Winners of the men’s and women’s categories

If a marathon is a challenge for the body, an ultramarathon is an even harder undertaking. Overload injuries are common, especially in the musculoskeletal system, and often related to high levels of training.

Long runs are difficult to organize. In 24h races top runners usually run distances longer than 250 kilometres. As there is a fixed time limit, and not a distance, these races are usually organised around a course, ranging from 400 metres to 3 kilometres in length, where the athletes must run as many loops as possible. Besides the athlete’s wellbeing, organisers must also consider the accommodation of participants´ teams and audience.

Course characteristics can determine a race difficulty level and athletes’ comfort. In track races (400 metres) running direction usually changes every few hours. But there are also loop shapes including turns with 180-degree angles.

A recent article tried to find and study the weakest point of an ultramarathoner.


The study

Focusing on the 24h Polish Championships of 2017, six of the top ten runners complained about right knee pain. Competition was held in a rectangular-shaped asphalt course, almost 2 kilometres in length (see figure). Each lap included four 90-degrees turns and was run in clockwise direction.

The runner subject of the study had completed previously more than 50 ultra-marathons, was two-times 24h Polish Champion and winner of the 2016 Spartathlon.

Approximately 12h into the race the runner started complaining about pain in his right knee. Despite this, he managed to run 258kms, completing 129 loops that involved 516 rectangular turns.

A right knee resonance image taken 24h after the race confirmed:

  • Synovial edema, or in other words, inflammation of the joint due to fluid collection.
  • Tear in the anterior root of the lateral meniscus.

As mentioned earlier the right knee was the most common pain location among the ultra-runners participating in this race. Despite the limitations of this study, the pain seemed to be caused by the rectangular shape of the course and the atypical clockwise running direction.


How should be the course in 24-hour races?

In order to minimize injuries organizers should try to design courses adhering to the following recommendations, whenever possible:

  • Athletic stadium shape, to avoid rectangular and 180 degree turns.
  • Loop length between 2000 and 2500 metres.
  • Varying running directions, or counterclockwise if only one-way allowed.

Reasons to run in a counterclowise direction are varied, but they are in accordance with recommendations from World Athletics, that in its IAAF Rule 163.1 says: “The direction of running shall be left-hand inside”.

Don´t forget these recommendations and good luck in your ultra-running races!



Right Knee-The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study. Gajda R, Walasek P, Jarmuszewski M. Int J Environ Res Public Health. 2020; 17(16): E5955. doi:10.3390/ijerph17165955

The loop on which 24‐h ultramarathon run took place

Leave a Reply

Your email address will not be published.