The UTMB® and Health issues by Nathalie Ecuer

WORLD SUMMIT OF TRAIL-RUNNINg

22-28 AUGUST 2016 5 races

PARTENAIRES ULTRA

around mont-blanc

The UTMB and HEALTH issues

3 countries on the route, 7500 runners, 87 NATIONS

www.utmbmontblanc.com

Press file - The UTMB® and HEALTH issues

The 2016 UTMB® at the service of science and good health More than just a simple race, the UTMB® is an event which is committed to creating strong links with ALL the players: the runners originating from 87 different countries, the 2 000 volunteers, the 19 communes through which the race passes, the partners, the service providers, the media, the runners and their supporters, including those who have not travelled to the event and who follow via the internet... A same story of passion and emotions shared by everybody, throughout each year for fourteen years. The stakes for the organisation are to stay on course, keeping the human values, which have gathered all the players together since the beginning, intact. Equity, respect for the environment, respect for others and oneself, solidarity, fair-play and lucidity : so many values which are dear to us and which we wish to share. Over and beyond a simple sporting event, the UTMB® is a true human adventure open to the world and to diversity. As a pioneer, renowned in the international trail-running domain, the UTMB® is always ready to « explore », by becoming a « great outdoor laboratory » at the service of varying domains like the environment, information technology, health or valorising the Mont-Blanc country. Like sailing, triathlon, cycling, adventurous trips, ski-mountaineering..., ultra-running is a sport which demands extreme effort from the body. That is why the UTMB®, very committed to its health policy - and all actions which can be linked to the prevention and protection of the good health of sports-persons -, is a true research laboratory for ultra-endurance sports. The UTMB® this, its fourteenth, year is welcoming the 3rd International Medicine and Science in Endurance Sports Conference, August 21st - 23rd. At the same time, with the International Trail-Running Association and the Foundation of Ultra Sport science, the UTMB® is participating in the « QUARTZ » programme : an innovative approach to anti-doping and the good health of athletes.

The UTMB®'s engagement to good health Since its first year in 2003, the UTMB® has been highly involved with health matters and security in order top preserve the values of solidarity, equity and the respect for the environment which are its driving forces.

The UTMB®'s medical commission Good health of runners is of priority for the organisation. Since 2007 a medical commission, comprising of members of the medical and paramedical corps, contribute, at the end of each full event, a report of the medical activity which took place during the event. This medical commission, actually chaired by Jean-Charles Rollier, orthopaedic surgeon and traumatologist, goes beyond the strict consideration of medical problems. It advises the UTMB® directors about medicalisation and on the organisation of the rescue and medical plan during the race and it advises runners in terms of their health. Analysis of the interventions and care given during an event helps the medical commission to put together an inventory of pathologies and problems encountered and to come up with research subjects or to research the pathophysiology of the effort made. One of the important roles of this commission is to validate, amongst the research studies, those which will be carried out during the UTMB®. Among the numerous studies already carried out are : the trail-running population and cardio-vascular risks, the pathologies shown during races, the causes of abandonment, self-medication, fatigue and high endurance and the recuperation problems, digestive problems, sleep management, addictive profiles, the effect of kinesio-taping, running with a protheses... All these studies help the development of simple advice which is adapted to the UTMB®'s environment, and which helps the runners in their practise of trail-running. This advice is published on the web-site at www.ultratrailmb.com.

Press file - The UTMB® and HEALTH issues

Preventative actions concerning health matters and the medical counsel The UTMB® has, since 2008, led a preventative action concerning health matters so that the races take place as equably and ethically as possible. A modest contribution from the runners, for the runners, and with vigilance so that the sport stays clean. Led in collaboration with Athletes for Transparency and the ITRA, this action has neither the vocation nor the competence to be a substitute for national and international regulations regarding anti-doping but aims to reinforce the medical supervision of the race which the Organisation wishes for. By registering for one of the UTMB® races each runner agrees to : 1) enter information relating to the use of a prescription which is subject to a Therapeutic Usage Exemption (TUE) on their ITRA health page 2) accept to give any samples requested by the Organisation's Medical Counsel (at the organisation's charge). Thereafter they will be able to access their analysis results on their personal ITRA health page. 3) accept to answer to any summons that the Medical Counsel may send them based on the medical information which concerns them in order to discuss their ability or not to take part in the race.

