Marathon Research Articles

Do upper leg compression garments aid performance and reduce exercise-induced muscle damage in recreational marathon runners?

Despite the lack of scientific knowledge on the physiological and biomechanical effects of wearing compression garments (CGs), there has been an increase in the use of compression garments (CG) amongst endurance runners. To compare marathon race performance, post-race pain, and mid-thigh circumference in marathon runners using upper leg CGs, with runners who did not use CGs in the same marathon race. The study was conducted on healthy, long-distance runners (n=18) participating in the Winelands Marathon race, Cape Town, South Africa. The CG group (n=10) participated in the race wearing upper leg CGs, while the control group (n=8) did not. Participants were tested on three occasions for various subjective markers of exercise-induced muscle damage (Visual analogue scale (VAS) pain rating score, and Likert scale for muscle pain), mid-thigh circumference for muscle swelling, and running performance (race pace). VAS pain ratings for hamstring (p=0.04), knee flexion (p=0.02) and hip extension (p=0.04) were significantly lower than the ratings of the control group immediately post-race and two days post-race. No statistically significant differences were detected in race performance, mid-thigh circumferences or Likert scale for determination of muscle soreness. Wearing of upper leg CGs while running a marathon race improved VAS pain ratings immediately post-race through to two days post-race. However, due to no placebo control, this beneficial effect may be psychological as opposed to a physiological effect of the CGs on muscle pain. The use of upper leg CGs reduced subjective muscle pain in runners in the first 48 hours post-race.

Amateur marathon running in modern literature: types of description and reflection of reading

The main purpose of this work is to analyze the modern literature on amateur marathon running and the motivational effect that such publications give to novice marathon runners. The author pays special attention to the fact that the appearance of such literature in recent years has coincided with a general decline in reader activity around the world. This demand may be explained by the fact that the preparation of a marathon runner is very specific and requires a lot of time for training. And this feature, which consists in long-term planning, makes it an additional attractive "long-term project" in comparison with most modern tasks, which are increasingly, being short-term, perceived as a duty-passing fluidity of life. The fact that there is no similar literary activity in other sports (best-selling books based on the description of the sport as a plot basis, the presence of authors – former athletes), allows us to conclude that marathon running, becoming not only a professional sport, but also acquiring the status of an amateur, is a challenge, generating the need for constant reflection both among the authors themselves and among readers. Against the background of the analysis of the content of books and "feedback" (readers' feedback), it is concluded that the basis of the appeal and mass popularity of amateur marathons should be associated with the "culture of challenge", which is clearly manifested in the practices of understanding and development of amateur running. The culture of challenge can be interpreted from the standpoint of L.N. Kogan's value-motivational analysis of culture and understood as the realization of essential human forces.

Running a mutual fund: Performance and trading behavior of runner managers

This paper examines the relationship between the representation of marathon runners in a fund management team and its future performance. We find that funds with a larger proportion of runner managers have a higher level of risk-adjusted excess returns. We also find that these funds have a lower level of the disposition bias, deviate more from their benchmark portfolios, hold fewer stocks in their portfolios, and hold their stocks for a longer duration. Also, they tend to hold more stocks that are about to experience desirable earnings outcomes. Overall, the results suggest that personality traits that affects achievement in other dimensions of life may translate into fund management success. • Fund managers who run marathons deliver higher risk-adjusted returns. • Runner managers have less disposition bias and are more prompt to exit losing positions. • Runner managers have higher active share and longer duration, and hold fewer stocks. • Runner managers tend to hold more stocks that are about to experience desirable earnings outcomes.

ANGPTL4, IL-6 and TNF-α as regulators of lipid metabolism during a marathon run

The aim of the study was to reveal whether marathon running influences regulators of lipid metabolism i.e. angiopoietin-like protein 4 (ANGPTL4), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α). Plasma concentration of ANGPTL4, IL-6, TNF-α and lipids were determined in samples collected from 11 male runners before the marathon, immediately after the run and at 90 min of recovery. Plasma ANGPTL4 increased during exercise from 55.5 ± 13.4 to 78.1 ± 15.0 ng/ml (P < 0.001). This was accompanied by a significant increase in IL-6, TNF-α, free fatty acids (FFA) and glycerol (Gly) and a decrease in triacylglycerols (TG). After 90 min of recovery ANGPTL4 and TG did not differ from the exercise values, while plasma IL-6, TNF-α, FFA and Gly concentration were significantly lower. The exercise-induced increase in plasma concentration of ANGPTL4 correlated positively with the rise in plasma IL-6, TNF-α, FFA and Gly and negatively with the duration of the run. The increase in plasma IL-6 and TNF-α correlated positively with the rise in Gly. Summarizing, marathon running induced an increase in plasma ANGPTL4 and the value was higher in faster runners. The increase in plasma FFA, IL-6 and TNF-α concentration during a marathon run may be involved in plasma ANGPTL4 release, which could be a compensatory mechanism against FFA-induced lipotoxicity and oxidative stress. All of the analyzed cytokines may stimulate lipolysis during exercise.

