Hearts and endurance runners

Odysseus

Hi all,

I'm not looking for medical advise as I have spoken to my GP and some of the GPs in work about this.

Basically I had to get a ECG done this for a race I'm doing at the end of the month. I'm an ultra runner which means I running very long distances up to 100km or long distances in desert environments.

The results of my ECG show my left ventrcal [sp] is enlarged, which is a result of what people like me do for fun. Basically I'm just trying to develop my understanding of this, so I was wondering if anyone had any readable refs or further knowledge on this. Cheers.

ergo

this is also known as "Athlete's Heart" or "Athletic Heart Syndrome"

had a quick search but the most readable link (as is often the case) was on Wiki http://en.wikipedia.org/wiki/Athlete's_heart

there is a link at the bottom of the Wiki page to the Merck medical text that most of the article is drawn from

Odysseus

ergo wrote: »

this is also known as "Athlete's Heart" or "Athletic Heart Syndrome"

had a quick search but the most readable link (as is often the case) was on Wiki http://en.wikipedia.org/wiki/Athlete's_heart

there is a link at the bottom of the Wiki page to the Merck medical text that most of the article is drawn from

Cheers.

drzhivago

Odysseus wrote: »

Hi all,

I'm not looking for medical advise as I have spoken to my GP and some of the GPs in work about this.
Basically I had to get a ECG done this for a race I'm doing at the end of the month. I'm an ultra runner which means I running very long distances up to 100km or long distances in desert environments.The results of my ECG show my left ventrcal [sp] is enlarged, which is a result of what people like me do for fun. Basically I'm just trying to develop my understanding of this, so I was wondering if anyone had any readable refs or further knowledge on this. Cheers.

The risk relates to sudden cardiac death, having an enlarged ventricle can lead to a higher risk but not sure how much higher. ECG is a good screening tool but you need more tests.

If you are worried you need to get an ECHO cardiograph and get GP to refer you on to cardiologist pronto

Tallaght has a service specifically for this Dr ward I think her name is

For background info you should do a google scholar search on sudden adult death and ventricular enlargement that will give you some background

THIS IS NOT MEDICAL ADVICE

Odysseus

drzhivago wrote: »

The risk relates to sudden cardiac death, having an enlarged ventricle can lead to a higher risk but not sure how much higher. ECG is a good screening tool but you need more tests.

If you are worried you need to get an ECHO cardiograph and get GP to refer you on to cardiologist pronto

Tallaght has a service specifically for this Dr ward I think her name is

For background info you should do a google scholar search on sudden adult death and ventricular enlargement that will give you some background

THIS IS NOT MEDICAL ADVICE

Cheers for that mate. I will have a chat with him next time I'm there. I don't think there is a need for anything at the moment. Its not a worry or anything I just like to know whats happening with my body when I push the limits. Helps me make informed decisions around thing I do. Thanks again,

RobFowl

Odysseus wrote: »

Cheers for that mate. I will have a chat with him next time I'm there. I don't think there is a need for anything at the moment. Its not a worry or anything I just like to know whats happening with my body when I push the limits. Helps me make informed decisions around thing I do. Thanks again,

I'd agree with DrZhivago there. Am a doctor for one of the national sporting bodies and there is a protocol that if an ecg is abnormal the an echo at least is warranted.
See your GP again .

Odysseus

RobFowl wrote: »

I'd agree with DrZhivago there. Am a doctor for one of the national sporting bodies and there is a protocol that if an ecg is abnormal the an echo at least is warranted.
See your GP again .

Cheers mate. I'm doing my best to stay within the charter here and keep it around endurance sports and their effects. However, my own GP as well as a GP in work [I work in the addiction services] thought it was ok. I got the GP in work to explain the ecg. I have to present the ECG to the medical team in the desert it was signed off as normal.

However, thanks for the above info so I have another chat again.

