The Medics Know Best: 10 Tips For Ultramarathon Success

The medics at ultramarathons get a first-hand look at where races go wrong. Here is their advice to get you to the finish line.

When it comes to participating in ultras, the medical team is one group of volunteers you usually don’t think about until you need them. And they have the privilege of seeing you at your worst—from ankle sprains to dehydration, vomiting to compromised kidney function, blisters and more.

Runners are a stubborn lot, often viewing the medical team as a last resort. But, believe it or not, their goal isn’t to pull you from a race.

“I want everyone to finish,” says Dave Heckman, a firefighter paramedic from Engine 7 of Woodside Fire District in the San Francisco Bay area and a 12-year volunteer at the Badwater Ultramarathon, a 135-mile race in July through the California desert. “I always hope people recover and keep going.”

The medical crew at Badwater sees its fair share of heat-related sickness, dehydration, exhaustion, sunburns (cover up!) and blisters. Many of the medical team members are ultrarunners and endurance athletes themselves, a benefit when it comes to understanding what racers may be experiencing–not just physically, but mentally as well. During the 2014 race, members of the medical crew shared lessons they’ve learned along the way.

Thanks to Heckman (who circumnavigated Death Valley National Park in 2012 during the hottest month in U.S. history), Chris Frost (an EMT from Parker, Ariz., with nine Badwater 135 finishes to his credit) and Dr. Darryl Macias (an Albuquerque, N.M.-based ER doctor, runner and climber who has climbed Aconcagua and runs mountain races) for their insights.

Preparation is 90 Percent of Success

In addition to running and training, ultra preparation involves studying the course, knowing what conditions to expect, dialing gear, testing hydration and fueling strategies.

Practice Hydration and Electrolytes

Dehydration and electrolyte imbalance can end a race. Practice it during training and stay on top of it while racing.

Train For the Race Environment

That may mean sauna or heat training for hot temperatures, hill running for a course with significant elevation changes or spending some time at altitude for a high elevation race. It’s important to acclimatize yourself and know how you’re going to handle the conditions.

Keep Moving

That is, unless you need to take a break. Constant forward motion gets you to the finish line, but sometimes a few minutes of sitting or resting can be an energizing boost. It’s important to know what works for you. And remember, walking counts as moving.

Recover on the Run

Learning what to do when you feel bad and sticking with your goal, even through low points (because there will be low points), is critical. Taking on food, water and electrolytes can help you recover physically, and mental diversions (talk to your pacer, sing, map out a truly relaxing vacation) are often useful in making it through low points.

Keep a Positive Attitude

This is supposed to be fun, relatively speaking! At some point in time, you actually wanted to run whatever race you are in. Remember that and stay positive.

Take Good Care of Your Feet

Address small hot spots before they turn into angry blisters. Put on fresh socks when needed and try to keep your feet dry. Your feet are your transportation to the finish line, and proper foot care cannot be emphasized enough.

Eat Real Food 

Many runners get to a point during a race where not only can they no longer stomach gels and chews, but nothing sounds appetizing. Have options and test food during training. Know what works for you. Peanut butter, honey, bananas and soup are good options. When you do take on food, slow down for a few minutes to allow your body to absorb the calories. Your heart rate needs to be below 160 to absorb calories. Take advantage of slower uphill portions to take on food.

Trust Your Crew

You chose your crew for a reason. Their goal is to help get you to the finish line. Remember that when you’re exhausted, sore and (possibly) grouchy. Listen to them, pay attention to their advice and trust them. Being kind is always appreciated too.

Accept That Ultras Are About Suffering

There is nothing easy about an ultra. Accepting that before you get to the starting line means you won’t be surprised when things become difficult. Pain management, sleep deprivation and low points are all part of it. But they also make your successes that much more rewarding.