October 26th, 2015

Everyone who crosses the start line is familiar with the concept of acceptable risks in OCR – if they hadn’t thought about it, they would still be in bed or on the sofa. This article is designed to reduce the risk of becoming ill AFTER the race.

Disclaimer: This article is aimed at preventing infections during, or as a result of, obstacle course racing. No claim is made regarding the aftermath of what you get up to if you decide to camp at the venue for a racing weekend, get overly-friendly helping someone over an obstacle or propose at the finish line.


Diarrhoea and vomiting


As well as stories and pictures of wounds and “kisses”, during the week after a race the social media feeds and groups are awash with stories of people who have come down with a gut bug.

Much of the water we run/crawl/swim through is not drinking-quality and drinking it is not recommended!

Open-water swimmers suggest breathing out whenever your face is in the water, added to which keeping your mouth closed when not breathing out is also pretty sound advice.

This has kept me safe most of the time, but I too succumbed after inhaling water through the nose during the Tough Mudder London West Cage Crawl.

If you have ingested some mucky water, is there anything you can do to protect yourself afterwards?

Unfortunately the short answer is – not much!

Urban myth says drink a can of coke straight away – but stomach acid is more acidic than coke, so the acid alone would make no difference and many nutritionally-aware racers abhor the idea of drinking it. No-one seems to suggest Pepsi for some reason, or Dr Pepper, or any other sugar-filled carbonated drinks (although that may be because apparently Father Christmas drinks coke).

Little formal research has been conducted into this – the antibacterial properties of various food extracts have been assessed, but the only one regarding drinks that I could find was a paper from 2007 in the “Journal of Food Protection” where the antibacterial properties of various comestibles were tested – vinegar, olive oil and wine were all shown to have bactericidal properties but coke and fruit juices didn’t. Coffee and beer had no effect either -they didn’t test whisky, vodka, rum, brandy or other spirits unfortunately…

Despite the pints offered at the finishing line of some races, for many people who drive to and from a race alcohol is not an option (“Honestly Officer, I drank it to stop me getting the squits…”). I’m not sure I’d fancy drinking large quantities of vinegar, but I suppose if it was good enough for Roman Legionaries maybe I shouldn’t be such a big girl’s blouse.


I polled opinion among friends who are microbiologists and public health doctors – but no-one could come up with a reason why drinking coke would protect you from diarrhoea/vomiting. The organisers of the London Triathlon recommend paracetamol + coke as a way to prevent Thames Tummy, but at the time of writing they have not responded to my requests to find out where this idea came from. Another friend who is an experienced marathon and white-water kayaker also swears by drinking coke when he leaves the water, but beyond anecdotal personal experience (albeit from a lot of people!) there is no evidence that it will protect you.

Preventative antibiotics would also not be a great idea for racers, because the one most often used for traveller’s diarrhoea (Ciprofloxacin) also has temporary tendinopathy as a recognised side-effect.


It is also worth noting that the bacteria commonly implicated in food poisoning and diarrhoea are GROUPS of bacteria – E. coli is a common group, but E. coli 0157 is the one which can really cause you problems; Salmonella another, of which PT4 is most worrying. Cryptosporidium rarely needs treatment, Giardia parasites do. If you have diarrhoea for more than a week – or if there is blood in the diarrhoea at any stage – see your GP who will probably ask you to collect a stool sample and send it for culture/testing. If you are told you have one of the infections above, do not panic – most do not need treatment, others are easily treated – there is no need to start writing your will!


Weil’s (Leptospirosis)

Many will have heard of Leptospirosis as Weil’s disease, but strictly speaking Weil’s disease is the most severe manifestation of Leptospirosis in humans and is rare (<10% of all infected, it involves multi-organ failure and can involve kidneys, lungs, heart and brain – so basically you don’t want Weil’s disease). This disease has achieved notoriety amongst open-water swimmers, kayakers and canoeists in particular – passed via infected rat urine, but also via pets and other domesticated animals. Pets can be vaccinated against it but you would not have been as a baby (no matter how hairy you were!) and there is no vaccine for humans.

