Going to extremes: Doctoring desert runners

A Seattle physician lends a hand to make sure adventure racers stay the course without injury.

By Bonnie Booth, AMNews correspondent. Feb. 18, 2008.

What would possess someone to run 150 miles across four of the world's most formidable deserts in the span of eight months?

That's the question Brian Krabak, MD, hopes to answer with the help of the approximately 100 racers who participate in the annual 4 Deserts -- a series of seven-day races across deserts that are among the hottest, driest, windiest and coldest places in the world.

Dr. Krabak has been medical director for six races -- the most recent in Antarctica in 2007. He has amassed data about injury rates and illnesses and questioned racers about their techniques for rehabilitation and fueling up for the different legs of the race, some of which top 50 miles a day.

Dr. Krabak is planning to submit his research for publication in a couple of months and wants to use the information to counsel extreme-sport athletes on their risk of injury and how to avoid harm.

"If a racer can make it to day five, he or she likely will finish," said Dr. Krabak, an associate clinical professor of orthopedics and sports medicine at the University of Washington and Children's Hospital in Seattle. "The medical incidents usually come in the first couple of days. A racer can't adjust to the climate and just doesn't make it through."

Ideally, racers need two weeks to give their bodies time to acclimate to the conditions of each race location. But most runners come in just two days before the race starts.

The most common medical issues tend to be dehydration and skin infections. Frequent injuries are muscular strains and -- not surprisingly -- foot blisters. Lots of them.