Follow up From the Hardrock Hundred Medical Symposium

Long overdue follow up post from Hardrock week and the second annual HR100 Medical Symposium. For those of you unfamiliar the Hardrock Hundred Endurance Run is a notable ultaramarthon footrace ran each (most) July in the San Juan mountains. The course starts and begins in historic Silverton, CO and covers over 100 miles of remote mountain terrain with over 33,000 feet of climbing. While mountain ultra-running has greatly increased in popularity, the Hardrock stands out because of its crushing yet beautiful course, longstanding success and incredible community of runners and volunteers which make the race what it is. Because of the unique medical challenges on the course, in 2018 for the first time we expanded the traditional medical volunteer briefing to a full day of medical education.

Although the 2019 race could not be run due to excessive snow and debris on the course after a record setting avalanche cycle this past winter, there was a full week of fun activities, camaraderie and volunteer work instead of the run. The medical symposium was part of this, and I have the privilege of chairing the event.  

For the 2019 symposium we had a great line up of speakers, including prolific researcher and author Dr Marty Hoffman, HR100 Medical director Dr Stephen Halvorson, accomplished ultra runner and physical therapist Nikki Kimball, and myself. Despite not having the race, the symposium was well attended by a variety of medical professionals – WFRs, EMTs, Paramedics, PAs, Athletic Trainers, Nurses /NP’s and Physicians. 

While we covered a ton of material (maybe too much for one day) I think some key take aways can be grouped into two categories 

Take aways for medical professions working at endurance events:

-be prepared to recognize and appropriately treat hyponatremia, heat stroke and hypoglycemia, and differentiate them from other conditions. 

-IV hydration is rarely needed, and is more frequently potentially harmful 

-a rectal temperature is the only appropriate way to prove or exclude heat stroke 

Take aways for athletes:

-Sodium tablets are entirely disproven for both cramping and hyponatremia. 

-Sodium tablets will increase GI difficulties and may actually lead to INCREASED risk of hyponatremia by stimulating excess thirst while the hormonal changes that make hyponatremia possible are still going on. 

-Pay to play post race IV fluids are a dangerous scam

-Drink to thirst for best performance 

Planning has already begun for an even better and more interactive medical symposium to accompany the 26th running of the Hardrock Hundred in 2020. I hope to see you there!

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