A health page for runners on the ITRA web-site (*) A « health page » is made freely available to runners by the ITRA on their web-site. This page helps to improve the following of medical concerns, and therefore the security of everybody, by supplying doctors present at the events with essential information. It allows space for medical certificates, information on any possible medicines, allergies and operations and also precious information in the case of a rescue such as a runner's blood group. The completion of their profile on their « health page », helps to associate a race-bid with a name and a profile: gaining sometimes vital time for the chain of rescue workers who intervene on the ground. It also gives the names of the relevant people to be informed, if necessary. This « health page » contributes to the respecting of regulations in matters concerning anti-doping, notable by declaring the famous TUE (Therapeutic Usage Exemptions). (*) International Trail-Running Association

The latest studies carried out in 2015 on runners who volunteered 1) A study on the prevention of hyponatremia during effort :

During an event of ultra-endurance, runners experience significant dehydration with a high loss of salt. This phenomena is known by all and the major risk is hyponatremia linked to effort could lead, in extreme cases, to a cerebral edema. The aims of the study : - To evaluate the impact of natremia with a protocol of hydration “when thirsty”, that is drinking water only upon the sensation of thirst, compared to other usual methods of hydration. The first results of this study have led Dr Jean-Luc LE MASLE-LASTIOLAS to come to the following conclusion : soon

2) A study on the runners with a prosthesis of the hip or knee :

Doctors have noticed an increase in the number of patients taking part in sporting activities with their prosthesis of the hip or knee without being able to measure the precise scale or consequences . The aims of the study : - To define specific training programmes. - To know the eventual limits. - To continue to improve the surgical techniques so as to favour participation in sports with a joint replacement.

3) A study on sleep and vigilance :

Initiated in 2013 and 2014, this study carries on : tests of vigilance before the start, during the race and at the finish. The aims of the study : - To understand better from what moment the loss of vigilance appears and to what extent it can manifest itself. - To formulate invaluable advice relative to sleep, the preceding days and during the race, to improve the vigilance of the runners and thus their safety, as well as their performance. More studies at http://utmbmontblanc.com/fr/page/60/Commission.html

Press file - The UTMB® and HEALTH issues

The UTMB®, opinion leader and an "accelerator" of the evolution of the discipline of trail-running at the international level. History

2003

1st UTMB®

2007

Setting up of the Medical Commission UTMB®'s and realisation if the first research projects

2008

The UTMB® breaks new ground with « Athletes For Transparency » ; it asks runners to voluntarily supply TUEs and to accept to having blood, capillary or other samples taken by the organisation's doctor before the race.

2009

Following an accident at the Mercantour, the UTMB® was invited by the FFA to take part with Dokever in establishing regulations designated for trail-running.

2011

The start of the collaboration for international research between Marty Hoffman (WSER 100 Miles) and Patrick Basset, the UTMB® 's medical director

2012

1st International trail-running conference in September

2013

Creation of the ITRA in July

2014

1st scientific document produced by 10 international trail-running doctors about on-foot ultra-endurance races

2015

Creation of the health page for runners (free service) http://itra.run/page/261/Politique_sante.html Creation of the health platform SHOL(*) in the framework of the ITRA's health policy (realised by Athletes for Transparency) allowing organisers operating a health policy in partnership with the ITRA, to study via their medical counsel the information supplied by the runners on their health pages and to complete their race participants' medical profiles with the results of the analyses realised from samples given The IAAF validates a new sport, trail-running, in Article 252 of its competition regulations

2016

Launch by the ITRA of a programme to monitor sports-persons of a high calibre « Quartz » (powered by AthletesFor Transparency) http://media.wix.com/ugd/63ade2_4798fa8e89a447b2975674e690bdf351.pdf 3 doctors create an endowment fund Ultra Sport Science

(*) : (Sport and Health On Line)

Press file - The UTMB® and HEALTH issues

The International Trail-Running Association's health policy The term « health policy » refers to the actions which aim at increasing preventative measures and the protection of the good health of sportspersons.

A health policy for runners… A « health page » is made freely available to runners by the International Trail-Running Association (ITRA) on its website. This page contributes to the improvement of the medical follow-up, and thus the safety of each, by supplying up to date essential information to the doctors present at events. It allows space for medical certificates, information on any possible medicines, allergies and operations and also precious information in the case of a rescue such as a runner's blood group. By completing their profile in the « health page », it associates a race-bib number to a name and a profile : gaining sometimes vital time for all the chain of rescue workers who intervene on the ground. It also gives the name of people to be contacted if necessary. This « health page » contributes to the respecting of the rules concerning anti-doping, notably by declaring the famous TUEs (Therapeutic Usage Exemptions)

…And for the organisers They may, with the ITRA, strengthen their medical surveillance of participants during their event. The ITRA offers to accompany event organisers, who are members of the association, in the implementation of a health policy. This allows contribution to the standardisation of the regulations on aspects connected to the good health of the participants and to favour information sharing between event organisers. The « health page » is also a means of conserving a history of all treatments carried out by the medical teams. It records not only the treatments carried out on the spot during the event but also the results of the possible pre-race medical analyses managed by the organisers. Without being a substitution for existing federal regulations for matters concerning anti-doping, the ITRA suggests race organisers add preventative initiatives to their internal regulations.

