Running Emergencies

Running in the Philippines is a challenge. PUV and private vehicles swerving left and right. Cars, motorcycles and bicycles threaten each runners safety during training and especially during races.

Registration for any race includes a waiver of fitness which includes that organizers are not liable for injuries incurred during the race. This means runners should pay more attention to the environment to lessen the chances of injury or accidents.

Most running emergencies are avoidable if runners take extra precaution during runs. Never assume that motorists can clearly see you especially during early hours. It may even be advisable to assume that motorists can not see you running and take precautionary measures to avoid accidents. Run against traffic. Wear bright clothing. These are some rules runners follow to avoid accidents. Running emergencies can occur before, during and after runs. These situations are not necessarily life-threatening however will need urgent attention. I will enumerate and categorize some of the emergencies encountered during runs and provide runners with tips on how to avoid them or, if needed, treat them.

PRE-RACE EMERGENCIES 
1. Potty Time. Some runners get anxious and go to the comfort room more often. Some to pee but others to move their bowels. REMEDY: Avoid drinking too much coffee before races. Avoid eating too much fiber a day prior to the race. Never over hydrate hours prior to a race. Hydrate the day before. Avoid carbo loading the day prior to a race.

RACE EMERGENCIES 
 1. Vehicular Accidents. Once hit by a motorist, always check the areas of impact for bleeding or fractures. Stand or walk after hits in the leg. If unable to stand/walk or pain too severe, DO NOT finish the race and ask other runners for help. Ask for hospital transportation and have a complete evaluation by an emergency Doctor. Never attempt to correct or move fractured bones to prevent additional injury. Keep fractured bones fixed and unmovable using braces. If impact site is bleeding, apply firm pressure on the area and go to nearest hospital for evaluation. 

2. Dizziness / Vertigo or Nausea. Overexertion or undertrained runners sometimes feel lightheaded, dizzy or nauseated during runs. This can be caused by many factors. Lack of rest, hypoglycemia, hypoxia are common. Hypoglycemia can be avoided by not running on a completely fast state (no meals 10-12 hours before a race). Eat a slice of bread or a banana an hour prior to a race to provide energy during races. Hypoxia rarely occurs unless running in high / elevated areas or not breathing enough during runs. Sleep at least 6-8 hours prior to races (although some runners, myself included, still manage to run marathons despite sleeping only 2-4 hours). Uncommon causes include heart problems or hypertensive emergencies. Heart attacks, although commonly present with chest pain, can cause lack of blood supply to the brain and cause dizziness or vertigo. Blood pressure (BP) elevations are normal during runs but uncontrolled hypertension may cause BP elevations to as high as 210/120 mmHg. This can present with chest pain, numbness on any extremity, dizziness, vertigo and nausea. Although Heatstroke can also cause dizziness and vertigo this is not common among shorter races. Wearing appropriate running apparel (singlet, shorts and cap) and adequate hydration help prevent this emergency. 

3. Abdominal Pains. Runners sometimes feel abdominal pain during  runs. It usually occurs at the right side beneath the chest or above the hips. These are commonly due to muscles spasms or lack of blood supply to the gastrointestinal tract (stomach to intestines). If caused by muscles spasms from the chest muscles or abdominal muscles, slow down and maintain a comfortable pace. Use slow, controlled shallow breaths until muscle spasms resolve. Abdominal pain can also be caused by running after a full meal. Blood preferentially goes to the muscles when running depriving the gastrointestinal organs  of adequate perfusion. Avoid running after a full meal. 

4. Cramps and Joint pains. Muscle cramps during races can be caused by multiple factors. Commonly, it is caused by unprepared or unconditioned muscles due to lack of training. Electrolyte imbalance and dehydration can also cause muscle cramps. When cramps occur, slow down or stop running, press the muscle for a few seconds then slowly stretch. Avoid overstretching because this can cause the muscles to "Lock-up". Joint pains during runs can be caused by poor technique or inappropriate running shoes. 

POST-RACE EMERGENCIES 
1. Fainting / Loss of consciousness. Leg muscles need increased amounts of blood during runs. Blood vessels in the leg dilate and increase blood flow to the exercising muscles. When runners abruptly stop and sit after completing a race, extra amounts of blood in the legs do not recirculate and cause reduced blood flow to the brain. This causes the fainting, dizziness or vertigo after runs when a runner sits and relaxes without stretching or walking to cool down. Fainting can also be caused by hypoglycemia when energy has been depleted after a run. This can be avoided by eating or drinking carbs after a run (bread or juice). More serious causes of fainting includes heart attacks and hypertensive emergencies. Emergency Personnel should be available during races to provide aid to runners who faint. Pulses and blood pressures are checked. If faint or thready, immediate hospitalization is warranted. 

2. Tea-colored Urine. Rehydration after a race or run is vital. Dehydration can cause reduced blood flow to the kidneys and cause acute renal injury. This condition manifests as highly concentrated or sometimes tea-colored urine. When this occurs, hospitalization for intravenous rehydration is advised to avoid permanent kidney damage. Avoid dehydration by drinking water frequently during runs. Thirst is not a reliable sign of hydration while running. It occurs when dehydration has already set in.

Always aim for a SAFE and INJURY-FREE Run.