Drowning, dehydration and heart attacks. Are we taking ultra fitness too far?

‘I found myself being attacked by an ostrich once. I also saw someone almost die in front of me in a river in Panama, because he was dehydrating. He was telling me; “tell my wife I love her”, it was horrible.’

These are the words of Allie Bailey, an endurance runner with more than 200 marathons and ultra-marathons under her belt. She once watched a friend on a 100-mile race stagger under a bush to put all her clothes on despite the fact that the temperature was 38 degrees. Confusion is a symptom of heat stroke. 

Despite these tales, Allie, 42, insists endurance racing isn’t dangerous. In fact, she argues, we take greater risks every day, just getting in the car to go to the shops. 

But there is no denying that ultramarathon runners and triathletes are exposed to a myriad of risks; bike collisions, falling off mountains, drowning in lakes – or the body just giving up amidst the extreme conditions. 

Runner Sabrina Pace-Humphreys found herself clinging onto the edge of a mountain as her fingers froze and her arms weakened, pleading for her life and regretting taking part in an alpine mountain race in France in 2019. 

‘It was one of the first mountain runs I had done. I had trained for it and I was really enjoying myself, I felt strong. But I was traversing a very narrow snow-covered path and one of my legs just slipped,’ she tells Metro. 

‘As I held on, I screamed until I was hoarse and I begged for help. The snow was melting in my hands and I was losing my footing. I was hanging on by my fingernails.’ 

Beneath her was a 200-meter near-vertical drop, and Sabrina found herself thinking of her family and wishing she were at home. 

‘It was terrifying. Nothing like that had ever happened to me before. I was probably only there for five minutes but it felt like forever.’ 

Meanwhile, runners above passed the 46-year-old mother of four, as she contemplated death. 

‘Five male runners went past me as If I was invisible,’ the running coach and personal trainer recalls. ‘I knew I couldn’t hold on much longer and no-one was going to help me. I was saying goodbye to my children and my husband – and then the sixth runner reached out and pulled me up with all of his might and he saved my life.’

Accidents are common in endurance events, and Sabrina knew she was lucky that her name wasn’t added to the growing list of people who lost their lives in the elements. 

A runner died at a Vietnamese ultramarathon in March this year, while two men died at an Ironman in Cork last year. In May 2021, 21 ultrarunners were killed at an event in Gansu, China, as high winds and freezing rain hit participants in the 60-mile ultramarathon.

The majority of Ironman deaths happen in the water. But alongside drowning, causes of death of competitors in extreme triathlons over the past twenty years make for grim reading.

Listed online are seizure, heart attack, acute dehydration and hypoglycaemia, multiple organ failure, bike accident or collision and ‘being found unresponsive in the water’ among other harrowing ends.

Athlete and consultant Brian Hanley has researched fatalities during extreme racing and alongside physiological problems and the ‘regular instances of cardiac death’ he lists accidents among the many risks. 

His research shows that since 1986, there have been 171 deaths during ironman competitions worldwide: 122 during the swim, 26 during the cycling section and eight deaths during the run and 12 deaths after – although this data was collected in 2021, so no doubt the actual figure will be higher. 

Brian, who splits his time between California and Idaho, says: ‘Getting kicked in the head in a mass swim start is common. Participants might also crash on cycling downhills when they get going fast. Or, on occasion, they can be hit by cars or trucks.

‘Rarely, an athlete in excellent condition pushes themselves beyond their capacit, however, a top finisher in the Kona Ironman [Hawaii] had to get emergency bowel surgery a week later because his body shut down blood flow to his intestines to keep going.’

A keen athlete and outdoor swimmer, Brian, 67, volunteers at races and has seen first hand the danger competitors put themselves in. He’s also experienced heat exhaustion during an event himself. 

‘One day was above 40 degrees. I was cycling and ran out of water. It was very hot, with no wind. I felt my body change, and recognised what was happening,’ he remembers. ‘I was 12km to the nearest town. I slowed down, but didn’t stop. I knew that stopping out there was a quite possible ticket to dying. You feel it. The body knows and I had studied how people died of heat stroke. 