Inflammatory activation biomarker profile after marathon running and its impact on cardiovascular stress in amateur middle-aged male runners.

Cardiovascular safety of marathon running middle-aged amateurs remains unclear. We previously hypothesized that transient release of cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), in addition to an acute inflammatory response to exercise, may be the cause. To evaluate the effects of running a marathon on inflammatory biomarkers, and its impact on cardiovascular function. Thirty-three healthy male amateur runners aged ≥50 (mean age: 57 ±7 years) were enrolled in the study. Venous blood samples were obtained before the marathon, just after the race, and 2-4 days and 7 days after the marathon. Using novel single molecule counting (SMC) technology, we measured plasma concentrations of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α). White blood cell (WBC) count was measured using a certified hematology analyzer. The results were related to previous analyses on cardiovascular stress and endothelial function biomarkers. Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) were used to determine myocardial function. We observed a sharp rise of all studied biomarkers after the race, which subsequently normalized after 2-4 days and stayed within the normal range 7 days after the race. We found no correlation between inflammatory and cardiovascular stress biomarkers. Transthoracic echocardiography and CMR did not show ischemic or inflammatory myocardial damage. Marathon running is associated with a sharp and significant rise in inflammatory and cardiovascular stress biomarkers. We found no connection between immune activation and cardiac biomarker release. Cardiovascular imaging showed no myocardial damage due to ischemia or inflammation.

Exercise-Associated Hyponatremia in Marathon Runners.

Exercise-associated hyponatremia (EAH) was first described as water intoxication by Noakes et al. in 1985 and has become an important topic linked to several pathological conditions. However, despite progressive research, neurological disorders and even deaths due to hyponatremic encephalopathy continue to occur. Therefore, and due to the growing popularity of exercise-associated hyponatremia, this topic is of great importance for marathon runners and all professionals involved in runners' training (e.g., coaches, medical staff, nutritionists, and trainers). The present narrative review sought to evaluate the prevalence of EAH among marathon runners and to identify associated etiological and risk factors. Furthermore, the aim was to derive preventive and therapeutic action plans for marathon runners based on current evidence. The search was conducted on PubMed, Scopus and Google Scholar using a predefined search algorithm by aggregating multiple terms (marathon run; exercise; sport; EAH; electrolyte disorder; fluid balance; dehydration; sodium concentration; hyponatremia). By this criterion, 135 articles were considered for the present study. Our results revealed that a complex interaction of different factors could cause EAH, which can be differentiated into event-related (high temperatures) and person-related (female sex) risk factors. There is variation in the reported prevalence of EAH, and two major studies indicated an incidence ranging from 7 to 15% for symptomatic and asymptomatic EAH. Athletes and coaches must be aware of EAH and its related problems and take appropriate measures for both training and competition. Coaches need to educate their athletes about the early symptoms of EAH to intervene at the earliest possible stage. In addition, individual hydration strategies need to be developed for the daily training routine, ideally in regard to sweat rate and salt losses via sweat. Future studies need to investigate the correlation between the risk factors of EAH and specific subgroups of marathon runners.

Prevalence of Iron Deficiency in Endurance Runners: A Cross-Sectional Study of the Detroit Free Press Marathon and Half-Marathon Athletes

