2015 Leona Divide 50K - Midol Won't Touch These Cramps

"Hey, do you have salt tabs?" "Here, have some salt tabs." "You're cramping? You need some salt."

Everywhere I turned on this course well-meaning runners, volunteers, even health care professionals were pushing salt tabs on me like crack-dealers who'd found a new market in selling salt to deer.

"Cramps, huh? You just gotta push through it. Oh, and take some salt."

After the wheels came off at mile 20 of my 2014 LA Marathon with bilateral calf cramps that forced me to limp the rest of the 6.2 miles to the finish, I've been exploring what causes exercise-associated muscle cramping (EAMC) and therefore how to prevent and treat it. And after yesterday's Leona Divide 50K degenerated in to a cryscreamlaughing cramp-fest and my fears that every distance that I run in the future may be the same I'm now even more curious about this most common endurance-sport related complaint. Well, maybe chafing in weird places jockeys for most common. Along with weird blurred tan lines.

So about the race first: my second ultra, also at the 50K distance, but as I mentioned in my post about the The North Face Endurance Challenge San Francisco 50K (four months later and I still feel compelled to write it all out like that) (by the sponsors of the The North Face Endurance Challenge San Francisco 50K), the 50K really is the entry-level ultra - it's basically doing a marathon and then walking to your parked car afterwards. In comparison, I happened to run into (no pun) one of my workplace's surgical residents, who remembered me from his rotation through the emergency department as an intern, who was running the 50 miler that day. As a RESIDENT! How did he even have the time to train? Even more amazing, he'd only started running a year or so before, and this was also his second ultra, having completed a 50K recently. (Cute story: the reason he got in to running was that his parents had decided they wanted to run a marathon, in their 50s, which was got him in to it.) When I praised him for doing these ultras as a resident, his half-apologetic excuse to me was that he wasn't married and therefore had all the time to train, and that he was on a research elective and had more time to run, but come on, I'm no dope - the guy lapped me and actually finished the 50 miler before I'd run in the 50K, and the best part? I ain't mad at him! He has the talent, he put in the work, nothing but respect for the guy's awesome running. But now I want to do 50 milers, with the ultimate goal of a 100 miler, 'cause come on, if even I can do a 50K, it's not cool until I can do a 100 miler - the race is always against myself, yo. Or something like that. That sounds less weirdly masturbatory. (Which reminds me: on the trail, I had a lot - and since I'm slow, I mean a LOT - of time to think, and to try to come up with jokes. One of them is to remember that with the exception of two people, there's always going to be someone who finishes before you and someone who finishes after you. #circlejerkwisdom - See?! It's funny because you thought it was going to be about running!) (Actually, come to think of it I'd probably heard that joke elsewhere and recycled it to myself in my delirium, whatever gets you through the day.)

And that was kinda the marker of the Leona Divide for me, this positivity about my fellow runners. The course is basically as follows, you run to the first aid station at mile 2.6, and then there are two out-and-back arms, one to an aid station about 7 miles to southeast, the other to one about 7 miles to the northwest. The 50 milers have a longer southeast limb which adds to their total distance. Out-and-back courses are interesting because you eventually start encountering the faster runners (and then once you start heading back, the slower runners), and when I realized with some amazement that the people with race bibs on heading my direction were actually the fast fast fast 50Kers who were essentially already lapping me, I began giving them all, the people faster and the people slower, a thumbs-up and a grin, with some encouragement, you're awesome, you look great, looking strong, something, and even though some were too in to their own heads to look up and answer back, and some could only grunt out that they felt terrible, most of them responded with surprised grins of their own, calls back, high-fives, just all kinds of positivity.

Quick aside: many would say, "nice job," and although it's ultimately still a positive response and an easy one to make, I started thinking that to equate running this race to work was a bit of a downer, we were all there because it's a past time we find enjoyable.

Later in the race it became tougher to maintain that kind of positivity, by no means impossible, but harder to do because the cramping began. Mile 15 was the return to the first aid station before heading out on the northwest limb, and I was starting to feel a fatigued, and about mile 18 is when the cramping began. About mile 20 was when I was passed by Maria, an ultrarunning grandmother of 9 I'd met on the trails in Chino Hills (and of course I'd get passed by someone that tough), we talked for a bit as we walked, and her advice? Walk when you have to, and hey, someone told me that you should really take some of those salt tablets.

So the conventional running wisdom is that salt (and other electrolytes, but primarily salt) loss is the reason why endurance athletes cramp. I mean, think about the salt that collects on your skin after a sweaty run, seems to make sense, right? But like so many of these common-sense reasons we offer for the phenomenon we experience, it turns out we may have been wrong the whole time. Like, if low sodium levels in your blood is the reason for cramping, why is it that only particular muscle groups cramp, and not all of them? One article addressing a lot of these offered reasons is Schwellnus MP, Muscle cramping in the marathon: aetiology and risk factors. Sports Med 2007;37(4-5):364-7.

