How Comrades runners can avert life-threatening situations — experts

Exercise and health experts say Comrades runners can minimise falling seriously ill or experiencing life-threatening situations through proper training, gradual progression, adequate rest and recovery, hydration and nutrition strategies.

On Sunday nearly 18,000 runners will pound the road from Pietermaritzburg to Durban in an ultimate test of endurance.

Rowena Naidoo, an associate professor of biokinetics, exercise and leisure sciences at the University of KwaZulu-Natal, told TimesLIVE while it may be impossible to eliminate all risks, runners need to employ strategies to safeguard themselves.

“Educating yourself about the signs and symptoms of common running-related issues such as heat exhaustion, dehydration, hyponatremia, and cardiac events is vital.

“This goes hand-in-hand with listening to your body. Paying attention to any warning signs from your body during training and the race itself. If you feel excessively fatigued, experience persistent pain, or notice any concerning symptoms, it's important to slow down, seek medical attention, or even withdraw from the race if necessary.

“Fit runners generally have a lower risk of falling seriously ill or dying compared to individuals with poor fitness.”

She said pushing the limits of physical exertion without proper training, rest, or recovery can lead to overexertion and increase the risk of various complications. Insufficient hydration or improper balance of electrolytes can lead to dehydration or electrolyte imbalances, which can cause dizziness, heat-related illnesses, muscle cramps, or even more severe complications like kidney damage. Though rare, cardiac events such as heart attacks or arrhythmias can also occur in fit runners.

“In some cases runners may experience unexpected medical emergencies unrelated to their fitness level, such allergic reactions, seizures, strokes, or other sudden health crises.

“It's important to note that while these risks exist, they are relatively rare, and the benefits of regular exercise and maintaining fitness outweigh the potential risks.”

Dr Deepak Patel, principal clinical specialist and head of research at Discovery Vitality, said in the context of the Comrades, when runners begin intense training with long mileage and then going into taper phases, “they might experience a drop in their immune defence”.

“It is well known that regular bouts of moderate to vigorous exercise improves the immune system. However, it is possible that with high volumes of exercise one's immune system can drop, making you more susceptible to pick up a virus or fall ill.

“It is a good idea to stay away from others who are ill, avoid crowded public spaces, wash hands thoroughly and often, and get good quality sleep to boost immunity.

“Sudden cardiac death is extremely rare in healthy and fit individuals. Regular exercise and training reduce the long-term risk of an acute cardiac event such as a heart attack (myocardial infarction), but vigorous activity can, transiently, increase the risk of sudden cardiac death and acute myocardial infarction, particularly in susceptible people with risk factors such hypertension, high cholesterol, and diabetes.

“Younger athletes who have a sudden cardiac event during a marathon are more likely to have abnormalities of the heart such as hypertrophic cardiomyopathy in which the heart muscle is abnormally thick. Athletes who experience dizziness, fainting or abnormal heart beats called palpitation during training should consult a doctor to exclude a heart abnormality.”

Prof Naidoo and Dr Patel's tips for Comrades runners:

• Follow a well-structured training plan that gradually builds your mileage, includes speed work, and allows for sufficient rest and recovery. Consistency, gradual progression, and avoiding excessive training loads are key to reducing the risk of injury and illness.
• Prioritise quality sleep to support recovery and overall health. Aim for 7-9 hours of uninterrupted sleep each night leading up to the race.
• Maintain a well-balanced diet that includes a variety of nutrient-rich foods. Focus on consuming adequate carbohydrates for energy, lean proteins for muscle repair and recovery, healthy fats, and a wide range of fruits and vegetables for essential vitamins and minerals. Stay hydrated by drinking fluids throughout the day.
• Implement a tapering period in the weeks leading up to the race. Gradually reduce training volume and intensity to allow your body to fully recover and be fresh for race day.
• Practice mental strategies such as visualisation, positive self-talk, and goal-setting to build confidence and focus. Mental preparation can help you stay motivated and resilient during the race.
• Study the race course in advance, including elevation changes and any challenging sections. Knowing what to expect can help you pace yourself and mentally prepare for different parts of the race.
• Develop a hydration plan based on the race distance, weather conditions, and your sweat rate. Practice your hydration strategy during long training runs to find the right balance and avoid dehydration or overhydration.
• Pay attention to any potential signs of injury during training and address them promptly. Incorporate strength training, flexibility exercises, and cross-training activities to build overall resilience and reduce the risk of overuse injuries.
• Ensure you have appropriate running shoes and comfortable clothing for the race. It is recommended to train in the gear you plan to use on race day to avoid any discomfort or unexpected issues.
• Get organised for race day by planning transportation, parking, and logistics in advance. Prepare your race-day nutrition, clothing, and any required documentation or gear well ahead of time.
• Do not run on the day if you are sick or still recovering from illness, have a fever or any illness that can leave you dehydrated and cause damage to your heart muscle. Ask your doctor if you are not sure.
• Go easy on pain medication, particularly anti-inflammatory meds. It is best to avoid them in general

TimesLIVE

Support independent journalism by subscribing to the Sunday Times. Just R20 for the first month.