Background Iron deficiency, with or without anemia, may be more prevalent in endurance athletes than the general population. Marathon and half-marathon runners, a subset of these endurance athletes, are at risk for iron deficiency via several mechanisms, such as increased demand, foot-strike hemolysis, sweat, and others. The prevalence of iron deficiency among marathon and half-marathon runners in the United States has not been studied. Methods We performed a cross-sectional study to identify the prevalence of iron deficiency in runners participating in the Detroit Free Press Marathon or Half-Marathon on October 17, 2021. Eligible participants were screened at the pre-race expo, at which time they filled out questionnaires and had blood samples taken. The questionnaires included items such as demographic information, exercise and dietary habits, bleeding history, and symptoms. The blood samples were tested the same day for hemoglobin, hematocrit, ferritin, serum iron, total iron binding capacity (TIBC) and iron saturation. Participants received their laboratory results and a $30 Amazon gift card via email for participating. For the purpose of our study, we defined severe iron deficiency as ferritin <15 ng/mL, or ferritin <35ng/mL and iron saturation <16%. This was likely consistent with absent iron storage and similar to previous definitions used in studies examining other endurance athletes. As clinicians, we agreed upon clinical iron deficiency as ferritin <30 ng/mL, or ferritin <100 ng/mL and iron saturation < 20%. This was likely consistent with low iron stores, at-risk iron stores, or iron deficiency in some populations. This definition is also likely to prompt treatment and/or investigation. Data were analyzed using chi-squared analysis, Student's t-test, ANOVA and logistic regression using SPSS v. 28.0. Results Of 277 participants, the mean age was 40.6 ± 13.6 years, and 38.6% (n=107) were male. Most of our participants identified as white (n=219, 79.1%). All participants were residents of the United States; 213 participants (80.1%) were from Michigan. The majority of our participants registered for the half marathon: 185 (66.8%) half marathon, 87 (31.4%) marathon, and three (1.1%) unknown. The prevalence of clinical iron deficiency was significantly higher in females than males, 47.6% versus 15%, respectively (p<0.001). The same trend was found for severe iron deficiency, 14.7% in females vs. 2.8% in males (p=0.001). These results were independent of anemia status. On univariable analysis, factors associated with iron deficiency (clinical and/or severe) included younger age, race entered, history of anemia, heavy menstrual bleeding, blood thinner use, ≥15 hours of exercise per week, restrictive dietary habits, and lightheadedness. For multivariable analysis, we ran separate models by sex (Table). Conclusion Iron deficiency is prevalent in marathon and half-marathon runners and is associated with several risk factors, which differ by sex. Patients who participate in endurance sports and/or training should be screened accordingly. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Factors Associated With Running-Related Injuries in Recreational Runners With a History of Running Injuries.

To identify the incidence and characteristics associated with a higher injury risk in recreational runners who suffered a running-related injury (RRI) in the previous 12 months. Prospective cohort study among recreational runners who registered for a Dutch running event (5-42.2 km) and suffered an RRI in the 12 months before inclusion. Open population. Recreational runners with a previous reported injury. At baseline, information on demographics, training characteristics, health complaints, and RRI history was collected. With 3 follow-up questionnaires (2 weeks before, 1 day after, and 1 month after the running event), the occurrence of new RRIs was registered. In total, 548 participants (55.1%) sustained a new RRI during follow-up. In total, 20.5% of the new RRIs was located at the same anatomical location as the previous RRI. Runners who registered for a marathon had a higher chance to sustain a new RRI [odd ratio (OR) 1.72; 95% confidence intervals (CIs), 1.17-2.53]. Also previous RRIs in the upper leg (OR 1.59; 95% CI, 1.15-2.19) and lower leg (OR 1.61; 95% CI, 1.18-2.21) were associated with an increased injury risk. Especially being a marathon runner and the anatomical location of previous RRIs seem to be associated with the injury risk in recreational runners with a previous RRI.

The mediating role of psychological commitment between recreation specialization and life satisfaction: Evidence from Xiamen Marathon runners.

Although previous research spared no efforts to explain the life satisfaction of marathon runners, little was known about the relationship between recreation specialization (RS), life satisfaction (LS), psychological commitment (PC), and social support (SS). This study examines (i) how the dimension of RS (i.e., behavior, cognition, and affect) influences runners' PC and LS, and (ii) the mediating effects of PC and the moderating effects of SS on the relationship between behavior, cognition, affect, and LS. The results showed that behavior (β = 0.15, p < 0.01), cognition (β = 0.35, p < 0.001), affect (β = 0.28, p < 0.001), and PC (β = 0.59, p < 0.001) had significant and positive impacts on runners' LS; PC (Indirect path coefficient = 0.09 ~ 0.20) mediated the relationship between the dimensions of RS and LS. In addition, the results also confirmed the moderating effects of SS (β = 0.10, p < 0.05) between affect dimension and LS. These findings offered more evidence for understanding how RS dimensions and PC influence runners' LS. Future research should integrate runner's leisure experiences to better understand the results revealed in this study.