DrIndy

ergo wrote: »

this is also known as "Athlete's Heart" or "Athletic Heart Syndrome"

had a quick search but the most readable link (as is often the case) was on Wiki http://en.wikipedia.org/wiki/Athlete's_heart

there is a link at the bottom of the Wiki page to the Merck medical text that most of the article is drawn from

The only way to be sure is with an echo.

ergo

thanks for unlocking this thread, I realise it was veering towards being medical advice

so just to clarify, my initial response was just telling the OP the name of the condition associated with "hearts and endurance runners" and not advice that he/she actually has "Athlete's heart"

I say this as an endurance runner myself, although I wouldn't be in the ultra marathon region

it's been debated a lot before but maybe not on this forum. Anyway, I've never had an ECG but if I did I suspect it would or should show some evidence of LVH ("athletic LVH" from the physiological respnse to training)

should we be doing ECG's routinely on endurance athlete's with:

A)no symptoms such as chest pain/palpitations/collapse or syncope and
B)no family history of cardiac problems ?

many of them will be abnormal and lead to the question of getting an echocardiogram and the cost implication of that plus the worry of having an "abnormal" ecg when ultimately the echo may well turn out normal*

PS: I appreciate if a field sport athlete (soccer/rugby etc) has an abnormal ecg they should have an echo as the nature of their training makes it less likely for them to have physiological LVH for example than a marathon runner so that should be further investigated

but what about the ordinary Joe Soap marathon runner -> routine ecg for him?

* I've tried to find stats to back this up, I know they're out there but can't find them this minute and don't know the exact numbers

Odysseus

Cheers thanks for that ergo, I didn't realise that the thread was locked. I was in no way looking for medical advise, I supposed I ended up using myself as an example and that's maybe where I went wrong.

I go to my GP for advise or one of the lads in work if its a more general query, what I was try to get was basic info around this issue in general, so thanks for everybody's imput. Just for peoples info I was told I don't need an echo.

Its unusal for my to have to undergo such a medical before a race but then again its not a normal race, so I have no probs with that. I actually felt sorry fo my GP who had to sign of a document stating there are no medical problems with me running a 230km marathon in heat of up to 45 degrees.

I would be greatful if anyone has any extra "general" info on the effects of such events on the body, for example Dr Mike Sourd [sp] agrues that the human body is designed for such reperated endurance events. Once again thanks for peoples imput.

hunnymonster

ergo wrote: »

but what about the ordinary Joe Soap marathon runner -> routine ecg for him?
* I've tried to find stats to back this up, I know they're out there but can't find them this minute and don't know the exact numbers

In the very small survey of 3 boardsies doing Odysseus' event this month it's 2-1 with the abnormal ECG's winning. Admitedly the sample is WAY too small to be of any relevance but unless I can do a rather large recruitment drive on Athletics/marathon/triathlon that's all I've got.

Odysseus wrote: »

Its unusal for my to have to undergo such a medical before a race but then again its not a normal race, so I have no probs with that. I actually felt sorry fo my GP who had to sign of a document stating there are no medical problems with me running a 230km marathon in heat of up to 45 degrees.

I would be greatful if anyone has any extra "general" info on the effects of such events on the body, for example Dr Mike Sourd [sp] agrues that the human body is designed for such reperated endurance events. Once again thanks for peoples imput.

lol, mine was more worried I would end up pregnant (taking "just in case" anti-biotics with me and using OCP). Somehow, sharing an open tent with 8 strangers, running a marathon each day, living on rations, in the desert, might not lead to the most romantic setting.

I've just finished Dr Shrouds survival of the fittest book. I found it very interesting and well written. There were a lot of links to the literature in the back Odysseus, did you try any of those for info? I've been meaning to but not got around to it yet.

Odysseus

hunnymonster wrote: »

I've just finished Dr Shrouds survival of the fittest book. I found it very interesting and well written. There were a lot of links to the literature in the back Odysseus, did you try any of those for info? I've been meaning to but not got around to it yet.

No not got around to it yet but really enjoyed the book. I have to say that was just mad from you GP:D

ZYX

Odysseus wrote: »

Its unusal for my to have to undergo such a medical before a race but then again its not a normal race, so I have no probs with that. I actually felt sorry fo my GP who had to sign of a document stating there are no medical problems with me running a 230km marathon in heat of up to 45 degrees.

Just as an aside to this. I don't think your GP should have signed form. The purpose of this form is basically if you die, then your family should sue your GP rather than the race organisers.

Odysseus

ZYX wrote: »

Just as an aside to this. I don't think your GP should have signed form. The purpose of this form is basically if you die, then your family should sue your GP rather than the race organisers.

I see your point and I haven't got a clue about the legal side, but basically that would be just bad form. As an endrance athlete you take responsibility for you and each race you enter.

