Surgeon competes in ultramarathons, travels 100 miles in just over a day

The key: maintaining homeostasis against brutal conditions, dehydration and fatigue.

Issue: September 2006

In the running world, ultramarathons may be the most extreme variation of the sport with runners logging nearly 100 miles in a 24-hour period.

Andrish trains for events by running on rocky terrain and at high altitudes. During races, he can experience up to 57,000 feet in elevation change.

During a typical competition, racers can trek through deserts, woods or across mountains battling frigid temperatures, scorching heat or pelting rain. “A marathon is an effort,” Jack T. Andrish, MD, an orthopedic surgeon at the Cleveland Clinic and ultramarathon competitor, told Orthopedics Today. “A 50K is an effort. They’re all fun and they’re thrilling, but a 100-miler is a true adventure.”

Andrish, 62, became interested in the sport after his son urged him to go long-distance trail running. “So one time when I was out to visit with him, he took me out trail running through the desert and mountains of Arizona,” Andrish said. “And I still have the prickly pear thorns in my knee to show for it.”

He competed in his first ultramarathon, the Crown King Scramble, nearly a decade ago. The 50K-run winds through the Arizona desert, over a mountain range and ends in an old mining town.

“It was a very different experience,” Andrish said. “It was a lot of exertion and a lot of uphill [running].” He continued to compete in events such as the JFK 50-mile run and the Wasatch Front 100.

Western States Endurance Run

Through his skill and perseverance, Andrish worked his way to the Western States Endurance Run, an event widely considered the Boston marathon of ultramarathon running. It took Andrish five years to qualify for the 100-mile race, which includes 40,000 feet of elevation change. “The first time I ran it I got to 37 miles, and I was pulled because I didn’t make the time cut-off,” he said. “And I was devastated. It’d been five years just to work up to the point and qualify and do all these things, and I didn’t even get to the tough part of the course [at] 37 miles.”

During his second attempt, he reached 80 miles but failed to make the time qualification. He finished the event on his third attempt. “But what happened along the way, during that, is that I really discovered that I really liked ultramarathons and not just Western States, but the Wasatch Front 100 and the Masanutten 100, and the JFK 50-miler and the Manhattan Run 50K and the Buckeye Trail 50K,” Andrish said. “There are so many wonderful opportunities to spend the day running in the woods, through the desert or the mountains and that’s basically what I do as long as my health will permit. I’ll continue to do it.”

Before racing in ultras, the former 10-year marathon competitor saw running as a “means to an end.

Ultramarathons often extend from the daylight hours into the night. Therefore, Andrish says that understanding nutrition is crucial.

Andrish, a former marathon runner, has competed in the JFK Ultra and the prestigious Western States Endurance Run.

Images: Andrish J

“I always ran so that I could always be in a certain level of condition that I could enjoy what I really liked to do, which was back-country skiing, downhill skiing and bicycle touring,” Andrish said. “And it wasn’t until I discovered [trail running] that running became fun. Running became sort of the end result.”

Ultras vs. marathons

He noted that ultras offer a completely different experience than standard marathons in distance, elevation and training. Average Boston marathon runners finish in about four hours while ultra participants can take up to 36 hours to finish a race. “Plus Heartbreak Hill in Boston doesn’t even register a blip on the topography,” Andrish said. “It’s a 100 feet maybe, 200 feet max, where as when you run Wasatch, for instance, the amount of elevation change from start to finish is about 57,000 feet.”

Finishing times in ultras also depend on course conditions, which make it difficult to compare splits. “There may be times you run a course and it’s total mud and it’s pouring down rain and thunderstorms or it snowed on you,” Andrish said. “And other times it may be like at Western States this year, the temperature got to over 110° in the canyons.” Yet, he notes that his best times “are just that I’ve been able to finish within the time frame.”

Because the conditions change with each course, Andrish focuses on more than distance training. “What training for an ultramarathon is about is learning how to run and carry a pace on rocky, rooty, steep and uneven terrain,” he said. During training, he runs along three-mile hills and journeys up to 30 miles on weekends.

Understanding metabolism and maintaining homeostasis are crucial in ultramarathon training. Marathon participants may experience dehydration and heat exposure, but ultra runners face increased risks. “But, when you’re out there for extended hours running through the day and then you’re running through the night and then your running into the next day, there’re lots of opportunity to get fluid overload, to get dehydrated, to have not enough salt, too much salt [and it’s] certainly easy to run out of calories and all of your glycogen stores,” Andrish said.

While the race calls on physical reserves, it also requires mental fortitude. “I think that probably truth be known, the mental is more important than the physical,” he said. “I mean the physical follows the mental, because when you mentally shut down, then you physically shut down.”

His next goal: the Leadville Trail 100. The race extends through Colorado and pits runners against nearly 15,000 feet of elevation change. “I’m looking forward to seeing that in the summertime, hopefully, all the way,” he said.