Ten Marathons in Ten Days: Effects on Biochemical Parameters and Redox Balance – Case Report

768-km Multi-Stage Ultra-Trail Case Study-Muscle Damage, Biochemical Alterations and Strength Loss on Lower Limbs

A series of case studies aimed to evaluate muscular fatigue in running a 768-km ultra-trail race in 11 days. Four non-professional athletes (four males) were enrolled. Muscle damage blood biomarkers (creatine kinase (CK), lactodeshydrogenase (LDH), aspartate transaminase (AST) and alanine aminotransferase (ALT) and lower limb strength were evaluated by using Bosco jumps test; squat jump (SJ), countermovement jump (CMJ) and Abalakov jump (ABA) were assessed before (pre), after the race (post) and for two and nine days during the recovery period (rec2 and rec9), respectively. Results showed: pre-post SJ = −28%, CMJ = −36% and ABA = −21%. Values returned to basal during rec9: SJ = −1%, CMJ = −2% or even exceeded pre-values ABA = +3%. On the contrary, muscle damage blood biomarkers values increased at post; CK = +888%, LDH = +172%, AST = +167% and ALT = +159% and the values returned gradually to baseline at rec9 except for AST = +226% and ALT = +103% which remained higher. Nonparametric bivariate Spearman’s test showed strong correlations (Rs ≥ 0.8) between some jumps and muscle damage biomarkers at post (SJ-LDH Rs = 0.80, SJ-AST Rs = 0.8, ABA-LD H Rs = 0.80 and ABA-AST Rs = 0.80), at rec2 (SJ-CK Rs = 0.80 and SJ-ALT Rs = 0.80) and even during rec9 (ABA-CK). Similarly, some parameters such as accumulated elevation and training volume showed a strong correlation with LDH values after finishing the ultra-trail race. The alteration induced by completing an ultra-trail event in the muscle affects lower limb strength and may in some circumstances result in serious medical conditions including post- exertional rhabdomyolysis.

Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report

A case study involving a healthy trained male athlete who completed a 786 km multi-stage ultra-trail race. Several markers were analyzed in blood and urine samples: creatinine (SCR) for kidney damage, sodium ([Na⁺]) for hyponatremia, creatine kinase (CK) for exertional rhabdomyolysis, as well as other hematological values. Samples were taken before and after the race and during the recovery period (days 2 and 9 after the race). Results showed: SCR = 1.13 mg/dl, [Na⁺] =139 mmol/l and CK = 1.099 UI/l. Criteria for the determination of acute kidney damage were not met, and [Na+] concentration was above 135 mEq/L, indicating the absence of hyponatremia. Exertional rhabdomyolysis was suffered by the athlete (baseline CK increased fivefold), though this situation was reverted after 9 days of recovery. Ultra-trail races cause biochemical changes in athletes, which should be known about by healthcare professionals.