Profiling Collapsing Half Marathon Runners—Emerging Risk Factors: Results from Gothenburg Half Marathon
Abstract
:1. Introduction
1.1. Individual Factors
1.2. Environmental Factors
2. Materials and Methods
2.1. General Information
2.2. Participants from Gothenburg Half-Marathon 2010–2017
2.3. Review and Development of the Questionnaire
- General information: age, gender, education, profession.
- Preparation: Number of earlier contests. Average km ran in one year and 3–4 weeks before the actual contest. Factors negatively influencing the actual contest. Feeling over-confidence. Studying the map and test running the track before the contest. Checking the weather and comfortable temperature to run. Optimal dress and the color of choice. Aimed finishing time. Food and drink taken before the contest.
- Health information: Any actual diseases. Any disease in the family. ADHD diagnostic criteria for adults [33]. Collapse during physical activity. Physical condition last three weeks before the contest. Alcohol intake (number of occasions and glasses).
- Contest: Planned vs. actual finishing time. Intake of water before the collapse.
- Incident: Marking on the map (incident, ambulance pickup, when it started to be tough). Three critical factors influencing the collapse. Intrinsic factors and experiencing symptoms before collapse (stress, inner demand, nervousness, hunger, thirst, tiredness, cramps, dizziness, confusion, nausea, visual disorder, headache, strange thoughts, others). Extrinsic factors experienced before the collapse (public behavior, crowding, relatives, public cheers, uphill slope, uneven track, warmth, cold, upwind, rain, other). Potential measures to prevent collapsing.
- Post-incident: Any help while waiting for ambulance. Hospital admission and sick leave. Running after the incident and new contests. Other comments?
- Future contact: Available for new contact by email or mobile number.
2.4. Interviews
2.5. Ethical Approval
3. Results
3.1. The Results of the Questionnaire
3.1.1. Personal Information
- The average age of the respondents was 41 years (n = 28, 71% men and 29% women). Around 60% had an undergraduate/graduate degree from a university (average in the Swedish population, 42%).
- The participants reported an air temperature between 12 °C and 19 °C as the most comfortable temperature for running (average = 15.6 °C, SD = 4.1 °C). (Figure 1).
- Sixteen runners (57%) reported no previous diseases, while four had pulmonary diseases, including asthma. One suffered from Reynaud’s disease; two runners had high blood pressure; two were allergic; one had diabetes; one cardiovascular disease; one suffered from depression; and one runner reported kidney disease and hypotension.
- Ten participants (36%) reported previous collapses during contests and one during exercises.
- Twelve runners (43%) reported hereditary diseases, of whom five reported more than one disease in their family (Table 1).
3.1.2. Preparation before the Contest
- Nineteen of 28 participants (68%) had taken part in GV or equivalent races in the last five years before the collapse (Ran 1 to 17 times, an average of 4.2 + 3.9 times).
- Eighteen runners (64%) had run GV before, of whom 15 could report their running time (ran 80 to 141 min, average 107 + 18 min). None of the remaining 10 test ran the track before the contest.
- The respondents prepared themselves with running 19.7 km on average per week, within 12 months before the actual contest, with an increase to an average of 26.7 km 3–4 weeks pre-contest.
- Thirteen of 28 runners (46%) reported one or two factors with a possible negative impact on their result within one month before the contest. These factors were: (1) infections/flu; (2) stress/high workload; (3) sleeping problem the week before the collapse; (4) change of weather/high temperature; (5) chronic disease (depression and arrhythmia); (6) festivities and (7) pain.
- Eleven of 28 participants (39%) reported being over-confident in themselves and their performance.
- Nineteen participants (68%) did not study the race map before the start.
- Nineteen runners (68%) checked the weather report, days to hours before the contest.
- Only two (7%) respondents believed that they did not have an optimal running outfit. One reported being overdressed and the other had black clothes. The remaining respondents who reported optimal dressing had a different mix of light and dark colors.
- Regarding nutrition, the amount of the food and the time it was taken varied from a sandwich to a complete breakfast a few hours to minutes before the contest. Some did not have breakfast, and some had only lunch. Others had no lunch but breakfast. Some drank water, tea, or coffee, and others had energy drinks.
3.1.3. During the Contest
- Twenty-five runners (89%) predetermined their running time, while two did not. One runner did not reply to the question. Seventeen runners (61%) ran as they planned, while nine reported slower speeds, and three faster speeds.
- Twenty-two runners (79%) reported intake of fluid on predesignated water stations. Four did not take water, and two did not reply.
- The most common intrinsic factors before collapsing were symptom/feelings experienced by runners: tiredness (60.7%), followed by dizziness (50%), and intense inner demands (42.9%). Six runners (21%) experienced all these three symptoms/feelings, and 10 of 28 runners (35.7%) experienced tiredness and dizziness in combination. Other essential symptoms were: nausea, confusion, visual disorder, thirst, cramps, nervousness and headache.
