Wednesday, January 10, 2018

At What Age???

5k:  Ava Johnson, Megan Crum, Aaron Westrip, Daniel Skandera
10k:  Ava Johnson, Carrie Garritson, Aaron Westrip, Grattan O’Neill, Caleb Hymans
Half Marathon:  Tabitha Francks, Nasiya Jobe, Matthew Feibusch, Charlie Westrip, Grattan O’Neill
Marathon:  Mary Etta Boitano, Tabitha Francks, Julie Mullin, Kevin Strain, Wesley Paul, Charlie Westrip

According to the Association of Road Racing Statistics, each of these runners holds a world record time in the event listed. The surprising part of their record? Their age at the time; ranging from 3 (Aaron 5k) to no more than 12 years and several of these runners hold multiple age range records. When I reviewed published reports and comments and quotes from these runners and their parents, they all used the words “fun, family sport, exercising.” There was no mention of “punishment or because my parents made me.” Many families see it as bonding time and a chance to travel. In fact, youth half marathon times dropped quite a bit in 2016.

Nike has a website called Marathon Kids; the American Academy of Pediatrics (AAP) has issued statements in the past about distance running for children. Some physicians and coaches recommend no marathons until past the age of puberty. The AAP reports that sprint distance triathlons are a good thing because they incorporate “lifetime sports, short sensible distances, non-specialized training before puberty and have health and weight benefits.” There is a lot of confusion, concern and conflicting information.

However, for those of us who set policies for our events, council our race directors to say no to a parent of a 6 year old who wants to run our marathon what is the best answer? We know that our kids of today are not physically active – many are couch potatoes. We know schools have cut back on many non-academic programs including physical education and recess due to budget costs. We know 12% of our youth are seriously overweight and have health issues because of it. We also see more event weekends with kids activities added in to attract families and not just mom or dad runners.

So what is the answer? Is there one? How does your event answer this question?

Wednesday, December 6, 2017

Testing and Treatment

The 2017 Marine Corps Marathon was the second warmest on record and the second busiest in the medical tents.  Temperatures started at 53.2 degrees F and reached a max of 77.3 degrees F. WBGT readings done every hour at three locations on the course. With a low of 53.2 at 0800 and a high of 73.9 at 1400 on the course. Of our 42 transports 22 were heat related and one runner; a 61 yo female runner presented confused, with several bouts of nausea and vomiting and a serum sodium of 131 mmol/L.

Various references define hyponatremia as a serum sodium <135 mmol/L and critical hypernatremia as <120 mmol/L. Other risk factors include fluid intake, gender, exercise duration > 4 hours, pre-exercise over hydration, easy access to fluids on the course and temperature. Symptoms range from confusion, nausea, vomiting, confusion, seizures and unresponsiveness. Some runners have low serum sodium levels and no visible symptoms.

The discussion point I bring up is testing and treatment. Should all runners presenting with symptoms of hyponatremia have sodium levels tested prior to the introduction of an IV?  In cases where athletes are picked up on the race course and transported immediately by EMS service, should an IV be withheld until testing is complete? There are events that have few if any aid stations and protocols that do not cover all these possibilities. Would you start an IV on a runner in your aid station without a serum sodium level?