that their bodies will burn the ingested carbohydrates but will be able to rely on fat stores for energy when the carbohydrate supply decreases.


  • Drink to thirst

  • Train with the fluids you will use during the event.

  • Aim for no more than 2% weight loss during training/event; avoid weight gain, as too much fluid may lead to hyponatremia.

  • If mixing calories in fluids, make sure to avoid >6% sugar solutions, because they can interfere with fluid absorption and cause GI distress.

  • Utilizing different types of sugars (e.g., glucose, fructose, maltodextrin) may be helpful.

  • Maltodextrin is a complex carbohydrate that may be mixed at high percentages (e.g. up to 18%) without exceeding system osmolality, and it may cause less GI distress than other sugar types.


  • Mainly used by athletes for the prevention of exercise-associated muscle cramping

  • Larger athletes, faster athletes, and those who have high volumes or high concentrations of sodium in their sweat (white salt deposits on chin straps, headband, clothes, skin, etc.) may need to ingest additional sodium beyond what can be found in sports drinks, but the best method to ingest is in fluid or food form.

  • Some athletes use salt tablets but can easily ingest too much; GI upset and cramping are common.

  • Need to remember that muscle cramping is also frequently a result of exercise-associated muscle fatigue, excitability, dehydration, and heat illness

Practical Issues

  • Must experiment with a variety of different foods/nutritional items during training; essential to have a basic hydration and nutrition plan before entering competition

  • The amount of calories tolerated per hour is inversely related to the intensity of effort (harder the effort, fewer calories tolerated).

  • Should assume that calorie and fluid deficits are inevitable even in ideal circumstances; must plan to minimize this as much as possible

  • In multiday events, the goal is to return to a state of euhydration prior to resuming competition the next day.

  • Urine should be “copious and clear” prior to resuming competition.

Environmental Issues

  • Remember that the variables listed below are often a greater threat in ultraendurance athletes due to sustained exposure.

  • Heat (see Chapter 21: Exercise in the Heat and Heat Illness )

    • The most serious temperature-related illnesses are heat stroke and hyperthermia.

    • Heat acclimatization is an important adaptation but is unrealistic for many athletes who may live in variable climates; takes approximately 10–14 days training in heat to acclimate, loss of acclimatization is rapid once heat exposure is removed.

  • Cold (see Chapter 22: Exercise in the Cold and Cold Injuries )

    • Hypothermia and frostbite are the most serious cold–related illnesses.

    • Need to factor in wind chill (especially when on a bike) and body heat loss in water, which is constantly displaced from body in swimmer (wetsuit helps).

  • Altitude

  • Lightning

    • 54 running-related lightning deaths per year

    • Strike types:

      • Direct strikes: lightning directly strikes the athlete

      • Ground strike: travels through ground and may be conducted through an object (body) nearby

      • Side flash: lightning strikes a taller object and part of the current jumps to the victim

    • If feasible, suspend event start if thunder or lightning is in the area (“if you can hear it, clear it”).

    • Athletes should seek shelter if thunder heard or lightning seen while on course.

    • Avoid ridgelines or summits, as well as tall objects such as ski lifts, cell phone towers, or isolated trees.

    • If lightning strike is imminent, assume lightning position:

      • Sitting or crouching with knees and feet close together to create only one point of contact with the ground; get as low as possible.

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Jul 19, 2019 | Posted by in SPORT MEDICINE | Comments Off on Ultraendurance and Adventure Racing and Events

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