Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2015) 14, 702 - 707

Case report
Clinical and Laboratory Responses of Cross-Country Skiing for a 24-H World Record: Case Report
Markus Niemelä1, Jukka Juvonen2,3, Päivikki Kangastupa4, Onni Niemelä4, , Tatu Juvonen1
Author Information
1 Department of Surgery, Oulu University Hospital, Finland
2 Internal Medicine, Oulu University Hospital, Finland
3 Kainuu Central Hospital, Kajaani, Finland
4 Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, and University of Tampere, Finland

Onni Niemelä
✉ Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, Finland
Publish Date
Received: 01-07-2015
Accepted: 27-07-2015
Published (online): 24-11-2015
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The physiological consequences of ultra-endurance cross-country skiing in cold conditions are poorly known. We report here clinical, echocardiographic and laboratory findings from a 41-y old male elite skier in a world record trial for 24-h skiing. The athlete completed a total of 406.8 km outdoors with the temperature ranging between -24°C and –5°C during the 24-h period. Post exercise, notable increases from baseline values were observed in myoglobin (50-fold), creatinine kinase (30-fold) and proBNP (6-fold), whereas troponin T or troponin I levels remained unchanged. At baseline, echocardiographic findings showed cardiac hypertrophy and after skiing, a 5% reduction of left-ventricular end-diastolic dimension. Increases in markers of kidney (creatinine) and liver function (alanine aminotransferase), serum uric acid, C-reactive protein and white blood cell counts were also noted. In addition, electrolyte disturbances including hyponatremia, hypophosphatemia and hypocalcaemia were noted during the follow-up. The data indicates that a prolonged period of high-intensity skiing leads to muscle, heart and kidney affection and activation of inflammation even in an experienced elite skier. The observed health effects underscore the need for strict medical surveillance of participants in extreme sports with long duration.

Key words: Ultra-endurance sports, organ function, muscle, kidney, heart

           Key Points
  • An elite athlete was able to ski over 400 km during 24 hours with an outdoor temperature ranging between –5 °C and –24 °C.
  • Several postrace abnormalities occurred in biomarkers of muscle, heart, kidney, liver and inflammation status.
  • Serum troponins, specific markers of myocardial cell damage, remained stable.
  • The report supports careful medical surveillance of participants in extreme sports with long duration.
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