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MEDICAL ADVICE FOR COMPETITORS

Tuesday 24th January 2017

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GODZone 2017 – Athlete’s self-help medical advice sheet

Hi all from your race doctor, Lynne John. With only a short time until the race, it’s timely to give you some pearls of wisdom re looking after yourself before and during the race. With any luck that’ll mean you don’t get to see me, nor any of the other medical team for the whole race- and I get to camp out in glorious wilderness and have more sleep than you do!

Just before the race I’ll send you a brief questionnaire about your preparation and experience, to be followed by a post-race sheet, aiming to learn more from you what is protective and helps you to ‘race-to-perfection’. There have been very few such analyses in your specialist field of endurance racing, so with my doc son, Rhys John in the lead, we have submitted this study for Medical Ethical Approval-a painstaking process ensuring the conclusions reached will have validity. These will be shared with you, of course, allowing many years of pain-free racing to come!

Last year we had numerous injuries which broadly grouped as follows

  1. FEET- a huge problem for many- from minor blisters and toenails ‘floating off’ painfully, to complete (WW1 era) trench feet, where skin was peeling off in strips.
  2. Sprains of joints- wrists/ankles- and muscle strains (ITB/forearm/lower shin & ankle)
  3. Impacts-broken bones/concussion
  4. Dehydration
  5. Wasp stings
  6. Skin tears- shins/forearms/bike gravel-rash, followed rapidly by infections ( due to your immune system being suppressed by high activity/fatigue/dehydration)
  7. Chaffing of feet/trunk/butts/’undercarriages’/mouths
  8. Problems due to overuse of self-medication- stomach (ulceration) AND kidney damage from (NSAID) anti-inflammatory pain-relievers. +Possibly some hallucinatory effects of other pain drugs ( codeine/tramadol) under the duress of the race.
  9. Eye injuries- from minor scratches to the eyeball to a perforation from gorse bush-bashing which necessitated the athlete withdrawing for sight-saving treatment!
  10. Sleep monsters

Prevention is better than cure … in all things….. So here’s how to make your race more enjoyable and effective

  1. Feet-due to the prevalence of foot problems even in the ‘top’ teams, I have formulated a special sheet for these- see attachment. Your feet will be constantly wet – due to immersion and your own sweat. Key points- don good sturdy worn-in shoes, dry-dry-dry ( even just let steam off) at every minor stop, apply chaffing goo, cover rubbing points early with tape, AND IMPORTANTLY CONDITION YOUR FEET-get out for multiple 6-8+ hour rugged tramps now- merely running on roads won’t work for you
  2. Sprains/strains- training helps! Building up to long hours on your legs or paddling is key. Start low/go slow. If you need to strap, apply a protective stretchy mesh ( mefix/flixomull etc) to your bare skin before the sports tape or you will lose strips of skin during the required changes. Consider visiting your favourite physio to be shown how to apply strapping. Last year many athletes developed leg swelling due to racing and the applied strapping became tight and constricting, cutting off circulation ( and stripping skin). You may need to reapply daily.
  3. Consider Use of light protective helmets on high mountainous rocky stages
  4. Drink lots- water/electrolytes hourly . Aim to be ‘peeing clear’ frequently. This way you will perform optimally; clearer thinking, stomach/skin infection/kidneys will be protected
  5. Wasps/sandflies- take an antihistamine immediately after bites to avoid swelling and infection
  6. Skin-wear shin-high gaiters and long light ( polypro?) sleeves if poss. Those tiny scratches soon fester in race conditions, as the ‘normal skin bugs’ have a field day on your moist, sweaty immunosuppressed body. Wash off mud/grit in streams or under taps asap + daub with iodine daily to zap the bacteria ( good for feet too). Cover grazes directly with the sticky mesh above or a massive bandaid! Covered ( cleaned) wounds heal quicker. Remember to apply sunblock often to avoid suffering
  7. Chaffs- invest in a big pot of Antichaf/Gurney goo and apply EVERYWHERE at every transition ( and more often) -feet/toes/armpits/nipples/butt creases and orifices. Re bottoms- the race stress+ concentrated electrolyte mixtures you quaff often produce race diarrhoea and even ‘piles’. You may need a few stopper tablets to take ‘just in case’. The mouth can ulcerate with lots of sugary ‘sports foods’- keep eating proper food and swill mouth with water regularly ( toothbrush in transition?)
  8. Drugs- athletes must use pain relievers with caution. Do not take ‘just in case’. If pain or swelling develops, then start with 2 paracetamol tablets ( up to total of 8 in 24hrs). Antiinflammatories ( NSAIDs) can be dangerous in dry, hungry people ie multisport athletes in a race! To avoid stomach ulcers, vomiting /gastritis and kidney stones or failure ( all occurred in 2016!!), keep drinking fluids ( see #4) and eat when you are taking NSAIDs. Don’t mix different NSAIDs ( ibuprofen, diclofenac, naproxen) on the same day. Additional pain relievers also to be used with caution- codeine and tramadol can cause bizarre ‘spacey’ feelings and even hallucinations especially as you will be physically and mentally under great duress!
  9. Eye protectors – sunglasses are essential for the ultra-strong NZ sunlight. In dim (no!) light, clear specs are advisable if bush-bashing or in forest, or even road biking with moths flying.
  10. Sleep monsters- deprivation of sleep makes your racing inefficient. Many top 10 teams plan for 2+ hour ‘power naps’ and also then manage to enjoy their race!

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