My GP would have seen me come for a medical before my big event every year, so following a full medical it not a big leap to state that based on BP, Pulse and a ECG that they do not indicate a medical reason not to race.

tallaght01

I have only just read this thread now. But I think the points the medics are making here is that no-one can be sure if LVH on an ECG is simple athletes hypertrophy.

Sure, people who are very fit get some LVH. But so do sick people.

Sure, people who are very fit most likely have benign LVH, but endurance runners can also have congenital cardiac problems.

So, basing things on probability like that is fine for most things. But for their ticker, most people would want an echo to make sure.

There's no point in people ordering tests if they're not going to act on abnormal findings.

drzhivago

Odysseus wrote: »

I see your point and I haven't got a clue about the legal side, but basically that would be just bad form. As an endrance athlete you take responsibility for you and each race you enter.

My GP would have seen me come for a medical before my big event every year, so following a full medical it not a big leap to state that based on BP, Pulse and a ECG that they do not indicate a medical reason not to race.

Now before I get rapped on knuckles am not giving advice nor am I downplaying GP role however most GPs are specialists in primary care/family medicine and not specialists in sports medicine

GP would normally do ECG/BP/Physical and say no gross reason why average individual should not engage in exercise such as the gym etc. These however are very basic tests and do not give any evidence about how the persosn heart or lungs will actually respond to extreme physical stress

Extreme or ultra sports should really have specialists opinion regarding ability to compete and in the ideal world should be backed up by spirometry/PFTs with provcation testing (a lot of these ultra events take place in extreme heat or extreme cold) ECHO, one week holter or event recorder to be used while training to look for any evidence of arrhythmia and CT angio as a screening tool

Some may say this is extreme but then so is the event and so is death, the ultimate no come back diagnosis

drzhivago

tallaght01 wrote: »

I have only just read this thread now. But I think the points the medics are making here is that no-one can be sure if LVH on an ECG is simple athletes hypertrophy.Sure, people who are very fit get some LVH. But so do sick people. Sure, people who are very fit most likely have benign LVH, but endurance runners can also have congenital cardiac problems.
So, basing things on probability like that is fine for most things. But for their ticker, most people would want an echo to make sure.
There's no point in people ordering tests if they're not going to act on abnormal findings.

The problems that are likely to cause sudden death in extreme athletes are arrythmias and also widow maker lesions which become pathological during extreme stress/high adrenaline loads and sludgy blood when dehydrated

tallaght01

But surely, in the absence of an arrhythmia at rest, you wouldn't just regard LVH as normal?

drzhivago

tallaght01 wrote: »

But surely, in the absence of an arrhythmia at rest, you wouldn't just regard LVH as normal?

Nope not saying that
From reading the posts though it would appear as if that is what is happening
arryhthmia at rest not uncommon and often disappear with exercise

Arrhythmia that come on during exercise can be more pathological but they didnt do exercise tests it seems here

tallaght01

drzhivago wrote: »

Nope not saying that
From reading the posts though it would appear as if that is what is happening
arryhthmia at rest not uncommon and often disappear with exercise

Arrhythmia that come on during exercise can be more pathological but they didnt do exercise tests it seems here

Ah, ok, gotcha.

Totally agree with you.

Odysseus

tallaght01 wrote: »

I have only just read this thread now. But I think the points the medics are making here is that no-one can be sure if LVH on an ECG is simple athletes hypertrophy.

Sure, people who are very fit get some LVH. But so do sick people.

Sure, people who are very fit most likely have benign LVH, but endurance runners can also have congenital cardiac problems.

So, basing things on probability like that is fine for most things. But for their ticker, most people would want an echo to make sure.

There's no point in people ordering tests if they're not going to act on abnormal findings.

I really only got the ECG done as its a requirement to race, I have to hand in the result to the team medics the day before the race, I believe there is a group of 41 medics with us this year, those thankfully they most only have minor things to do, i.e., patching up peoples feet the desert takes it on your feet, also looking after people who don't take care of there hydration levels. Though on that you there is a pentaly if you require IV fluids and if it happens three times your out.

Now in terms of follow up, I'm trying to keep this general. So taking a non-medic ultra runner who was told what I was told. Seeks second opinion and told there didn't seem to be a need to follow up on it. The person goes with that advise.