Abstract 12307: Exercise-Induced Ventricular Fibrillation in Patients with Brugada Syndrome Phenotype

Introduction: Ventricular fibrillation (VF) in Brugada syndrome (BS) patients are thought to be triggered by vagal nerve activation, which leads to sudden cardiac arrest (SCA) at rest or while asleep. Generally, exercise is not considered as trigger of SCA in BS patients. Aim: To report 2 rare cases of patients with BS phenotype developing exercise-induced ventricular (VF). Case reports: Case 1: 48 year-old male developed SCA during marathon running and was successfully resuscitated with cardiopulmonary resuscitation (CPR). The stored automatic external defibrillator (AED) electrogram (ECG) showed VF. The 12-lead ECG did not show abnormal morphology, however sodium channel blocker challenge test (intravenous injection of pilsicainide, a pure sodium channel blocker 1mg/Kg) unmasked typical type-1 BS ECG. The treadmill stress test induced single premature ventricular contraction by Bruce protocol, and ventricular tachycardia by a flat-out dash without a run-up. Genetic analysis did not show mutation of SCN5A gene. Case 2: 18 year-old male experienced SCA while playing basketball and was successfully resuscitated with CPR. The stored ECG record of AED showed VF. The 12-lead ECG showed normal result, then we performed the drug challenge test. Pilsicainide unmasked typical type-1 BS ECG. He also had exercise-induced atrial fibrillation (AF) and experienced inappropriate shock delivery from implantable cardioverter defibrillator. The treadmill stress test by Bruce protocol did not induce any ventricular arrhythmias. We avoided a flat-out dash protocol because of possibility of exercise-induced AF. Genetic analysis did not show SCN5A mutation. Conclusion: These 2 rare cases of drug-induced BS phenotype developing exercise-induced VF highlight important role of exercise testing as risk stratification tool in certain BS patients.

Acute Effects of Marathon Running on Lung Function, Lung Mechanics, and Inflammation

This study investigated the influence of the marathon on lung function, mechanics, and pulmonary inflammation. Twenty-eight male amateur marathon runners (42.1±6.2 years) were evaluated before and immediately after marathon. Pulmonary function and mechanics were assessed using spirometry and impulse oscillometry, respectively, whereas fatigue of the respiratory muscles by manovacuometry and lung inflammation by fractional exhaled nitric oxide (FeNO). Marathon induced a significant reduction in the lung function as compared to baseline values: FVC (4.81±0.72 vs 4.67±0.62, p=0.0095), VC IN (4.81±0.72 vs 4.67±0.62, p=0.009), FEV1 (3.83±0.62 vs 3.72±0.59, p=0.0232), and FEV6 (4.87±0.68 vs 4.57±0.63, p=0.0006), as well as an impairment in the lung mechanics in comparison to baseline values: reduced pulmonary impedance (Z5Hz; 2.96±1.36 vs 2.67±1.11; p=0.0305), reduced resistance of the whole respiratory system (R5Hz; 2.76±1.27 vs 2.5±1.08; p=0.0388) and pulmonary reactance (X5Hz; -1.05±0.55 vs -0.91±0.36; p=0.0101) and of resistance of proximal airways (R5Hz; 1.26±0.73 vs 1.06±0.86; p= 0.0377). In addition, maximal inspiratory (MIP; 94.14±41.88 vs 72.52±25.50; p=0.0023) and expiratory (MEP; 99.31±31.84 vs 91.29±19.94; p=0.0454) pressures, as well as FeNO levels were lower after the marathon than values pre-marathon (p=0.0359). Marathon running causes an acute disturbance in lung function and mechanics and compromises respiratory muscle strength.

Living with Multiple Sclerosis as a former marathon runner: Impact of attitude and past behaviour on self-care maintenance and perseverance

As healthcare professionals, we have a duty to promote the wellbeing of individuals living with chronic diseases and this could be accomplished through the establishment of self-care strategies that are both collaborative and self-directed. Insight into the complex behaviours and backgrounds of individuals who show initiative in dealing with chronic disease could help achieve this by revealing drivers of health-seeking and engaging behaviours. Therefore, by deducing the complex interactions between attitude, past experiences and disease outlook, broader patient welfare could be championed through the implementation of targeted interventions which promote self-care in chronic disease. This article aims to explore these ideas by focusing on the story of a former marathon runner and proactive secondary progressive Multiple Sclerosis sufferer, Mr. Evans, who has taken charge in leading an active and healthy lifestyle to manage his condition. His sense of patience and self-worth are rooted in his attitude and upbringing and are factors which have championed his ongoing wellbeing and understanding of his condition.

Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review.

Limited data are available on the long-term consequences of early sports specialization in high-level athletes. To evaluate the existing literature on the effects of sports specialization among professional, Olympic, and other elite athletes. Systematic review; Level of evidence, 3. We performed a systematic review of studies from 1990 to 2021 on youth sports specialization in professional, elite, and/or Olympic athletes following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An elite athlete was defined as one who performed at the highest level of his or her sport, beyond college level. Data were summarized according to 6 objectives: (1) definitions of specialization, age at specialization, and participation in other sports; (2) motivation for specialization; (3) athlete perspectives on specialization; (4) performance data; (5) specialization and injury risk; and (6) career longevity. From 8756 articles, 29 studies were included, of which 17 (58.6%) were survey-based studies. Of the 8 articles that commented on injury risk, all demonstrated reduction in injury risk in athletes who delayed specialization. Performance benefits were apparent with later specialization in 7 of 9 articles; the remaining 2 showed benefit with earlier specialization in marathon runners and soccer players. There were less definitive results on career longevity, with 5 of 9 articles finding no association between career longevity and sports specialization. Although current data on sports specialization in elite, professional, and Olympic athletes are mostly retrospective and survey-based evidence, most sports demonstrate better performance after youth multisport engagement, and youth sports specialization was linked with increased injury risk in athletes at the highest levels of competition.

ODP255 Woman With Maturity-Onset Diabetes of the Young Type 2 (MODY2) Mistakenly Diagnosed and Treated as Type 2 Diabetes Mellitus

Abstract Background MODY2 is a rare, monogenic form of diabetes, caused by mutations in the glucokinase gene (GCK), and is often misclassified as type 2 diabetes. Clinical case: A 37-year-old woman, during childhood, at the age of 9, was characterized as overweight and had a poor diet, despite being physically active. Her pediatrician diagnosed her with DM2 and started treatment with metformin. However, there was no improvement in fasting glucose levels, so the family decided to stop the medication on their own. In 2008, the patient became pregnant, presenting fasting glucose levels between 120-130 mg/dl (n&amp;lt;99 mg/dl), and continued without hypoglycemic treatment. In 2010, she resumed treatment for glycemic control having used: metformin, sulphonylurea, IDDP4, and basal insulin. Despite the various treatments tested, there was altered fasting glycemia, in the 130mg/dl range. In 2012, she increased her physical activity by training for a half marathon run. At the peak of her form, but maintaining hyperglycemia (always measuring while fasting), she started liraglutide 1.8mg. In 2019, she presented episodes of malaise during training, being indicated by her physician, to discontinue liraglutide, then starting dapagliflozin, but there was still no improvement of blood glucose levels. In August 2019, she was instructed to take the following medications: insulin degludec, liraglutide, and dapagliflozin. Current weight was 53kg, height 1,57cm and a BMI 21,5kg/. Laboratory exams were requested with the following results: A1C 6,6% (n: &amp;lt;5,7%), mean glycemia 143mg/dL (n: 70-99 mg/dL), fasting glycemia 127mg/dL (n: &amp;lt;100mg/dL), urea 24mg/dL (n: 13-43 mg/dL), creatinine 0,83mg/dL (n: 0,8-1,3 mg/dL), AST 16U/L (n: 10-34 U/L), ALT 17U/L (n 10-130 U/L), LDL 109mg/dL (n&amp;lt;100mg/dl), HDL 80mg/dL (n&amp;gt;60 mg/dL), TG 90mg/dL (n&amp;lt;150 mg/dL), total cholesterol 207mg/dL (&amp;lt;200 mg/dL). Faced with the suspicion of diabetes with different behavior than DM1 and DM2, genetic testing was requested for confirmation. In September 2019, the result arrived, pointing out a genetic change in heterozygosis in the GCK gene. This is a rare mutation that results in the depletion of the phenylalanine amino acid at position 150 of the protein glucokinase. This result confirmed the diagnose of MODY type 2. The patient was oriented to discontinue anti-hyperglycemic agents, maintain a low glycemic index diet, and daily physical exercises. Thus, she has been maintaining excellent glycemic control and adequate weight. Conclusion Suspicion and characterization of MODY through clinical history, and confirmation of diagnosis through genetic testing, is essential to avoid unnecessary or inefficient treatments, and to ensure a better quality of life for the patient. Presentation: No date and time listed

Sex Differences in Training Behaviors of 10 km to Ultra-Endurance Runners (Part A)-Results from the NURMI Study (Step 2).

