Unfortunately, self-medication is widespread in ultra-endurance events. Improper use can have counterproductive consequences much serious than those of the original problem.

Our advice :

• Treatment of your chronic diseases: YES, you must take your medicine during the race!
• Paracetamol: YES with moderation. Be careful, however: any painkiller can hide a problem that needs to be treated. Pain is an important alert to be considered!
• Corticosteroids: NO, they are doping agents!
• Muscle relaxants: NO, they are ineffective for muscle disorders
• Non-Steroidal Anti-Inflammatory drugs (Ibuprofen, Nurofen®, Advil®, Spedifen®, Ketoprofen, Diclofenac, etc.): NO, they can have a deleterious effect on your body as we will present it below.
• Aspirin: NO, because it increases the risk of bleeding in case of an accident. In addition, it may cause the same problems as anti-inflammatory drugs.

50% of withdrawals is related to digestive problems, especially in Running, which affect between 60 and 96% of ultra-enduring athletes during competition.

The causes :

• Ischemia: the abdominal vascularization being reduced in favor of the vascularization of the muscles
• Microtrauma related to shaking

What are the factors?

• Intense and violent efforts
• Hyperthermia (heat stroke)
• Ingesting of highly concentrated salt tablets or other products (power bars)

Our advice :

Before the race :

• Test your nutrition as much as possible on your long and intense training to know your tolerance during the effort. Experiment with different volumes, compositions, and tastes.
• Eat a residue-free diet at D-3, avoid solid meals at Hr-4, and go to the toilet at Hr-0.

During the race :

• Do not test anything during the race, keep your habits.
• Manage your temperature and hydration.
• In case of gastric disorder, take a break of 15 to 30 minutes, or more in case of persistent pain.
• Possibility of taking a gastric bandage (®Gaviscon), an antispasmodic (®Spasfon), or an antiemetic (®Motilium), or an anti-diarrheal (®Smecta but not ®Imodium or ®Tiorfan) after talking about it with the race doctor only.

Cramps affect almost 25% of ultra-endurance athletes and are the leading cause of withdrawal. There are many theories regarding their origin but none of them have scientific definitive validation.

Among the unproven popular belief we find:

• “If I drink a lot and eat salt, I won’t get cramps”
• “Cramps are caused by magnesium deficiency”
• “Against cramps, eat bananas”

The most successful studies suggest an impaired neuromuscular control caused by muscle fatigue and an individual predisposition of each athlete.

Our advice :

• Rest before the race
• Start slowly! Most stressed muscles are most likely to experience overspeed cramps. So, in trail running, the use of sticks can help to distribute the workload.
• For cyclists, if a cramp occurs in only one calf during a long effort, talk to the race doctor!

Cramping is a sign of dysfunctions that must be considered but does not necessarily imply withdrawal. In case of cramps, spread out the effort and adopt an economical stride, possibly interrupted by short stretching of the painful area.

Rhabdomyolysis refers to a situation in which muscle cells quickly break down and release their contents into the bloodstream. This degradation is then harmful for the kidneys which are no longer able to filter all these wastes. As a result, your kidneys stop working, without causing immediate symptoms. It is therefore particularly important to identify some warning symptoms. 

What are the factors ?

• Taking anti-inflammatory drugs 
• The onset of hyperthermia 
• A state of dehydration 
• An insufficient or inappropriate physical preparation 
• An intense and continuous effort 
• A history of kidney disease 

Caution! Taking non-steroidal anti-inflammatory drugs (Ibuprofen, Nurofen®, Advil®, Spedifen®, Ketoprofen, Diclofenac, etc.) worsens a phenomenon of rhabdomyolysis which can even alone cause this acute renal failure. 

What are the symptoms ?

• Intense muscle pain 
• Unusual fatigue 
• Dark urine 
• Inability to urinate or very low urine output 
• Edema of extremities / generalized 

Our advice :

• If your urine turns dark or you are unable to urinate, consult the race doctor! 
• Palpate the muscles: if your muscles are very painful, you must stop your effort and consult the race doctor! 

Hyponatremia is a disorder in which your cells have a too low concentration of sodium, due to overhydration. This sodium deficiency can induce intracranial hypertension, which can cause confusion and fatal convulsive seizures.

What are the factors ?

• Excessive and inappropriate hydration
• A dilution of the salt level

What are the symptoms?

• Agitation / Altered consciousness / Coma
• Vomiting / Headache

Our advice :

• You should drink when you feel thirsty only. This is called “Drinking when thirsty“.
• Do not try to over-hydrate yourself thinking that you will avoid cramps! Nothing is scientifically proven about it.
• Drink soups and eat salty! Add two bouillon cubes in a cup, rest, and restart! Hypo, iso, or hypertonic drinks are not concentrated enough to maintain your salt level.
• Do not consume salt capsules! It is ineffective as a preventive measure and potentially dangerous! Thus, we “salt to taste” our food.