Having access to specialists sounds great, however, going through a battery of tests before each race would that have a significant cost? Would that then make these events prohibitive. I have run in some lovely parts of the world covering significant distances, and before I go, I have dreams over a jungle experience and running at one of the poles, not the marathons but the real runs the 100kms.

Yes I do my best to factor in my health, but you have to remember that most of us recieve no sponorship, I am personally at a leve of a person who finishs these event, I will never be a winner. So what I am saying is I have to cover ever thing myself, learning about distances and environments thorugh experience.

Also lads please remember I'm not a medic so I getting struck on terms here, could people expand a tad on terms please:) Cheers.

drzhivago

Odysseus wrote: »

I really only got the ECG done as its a requirement to race, I have to hand in the result to the team medics the day before the race, I believe there is a group of 41 medics with us this year, those thankfully they most only have minor things to do, i.e., patching up peoples feet the desert takes it on your feet, also looking after people who don't take care of there hydration levels. Though on that you there is a pentaly if you require IV fluids and if it happens three times your out.

I hear what you are saying but often the medics involved in events/sports are not there because they are specialists, they are there because they have an interest

Example from personal experience-- was at a sporting event- significant head injury, doctor involved was a pathologist (deals with the dead) but on paper for the clubs insurance is a doctor - sees me in crowd and asks for help, fair enough
But if I am not there the club thinks it has fulfilled its function by having a doctor present (which they have just that person is not in a role where they actually deal with these types of situations in their normal work, neither would a gynaecologist, dermatologist, ENT specialist, ophthalmologist, psychiatrist and yet I have been involved with sports for many years and have often come across doctors from these specialties happily occupying the role o team doctor or event doctor at such events because they know the sport and are a member of a certain club.

BASIC ECG tells you very little as a screening tool for someone going into an ultra event

Odysseus wrote: »

Now in terms of follow up, I'm trying to keep this general. So taking a non-medic ultra runner who was told what I was told. Seeks second opinion and told there didn't seem to be a need to follow up on it. The person goes with that advise.

Again not being pedantic here but who was the second opinion form, what type of specialist.
It seems odd to have these screening tests done, find something which could be signifcant and then not do any more about it

I suppose the question I should ask is what is it on an ECG that would rule you out of competing, if you could find that out for us that would be useful.

Odysseus wrote: »

Having access to specialists sounds great, however, going through a battery of tests before each race would that have a significant cost? Would that then make these events prohibitive. I have run in some lovely parts of the world covering significant distances, and before I go, I have dreams over a jungle experience and running at one of the poles, not the marathons but the real runs the 100kms.

Unfortunately dude there is a cost everywhere, all professional rugby players must have very detailed medical done at their costs annually

All professional boxers must have a detailed annual medical, a medical before every pro fight and an MRI ad CT at leats once per year and after a knock out, at their cost

Divers have to have detailed exams done annually

I get the point you are an amateur athlete and costs is important but to paraphrase longshanks from braveheart

"send in the irish the dead cost nothing"

You wouldnt need the same battery done every time unless something new had happened to you, you would probably benefit from blood tests prior to events to check kidney function, blood thickness, Iron count, Haemoglobin level etc

Also urine testing for renal damage as well, myogobinuria (sorry for terms but you can google these would make post too long to explain)

Odysseus wrote: »

Yes I do my best to factor in my health, but you have to remember that most of us recieve no sponorship, I am personally at a leve of a person who finishs these event, I will never be a winner. So what I am saying is I have to cover ever thing myself, learning about distances and environments thorugh experience.

Also lads please remember I'm not a medic so I getting struck on terms here, could people expand a tad on terms please:) Cheers.

So to quote you here you are learning how to compete and the demands that will be made on you yet you go to the GP for a physical to be allowed to compete without being able to tell him what exactly the demands that are going to be made on you are

Remember a GP is a GP, general practice, you are going into a very specialised sport with very specific demands which could have lasting consequences

The ARMY would strike me as similar with their demands on soldiers in training however the ARMY Medical personnel (GPS) train alongside these people (slower pace), are able to witness the demands, judge reactions to body stress and have the opportunity to suggest that X perosn needs medical attention becaiuse or will be unfit for such duty because.

