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  1. M Khodaee1,
  2. J Spittler1,
  3. JC Hill1,
  4. MD Hoffman2,3
  1. 1University of Colorado School of Medicine, Denver, USA
  2. 2University of California Davis Medical Center, Sacramento, USA
  3. 3VA Northern California Health Care System, Sacramento, USA


Background Little is known about the effect of injuries during training on ultramarathon performance.

Objective Determine effects of injuries during training on race performance.

Design Observational study using a self-administered pre-race survey. Finish times were obtained from race results posted online.

Setting The 2013 Leadville Trail 100 (LT100) and Western States Endurance Run (WSER).

Participants Participants of LT100 and WSER 161 km ultramarathons.

Risk factor assessment Age, gender, educational level, prior completion of a 161 km ultramarathon, shoe type, self-report of foot strike pattern, and injuries or illnesses interfering with training in the past year were considered.

Main outcome measurements The primary outcome measure was whether sustaining an injury or illness resulting in missed training days affected successful completion of an ultramarathon.

Results Out of 1206 LT100 and 408 WSER entrants, 893 and 368 completed the pre-race survey (73.9% and 90.1%, respectively). Most participants were male (82%) with average age of 41 years. 52.3% of LT100 and 72.3% of WSER starters finished the races under the 30 hour cutoff time. Among respondents, 40% had masters or higher degrees and 45% reported using dietary supplements on a regular basis. Respondents reported 1432 (multiple answers per runner) injury episodes causing less than a week of missed training and 641 injury episodes causing a week or longer of missed training in the past year. Pain in Achilles (n=196), lower iliotibial band (n=164), upper hamstring (n=115), and groin pain (n=106) were the most common reported issues interfering with training. Only 45 (2.8%) of respondents reported sustaining a stress fracture during training in the past year. Of these, 27 (60%) involved the metatarsals and 10 (22%) involved the tibia. Using a binary logistic regression model, sustaining an injury during the training, age, gender, educational level, prior completion of a 161 km ultramarathon, shoe type, and self-report of foot strike pattern did not affect finish status (P>.05).

Conclusions Many ultramarathon runners sustain injuries and illnesses interfering with training schedule, but this does not seem to be a predictor of successfully completing the race.

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