Only a few miles from the finish of the UTMB, desperately crawling up the final climb of the race and trying to avoid the cut-offs, Sabrina Pace-Humphreys was experiencing all the normal symptoms of someone who is trying to run 108 miles across mountains and had reached their very limit.
“ I really wanted to get to La Flegere,” said Sabrina, talking on the Runner’s World podcast, but the “fermé crew” [sweeper team] had caught up with her and began to ask if she was okay. “I was saying to them, ‘Oh, go on, you know, you go on,’ totally oblivious to what was happening”.
After an initial assessment where medics tried to reinvigorate her with a bouillon drink [a hot, salty beverage] so she could get down off the mountain, it was becoming more and more obvious that something serious was afoot.
Sabrina can’t remember a lot of what happened after this, but she has pieced together the following events. “They were apparently asking me questions, ‘Who are you? What's your date of birth? What’s your husband's date of birth? Where do you live? Why are you here? What's the date today?’ And I was taking a while to answer that, and then I kind of turned a bit more. And they asked me a question, apparently, which was ‘when was the last time you can remember weeing, and what did it look like?’”
This was when alarm bells really began to ring, as Sabrina cast her memory back through the race and remembered that her urine had been brown. They took a pinprick test, like a glucose test, and the medics fed the results of that test to the doctors on the ground at UTMB medical centre. Things quickly went from them trying to reinvigorate Sabrina to “she needs to get out of there now”, so they sent a helicopter to rescue her, something Sabrina can only partially remember, “ The helicopter coming down, I don't remember that. All I remember is the pain that I felt of them pushing me into the helicopter. My body was in such pain.”
Sabrina was first taken to the UTMB medical centre, then to hospital and then to the ICU as more tests revealed that she was suffering from a condition called exertional rhabdomyolysis, more commonly called rhabdo. Never heard of it? Nor had Sabrina.
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Rhabdo is a serious medical condition where extreme physical exertion causes rapid muscle breakdown at a cellular level, releasing harmful proteins into the bloodstream, potentially causing kidney damage as well as risks to the heart due to an excess of potassium.
What are the symptoms of rhabdomyolysis?
The symptoms of rhabdomyolysis consists of 1) muscle pain, 2) weakness and 3) tea-coloured urine.
The issue that Sabrina highlights in the podcast is that muscle pain and weakness are pretty much a given during an ultra race, so monitoring the colour of your urine is not only smart to gauge dehydration, but also crucial in recognising any early signs of rhabdo.
While the condition is extremely rare, Sabrina is keen for all runners to understand the risk, especially those who compete in longer races over rough terrain (extensive downhills and the impact on the muscles can increase the risks).
“ There was no ‘off’. I just thought, as many of us do, this is part of ultrarunning. Of course I'm tired. Of course I feel sick. Of course I'm hallucinating. Of course I'm confused. I'm 101 miles into the Ultra-Trail du Mont-Blanc. There was nothing in my head that said, ‘That's it’, because I just equated these symptoms with doing a hard thing. I didn't understand rhabdo. I didn't know what it was.”
Ben is Runner's World's Multiplatform Director and has worked at the title for over 13 years. He has always had a deep interest in running shoes and tech and has amassed a wealth of knowledge on running products during this time and through countless hours of testing. Ben also enjoys exploring the science behind running and how it informs advances in training and racing. He is also the co-host of the weekly podcast. Ben is a firm believer that running is just as much about adventure and fun as about chasing PBs, and he likes nothing more than a day spent explore new trails.