- The most common extrinsic factor before collapsing was high temperature, followed by uphill slope, public cheers, public behavior, narrow track, crowding, and relative bystanders.
- Twenty-two runners believed they could prevent their collapses, while two could not, and two were not sure. Two runners did not reply. The following measures were perceived as preventive to avoid a collapse: Slower tempo/do not put pressure on yourself/Have fewer demands on yourself/Listen to your body; Do not run at all/Stop running; Take in more fluids; Eat more; Take more salt; Exercise more; Test the track before; Wear less clothes and Exercise in high temperature.
- Six runners (21%) did not remember who helped them after collapsing, while the remaining participants mentioned organizers, healthcare staff and spectators.
3.1.4. Post-Collapsing Period
3.2. The Results of the Interviews
Incident and Individual Characteristics
- Three of the interviewees collapsed more than once during the study period, but only on one occasion did they need ambulance transportation to the hospital. Two of interviewees collapsed long after finishing the race and while on public transportation, but still needed ambulances. In total, these 13 runners suffered 16 collapses of which 11 took place during the years with the highest air temperature and highest PET.
- All interviewees exercised regularly 3.4 h per week before the contest. The most common type of exercise was running; however, rarely over 15 km per training session.
- Most of the participants had an extra intake of carbohydrates weeks before the contest and until the contest day. Most participants had a large breakfast, but ten runners skipped the lunch. Most of those reporting less intake of food could not schedule their nutritional intake on time. Three runners did not eat due to being nervous. Five runners had proper fluid intake before the contest but did not drink during the contest. Others reported sufficient control over their fluid intake.
- Few runners experienced immense stress to get to the race on time. One person could not sleep but still took part in the race since he believed that he was experienced enough to handle that.
- Besides medical conditions mentioned in the questionnaire, some runners claimed to have orthopaedic injuries before the contest (included in the health issues, Figure 2).
- Despite the collapses, few runners reported previous collapses as a favorable factor, contributing to useful knowledge and understanding of their body and a better ability to pace themselves.
- All interviewees described themselves as stubborn, ambitious and disciplined persons. Most of them measured their performance based on figures such as the number of kilometers, pulse, or time. They emphasized that these characteristics were the primary motivation for training, but even possibly the major reason for the collapse. Some reported the importance of pacing and ability to adjust their performance based on the actual circumstances. However, sometimes, the inner demands, pressure from other runners, and the comparison of last year results to the actual contest influenced their running behavior, and they continued running even though their body signaled exhaustion.
- The most remarkable post-contest experience for many of the runners was the inability to remember crucial details such as names, numbers, addresses, etc. after the event. Some believed they had a nervous breakdown and cerebrovascular insult. Many had experienced fear and anxiety, and many emphasized that the event had had an impact on their lives and training routines.
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Hereditary | ||
---|---|---|
Hereditary Diseases | Frequency | Percent |
High blood pressure with or without medication | 7 | 41.2 |
Early myocardial infarction or stroke (<60 years of age) and other heart diseases | 3 + 1 | 23.5 |
Systematic diseases (Myelofibrosis, SLE, MS) | 1 + 1 + 1 | 17.7 |
Diabetes | 1 | 5.9 |
Pulmonary diseases, including asthma | 1 | 5.9 |
Regular medication for other diseases | 1 | 5.9 |
Total | 17 | 100.0 |
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Khorram-Manesh, A.; Löf, T.; Börjesson, M.; Nilson, F.; Thorsson, S.; Lindberg, F.; Carlström, E. Profiling Collapsing Half Marathon Runners—Emerging Risk Factors: Results from Gothenburg Half Marathon. Sports 2020, 8, 2. https://doi.org/10.3390/sports8010002
Khorram-Manesh A, Löf T, Börjesson M, Nilson F, Thorsson S, Lindberg F, Carlström E. Profiling Collapsing Half Marathon Runners—Emerging Risk Factors: Results from Gothenburg Half Marathon. Sports. 2020; 8(1):2. https://doi.org/10.3390/sports8010002
Chicago/Turabian StyleKhorram-Manesh, Amir, Therese Löf, Mats Börjesson, Finn Nilson, Sofia Thorsson, Fredrik Lindberg, and Eric Carlström. 2020. "Profiling Collapsing Half Marathon Runners—Emerging Risk Factors: Results from Gothenburg Half Marathon" Sports 8, no. 1: 2. https://doi.org/10.3390/sports8010002
APA StyleKhorram-Manesh, A., Löf, T., Börjesson, M., Nilson, F., Thorsson, S., Lindberg, F., & Carlström, E. (2020). Profiling Collapsing Half Marathon Runners—Emerging Risk Factors: Results from Gothenburg Half Marathon. Sports, 8(1), 2. https://doi.org/10.3390/sports8010002