Hyperthermia is characterized by a dangerous increase in body temperature. Stress hyperthermia for an healthy athlete can lead to destruction of the liver, which will require urgent liver transplantation to survive. Mortality is correlated with the time spent at a temperature above 40.5 °C. 

What are the factors ?

• Intense effort with poor heat dissipation 
• Efforts made in a hot and humid environment 
• Insufficient training, lack of acclimatization 
• Inadequate hydration 
• Cardiovascular disorders 

What are the symptoms ?

• Headache and severe headache 
• Irritability 
• Confusion & abnormal state of consciousness 
• Rectal temperature> 40 °C 

Our advice : 

• Hydration does not refresh! Hydrate yourself normally! 
• Prevent hyperthermia by spraying your body with water regularly during intense exertion in hot weather. 
• Hyperthermia must imperatively be stopped very quickly: your temperature must drop below 39 ° C within 30 minutes ! All means are good to lower the temperature: ice cube pool, ice packs on the neck and groin! 
• Your state of health should be monitored for 48 hours after the onset of hyperthermia : ask for a medical advice! 

Hypothermia occurs in subjects immobilised in a cold environment with a drop in body temperature below 35°C.

What are the factors ?

• Prolonged sports practice in the cold, in the wind, in the rain and with unsuitable equipment 
• Alcohol or drug use 
• Dehydration and consumption of energy drinks (caffeine, taurine, etc.), 
• Taking drugs increases sensitivity to cold (benzodiazepines, anti-depressants, beta blockers, etc.). 
• Some predisposing conditions: diabetes, endocrine disease, etc. Individual sensitivity and age of the athlete. 

What are the symptoms ?

• Mild hypothermia (36 ° C to 32 ° C): chills, chicken flesh, cold sensations, increased heart rate, breathing difficulties, urge to urinate. 
• Moderate or Severe hypothermia (< 32°C) : end of shivering with rather tremors, feeling of well-being with decrease in heart rate, onset of coma 

Our advice :

• Even during the summer, a thunderstorm can suddenly drop the temperature by 20 ° C. Always bring at least one warm clothing and one waterproof jacket ! 
• Undress yourself to put your dry clothes next to the skin. 
• Bring a lighter, candle and a survival blanket with you so you can make a “hot spot”, as the video below explains (in French): 

Although all sportsmen and women are aware of chillblains, it is important to be vigilant so that it does not turn into frostbite or even severe frostbite.

What are the symptoms ?

• Chilblains: painful numbness at the fingertips. The warming-up phase is very painful and may be accompanied by nausea. 
• Light Frostbite: purplish pimples at the extremities with edema and itching. 
• Heavy Frostbite: deep lesion with tissue necrosis due to lack of vascularization. 

Our advice :

If your fingers do not return to normal coloring within an hour, get warm and ask for a medical advice! 

You become Ultra-endurance finisher by taking care of your sleep! 

The deleterious consequences of a lack of sleep are naturally a lack of lucidity, but also a drop in motivation, mood disorders, falls, hallucinations, increased perception of effort, etc. The brain activity of finishers at the end of ultra-endurance races can be compared to a blood alcohol level of 1.5g/l.

Our advice :

• Sleep as much as possible in the weeks before the start (full battery).
• Start a race with a strategy which complies with the expected race duration and your experience.
• Try to keep your regular meal and rest times. 
• Regular and  short naps are very beneficial to reduce your sleep debt (8 to 20 minutes maximum to remain focus when you wake up). 

Hospital Admission

Each day of hospitalization in intensive care can amount to 4000€/day. For instanc,e given rabdomyolysis care can exceed 10 days of hospitalization, it is important to be covered for this risk of hospitalization!

Helicopter Evacuation

Although ground rescue is almost always free at sporting events, this is rarely the case for helicopter rescue.

While Medical Care is generally free of charge during the event, treatment becomes chargeable when your condition requires the use of a helicopter, transport to the hospital treatment at the hospital and repatriation. The helicopter itself can cost up to 100€/minute with rescue duration up to 90 minutes. So be careful that your Search and Rescue insurance is valid in competition and covers you for an amount greater than €10,000.

Our advice :

In order to offer a simple insurance solution for endurance sports, the broker ASSURINCO has built an ASSISTANCE INSURANCE product, valid both for training and competition, anywhere in the world and regardless of your country of residence, and having substantial guarantees.

Here are the main MUTUAIDE guarantees:

• valid for training and competition
• valid anywhere in the world, regardless of your country of residence
• 🚁 Search and rescue costs : 50 000€.
• 🏣 Medical expenses: €150,000 outside the country of residence (€5000 in the country of residence).
• ✈ Repatriation or medical transport: Actual costs.
• 🚲 Repatriation of sports equipment in the event of hospitalisation: Actual costs.