Prior to the race, each runner is strongly encouraged to consult with his or her own doctor about any physical or medical potential limitations. It is important for each entrant to recognize the potential physical and mental stress which may evolve from participation in this race. Adequate physical and mental conditioning prior to the race is mandatory. If you have not been able to prepare properly, it is best to not attempt the race. The event takes place in the Rann of Kutch, sometimes stated as the dustiest and hottest region of India. Here summer temperatures can peak to 50°C and winter temperatures often go below 0°C. At the time of the race which is early to mid February, temperatures expected during the day would be around 30°C with regular peaks of around 40°C. Other than long flat salt sandy stretches of land, the vegetation consists of grasses and dry thorny shrub. Despite the inhospitable conditions, this eco region is a wildlife sanctuary and is home to charismatic mammals such as wild asses, gazelles, antelopes, desert cats and foxes. But it also provides the adventure runner its share of potentially more vicious encounters, especially at night, such as wolves, hyenas, caracal and snakes.
Everyone should understand that participating in Run the Rann is at the participant's own risk. In the proportion of its three distances, Run the Rann is among one of the most physically challenging events in the world and running it presents numerous medical risks, few of which can be extremely serious or on rare occasions fatal. Please keep in mind at all time that Run the Rann is not only a running event, it is an adventure. Although Run the Rann race management people are experienced ultra trail runners and the race has experienced medical personnel at various points along the course, the difficult accessibility of some of the routes may make it impossible for any of our medical assistance to reach the runner immediately. At selected aid stations, at the start of the race and at the finish line, the medical staff will focus on how the runner feels and looks but ultimately runners must understand their own limitations. As a doctor from Western States 100 miles Endurance Run once said: "It is better to follow the dictates of your body - not your ambitions!"
Please also understand that rescue, medical decisions and actions may have to be taken on your behalf under extreme time constraints and adverse circumstances and that race management will never be responsible for any debts incurred. We will make the best efforts to give assistance at all time but ultimately and primarily you are in charge, and you are likely to be solely responsible for creating your own crisis that we must then respond to. Be careful, be responsible, and do not exceed your own abilities and limitations. In the event that a runner requires emergency evacuation, the runner assumes all financial obligations connected with this service.
Some of the main risks of Run the Rann, but certainly not all of them, are listed here. These should be understood, eventually discussed with your personal doctor and remembered by all runners and their families, before and during the event. Trail running is fun but it is also legit to consider it as an adventure sport or an extreme sport. No drugs of any kind should be taken before, during or immediately after the run! Many drugs can increase the risk of heat stroke. A partial list of problem drugs includes amphetamines, tranquilizers, and diuretics. Just be very careful with this matter because to this date there is little scientific knowledge about drug reactions with the stress of running long distances like 101 kms and over. A good way to avoid over-dramatizing the risks is to be fully aware of them and understand the immediate and emergency response to apply in case of an emergency. Please note that death can result from several of the risk conditions detailed below or from other aspects of participation in Run the Rann. Although medical and other personnel will assist you when possible, remember that you are ultimately responsible for your own well-being on the trail. Only you will know how your body and mind feel at any given time. Monitor yourself during the entire Run, and prepare yourself to drop out at the nearest check-point if you find it just isn't your day. As you continue past each medical checkpoint, be aware of the number of miles to the next one, realizing that getting rescue vehicles into these areas can be difficult, if not impossible. Remember and get inspired by the fact that several of the elite runners of some of the most extreme footraces listed have dropped out in some races but have come back to win in others.
Renal Shutdown: Cases of renal shutdown (known technically as acute kidney injury or AKI) have been often reported in ultra endurance events and have sometimes caused the death of the participant, possibly weeks after the event (Ironman France in Nice saw one of such case in 2011). Appropriate training and adequate hydration are key to prevention of renal shutdown. While usually reversible in healthy people, renal shutdown may cause permanent impairment of kidney function. It is indeed crucial to continue hydrating for several days following the race or until the urine is light yellow and of normal frequency.