Centralisation of information on the SHOL (Sport and Health On Line) platform Developed by the Association Athletes For Transparency (AFT) for the ITRA, this on-line IT platform allows :

Participants

to enter different information of a medical nature (medical certificates, declarations of Therapeutic Usage Exemptions (TUE), medical history, current treatments, etc.) and to keep them updated as and when according to their participation in events.

Event organisers

via their Medical Counsel, to study the information given and to complete their participants' medical profiles with the results of analyses carried out in situ. These centralised medical profiles facilitate the reading of the data by Medical Counsels which differ according to organisations The ITRA manages, in partnership with the organiser, the setting up in situ of biomedical analyses (blood and/or urinary and/or capillary) before the start of the race. These analyses, generally orientated towards « elite » runners, could concern all the participants. In the case of an abnormal result or based on information supplied by the runner, the procedure could go from simply informing a participant to race jury eventually excluding a runner from a race on medical grounds.

Press file - The UTMB® and HEALTH issues

The QUARTZ programme : an unique health study The association Athletes For Transparency (AFT) have, for ten years, collaborated with a group of institutional players, notably the World Anti-Doping Agency (WADA), the National Anti-Doping Organisations (NADO) and the International Sports Federations (IFS). The association AFT has a renowned expertise in the domain of health and the anti-doping battle. After the SHOL platform, the AFT was approached by the ITRA to help it set up an unique programme to follow the runners' health matters.

QUARTZ An important evolution for good health and the anti-doping battle Based of athletes volunteering, this pilot programme will be trialled for 6 months, from April until the end of October 2016, by the International Trail-Running Association. It is an unique study which will follow the state of health of the sportspersons, allowing for the revelation of a possible pathology or an abnormal profile in connection with doping. QUARTZ proposes to regularly verify athletes' general state of health, by carrying out different tests : sampling of blood, capillaries and urine. In total, there are more than 66 markers at a biological level which are verified, this corresponds to very elaborate analyses. One of the major evolution is that the sampling is not only realised by the ITRA during competitions but equally may be realised in an autonomous fashion by the athlete in a medical analysis laboratory of their choice, upon request of the ITRA and within a given period. The athlete simply has to : - State their personal doctor and trainer if they have one. - State their location (country/town) and their competition diary. - State their Therapeutic Usage Exemptions (TUE) - State the medicines that they use. - To comply to give all the blood, capillary or urine samples, requested by the ITRA, for analysis. In the framework of an approach of transparency, the runners have the possibility of making their computerised data public to show that everything is normal. This programme is free, costs are entirely covered by the ITRA. Based of the willingness of the athletes, this pilot study is aimed, particularly, at « elite athletes » whose ITRA performance index is superior to 850 for Men and 750 for Women. For budgetary reasons, « QUARTZ » can only include a maximum of 20 male athletes and 20 female athletes. The results of this study, which will end with the World Championships in Portugal at the end of October, will help to envisage in the longer term a future ITRA health policy at the level of elite athletes for those who wish to participate in races affiliated with the ITRA. QUARTZ does not have the authority to be a substitute for regulations in force at neither the level of the anti-doping battle nor at the level of the biological passport but comes as a supplement to what is already in place today, with a wider and more general vision. The deep evaluation of the health of sportspersons, allows for better understanding of the profile of each and apprehend their behaviour.

« QUARTZ » The name of this programme is a reference to the crystals of a translucid rock. Translucid like the transparency demonstrated by athletes, but who all have different aspects, just as each athlete's profile can be unique.

