The Dark Side of Fitness

Inside the often unfortunate, sometimes weird, and occasionally gruesome drawbacks of fitness fanaticism.

April 2016

—Photography by Tom Speruto

Because there’s something called the female athlete triad—and it’s not awesome.


When female athletes don’t give their bodies the fuel they need to expend the energy they want to, a troika of nasty medical problems can ensue.

1. Energy Deficiency 

This is the root of the problem: Whether an athlete is purposefully restricting caloric intake or doesn’t know she isn’t eating enough, energy deficiency forces her body to alter critical physiological systems—like growth and reproduction—to conserve energy for survival. Athletes who are energy deficient will often feel fatigued and unable to focus.

2. No Menstrual Cycle 

When the body halts menstruation because of low energy stores, the suppression of estrogen—an important developmental hormone—leads to decreased bone growth and bone strength.

3. Low Bone Mass

 A poorly fueled body that has been compelled to curb estrogen is unable to support bone health. The result can be osteoporosis and stress fractures. Although not all are caused by low bone density, stress fractures account for up to 16 percent of injuries in runners and up to 20 percent of all athletic injuries.

Because seemingly minor irritations can morph into agonizing indignities.

The Problem: Chafing

Cause: Friction, either skin on skin or skin on fabric

PresentationRed, rashlike irritation, sometimes accompanied by bleeding, which most commonly occurs on the nipples, thighs, groin, armpits, and shoulders.

In-race quick fixRemove the offending fabric if you can. Turning clothing inside out can help; rubbing a layer of ChapStick over the irritation can work in a pinch.

Avoid: Use lubrication. Vaseline is OK, but runners and triathletes like BodyGlide, while cyclists swear by Chamois Butt’r and DZ Nuts.

The Problem: Blisters

Cause: Friction

PresentationPockets of fluid (pus, blood, serum) materialize under the top layer of skin, usually where socks or shoes rub the skin.

In-race quick fix: Hopefully you have some moleskin in one of your drop bags; if not, you’ll have to decide if it’s worth stopping at a medical tent to get some.

Avoid: Keep your feet moist by using lotion every day, and on race day slather your feet with Vaseline. Don blister-free socks and wear shoes that fit.

The Problem: Runner's Trots

Cause: Unknown; researchers surmise organ jostling, decreased blood flow to the intestines, and pre-race jitters might be contributing factors

Presentation: It feels like your everyday bout of diarrhea, except there’s often nowhere to relieve yourself—unless you’re cool with using the bushes.

In-race quick fix: You’re kinda SOL (pun intended).

Avoid: Take Imodium an hour before the start; limit fiber within 24 hours of the race; avoid caffeine on race day; drink fluids before and during your event.

The Problem: Incontinence

Cause: Stress applied to the bladder during exercise causes leakage (experts suggest weakened pelvic muscles could be a factor)

Presentation: Ever laugh so hard you peed a little? It’s kinda like that. Studies suggest up to 30 percent of female runners experience it.

In-race quick fix: Find a Porta Potty or, honestly, don’t worry about it. A little urine never hurt anyone.

Avoid: Doctors say pelvic-strengthening exercises can help. Most runners wear an absorbent pad, bring wet wipes, or just change clothes after the race.

The Problem: Nausea/Vomiting

Cause: Pre-race anxiety, decreased blood flow necessary for digestion during a race, and a sudden change in exertion after the race can all cause GI distress

PresentationYou feel like—or actually end up—puking.

In-race quick fix: Take it easy on the energy gels; stay adequately hydrated; and pop an antacid if you have one. 

Avoid: Finding a way to avoid nausea and vomiting takes trial-and-error research—meaning, you need to find out what combo of race-day nutrition works for you.

The Problem: Excessive Snot

Cause: Unknown, but up to 40 percent of endurance athletes suffer from exercise-induced allergy symptoms

Presentation: Runny nose, sneezing, itchiness, and congestion can occur.

In-race quick fixThe “snot rocket.” Depress one nostril while blowing through the other to clear it—without using a tissue. 

Avoid: Using a nasal spray that relieves your runny nose is about all you can do.

Because Colorado’s fickle terrain can mount a sneak attack.

Pounding the pavement has its advantages: A jog on an urban running path is quick and convenient. But many of Colorado’s endurance elite prefer the knee-saving qualities, challenging topographies, and distracting beauty of backcountry trails. Which is exactly what Dave Mackey was looking for on May 23, 2015, when he headed toward Boulder’s Bear Peak on an overcast 40-degree morning.

“I had planned a three-hour run,” says Mackey, a well-known and decorated trail runner sponsored by shoemaker Hoka One One, “but the outing took a bit longer than that.” After cruising up Shadow Canyon and South Boulder Peak—a 3,000-foot climb—Mackey summited Bear Peak around 9 a.m. and began picking his way down a scree-filled path on the west side of the mountain. He’d done this route on a hundred previous occasions, but this time the earth moved under his feet. “I stepped on a giant rock, and it rolled,” he says. “I tried to catch myself, but I took an out-of-control 50-foot fall.”

Although he tumbled a long way over rough terrain, Mackey says he’s certain the compound fracture of his left leg happened when the 250-pound boulder came to rest on his lower leg. As luck would have it, the two-time USA Track & Field Ultrarunner of the Year had just minutes before passed a friend on the trail; Paul Gross was still close enough to hear Mackey’s screams and was able to lift the rock off his shattered leg with the help of a tree branch. It then took several good Samaritans and the Rocky Mountain Rescue Group four hours to evacuate a bloodied Mackey from his precarious perch to Boulder Community Health.

“Before that day, the worst injury I’d had was a sprained ankle,” Mackey says. The Bear Peak accident was something altogether different: Over the subsequent six months, Mackey endured 12 surgeries, including procedures to stabilize his leg, address myriad infections, insert rods and plates, and place bone and muscle grafts. Mackey knows he’ll likely never again be 100 percent, but he hopes he can at least get back into running someday. He also knows he was lucky. “If it had been later in the afternoon or during the winter,” Mackey says, “I might not have survived. There might not have been someone on the trail to help me.”