‘The problem is that if you stop and sit or lie down, the ground is hotter. The pavement was probably 55 degrees, which is deadly. Go down on the ground and you can cook. I slowed to as easy a pace as I could manage without falling over. That kept a self-made light breeze going. You get into an endless time space. A long time later I saw a bookshop. I went in, and lay down to one side of the entrance to cool off in the air conditioning. I felt the after effects for around a month.’ 

Brian urges people to train properly and be ‘intelligent’ about competitions. 

‘Be smart about heat stroke, hydrate and maintain electrolytes’, he advises.

For Keith Boyd, the point of ultra running is that it is so difficult. The 57-year-old ultra runner holds the world record for running from Cape Town, South Africa, to Cairo, Egypt in the fastest time, facing off kidnapping attempts and the ravages of war zones – although he was unharmed.

Keith was drawn to triathlon because the race provides a more balanced workout as you master the many muscle groups involved in swimming, cycling and running.

He tells Metro.co.uk: ‘Ironman races are meant to be tough. If the sea throws some waves and extra swells up on the day of the race, that’s the way it’s meant to be.

‘I sign up for Ironman events as it gives me a difficult fitness goal to aim for over a few months. You know that there can be no excuses to miss out on your training each week, as, if you do, on race day you will be in enormous difficulty, and possibly not even finish. On shorter course events, and even running a marathon, you can skip training days and still finish on race day. With Ironman, you cannot. There is no place for excuses.’

Seasoned runner Sabrina, who took on the Sahara Desert’s Marathon des Sables – a six-day 250km event – eight years ago, argues that endurance racing is safe as long as you put in the training. 

She didn’t start running until her thirties, when the doctor advised it as a way to deal with postnatal depression. Since then Sabrina has suffered from blistered and bleeding feet (that she says were more painful than childbirth), nerve damage and running through the nights into ‘a different mental pain cave where there is nothing to look at’.

‘But as a peri-menopausal mum of four and grandmother, I am drawn to understanding what my body can do,’ she says. 

And for Sabrina, her terrifying accident on the mountain changed the path of her life. She finished the race and when she got back to the UK she set up charity Black Trail Runners to increase diversity in the sport because: ‘I couldn’t help but feel that had I been a white, blond haired, blue eyed woman, I may have got help quicker while hanging on that ledge.’ 

Meanwhile Allie maintains that we face far greater risks in the everyday. A recovering alcoholic; she used to drink two bottles of wine before a 100-mile race, dubbing it ‘sports wine’ before giving up drinking.

The endurance runner, coach and author says: ‘My recovery from addiction and depression came from those hills; being exposed to nature, problem solving and mindfulness.’

Allie, from Leeds, who has run more than 200 marathons since she started running 14 years ago, explains: ‘We live in a world where we never have the time with our own thoughts. We distract ourselves in any way we possibly can using our phones mainly, with music, podcasts, Instagram, or whatever. 

‘When you go and do something like an ultra marathon, having that time by yourself in nature, and really having to look after yourself and problem solve creates confidence that you won’t get anywhere else.’

She adds that ultramarathons provide a safe environment in which to test yourself, because you’re being looked after by the race company – her friends with heat stroke and hypothermia were ‘absolutely fine’ because they were quickly taken care of by medics. If she falls on a route, a tracker will alert those who need to help her. 

After a race, Allie, author of There Is No Wall, will have a short burst of euphoria, followed by a few days of depression. But when she comes out of it she has a renewed sense of pride in her achievements. And any risks are far outweighed by the benefits, she adds. 

‘I know one person who died at an event in Patagonia from a catastrophic head injury that was an accident with a bike. I don’t know anyone that has died from anything heat-related. But I know loads of people who have killed themselves from depression or who have been killed in car crashes. And people die from obesity every single day.

‘Ultramarathons give you such confidence and tangible evidence that you can do hard stuff. It makes you fit physically and mentally and that has an impact on every single other area of your life; relationships, profession, because if you have the tools to get you through a really hard endurance run, you have the tools to do anything.

‘Doing an endurance sport; the last thing it is is dangerous. It gives you confidence, it empowers you and it changes your life in a really good way.’ 

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