15 November 2013

To Do Not Finish (DNF) or Not?

I have not yet experienced a Did Not Finish (DNF) in an ultramarathon race. On the contrary, I quite often quit races in my previous life when I was competing in shorter 10K, half-marathon and trail runs. The reason for the DNFs was always that I during the run realized that I would not reach my time goal and therefore could not motive myself to continue to suffer the requested pain to complete the race with a good time. I also saw no reason just to jog to the finish line to get a medal for completion. This is clearly different from ultramarathons were my primary goal always has been to just complete the race within the time limits. And, I have so far not even been close to not meeting the cut-off times, probably as I mostly have been running in races with generous ones. I think not meeting the cut-off times is one of the major reasons for DNFs in ultramarathons, looking at the number of participants in most 100 miles and longer races who complete the race close to the final cut-off there is not much margin for the inevitable lows that always occurs during such a long race before a DNF is occurring. I usually start my ultras to fast and even though it will make me suffer more during the latter part of the race and I probably loose time I am usually way before the cut-off times already at the beginning of the race. I have recently read some excellent blog posts about DNFs, in particular Andy Cole´s at his blog “Running Late” ,  James Adam’s at his blog “Running and Stuff – When going through hell keep blogging” , Sam Robson’s at his blog “One Foot in Front of the Other” and Kevin O'Rourke’s at his blog “Ultra Kev's thoughts on Ultra Running”  and I will in this post briefly summarize those thoughts and my own.

That I have not DNF’d an ultra yet does not mean that I have not thought about dropping out during the races – it is constantly there luring as a quick way out. To me, however, a DNF when the goal is to finish the race is really a four letter word. Finishing an ultra is to me over 90% mentally how to embrace and endure pain and discomfort in all sorts of varieties and to DNF,  if it is not physically impossible to finish due to a serious acute injury or medical emergency like a fall or similar, would be to fail completely. I think it much better, and safer, to Do Not Start (DNS) if you have any risk of getting a physical injury during the race making a DNF a necessity. Once over the starting line it really is all about getting back over the finish line. Period. I do not want to be sitting on the “death bus” back to the finish after a DNF feeling like a MTFU just because I had a bad day. The statement “Pain is temporary, quitting is forever” is truth.

On the other hand I think having a “Better Dead than DNF” mentality in absurdum is a sign of real stupidity and immaturity. To continue a race when there is a real risk for physical impairment and even death is like making a summit climb of a high mountain without thinking about the safe descent, or to put it in Ed Viestur’s words “Getting to the top is optional. Getting down is mandatory”.  At Tor des Géants it was close that I did not get down but instead had stumbled into oblivion when I fell asleep running on the small single-track traversing on a steep ridge the last night of the race. In the sleep deprived state I was in I did not act rational and did not take the right decision to stay in a refugio and sleep for a couple of hours - I would still have finished on a really good time and certainly within the cut-off time limits. Earlier during TDG I had periods of excruciating pain, so severe that thoughts of DNF also entered my mind, in my right knee, my Achilles tendons and in my feet, but these episodes were transient lasting for a couple of hours before improving, with the exception of the pain from my foot blisters and no one has to my knowledge ever died from acute blisters.
The finisher fleece from TDG - it would have been sad to not receive it
Another common reason to DNF is stomach issues and I have had my share of that as well. Proper nutrition and hydration are paramount during a long race and some have even said that “A 100 mile race is an eating contest with a bit of running thrown in”.  When running a short 50 miles ultra called Black River Run 2012 I got nausea and started vomiting after only 20 miles. I refer it to intolerance to the sport drink Perpetuem from Hammer Nutrition, which I had never tried before, and now never will again. The cut-off times were extremely generous, and I could jog and walk to the finish line while I continued to vomit. I guess you are not dying from emesis either. I have felt nauseated also at other races, but always been able to run through the feeling with just a period when I ate less and stuck to water or Coke to drink. When running in rain I make sure my stomach is not getting cold from the outside, something I have discovered can make me feel bad.

