Jack Spittler

Effects of Running an Ultramarathon on Cardiac, Hematologic, and Metabolic Biomarkers.

Serum biomarkers fluctuate as a result of running marathons, but their changes during ultramarathons have not been adequately studied. We collected blood samples from 20 participants before and 21 participants after the 161-km ultramarathon in Leadville, Colorado in August 2013. Using a portable analyzer, we measured cardiac troponin I (cTnl), hematologic, and metabolic biomarkers. Out of 10 runners for whom we collected both pre- and post-race samples, 8 were able to successfully complete the race. Mean cTnl increased from 0.001 to 0.047 ng/mL (p=0.005). Mean sodium decreased from 141 to 138 mmol/L (p <0.01). However, all runners had a sodium of ≥135 mmol/L post-race (reference range 138-146 mmol/L). Mean creatinine increased from 0.93 to 1.17 mg/dL (p <0.05). Only one out of 10 runners had an abnormal creatinine level of 1.8 mg/dL post-race (reference range 0.6-1.3 mg/dL). The other parameters did not reach statistical significance. Analyzing the samples from 21 runners after the race revealed that runners who finished the race in faster time had higher cTnl levels compared to those who finished the race close to the 30-hour cut-off finish time (P=0.005). Running an ultramarathon caused significant changes in cardiac and metabolic parameters. Ultramarathon running intensity and finish time may have effects on post-race cTnl level.

Obturator Internus and Obturator Externus Strain in a High School Quarterback

Introduction: Buttock pain is a relatively common complaint among adolescent athletes and can have a very broad differential diagnosis. Case Presentation: The authors present a previously unreported case of acute obturator internus and obturator externus strain in an adolescent male American football player. The diagnosis was made by MRI. The patient was treated with relative rest, physical therapy, and gradual return to physical activities as tolerated. Conclusions: Despite rarity of the hip external rotator muscles strains, it should be considered in the differential diagnosis of athletes with proximal posterior thigh and buttock pain.

Medical Care for Swimmers.

Swimming is one of the most popular sports worldwide. Competitive swimming is one of the most watched sports during the Olympic Games. Swimming has unique medical challenges as a result of a variety of environmental and chemical exposures. Musculoskeletal overuse injuries, overtraining, respiratory problems, and dermatologic conditions are among the most common problems swimmers encounter. Although not unique to swimming, overtraining is a serious condition which can have significant negative impact on swimmers’ health and performance. This review article is an attempt to discuss various issues that a medical team should consider when caring for swimmers.

Psychological Attributes of Ultramarathoners

INTRODUCTION As the popularity of ultramarathon participation increases, there still exists a lack of understanding of the unique psychological characteristics of ultramarathon runners. The current study sought to investigate some of the psychological and behavioral factors that are involved in ultramarathon running. METHODS We obtained information from participants of the Bear Chase Trail Race via an online survey. This race is a single-day, multidistance race consisting of a 10 k, half marathon, 50 k, 50 mi, and 100 k run in Lakewood, Colorado, at a base altitude of 1680 m with total altitude in climbs ranging from 663 to 2591 m. We correlated information from the Exercise Addiction Inventory and the Patient Health Questionnaire-2 and demographic information with race finish times. RESULTS Out of 200 runners who started the race, 98 (48%) completed the survey. Over half of the runners were men (61.2%), and the average age was 39.0 years (SD±8.9; range 21-64 years). A number of respondents (20%) screened positive for exercise addiction concerns. Approximately 20% of our sample screened positive for depressive symptoms (Patient Health Questionnaire-2 score >3). The majority of participants reported receiving strong social support from current partners with regard to their ultramarathon running training time and goals. CONCLUSIONS Although only a screening, the number of positive screens on the Exercise Addiction Inventory suggests use of screening measures with an ultramarathon running population. Athletes with positive screening tests should be fully evaluated for depression and exercise addiction because this would enable appropriate athlete support and treatment referral.