Training for running events is fundamental for successful participation in various running events such as 10 km, half-marathon, marathon, or ultra-marathon distances. Training behaviors are likely based on runner motivations and social constraints, particularly for females. Participants completed a questionnaire following a cross-sectional approach, including questions on sociodemographics, general training behaviors, and periodization training strategies. The final sample included 245 participants (141 females, 104 males), mostly from Germany (72%), Austria (18%), and Switzerland (5%), with a median age of 39 years (IQR 17) and a BMI of 21.7 kg/m² (IQR 3.5). Males more often trained alone and independently, whereas females were most likely to follow an external resource (p = 0.037). Non-parametric ANOVA revealed significant training differences between sexes in daily training mileages and durations at each phase and stage (p < 0.05) as well as in weekly training mileages and durations for general basic training and race-specific training (p < 0.05). Critical sex differences in training behaviors may arise from physiological differences and social expectations, which may be related to the distances they prefer to race at as well as their motivations for running and racing. This study provides a wide overview of training behaviors for endurance runners or professionals guiding healthy running performance.

Aging and Possible Benefits or Negatives of Lifelong Endurance Running: How Master Male Athletes Differ from Young Athletes and Elderly Sedentary?

Regular physical activity, recommended by the WHO, is crucial in maintaining a good physical fitness level and health status and slows down the effects of aging. However, there is a lack of knowledge of whether lifelong endurance running, with a volume and frequency above the WHO limits, still brings the same benefits, or several negative effects too. The present study aims to examine the protentional benefits and risks of lifelong endurance running training in Master male athletes, as this level of physical activity is above the WHO recommendations. Within the study, four main groups of participants will be included: (1) endurance-trained master athletes, (2) endurance-trained young athletes, (3) young sedentary adults, and (4) elderly sedentary. Both groups of athletes are strictly marathon runners, who are still actively running. The broad spectrum of the diagnostic tests, from the questionnaires, physical fitness testing, and blood sampling to muscle biopsy, will be performed to obtain the possibility of complexly analyzing the effects of lifelong endurance physical activity on the human body and aging. Moreover, the study will try to discover and explain new relationships between endurance running and diagnostic parameters, not only within aging.

Efficacy of Cryo-compression on Shin Splints in Female Amateur Marathon Runners

Background: Medial tibial stress syndrome (MTSS) or Shin splints is exercise-induced lower leg pain along the distal posterior-medial aspect of tibia caused by repetitive loading stress during running and jumping. It is one of the most common lower leg sports injury. Cryotherapy is the most commonly used treatment during immediate care of athletic injuries and acute soft tissue injuries and is also included as part of RICE (rest, ice, compression and elevation). Cryotherapy is helpful in reducing swelling as well as it exerts analgesic effect. The external compression is also used during immediate care phase and it helps in decrease tissue temperature and prevent oedema formation. Cryotherapy in combination with intermittent pneumatic compression hypothetically help in reducing the physiologic effects of traumatic tissue damage which is based on the models of cryotherapy and static compression therapy. This study aims to establish the efficacy of cryo-compression on shin splints in female amateur marathon runners. Methods: A total 30 subjects diagnosed with shin splints were selected for study. Subjects received cryo-compression for reducing pain and swelling and exercises to strengthen the muscles. Each session was conducted for 45 minutes duration, 5 days per week for 4 weeks. Outcome measure used was Numerical Pain Rating Scale (NPRS), Goniometry for ROM and Manual muscle testing (MMT). Results: According to statistical analysis, the results of the study demonstrate that there was a significant effect of the use of cryo-compression on numerical pain rating scale (p&lt;0.0001), range of motion (ankle plantarflexion, dorsiflexion, eversion and inversion) (p&lt;0.0001), manual muscle testing – ankle plantarflexors (p=0.0028) and ankle dorsiflexors (p&lt;0.0001) during the pre and post intervention assessment. Conclusion: The conducted study shows that efficacy of cryo-compression on shin splints in female amateur marathon runners is very effective in reducing pain, increasing range of motion (ROM) and strength of muscles along with other treatment program. KEYWORDS: Cryo-compression, shin splints, numerical pain rating scale (NPRS), range of motion, ankle plantarflexion, ankle dorsiflexion, ankle eversion, ankle inversion, manual muscle testing, ankle plantarflexors, ankle dorsiflexors.

