In fact, fatal injuries sustained during obstacle races are rare. There have been two reported deaths: a man who drowned after jumping into ice-cold muddy water at a Tough Mudder event and a cardiac event sustained by a rescue worker at another. However, some physicians have questioned the safety of these extreme racing events. In a published case series of Tough Mudder participants treated at the Lehigh Valley Hospital in Allentown, Pennsylvania, the authors summarized participants’ diverse injuries requiring transport to the emergency department. The injuries ranged from moderate dehydration to contusions and dislocations to near syncope and electrical injuries.¹ Although the injuries were not excessive compared with other endurance competitions or military training exercises, the authors did “strongly encourage” participants to obtain sign-off from their physicians before enrolling in such competitions.

Benefits Outweigh Risks

Participants often cite the benefits of camaraderie and accomplishment that they gain from completing such courses. Trina Flores, 37, of Atascadero, California, began participating in mud runs five years ago after shedding 50 pounds. She has now completed 17 races and enjoys the fun and teamwork required to help others surmount obstacles. “I like mixing it up,” she said. “Doing marathon runs would be boring for me, and the part I like is that [mud runs] really push you out of the box.” Next spring, Dr. Mell will participate with two other emergency department colleagues from medical school in a GORUCK event, founded by a former Navy SEAL, which features running with 40 pounds of bricks in a rucksack and emphasizes team building through accomplishment of a mission.

Dr. Bose said part of his motivation for participating in the Spartan Super was to raise awareness for his nonprofit foundation, The Battle Continues (www.thebattlecontinues.org), which provides aid to wounded veterans and advocates for health care issues. (Dr. Bose is also a motivational speaker, applying lessons learned from combat as a template for surmounting other life challenges. Proceeds from corporate leadership lectures also go to injured veterans.)

Teamwork and Challenges

In November, Dr. Bose and his team will tackle the Spartan Beast, a 13-mile course with different obstacles. He has added another goal to his regimen. He is seven pull-ups shy of winning a pull-up competition. “I’m gonna try to nail those pull-ups!” he says. Beyond that, though, he believes there is a psychological benefit to embracing the challenges of extreme racing. “I think it’s inspirational when people push their limits,” he said. “Whether it’s a physical race or another obstacle, you can take that same skill set and apply it to other aspects of your life. I also think what our injured veterans or patients overcome is much more difficult than any extreme race.”

Reference

1. Greenberg MR, Kim PH, Duprey RT, et al. Unique obstacle race injuries at an extreme sports event: a case series. Ann Emerg Med. 2014;63:361-366.