I dont get the sense that your GO could have that knowledge without actually seeing you do these things or being the doctor who participates in one of your events

I am not tryin to be a kiljoy, I think what you are doing is great, wish I could do it but knees and hips no longer willing BUT I think when people go to GPs for such medicals they are fooling themselves if they think they have received a pass that guarantees they can not come to harm from the extreme stresses they are putting themselves under

Odysseus

Thanks for that drzhivago, no I don't think your being a killjoy, I see the points your raising and looking at them I'm trying to see how and what I can do to incorporate them into my training.

For example I do gets full bloods done before big races, this has always been for me away of checking that I'm not pushing myself too far. I can't answer your question about what would need to be showing on the ECG in order to not to be allowed to race. However, when I'm presenting it at the medical the day before the race I try to get an answer to that.

I very strongly see you point about cost and death. However, I always acknowledge to myself that anything can happen on events like this, and even a medical before the event is no magic protection.

I'm away in a little over a week however, I am now at the point that I think I will seek a follow up on the ECG when I get back.

tallaght01

I understand it's a pain in the ass to have all these conflicting reports coming at you.

But, I think what the hospital docs, and non sports medicine specialists would agree on generally is the following:

There's not a huge point in doing a screening test (the ECG) if you don't follow up on things that the screening shows up.

An ECG at rest won't give an indication of how well your heart functions under stress.

GPs are awesome. I have much love for GPs as they have a wide knowledge base that I will never have. But they're not experts in endurance sports, so may not be the best people to give opinions to endurance athletes.

Having said that, I guess the guys who work as medics at these events have some kind of sports medicine training?

Odysseus

tallaght01 wrote: »

I understand it's a pain in the ass to have all these conflicting reports coming at you.

But, I think what the hospital docs, and non sports medicine specialists would agree on generally is the following:

There's not a huge point in doing a screening test (the ECG) if you don't follow up on things that the screening shows up.

An ECG at rest won't give an indication of how well your heart functions under stress.

GPs are awesome. I have much love for GPs as they have a wide knowledge base that I will never have. But they're not experts in endurance sports, so may not be the best people to give opinions to endurance athletes.

Having said that, I guess the guys who work as medics at these events have some kind of sports medicine training?

A tad confusing yes, but I'm greatful for peoples imput. Ultra running is though becoming more poplar is a small sport in Ireland. Also it is not very organised so Irish ulra runners so we don't get to meet each other that often.

If I was six months older it would have had to been after exercise, but my favourite distance is 100k, I really want to try a 100 miler but they are mostly over in the States. My point here is can that type of stress be replicated, I don't know about the amount of exercise required before an ECG but would that be completly different to the really distance that I cover in a race?

Any this thread had given plently to talk about at night out there. Thanks.

RobFowl

Odysseus wrote: »

A tad confusing yes, but I'm greatful for peoples imput. Ultra running is though becoming more poplar is a small sport in Ireland. Also it is not very organised so Irish ulra runners so we don't get to meet each other that often.

If I was six months older it would have had to been after exercise, but my favourite distance is 100k, I really want to try a 100 miler but they are mostly over in the States. My point here is can that type of stress be replicated, I don't know about the amount of exercise required before an ECG but would that be completly different to the really distance that I cover in a race?

Any this thread had given plently to talk about at night out there. Thanks.

Good luck in the event (though maybe a psychiatric assesment would have been more appropriate :rolleyes:)

Fot the record in ireland there is a faculty of sports and exercise medicine. If your GP has MFSEM or FFSEM after their name then they have some expertise in this area.

Odysseus

RobFowl wrote: »

Good luck in the event (though maybe a psychiatric assesment would have been more appropriate :rolleyes:)

Fot the record in ireland there is a faculty of sports and exercise medicine. If your GP has MFSEM or FFSEM after their name then they have some expertise in this area.

Cheers for that, however I trained as a psychoanalyst so unfourtunately I have some insight into my psyche Brrrrrr

drzhivago

tallaght01 wrote: »

Having said that, I guess the guys who work as medics at these events have some kind of sports medicine training?