Running through the in-between: Distance runners in a state of liminality

ABSTRACT This paper focuses on the way novice marathon runners experience and respond to a change – becoming marathoners. It utilises Victor Turner’s concepts of liminality and communitas to illustrate the complexity and challenges experienced by novice runners. The scope of sociological research regarding distance runners over the last two decades has expanded, nevertheless, very little has been written in reference to the process of the liminal phase per se. Therefore, the contribution of this paper is to address this lacuna of research and focus on the link between the process of ‘becoming’ and concepts such as solidarity, hierarchies, and standing norms, which play significant roles and constitute key components in the process of liminality. An ethnographic research design of three years was implemented in two running groups, using participant observation and semi-structured interviews. The data presented suggest that embarking on a marathoner identity requires a phase of betwixt and between wherein the ‘traditional’ borders of liminality and communitas are not fixed and often negotiable. Moreover, the relatively advanced age, similar socioeconomic status and military background among the running members serve as loopholes in liminality for novice runners towards ‘interested solidarity’ with veteran runners in achieving their new status as marathoners.

Using Wet Bulb Globe Temperature and Physiological Equivalent Temperature as Predicative Models of Medical Stress in a Marathon: Analysis of 30 Years of Data From the Twin Cities Marathon.

: Assess the relationships between wet bulb globe temperature (WBGT) and physiologic equivalent temperature (PET) at the start of a northern latitude marathon and their associations with medical stress and transfers to the emergency room (ER) when the race environment is unexpectedly warm, and participants are not acclimatized. : Retrospective review. : Twin Cities Marathon from 1990 to 2019. : Runners competing in the Twin Cities Marathon. : Start WBGT (prospectively collected) and PET (retrospectively calculated). : Marathon race starters and finishers and race day medical data (eg, medical stress, number of medical encounters, and number of ER visits). : The mean WBGT was 7.4°C (range -1.7°C to 22.2°C), and the meant PET was 5.2°C (range -16.7°C to 25.9°C). PET was not determined to be a significant predictor of medical stress (P = 0.71); however, a significant quadratic association between WBGT and medical stress was found (P = 0.006). WBGT (P = 0.002), but not PET (P = 0.07), was a significant predictor of the number of ER visits. Start WBGT was a better predictor of medical stress and ER visits than PET at the Twin Cities Marathon over a 30-year period. The start WBGT may be a better tool to predict race day environment medical safety.

Extracellular inflammasome specks are released after marathon running and induce proinflammatory effects in endothelial cells

Abstract Objectives The intracellular NLRP3 inflammasome is an important regulator of sterile inflammation. Recent data suggest that inflammasome particles can be released into the circulation. The effects of exercise on circulating extracellular apoptosis-associated speck-like protein (ASC) particles and their effects on endothelial cells are not known. Methods We established a flow cytometric method to quantitate extracellular ASC specks in human serum. ASC specks were quantitated in 52 marathon runners 24–72 hours before, immediately after, and again 24–58 hours after the run. For mechanistic characterization, NLRP3 inflammasome particles were isolated from a stable mutant NLRP3 (p.D303N)-YFP HEK cell line and used to treat primary human coronary artery endothelial cells (HCAEC). Results Athletes showed a significant increase in serum concentration of circulating ASC specks immediately after the marathon (t1, +52% compared to baseline, p&amp;lt;0.05) and a decrease during follow-up after 24–58 hours (t2, 12% reduction compared to immediately after the run, p&amp;lt;0.01). Confocal microscopy revealed that HCAEC can internalize extracellular NLRP3 inflammasome specks. After internalization, endothelial cells showed an inflammatory response with higher expression of the cell adhesion molecule ICAM1 (6.9-fold, p&amp;lt;0.05) and increased adhesion of monocytes (1.5-fold, p&amp;lt;0.05). Conclusion These findings identify extracellular inflammasome specks as novel systemic mediators of cell-cell communication that are transiently increased after acute high-intensity exercise. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): University Hospital Leipzig