 Now that's not to say that actual hyponatremia in runners isn't a real phenomenon, and a really dangerous one, but it's caused not by sweat loss but by excessive forced hydration with free water. But the cause of EAMC may have to do with something else, something called the Central Governor.

And for me, the Central Governor has been sorta anthropomorphized into this guy:

Cramping WILL make you my bitch!

The idea is that your brain/central nervous system has a part of it that, depending on how you look at it, is the sensible friend telling you perhaps you should slow it down so you don't wreck your body ("naw mate, you really don't want another drink or you'll be way hungover in the morning"), or the major party-pooper that's putting the kibosh on the fun you're having by shutting it all down and causing you to miss that personal best you've been looking forward to ("three cars in the driveway? I'm calling the cops"). Here's an episode of Radiolab that describes the Central Governor theory. Here's an article I found in the New Orleans Time-Picayune of all places. Here's another from Outside magazine. Aaaand here's another from iRunFar.

So it's not sodium, it's not sugar, then WTF, Why The Flameout? Because your Central Governor is going, you a damn fool, no way I'm letting you take another step and wreck this whole thing we got going! But what's curious is that taking a swig of briny pickle juice may actually work, but not because it's replacing your lost sodium. Rather, it's because you're essentially suckering the Central Governor in to thinking that the reward is coming so it eases off to let you do your thing.

The 7 mile limb back to the 1st aid station at mile 2.6 became this grim return march. I actually tried taking salt tabs at the 22 mile aid station with the hopes that I could fool the Central Governor into easing off, but no luck, which is funny because a placebo will still work to a degree even if the person receiving it is told that it's a placebo. Nevertheless, every time my calves, or my quads, or my hammies, would seize up, I'd let out this groan - a manly, strong one - stop running, return to speed-limping, and ask what the Central Governor wanted this time. Gels? Sport drink? Michonne's sword in my calf muscles? What?

And the rest of the race was what any endurance event becomes, you just gotta finish because that's how you're going to get back to your car and go home. The 2.6 mile stretch back to the starting/finish line was temporarily impeded by a crossing rattlesnake, and I was going to blame missing my goal time on it (I'd hoped to finish in under 8 hours, i.e. to at least beat the time I'd clocked at the The North Face Endurance Challenge San Francisco 50K - man, I'm getting really good at typing that out), but nope, it was the last 200 ft climb followed by the 400 ft of elevation loss to get back to the start/finish, oh, and all of that cramping.

But at least all of that positivity was there. I managed to shuffle in across the finish line and still had enough pride to whip off the cachalot I wear (to my wife's chagrin) beforehand so I'd look slightly less geeky in the photos and was greeted by all of the as-always awesome volunteers (the races that the director, Keira Henninger, organizes are universally praised), including one guy who heard me say, "BEEEEER!" asked if I wanted one now, because if so he had Anchor Steam on draft, if that was okay. Bless him, I hobbled over, sat down, and the guy looked all the world like Hal Koerner, but when we exchanged names he told me his was George (I'd mentioned before that the ultrarunning world is small, but this time the only running celeb I recognized was Ethan Newberry, the Ginger Runner), but I'd call him St. George because beer always conquers any dragons.

Of course, chugging that beer was a huge mistake as I immediately started feeling lightheaded and nauseated, so I tried to scarf some sandwich down, which was another immediate mistake. On the way back to our rental house I thought I'd stop by the grocery store so I could get a Coke (miracle drink: it's got some sodium, it's got some caffeine, it's got some fluid, but it's also got phosphorated carbohydrates which work as a mild antiemetic) and a beer for the shower, but when I tried to get out of the car I felt so sick I couldn't move. I eventually swiveled back in to the driver's seat and got home where my child offered me salty peanuts (I haven't yet taught her about the Central Governor) and my long-suffering wife had to wash my feet, as bending over caused cramps in my right lowest rectus abdominis muscle and lifting my legs caused cramping everywhere else.

So - sophomore slump, but no big deal, because the day before the race I started researching other 50Ks to do this year (Ray Miller, anyone? Good? Bad?), and now I know I can't be undertrained and overnourished like I usually am, I'm going to have to get some distance on my legs if I'mma tackle 100 miles.

2015 Leona Divide 50K
31.37 miles, 4,281 ft elevation gain, 8hrs:24min:37sec, 16:05 pace, 68,918 steps, 5,696 calories