There are a number of scientific demographic studies looking at the reasons why runners DNF ultramarathons and the demographic characteristics of finishers versus non-finishers. Wegelin and Hoffman looked at finishers and non-finishers of 3956 individual runners between 1986 and 2007 in Western States Endurance Run, perhaps the most classic 100-mile (161 kilometers) race (Wegelin & Hoffman. Variables associated with odds of finishing and finish time in a 161-km ultramarathon. Eur J Appl Physiol 2011; 111: 145-153). The race was also until 2008 the largest 100-mile race in the US and accounted around 20% of all 161-km ultramarathon finishes in North America. Average annual finish rates at the WSER have ranged from 51 to 80% since 1986 (Hoffman and Wegelin 2009). Factors found to be associated with an enhanced likelihood of finishing the WSER included being a first-time starter, and advancing calendar years, i.e. there were more finishers in 2007 than in 1986 (probably due to the fact that first-time runners had increased exposure to other ultramarathons before starting WSER in 2007 than in 1986), for first-timers and those who had finished at least 75% of their previous starts. Factors that were associated with a lower likelihood of finishing the WSER included advancing age above 38 years and increasing ambient temperature. Women and men under 38 years were equally likely to finish, but beyond 38 years women had a lower likelihood of finishing than men. Furthermore, advancing age between 38 and 50 years decreased the odds of finishing at a more rapid rate among women compared with men. While higher ambient temperature was associated with a reduced probability of finishing, there was no evidence that the higher temperatures affected the likelihood of finishing differently for men and women.

From Wegelin & Hoffman 2011

From Wegelin & Hoffman 2011
The finding by Wegelin and Hoffman that advancing age beyond 38 years is associated with lower probability of finishing the race has also been found in a small study of the 1989 Leadville Trail 100 by Siguaw (Finishing and racing 100 miles: a statistical analysis. Ultrarunning 1990; 9: 22–23). Wegelin and Hoffman hypothesize that these findings are due to an increasing difficulty at meeting check point cutoff times with aging, and that this issue is more important for women given that they are slower than men on the average. Other studies discussing the age-related decline in endurance performance is for instance the study by Knechtle and colleagues of the 100-km race Lauf Biel in Switzerland (Age-related changes in 100-km ultra-marathon running performance. Age 2012; 34: 1033-1045) and Rüst and colleages of 78 km Swiss Alpine Marathon (Finisher and performance trends in female and male mountain ultramarathoners by age group. Finisher and performance trends in female and male mountain ultramarathoners by age group. Int J Gen Med. 2013; 6: 707–718). In these studie the decline in race performance were found to be at a later age than in the study by Wegelin and Hoffman, and the differences between males and females were also found to be less pronounced, in particular over time. The same research group has also found similar results in the multistage Marathon des Sables, covering 240 km in the Moroccan desert, with improved performance of older “master runners” over 35 years of age in recent years (Jampen et al. Increase in finishers and improvement of performance of masters runners in the Marathon des Sables. Int J Gen Med. 2013; 6: 427-38 and Knoth et al. Participation and performance trends in multistage ultramarathons—the ‘Marathon des Sables’ 2003–2012. Extrem Physiol Med. 2012; 1: 13.). Similar findings were also found by the same research group at University of Zürich in a large analysis of 39,664 finishers of 24-hour ultramarathons, where runners aged >40 years actually achieved the fastest running speeds (Zingg et al. Master runners dominate 24-h ultramarathons
worldwide—a retrospective data analysis from 1998 to 2011. Extreme Physiology & Medicine 2013; 2: 21), and in another study analyzing age and performance of finishers in the Jungfrau mountain marathon and Lausanne flat city marathon (Zingg et al. Reduced performance difference between sexes in master mountain and city marathon running. Int J Gen Med. 2013; 6: 267–275.), where female master runners aged 35–54 years reduced sex differences in their performance in both mountain and city marathon running. There is clearly a need for more studies of this controversial issue.

In summary, I think there are clear legitimate and good reasons to DNF mountain ultramarathons, however, with proper preparations and respect for the environment and current weather conditions I think most DNFs can be turned into DNS or avoided altogether. As I am aging, and if I continue to run ultramarathons, I expect to be closer to the cut-off timelines and thus the likelihood of DNF will increase. Still, however, I am improving my race times on both short 10-k runs (where I am now under 40 minutes) and longer ultras and hope to do so for some more years. I know this is a controversial subject – what are your thoughts? Is a DNF now and then OK or should it be avoided?

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