Heat Stroke/Hyperthermia: As its name suggests, it is a heat-related disorder. It is caused by environmental or metabolic heat load which can quickly become a serious medical emergency. In addition to the generation of heat from metabolism, environmental heat stress can be significant during your race. Heat stroke can cause death, kidney failure and brain damage. It is the third leading cause of death in athletes behind cardiac disorders and head neck trauma while falling or tripping over an obstacle. Your muscles produce tremendous amounts of heat when running. The faster the pace, the more heat is produced. Evaporation is the most important heat dissipation mechanism in warm environments. High humidity limits sweat evaporation and therefore, heat loss during exercise. Each liter of effective evaporated sweat removes about 550-600 Kcl from the body. When heat production exceeds the body's heat loss, body temperature rises. Heat stroke occurs when thermoregulatory natural body mechanisms fail to compensate for elevations in the body's core temperature. Heat stroke represents thermoregulatory failure, with core temperature elevated to 40°C or higher - reduction or cessation of sweating, rapid pulse, rapid respiration, hypotension but also unsteady gait, confusion, reduced consciousness, convulsion and, finally, coma. It is important that runners be aware of heat stroke symptoms. These include but are not limited to: nausea, vomiting, headache, dizziness, faintness, irritability, lassitude, confusion, weakness, and rapid heart rate. Impending heat stroke may be preceded by a decrease in sweating and the appearance of goose bumps on the skin, especially over the chest. Heat stroke may progress from minimal symptoms to complete collapse in a very short period of time. The heat stroke is more frequent with high temperature in high humidity, but hyperthermia can occur even on cool day. Consequently, the risk of heat related illness is greater when participants may be inadequately prepared in terms of training and have not acquired natural acclimatization to the heat of the location the event takes place. A light-colored shirt and ventilated cap, particularly if kept wet at all time, can help. Acclimatization to heat requires approximately two weeks. We recommend regular training 90 minutes in over 30°C heat for at least two weeks prior to the race. Dehydration and exhaustion (about 70% of treated problems during endurance events) that can lead to a heat stroke are reportedly much higher in longer distances but it can also occur on short distance events, when athletes run at their higher speed, higher percentage of their VO2 max and when their rate of metabolic heat production is at its highest. A heat stroke is a serious incident and it is associated with high mortality rate if treatment is delayed.
Risks associated with low blood sodium: Low blood sodium concentrations in the blood (hyponatremia) in long distance endurance events have been associated with severe illness requiring hospitalization. Generally, those individuals have been overhydrating with water only. The best way to avoid developing symptomatic hyponatremia is to not overhydrate. The best way to not overhydrate is to be properly trained and know yourself. There is no evidence that consuming additional sodium or using electrolyte-containing drinks rather than water is preventative of exercise-induced hyponatremia. Signs and symptoms of hyponatremia may include bloating, nausea, vomiting, headache, confusion, incoordination, dizziness and fatigue. If left untreated, hyponatremia may progress to seizures, pulmonary and cerebral edema, coma and death. If symptoms develop, one needs to assess whether they are due to overhydrating. If you know that you have been drinking a lot (and we mean a lot), then stop fluid intake until you remove excess fluid through urination. If severe symptoms are present, this is a medical emergency where you should be transported to a hospital. Because of the remoteness of the race, be aware that this will not be possible immediately.
Wildlife Hazards: Some of the most venomous snakes of South Asia are present in the Khadir bet island and the Kutch Desert Wildlife Sanctuary in Great Rann of Kutch. That being said, it is within our responsibility to inform you on those so you can keep alert and be careful where you stop, sit or place your naked feet and hands at all time, especially at night. If you happen to suddenly be faced with such a snake, immediately move away from its range and continue the race. Don't try to hurt or kill anyhting. You will also most probably fail to do so and it will then be fair for him to defend himself and attack you (and most probably kill you). We will not let runners carry anti venom pumps because they are too dangerous for the runner if mis-handled (The anti venom pump can make the poison go faster through the blood stream).