This has been my issue over the years with Sports Tallaght, most medics involved are there because they are volunteers who also compete occasionally

You rarely get people because of their skills ie GPs, Emergency Doc's

There is very little 'Sports Medicine" training out there
Having an MSc in sports medicine is not training per se for this type f stuff but is a start

Having MFSEM or FFSEM is also not a training qualification, as the Faculty has just been set up in last few years those already practising as team docs were automatically grandfathered in

Over next few years people will have to do exams to get MFSEM and that will help

In UK FA runs sports specific courses to teach docs the emergency stuff they need to know (REMO Course)

Rugby Football league runs similar course IMMOFP, immediate medical management on field of play, 3 days with parts of ACLS, parts of ATLS and also some sports specific stuff

Horse racing in Ireland run similar courses

Overall though very little courses of such like are run in Ireland and that is what we need here

RobFowl

drzhivago wrote: »

This has been my issue over the years with Sports Tallaght, most medics involved are there because they are volunteers who also compete occasionally

You rarely get people because of their skills ie GPs, Emergency Doc's

There is very little 'Sports Medicine" training out there
Having an MSc in sports medicine is not training per se for this type f stuff but is a start

Having MFSEM or FFSEM is also not a training qualification, as the Faculty has just been set up in last few years those already practising as team docs were automatically grandfathered in

Over next few years people will have to do exams to get MFSEM and that will help

In UK FA runs sports specific courses to teach docs the emergency stuff they need to know (REMO Course)

Rugby Football league runs similar course IMMOFP, immediate medical management on field of play, 3 days with parts of ACLS, parts of ATLS and also some sports specific stuff

Horse racing in Ireland run similar courses

Overall though very little courses of such like are run in Ireland and that is what we need here

Hi Dr Zivago
The FSEM is in it's infancy fair enough. They accepted diploma standard for MFSEM and Masters standard for FFSEM. Experience was also considered. The MPS (unrealistically IMO) recommended ATLS as their training for sports medicine. You have to go with what you have and at the present the FSEM (RCSI) is the best you can have. The HSE approved a training scheme for sports medicine but have to date refused to fund it. The IRFU and FAI run updates in cardiac and immediate trauma care yearly and the IOC have an approved sports medicine body . There is a quaterly training scheme for medical officers for all recognized sports bodies which has been ongoing for the past 3 years.
The UK is no better than us TBH their sports medicine faculty is well behind ours and standards their are no better if not worse. PM me if you want more. For the record I am a GP and medical officer for a national sports body and have international accreditation.
Medicals for these sort of events are nowhere near what they shoud be and as a gold standard the Lausanne IOC medical template is probably the best.
Ultra distance running and multiple ironmans (believe me triple iron mans exist!!!!) are new events and the evidence and experience base is simply not there yet.
FTR the ecg as a screening tool is not great at all . In my sport we have a very low threshold for echo's and at the top level they are mandatory. Stress testing at high temps and under extreme conditions is not realistic and if you are doing this type of event there is a risk.
The report on sudden cardiac death which was published in 2006 suggested 2/3 of sudden cardiac deaths in sport were not preventable which was TBH quite shocking. 1/3 are though and that is what we are working towards.
If you have a better suggestion for the OP as to who to see for screening than an MFSEM or FFSEM I would welcome it

drzhivago wrote: »

Having MFSEM or FFSEM is also not a training qualification, as the Faculty has just been set up in last few years those already practicing as team docs were automatically grandfathered in

BTW this is standard for all specialties rightly or wrongly when a new faculty is set up.

hunnymonster

RobFowl wrote: »

Ultra distance running and multiple ironmans (believe me triple iron mans exist!!!!) are new events and the evidence and experience base is simply not there yet.

let's not forget the deca ironman :-) I don't think they are new events but the numbers participating (compared to say a standard marathon) are quite low so it will take a while to have a significant number of problems. There are plenty of studies looking at standard complications (electrolyte imbalnaces, muscular catabolism) of these events.

RobFowl

hunnymonster wrote: »

let's not forget the deca ironman :-) I don't think they are new events but the numbers participating (compared to say a standard marathon) are quite low so it will take a while to have a significant number of problems. There are plenty of studies looking at standard complications (electrolyte imbalnaces, muscular catabolism) of these events.

Ironmans + are the only events where is is mandatory to have electrolyte testing facilities available at the finish !!
Hyponatraemia is the biggie :eek:

ZYX

ZYX wrote: »

Just as an aside to this. I don't think your GP should have signed form. The purpose of this form is basically if you die, then your family should sue your GP rather than the race organisers.

