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Endurance events: Pushing the limit

The origin of the marathon stems from the Greek solider Pheidippides, who in 490 B.C., ran non-stop from the battlefield of Marathon to Athens to announce the victory of his army. Upon his arrival, Pheidippides announced ‘Niki,’ translated as victory, before he collapsed and died.

The modern marathon race originated in 1896 and has been a long standing event of the modern Olympic Games. Originally the race encompassed 24.85 miles (40kms), the distance from Marathon Bridge to the Olympic Stadium in Athens. However the 1908 London Olympic Games added a couple of extra miles so that the race would finish in front of the Royal family’s viewing box and hence today’s distance of 42.195kms.

The men’s Olympic marathon is traditionally the last event on the Olympic games athletics calendar and finishes inside the Olympic stadium. Breaking tradition this year, the marathon at the London Olympics will finish at The Mall which is a road which starts at Buckingham Palace and finishes at Trafalgar square.

For those willing to push their bodies further, ultra-marathons (defined as running any distance greater than a marathon) provide a greater challenge both mentally and physically. Marathons, ultra-marathons and other endurance events such as long course triathlons entice a range of participant numbers from a few dozen to tens of thousands. The organisers of such events are required to provide medical coverage to ensure safety and timely access for all participants to medical services and treatment. Commonly seen presentations include blisters, bruises, lacerations and muscle cramps.

Professor Timonthy Noakes (Sports Physician and exercise physiologist), co-author of Chapter 65 of the new Clinical Sports Medicine textbook, titled: Medical Coverage of endurance events, is no stranger to such events. He has completed more than 70 marathons and ultramarathons, and is the author of the running book Lore of Running as well as a co-author of numerous other running texts.  With a long list of awards and scientific publications to his name, Professor Noakes has a special interest in the role of the brain and fluid intake in determining exercise performance. He has challenged the theory of VO2 Max and developed the central governor concept for regulation of the body’s exercise tolerance. The central governor concept proposes that the brain is responsible for how fast, how long, and how hard an athlete can exercise.

Chapter 65 of the Clinical Sports Medicine textbook, highlights how experienced medical teams can predict the number of casualties and the underlying causes of their presentations and therefore be prepared for such events. It is important for the medical team to keep medical records for all presentations attended to. Data from these records can later be analysed and aid in preparation for the next event covered. Chapters 58 and 59 of the Clinical Sports Medicine textbook titled Exercise in the heat and Exercise at the extremes of cold and altitude respectively, address thermal injuries which are frequently seen presentations to the medical area.

Resources for Chapter 65 ‘Medical coverage of endurance events’ include:

  • Suggested flow chart for the management of sportspeople one they enter the central medical facility
  • Essential resuscitation and diagnostic tools for an endurance sporting event with 1000 competitors
  • A list of basic medications required in the medical team facility at an endurance sporting event with 1000 competitors
  • A suggested list of supplies that may be required at the medical station(s) along the course and at the finish line of a marathon with 1000 competitors

Other Marathon Trivia:

In 1972, a company by the name of Blue Ribbon Sports first introduced a line of sporting shoes with a name derived from the Greek Goddess of Victory, Nike. By the 1980s, Nike comprised a large proportion of the US shoe market. Nike’s first national commercial was aired in 1982 during the television broadcast of the New York Marathon.

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