Injuries from Falling: Falling is an ever-present danger on some parts of the Run the Rann 101 kms and 161kms routes, with potentially serious consequences. Some of the trails on the North side of the island are narrow, uneven, rutted and with very unsteady stones. If you feel dizzy, disoriented or confused, do not risk falling. Sit or lie down on the trail until you recover or are found. An unconscious runner even a few feet off the trail could be impossible to find until it is too late. A few minutes gained in your final timing are not worth risking a serious injury.
Rhabdomyolysis: It has been found that some degree of muscle cell death in the legs occurs from participation in long distance trail runs. The recovery can take several months. This seems to be a bigger problem in runners who have exerted themselves beyond their level of training. Medical analysis of blood samples taken from Western States 100-miles endurance runners shows that this occurs to some degree in all runners. To prevent it, you must train accordingly and not try to run a distance you have not been seriously preparing for.
Overuse Injuries: Obviously, innumerable overuse injuries can occur, especially in the knee and the ankle. Sprains and fractures can easily occur on these rough trails. Blisters have prevented many participants from finishing lots of long distance runs all over the world. You should never seriously and indefinitely hurt yourself. It's just not worth it. There are many races out there in the world you can attend later.
Common Fatigue: One of the biggest dangers you will encounter is fatigue. Fatigue, combined with the effects of dehydration, hypothermia, hyperthermia, hyponatremia, hypoglycemia, sleep deprivation and other debilitating conditions can produce disorientation and irrationality. Appropriate training and long distance racing experience which will both help you to know yourself are key to prevent unbearable fatigue and dramatic consequences.
Thorns: Consider all plants along the route to be thorny; sorry, VERY thorny. If you're not protected, thorns will scratch you from your ankles to your head. Especially on the long distances, we strongly recommend you to wear protective gear such as calf compression sleeves, arm sleeves or long sleeve tee-shirt, sunglasses and hat. Sunglasses are a must-have since those thorns often end up at head-high level and could seriously injure your face if you don't pay attention, especially when running fast or being over-exhausted.
Difficulty in gaining access to or locating injured participants: Much of the Run the Rann trail is remote and inaccessible by motor vehicles. Accordingly, in spite of the many layers of safety precautions instituted by race management (including mobile phone communications, foot patrols, mounted search, rescue dedicated personnel and medical personnel at many checkpoints), there is absolutely no assurance that aid or rescue assistance will arrive in time to give you effective help should you become sick, incapacitated or injured. In many of the most renowned international races such as Ultra Trail du Mont-Blanc or Western States 100 Endurance Run, ambulances and other emergency vehicles have experienced difficulties in gaining access over remote roads jammed with crew vehicles, and other delays have resulted.
Getting Lost: Although race management endeavors to mark the course and will make sure all GPS waypoints are installed properly into each 161 kms, 101 kms and 51 kms races, it is definitely possible to lose the trail. If you believe at any time that you may not be on the correct trail, do not attempt to find your way cross-country. If you are unsure of your route, backtrack to where you last saw a trail marker and try to find other markers showing the direction of the trail or other participants. If you are unable to find your way, stay where you are! Wandering randomly will likely take you farther from the trail and reduce your chances of being found. If you do become injured, exhausted or ill; stay on the trail. You will be found there either by another runner, a safety patrol which monitors the progress of runners during the event or at last by the sweep team. If you are assisted by individuals who are not associated with race management and you elect to leave the trail, you MUST notify the official at the nearest checkpoint of your decision to withdraw and surrender your official wristband and pull-tag.
Note: This medical information has been compiled from some of the best and most recognized long distance endurance events in the world, including but not limited to, Badwater 135 ultramarathon, Western States 100-mile endurance run, Marathon Des Sables, Diagonale Des Fous, Canadian Death Race, Hardrock 100 endurance run, Ultra Trail du Mont-Blanc and also a few Ironman triathlons. The information has also been compiled from the Snake Lovers club association in Ahmedabad and websites such as www.indiansnakes.org and www.snakeloversclub.50megs.com.