Ultrarunning: Are We Meant to Go the Distance?

Photo: Pond5

If you thought anyone who ever laced up for a marathon was crazy, maybe you’ve never heard of ultrarunning. These extreme athletes go even greater distances — running more miles in a single day than some of us can log in an entire month — and far beyond the 26.2-mile marker.

“What’s ‘crazy’ is all relative,” says Krissy Moehl, an elite ultrarunner and two-time Ultra-Trail du Mont-Blanc champion. “It depends who you’re hanging around with to know what normal is anymore.”

Back in her college days, Moehl, 36, was hanging around with the likes of Scott Jurek and Scott McCoubrey, her coworkers at the Seattle Running Company and two big-name ultrarunners. She ran in high school and college, but it wasn’t until that crew took her out on the local trails of Cougar Mountain that she fell in love with going long — really, really long. Fourteen years later, Moehl has finished more than 100 ultras and is training for her first 220-mile run on the John Muir Trail in the Sierra Nevadas this summer.

“People always ask me, ‘Well, what are you running from?’” she says. “But I honestly feel like I’m running toward answers. There aren’t many issues in life that a long run can’t solve and sometimes a run has to be a little longer than others.”

 Just How Long Are We Talking? 

“As humans, we’re designed to explore. We love stories of people overcoming boundaries and obstacles in order to succeed…”

Ultrarunning is considered any distance longer than a standard 26.2-mile marathon, though the “shortest” ultramarathon distance is generally 50K (31.07 miles). Most running is done on trails rather than road, but typical ultraracing distances include the 50-mile, 100-mile and fixed-time events that challenge runners to see how far they can go for a specific period (12-hour, 24-hour or even multi-day).

Whether you think it’s crazy or not, the sport is growing. According to UltraRunning Magazine, 69,573 people completed ultras in 2013. In 1980, there were just 2,890 finishers. And they’re not just the young and foolish out there. More than 65 percent of participants are between the ages of 30 and 49. So why are more and more runners adding more and more miles?

“People are always looking for new challenges and trying to push the envelope,” says Dr. Brian Krabak, a sports medicine physician at the University of Washington with expertise in endurance running events. “As humans, we’re designed to explore. We love stories of people overcoming boundaries and obstacles in order to succeed and it’s just another version of that story for a group of people who love running.”

Dr. Krabak, 46, has completed more than 30 endurance events himself, from 36-hour adventure races to a 250-mile mountain bike race through the Rocky Mountains to a slew of Olympic and Ironman distance triathlons. 

“I have this dual hat as athlete and physician,” he says. “I understand what it means to stress myself to near exhaustion to cross a finish line. And that amazing, euphoric feeling is what motivates me to start looking at the sport from a more scientific perspective.”

Is Running That Much Good for You? 

With the sport increasing in popularity, experts including Dr. Krabak say there’s a real need for more medical knowledge. He admits we don’t yet have all of the answers when it comes to ultrarunning’s effects on the body.  

A recent study published in PLOS ONE, however, started to look at these very questions. The Ultrarunners Longitudinal TRAcking (ULTRA) Study surveyed 1,212 ultramarathon runners (including Moehl) about their health and exercise history. Researchers wanted to see if there were any potential health consequences associated with exercising “beyond the moderate amounts known to have health benefits.”

Dr. Marty Hoffman, chief of physical medicine and rehabilitation at the VA Northern California Health Care System, led the study and discovered the prevalence of most chronic conditions (cancers, heart disease and diabetes, among others) was actually lower in ultrarunners, when compared to the general population. The presence of asthma and allergies, however, was higher in ultrarunners — something that has been previously linked to traditional marathon runners (and makes sense given the amount of time they spend outdoors).

“The ‘Deans’ of the world have certain genes and aerobic capacity that allow them to run forever. But for the rest of us, we need to slowly adapt to that change over time…”

More than half of the ultrarunners surveyed also reported an exercise-related injury in the past year (24 percent were knee issues; 5.5 percent were stress fractures). Interestingly, the majority of those sidelined were younger, less experienced runners. Dr. Hoffman, 57, a very experienced ultrarunner himself (the 2008 USATF Grand Masters National 100-mile Champion, in fact), says these pain points are not necessarily a cause for freak-out. The annual incidence of injuries in ultramarathon runners is very comparable to that of shorter distance runners, he says. 

Dr. Krabak agrees, but reminds all runners “there is four to seven times your body weight on a joint when you land in running. So if you have had a significant injury and you want to start running longer distances, in all likelihood, that injury may progress more quickly.” 

