Crawling to the Finish Line: Why do Endurance Runners Collapse?
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Crawling to the Finish Line: Why do Endurance Runners Collapse? Implications for Understanding of Mechanisms Underlying Pacing and Fatigue Alan St Clair Gibson • Jos J. De Koning • Kevin G. Thompson • William O. Roberts • Dominic Micklewright • John Raglin • Carl Foster
Ó Springer International Publishing Switzerland 2013
Abstract Effective regulation of pace enables the majority of runners to complete competitive endurance events without mishap. However, some runners do experience exercise-induced collapse associated with postural hypotension, which in rare cases results from life-threatening conditions such as cardiac disorders, cerebral events, heat stroke and hyponatraemia. Despite the experience of either catastrophic system failure or extreme peripheral muscle fatigue, some runners persist in attempting to reach the finish line, and this often results in a sequence of dynamic changes in posture and gait that we have termed the ‘Foster collapse positions’. The initial stage involves an unstable gait and the runner assumes the ‘Early Foster’ collapse position with hips slightly flexed and their head lowered. This unstable gait further degrades into a shuffle referred to as the ‘Half Foster’ collapse position characterized by hip flexion of approximately 90° with the trunk and head parallel to the ground. At this point, the muscles
of postural support and the co-ordination of propulsion begin to be compromised. If the condition worsens, the runner will fall to the ground and assume the ‘Full Foster’ collapse position, which involves crawling forwards on knees and elbows towards the finish line, with their trunk angled such that the head is at a lower angle than the hips. Upon reaching the finish line, or sometimes before that, the runner may collapse and remain prone until recovering either with or without assistance or medical treatment. The Foster collapse positions are indicative of a final, likely primordial, protective mechanism designed to attenuate postural hypotension, cardiac ‘pump’ insufficiency or cerebral blood flow deficiency. Continuing to attempt to reach the finish line in this impaired state is also perhaps indicative of a high psychological drive or a variety of neurological and psychological pathologies such as diminished sensitivity to interoceptive feedback, unrealistic situational appraisal or extreme motivational drives. A better understanding of the physiological, neurological and
A. St Clair Gibson (&) Department of Sport and Exercise Sciences, Sport, Exercise and Wellbeing Research Centre, Faculty of Health and Life Sciences, Northumbria University, Northumberland Road, Newcastle upon Tyne NE1 8ST, UK e-mail: [email protected]
D. Micklewright School of Biological Sciences, University of Essex, Colchester, UK
J. J. De Koning MOVE Research Institute Amsterdam, Faculty of Human Movement Studies, Vrije Universiteit, Amsterdam, The Netherlands K. G. Thompson Discipline of Sport Studies, University of Canberra, Canberra, ACT, Australia W. O. Roberts Depar
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