Two cases of paradoxical hypothermia in a Sahara desert multi-stage ultramarathon

Exertional hypothermia in a hot environment, a seemingly contradictory state, is a clinical presentation that has not been previously described in the medical literature. We present two cases of symptomatic hypothermia of 34-35°C (95°F) which resolved with ingestion of calories in otherwise healthy men competing in a multi-stage ultramarathon in the Sahara desert, Egypt 2012 with ambient temperatures of approximately 38-39°C (100- 102°F). Hypothermia is well documented in the medical literature as a presenting sign of hypoglycemia in both conscious and comatose patients. The mechanism by which hypoglycemia contributes to hypothermia is poorly understood, but may represent a compensatory response that reflects a decrease in energy demand during glucose deprivation. Wilderness medicine practitioners at endurance events should be cognizant of hypothermia as a potential presenting sign of hypoglycemia, as it can be empirically treated and rapidly reversed

The Practice of Physical Medicine and Rehabilitation in subSaharan Africa and Antarctica: A White Paper or a Black Mark?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147120/1/pmr2421.pd

Recommendations on Youth Participation in Ultra-Endurance Running Events: A Consensus Statement

Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16-18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race directors, and medical professionals often seek advice regarding the safety of youth athletes participating in these events, especially with regard to potential short and long-term health consequences. UER may impact key organ systems during growth and development. We propose a decision-making process, based on current knowledge and the experience of the consensus group that addresses age regulations, medical and psychological well-being, training status and race-specific factors (such as distance, elevation change, remoteness, ambient temperatures, level of medical assistance, and type of provisions provided by the race organizers) to use until evidence of long-term consequences of UER in youth athletes is available. These recommendations are aimed at safe participation in UER events for youth athletes with a proper and individualized assessment

Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation

Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.</p