Medical Information

Medical Advice & Guidance for Competitors

Competitor Responsibility Prior to Entering

By entering one of our events we presume that you already have a good level of fitness and experience and that your current medical state and history are all in good order. We recommend that all competitors visit their GP in the weeks prior to the event and complete a general health check, for the sake of a 30 minute appointment it will give you reassurance and it will also inform your GP of the activities you participate in, thereby allowing them to keep more accurate records. If your past medical history includes blood pressure, cardiovascular, cardiopulmonary or any other serious health problems YOU MUST visit your GP in advance to inform him of the challenge.

If you are taking any form of medication YOU MUST visit your GP in advance and check that there are no potential side-effects which will lead to problems during the event.

All our events are physically challenging and should not be undertaken without significant thought, planning and preparation. It’s unlikely that you will be able to complete the event if you are starting with illness or injury, so if you should develop any kind of injury or illness in the weeks preceding the event, don’t take the risk.


When you register online you will be asked to provide information about any medical condition or information that may be relevant in dealing with an incident during the event. This should include allergies, medication, any recent illness or injury that has resulted in you needing medical treatment. This information will be treated as confidential. Please also remember to record any medical information on the rear of your race number.

During the race

Our event medical team will be in place at various points on the course and our checkpoint staff will be monitoring you as you pass through. They may ask you a few simple questions and ask you to sit down for a few moments, drink and eat something if they are concerned. Please listen to them and take their advice. You will be issued with a route card which contains a contact number for the event medical team - you can call  at any time during the event if you feel unwell or need advice between checkpoints.

Common injuries, illness & treatment

There are many common injuries and illnesses which you may suffer as a consequence of competing in extreme running events. This is a list of the most common and is not a definitive list, it has been compiled to raise your awareness of their occurrence.

Ibuprofen vs Paracetamol

Ibuprofen – one of a group of drugs known as Non-steroidal anti-inflammatory drugs (NSAIDs) which also include Naproxen, Aspirin and Indomethacin. NSAIDs are commonly used in sports medicine and have known anti-inflammatory, analgesic (pain relief), antipyretic (temperature reducing), and antithrombotic (clot reducing) effects.

NSAIDs analgesic action is not significantly greater than paracetamol for musculoskeletal injury but does have a higher risk profile, with side-effects including asthma exacerbation, gastrointestinal and kidney failure, amongst others. If you are on a very long race and require analgesia, Paracetamol is a safer drug.

For more advice or to discuss personal circumstances, please speak to our medical team or your own doctor before you race.

Foot care

Something as simple as lack of foot care may well cause you to drop out of the event. Blisters can cause extreme pain and make it impossible for you to run and walk and prevention is always better than any attempt to cure. Use trusted socks and shoes, especially over rough terrain which will cause shoe ‘twisting’ and increase the likelihood of blisters. If you blister easily consider pre- taping, plasters or Vaseline to reduce likelihood but do try these out in advance. Take a blister treatment pack with you and stop as soon as you feel the start of blisters rather than continuing to the next check point. Our medical team are foot specialists and will gladly help if you need treatment or advice during the event.

Sprains and strains

Uneven terrain increases likelihood of sprains and strains, especially when you are tired and travelling during the night. Wear correct footwear and ensure that they are fastened snug to remove excess movement. Most sprains and strains can be dealt with an ice pack, compression, rest and elevation.


It is possible that you may fall and the impact may cause trauma such as a broken bone or torn muscle. In this event you will be forced to withdraw but you should be prepared to self-treat as you may be several miles from the next checkpoint. Ensure that you have a first aid kit to include bandages and dressings and you also have sufficient clothing plus emergency blanket / bag to keep warm. If you are unable to move, ask the next competitor to inform the checkpoint marshal and / or use your mobile phone if you have reception to inform the emergency services - 999 / 112 and the  Extreme Energy team. Remember even if you have no signal you can ring the emergency service, they can also triangulate your position through your mobile phone.


During periods of warm weather or increased activity, there is an increased risk of dehydration for all competitors and you should ensure that you drink regularly (guided by your thirst) to prevent its occurrence. There will be water available at all check points, carry a water bottle or similar between checkpoints to keep yourself topped up. Dehydration results in lowered blood pressure, increased heart rate and raised body temperature which can all lead to a decrease in performance.

Signs of dehydration are:

  • Drawn looking appearance
  • Pale / pasty skin
  • Difficult to find pulse
  • Very rapid pulse
  • Dizziness, weakness and confusion

The treatment for dehydration is rest and drinking fluids, re-hydration should take place slowly as opposed to drinking large amounts within a short time


Hypothermia is a reduction in body temperature caused by poor weather conditions and general fatigue. Heat is generated within the body through metabolism as a waste product of energy production. If energy production drops due to factors such as low blood sugar, then body temperature may also drop. One of the biggest factors which contribute to hypothermia is wind chill, most prominent on higher ground.

Sitting around for extended periods in cold/wet clothing is also a risk, especially at checkpoints. Keep out of the wind and consider additional dry/warm clothing if taking a break.

Signs of hypothermia:

  • incoherent speech
  • shivering
  • slow and weak pulse

Treatment includes warming up as soon as possible by removing the affected person from wind chill, changing into dry clothes, raising blood sugar and drinking warm fluids.

If your question has not been answered here please contact us with your enquiry.

Our Upcoming Events

  • 25Feb 2017

    UTMBŪ Races Seminar

    UTMB® Seminar 2017 - Helping you succeed in the Alps One Day, five incredible speakers, helping you to succeed with ultra running in the toughest conditions! The XNRG UTMB® Races Seminar aims to share as much information as possible from experienced UTMB® competitors to enable more people to complete the event. If you're entered into any of the UTMB® races – UTMB®, TDS®, CCC®, ...
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  • 11Mar 2017

    Humanity Direct Amersham Ultra

    Entries are now open for the free to enter ultra on 11th March! 31 miles, 1 day. To enter donate your entry fee or pledge to raise funds for this vital cause. Humanity Direct Ultra Be a part of this unique chance to get a place on an amazing one day ultra simply by donating or fundraising for a Humanity Direct patient instead of paying an entry free! After a successful Humanity Direct Ultra in ...
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  • 29Apr 2017

    The South Downs Way Devil's Challenge 2017- Sealskinz Ultra Trail Series

    We are thrilled to announce a brand new extreme challenge for 2017 - the XNRG Devil's Challenge, a multistage race along the South Downs Way. The three-day 97 mile route passes the legendary Devil's Dyke, a spectacular 100 metre deep valley. The point-to-point route starts in Winchester in Hants and heads South East through the stunning South Downs National Park, finishing in Eastbourne in East ...
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  • 17Jun 2017

    Alps Ultra Training Week

    ALPS ULTRA TRAINING WEEK 17th – 24th June 2017 Come and join the Extreme Energy team for an all-inclusive alpine ultra run/walking training week. Objective The objective of the week is to prepare those people who are taking part in the UTMB®, TDS®, CCC®, OCC® or as an opportunity to spend a week, running, walking and enjoying the stunning French Alps. “To compete in the Alps you have to train in the ...
    Book Now View all events How to prepare