Press file - The UTMB® and HEALTH issues

The Foundation for Medicine & Science in Ultra-Endurance Sports : Research and education of ultra-health ! In 2014, ten doctors produced a first international scientific synthesis document listing the specific diseases of ultraendurance and running in difficult environments. From this analysis was born the idea of focusing on symptomatic diseases of ultra-endurance. « In this universe of running races, as in all sporting universes, runners go faster and faster over stages leading them from 10km to semi-marathons, then marathons and they are more and more numerous in discovering the new horizons in the natural environment which trail-running offers. The distances run get longer and the levels of ascent increase. This is the world of ultra-endurance, where to finish an Ultra becomes the objective which is going to require long months of training » confirms Patrick Basset The foundation Ultra Sports Science, created on March 5th 2016, accompanies all parties involved with ultra-endurance - sportspersons, organisers, researchers, federations, trainer, authorities – in improving the preservation of good health and the well-being of the athletes due to the assembly and financing of research projects. The results of these projects are available to all. The foundation, Ultra Sports Science, has an unique position at the crossroads of research, sport and health matters. The Foundation finances research and studies without slowing down the organisers and guarantees the projects like Quartz independence, development and equity. The purpose being to reproduce the expertise in running to other ultraendurance universes.

The three objectives of the foundation : - To collect funds to realise international medical research, said to be of public interest and have it validated by the prefecture. It involves supporting and leading any basic, or advanced, research by studying the problems of health matters and specific pathologies linked with ultra-endurance sport, in different environments and in particular in difficult situations. - To transmit the research results to sports persons, trainers, scientists, doctors and sporting federations via a message which everybody can understand. - To set up a health policy for better and longer practise and notably to avoid doping problems.

The 3 founders

Patrick BASSET : French doctor, anaesthetist-resuscitator . Mountain rescue doctor and medical director of Dokever, he is in charge of the largest sporting events in France, like the International Paris marathon, the phase of the Tour de France or even the UTMB®. Director of multiple theses of medicine in the universe of ultra-endurance sports , he likes supporting sports events out with stadiums. Dr. Marty HOFFMAN : Professor of Medicine and Physical Rehabilitation,ex research director for the Western States Endurance Race. He has published more than 120 scientific articles. His is a member of the American College of Sports Medicine and the Academy of Wilderness Medicine the latter of which he is editor in-chief. He has been nordic skier and a long distance runner for several years, he adores pushing his limits to the extreme. Dr Volker SCHEER is a UK trained GP and sports medicine physician at the Olympic Training centre in the University from Heidelberg, Germany. He is deputy director in the department of Sports and Science at the University of Paderborn, Germany, and also professor of Sports Medicine and Physiology. He has published several scientific articles on the impact of ultra-marathons on the body. He was a sprinter at international level and today runs for pleasure on all distances up to that of marathons.

The UTMB® supports the foundation

"The UTMB® supports the foundation because research must open itself up to the discipline globally. By its route and duration the UTMB® is concerned by Ultra Endurance and the extreme situations it experiences. We have chosen, since the start, to be a natural laboratory at the service of innovation whether it be medical, technological or environmental. We are and must remain players. Finally to support the foundation, helping the research which must be free and without partnership constraints but which requires important finances. With the foundation's agreement, the UTMB® as from this year is making available health race-bibs(*) which are going to profit the Foundation and invites all those who wish to do so to make a donation : http://ultrasportsscience.org. So that research remains to be a service for everybody !" Catherine Poletti

Press file - The UTMB® and HEALTH issues

The UTMB® is welcoming the 3rd International Conference on Medicine & Science in Ultra–Endurance Sport from 21st - 23rd August 2016, in Chamonix This annual conference was created in 2014 by Dr Marty Hoffman within the framework of the Western State Endurance Race. Its objective is to create a meeting between experts specialising in ultra-endurance, to make known the results of the most recent research and to transmit them to all players involved with Ultra-Endurance. This year, the third international conference on Medicine and Science in Ultra-Endurance Sport will be organised by the Foundation Ultra Science Sport and will take place August 21st - 23rd 2016 during the UTMB®, the « Summit of World trail-Running ».

Practical Information August 21st - 23rd 2016 AT THE HOTEL LE PRIEURÉ *** 149, Allée du Recteur Payot 74400 Chamonix Mont-Blanc France

Programme http://www.ultrasportsscience-congress2016.com/en/programme/preliminary For more information or registration, rendezvous at http://www.ultrasportsscience-congress2016.com

CONTACTS PRESS AGENCY : INFOCIMES Anne GERY La Joelianne -Le Vieux Servoz- 74 310 SERVOZ Tel : +33 (0)4 50 47 24 61- Fax : +33 (0)4 50 47 28 79 Mobile : +33 (0)6 12 03 68 95 - annegery@infocimes.com PHOTOS F.O.C .DOWNLOADABLE : www.ultratrailmb.com - (Login and pass-word supplied upon demand)

Organisation UTMB® UTMB® Catherine POLETTI Tel : +33 (0)4 50 53 47 51 Mobile : +33 (0)6 11 55 63 37 - catherine.poletti@autmb.com

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