I have read the comments since I posted the above. My point however is that I might not have signed form irrespective of ECG report. If a GP is asked "do you know of any reason why this person should not partake in a particular sport?" then that is okay. When you are asked to state "a person is fit to do this race", it is a very different matter. The only reason the race organisers are doing this, is to reduce their insurance payments and move the onus onto the GP. The vast majority of GPs have no experience of such sports and therefore are unable to state what level of fitness is required. They are also unaware of what facilities are available during race eg amount and types of fluids available, equiptment used, availability of first aid or emergency care.

RobFowl

ZYX wrote: »

I have read the comments since I posted the above. My point however is that I might not have signed form irrespective of ECG report. If a GP is asked "do you know of any reason why this person should not partake in a particular sport?" then that is okay. When you are asked to state "a person is fit to do this race", it is a very different matter. The only reason the race organisers are doing this, is to reduce their insurance payments and move the onus onto the GP. The vast majority of GPs have no experience of such sports and therefore are unable to state what level of fitness is required. They are also unaware of what facilities are available during race eg amount and types of fluids available, equiptment used, availability of first aid or emergency care.

These type of events are relatively new and there is no way even if all tests are clear that you can guarantee that the person won't have a problem or event. It's purely a legal way of shifting the responsibility on to the GP. It means the organizer pays a much smaller insurance premium.

hunnymonster

if you're talking about suing, I think it's important to realise that this is a Moroccan race organised by French authorities, I don't know what legal set-up there if for international races like this but for a standard French race, with French authorities, the medical form is similar and if someone is going to get sued it will still be the organiser but the medical does bring down their insurance costs for the organiser. In France it is the practice for people to have medical forms signed before any endurance race and before signing up for sporting clubs etc. It is starting to happen in other countries. I saw the first example in the UK recently. Unfortuantely, given the irish health services limitations, the requirment that these tests are done within 28 days of the start of the race is a slight problem because if something does show up, it doesn't leave enough time to languish on an irish waiting list let alone get treated before the race. I suppose the sensible thing would be to get tested early for yourself and late for the race but at an econimic cost.

The actual wording of the medical which the doctor signs is " X ne présente aucune contre indication médicale à une compétition de marathon et à une randonnée de longue durée (environ 230 Km) en pays désertique." which I would interpret that there is no medical reason why the participant can't do the race. Leaving aside Odysseus' dicky heart for a moment, for someone whose bloods were ok, ECG normal, HR/BP etc normal, there is no reason why the GP shouldn't sign, I would have thought?

ZYX wrote: »

... They are also unaware of what facilities are available during race eg amount and types of fluids available, equiptment used, availability of first aid or emergency care.

All this information is readily avavailable for this (and most) races.

I can fully understand that GP's might be resititent to sign forms that they do not understand, but I wouldn't have thought this type of thing (in general - again ignoring Odysseus' specifics) in general requires further referral to a specialist.

RobFowl

hunnymonster wrote: »

if you're talking about suing, I think it's important to realise that this is a Moroccan race organised by French authorities, I don't know what legal set-up there if for international races like this but for a standard French race, with French authorities, the medical form is similar and if someone is going to get sued it will still be the organiser but the medical does bring down their insurance costs for the organiser. In France it is the practice for people to have medical forms signed before any endurance race and before signing up for sporting clubs etc. It is starting to happen in other countries. I saw the first example in the UK recently. Unfortuantely, given the irish health services limitations, the requirment that these tests are done within 28 days of the start of the race is a slight problem because if something does show up, it doesn't leave enough time to languish on an irish waiting list let alone get treated before the race. I suppose the sensible thing would be to get tested early for yourself and late for the race but at an econimic cost.

The actual wording of the medical which the doctor signs is " X ne présente aucune contre indication médicale à une compétition de marathon et à une randonnée de longue durée (environ 230 Km) en pays désertique." which I would interpret that there is no medical reason why the participant can't do the race. Leaving aside Odysseus' dicky heart for a moment, for someone whose bloods were ok, ECG normal, HR/BP etc normal, there is no reason why the GP shouldn't sign, I would have thought?


All this information is readily avavailable for this (and most) races.

I can fully understand that GP's might be resititent to sign forms that they do not understand, but I wouldn't have thought this type of thing (in general - again ignoring Odysseus' specifics) in general requires further referral to a specialist.

Thats interesting, The French for some reason insist on and ECG before most events.

hunnymonster

The ECG is for longer events, the basic medical (bloods/BP/HR/history) is for anything from an Oly or marathon type event, AFAIK.