Infection occurs when the bacterium gets in through an open wound or by swallowing – wounds should be covered (dressings do exist which can survive an OCR – I had one on under a calf sleeve for the Spartan Beast and it was still there at the end) or, if a major wound, it may be wiser to marshal rather than take part. Most people will earn a scratch, scrape or graze during an OCR and it is important to wash these with clean water as soon as possible after you finish.

Without wanting to sound too much like your Mum, it’s also worth rinsing your mouth out and washing your hands before you eat or drink anything (but I’m a hypocrite for suggesting this as I don’t wash my hands mid-race before stuffing in gels, flapjacks etc. either).

Leptospirosis can also be transmitted if you are bitten by an infected rat, but luckily the creators of “I’m a Celebrity, Get Me Out Of Here!” have not yet branched out into OCR so the risk of this mid-race is currently low.


90% of humans with Leptospirosis have a mild illness with headache, cough, fever/chills, muscular aches and pains. If you think you may have early signs of it, the Jury is out on whether antibiotic treatment for mild Leptospirosis is necessary – one study found that it only shortened the duration of the illness by a few days – but is definitely necessary if there is any chance you may be developing the more severe form.

If in doubt always get some advice from your GP or 111 – it is worth noting (in case you “Google” it)  that one of the antibiotics used to treat Leptospirosis (Azithromycin) is available to buy without a prescription in the UK, however I wouldn’t recommend trying to get this to treat yourself for 2 reasons:

1) It is not licensed to be sold to treat Leptospirosis without a prescription, so the Pharmacist may refuse to sell it to you and practising your OCR skills by throwing a spear at them and leaping over the counter and is frowned upon in most Pharmacies

2) It is  licensed to treat the sexually-transmitted infection Chlamydia, so even if the Pharmacist doesn’t’t ask why you want it they may start to look at you strangely if you keep going back to get more every Monday.




Most of the time racers will not be at much risk from ticks, because we’re moving through grass and undergrowth at a fair pace – but if you do find a tick then remove it rather than taking a picture and seeing how many “likes” you can get. The main (but also rare) risk from ticks is Borreliosis (Lyme disease) – the precursor of this is a characteristic rash (called erythema chronicum migrans) which looks like this:




 or this:





If you develop anything remotely like this, 2 weeks’ antibiotics will be recommended to stop you getting Lyme disease.



Remember the adage “The smallest thing that goes in your ear is your elbow”?

No cotton buds in the ear! Putting cotton buds in is likely to push any gunge deeper into your ear canal – movement of small amount of wax out of your ears will carry any grubbiness out with it, all though this may take a while.





If you get something so far up your nose that blowing it won’t get it out, preparations such as “Sterimar” can wash it out.

(other nasal douches are available…)






tough guy

More something for marshals to watch out for as the person suffering from it probably won’t be aware of it, but you may detect in another racer and need to tell a marshal. Clumsiness, slurred speech and poor decision making are all signs – but only racers and marshals who “get it” will know that this is different from someone grinning while they lock up with cramp, having a massive euphoric sense of achievement while looking like death warmed up, talking about their desire to enter another race despite being thoroughly broken etc.




On the plus side…

All of the potentially-nasty problems above are rare and most of the advice is common sense – it is far more risky for your long-term health to never leave the sofa.


There is a Zen koan-like difficulty with answering the question “Why do you do these races?” because if the person has to ask then he or she probably won’t understand.

However, if someone at the Office Party corners you then tell them about:

·       Endorphins – most people have heard of these, it’s a good ice-breaker

·       Mycobacterium vaccae – never forget that there are also “good bacteria” in the mud! If you want to explain why you “do it” in the mud not in a gym, these are present in the soil and have been shown to reduce anxiety and improve learning (in mice) and are being tested as an immune-system booster in humans.

·       Exercise being shown in a recent Swedish study to break down a chemical called Kynurenine, which is produced in response to negative stress and is thought to be implicated in causing depression. If they’re a scientific type this may be enough, but if their eyes have glazed over you could put it a different way – it is not only to change your frame of reference that you should “Spartan the f*** up!”