According to Dr. Hoffman, who is also the research director of the Western States Endurance Run (the world’s oldest 100-mile trail run), the overall results of the ULTRA study aren’t really that surprising — other than the wealth of media coverage it attracted. Its findings were simply meant to set the baseline for future research, as the study is scheduled to continue for 20 years. 

“This is a healthy group of people already,” says Dr. Krabak, of the runners surveyed. “What we need to know is the longevity of all of this. The real interesting aspects will be when we can look at the effects over 10 years and see how and if they are different from a normal population.” 

Photo: Pond5

So, Can Anyone Become an Ultrarunner?

Both Dr. Hoffman and Dr. Krabak believe there aren’t many major health or safety red flags when it comes to going the ultra distance. But is ultrarunning really for everybody?

“Most people with fairly reasonable biomechanics can get through an ultramarathon successfully if they set their mind to it and put in the proper training,” says Dr. Hoffman. “Running is not that complicated. You just need to be able to put one foot in front of the other, and do that for a long time.”

Still, we can’t help but wonder if it’s nature (some people like Moehl are just “born to run”) or nurture (anyone with ambition can do it with the proper training) when it comes to ultrarunning success. Beyond the physical elements, these athletes actually want to run this far — for fun. Moehl says ultrarunners aren’t as masochistic or totally nuts as many outsiders might assume. But they are crazy-focused when it comes to their dedication, sacrifices and commitment to putting in the miles.

“It takes a special mindset for sure,” Moehl says. “This community shares an understanding of what it takes to be a runner even though we come to this sport from very different walks of life. We all ‘get’ how important it is to each of us to want to meet at a start line or trailhead to enjoy the miles.”

While Dr. Krabak agrees ultrarunning requires that special mind/body balance, he jokes “it’s usually those who are genetically blessed that say it’s 90 percent mental.” 

“Some people are just designed to jump higher and run faster and longer,” he adds. “The ‘Deans’ of the world have certain genes and aerobic capacity that allow them to run forever. But for the rest of us mere mortals, we need to slowly adapt to that change over time based on our bodies.”

Do You Want to Go Long?

“The athletes I see that have longevity in the sport are the ones who are not afraid to take a little bit of downtime – not only physically, but emotionally.” 

How we prepare our bodies for ultrarunning, says Dr. Krabak, is with a smart approach to training and injury prevention.

“Your body is designed to adapt to stress,” he says. “So if you want to lift more weight, you slowly increase how you train. Running is the same thing. If you want to run longer distances, you have to work up by stressing the system a little bit, in a very structured program.” He recommends the 10 percent rule — slowly increasing the time and distance you run by no more than 10 percent each week.

Moehl’s elite training emphasizes strength training, stretching and cross-training (she likes swimming and yoga) to stay injury-free. She also says nutrition — keeping a close eye on the balance of calories in vs. calories out — is crucial for staying strong when you’re logging all those miles.

Ultrarunners can also get in trouble, says Moehl, by not respecting the amount of rest and recovery their bodies need with such an increase in physical activity. She learned that lesson the hard way in the summer of 2012, when she ran three 100-mile races in just nine weeks.

“It was all too close,” she says. “The athletes I see that have longevity in the sport are the ones who are not afraid to take a little bit of downtime – not only physically, but emotionally.” 

All of the experts we spoke to said it’s important to listen to your body, no matter how many miles you run. 

“While there is a need to push through some serious training if you want to be competitive, it is still best to adjust your training if you feel an injury or illness coming on,” says Dr. Hoffman. “And learn from the old dogs, but also take what they say with some healthy skepticism.” 

‘Why Do You Run?’

When he first meets with running patients, Dr. Krabak always asks them, “Why do you run?” Their answer usually tells him how serious or passionate they are about the sport and helps him determine the proper course of training or treatment.

“I’d like to think for the right people, ultrarunning is just another activity that promotes health,” he says. In his experience running, working ultramarathons as a physician around the world, and researching the sport, Krabak says ultrarunning is not actually that dangerous for a runner’s physical and mental state, despite its intense nature.

“People do relatively fine despite the ‘craziness’ of running really long distances,” he says.

As the research on ultrarunning continues for the next two decades, Dr. Hoffman — who is setting his sights on something longer than a 100-miler soon — says people will continue to run and push the limit in the sport. That’s good news for the strong, ever-growing tribe of ultrarunners — especially for Moehl as she prepares for that 220-mile journey along the John Muir Trail this summer.

“We’re going for a three-day, 20-hour record,” she says. “It’s got me nervous and excited and all those emotions that go along with it. And it will double my biggest run ever which is pretty, well… crazy.”

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