COMPARISON OF ANTHROPOMETRIC AND PSYCHOLOGICAL CHARACTERISTICS OF MARATHON AND ULTRAMARATHON RUNNERS

A Thesis submitted to the faculty of San Francisco State University In partial fulfillment of A s the requirements for the Degree POIt Master of Science In •ESI Kinesiology: Exercise Physiology

by

Kathryn Ann Enriquez

San Francisco, California

August 2016 Copyright by Kathryn Ann Enriquez 2016 CERTIFICATION OF APPROVAL

I certify that I have read Comparison of Anthropometric and Psychological

Characteristics of Marathon and Ultramarathon Runners by Kathryn Ann Enriquez, and that in my opinion this work meets the criteria for approving a thesis submitted in partial fulfillment of the requirement for the degree Master of Science in Kinesiology: Exercise

Physiology at San Francisco State University.

Dr. Matthew Lee, Professor of Kinesiology/Associate Chair

Professor of Kinesiology /Department Chair COMPARISON OF ANTHROPOMETRIC AND PSYCHOLOGICAL CHARACTERISTICS OF MARATHON AND ULTRAMARATHON RUNNERS

Kathryn Ann Enriquez San Francisco, California 2016

The purpose of this study was to investigate the psychological and physiological characteristics of marathon and ultramarathon runners. Fourteen marathon and 14 ultramarathon recreational runners were assessed for, body height, body mass, BMI, body fat percentage, circumference and skinfold measurements, and completed a semi-structured interview. IBM SPSS Statistics version 24 was used to conduct a MANOVA for all physical measurements to look for main and interaction effects of run group, sex and age. Univariate testing was done for interaction effects to find a simple effect. Statistical significance was set at p < 0.05. A main effect of age (p < 0.05) was found for runners < 45 years having greater thigh circumference than runners > 46 years. A main effect of sex (p < 0.05) was found on body fat percentage with female runners having a higher body fat percentage than male runners. A main effect of sex (p < 0.05) on upper arm circumference was found with male runners having larger upper arm circumferences than female runners. A main effect of sex (p < 0.05) on BMI was found with males having higher BMIs than females. A simple effect was found for calf circumference with female runners < 45 years old having larger calf circumferences than female runners > 45 years old. Interviews found marathoners to be described as lean individuals who participate for the physical health benefits and have set time goals for the future. Ultramarathoners described themselves as individuals who are focused on the total experience and are willing to push

themselves to extreme limits. PREFACE AND/OR ACKNOWLEDGEMENTS

I would like to thank my thesis committee members Dr. Susan Zieff, Dr. Matt Lee, and

Dr. Marialice Kern for their guidance and support throughout this entire research endeavor. Thank you to my friends, parents, grandparents and Eric who through all that has happened have always been my pillars of support and encouraged me to follow my passions. Lastly, thank you to the runners who participated in this study. Without your participation none of this would have been possible and getting to hear each one of your stories was truly a life changing experience for me.

v TABLE OF CONTENTS

List of Tables...... vii

List of Appendices...... viii

Introduction...... 1

Method...... 17

Participants...... 17

Study Design...... 18

Data Analysis...... 19

Results...... 20

Thigh Circumference...... 20

Calf Circumference...... 20

Upper Arm Circumference...... 21

BMI...... 21

Body Fat Percentage...... 21

Interviews...... 21

Exercise History Questionnaire...... 22

Discussion...... 26

Education Levels and Exercise History...... 27

Circumference, Body Mass Index and Body Fat...... 28

Interviews...... 30

Limitations...... 38

Conclusions...... 38

Reference...... 40

Appendices...... 45 LIST OF TABLES

Table Page

1. Marathon Runner Characteristics...... 22 2. Ultramarathon Runner Characteristics...... 23 3. Alternative Activities in which Subjects Participated...... 24 4. Anthropometric Measurements...... 24 5. What Does Your Running Mean to You...... 25 6. Describe Marathon Runners and Ultramarathon Runners...... 25 7. Ultramarathon Consideration...... 25 8. Future Running Goals...... 26 LIST OF APPENDICES

Appendix Page

A. Semi-structured Interview Guide...... 45 B. Exercise History Questionnaire...... 47 C. Recruitment Flyer...... 53 1

Introduction

Long distance running has changed throughout history from an activity of necessity to an activity of enjoyment. The marathon, which was once a more common bucket list item, now has participants running multiply weekend races throughout the year. Participation in the marathon here in the US has increased from an estimated

143,000 finishers in 1980 to an all time high of 550,637 finishers in 2014 (Running USA,

2015). The Boston Marathon, the world’s oldest annually contested marathon, has gone from barely 2,000 participants in the 1970’s to just shy of 30,000 participants as of last year (Boston Athletic Association, 2016).

Ultramarathon events, which are races with a distance greater than 26.2 miles, have also been increasing in popularity, with the number of races offered more than tripling since the 1980’s (Krouse, Ransdell, Lucas & Pritchard, 2011). The Western States 100 Mile

Endurance Run has expanded from just one participant in its inaugural year of 1974, to

353 participants in 2016, with thousands more trying to attain a coveted spot since entry is based on qualifying through a lottery system (Western States Endurance Run

Foundation, 2016). Participants can choose from two subcategories of ultramarathon events. The first is a set distance race with the most common being 50 km, 50 mile, 100 km and 100 miles. The second category of ultramarathons is set timed races. These can include 6-hour races, 24-hour races, or more, spanning up to multiple day races. Over the past 30 years most of the research conducted on ultramarathon runners has focused on potential health effects or participation. There is little research, in comparison to that of 2

other running events, that focuses on finding out what motivates ultramarathoners and how they view themselves and the sport (Knechtle, Rust, Knechtle, & Rosemann, 2012).

The current literature lacks studies in which both physical and psychological characteristics are compared between marathon and ultramarathon runners within the

same study. If we can better understand the factors that motivate ultra runners, we can set more effective training goals and possibly develop strategies to target individual athletes, based on race distance. This understanding is particularly crucial for practitioners (i.e., coaches, strength and conditioning specialists, physicians, physical therapists, sport psychologists, etc.) who will be working with this growing population.

Although both marathons and ultramarathons are considered long distance events, the question as to whether or not these groups should be treated the same or whether they are different enough to be separated into their own distinct categories is one that needs to be addressed. Without an understanding of how these athletes compare to one another we run the risk of developing training, health, and goal plans that may not be efficient for what the needs of these athletes are. People in the running community appear to be split on whether to treat these two groups as separate entities or to categorize them all as endurance athletes. The Road Runners Club of America, a non-profit organization that incorporates 2,400 running clubs and serves over 4,000,000 runners each year, bundles marathon and ultramarathon runners into one group when teaching their level 1 coaching certification courses (Road Runners Club of America, 2016). Among scholars of the physiology of performance, endurance and ultra-endurance athletes are categorized by 3

length of time of continuous participation. Those whose activity lasts 30 minutes to 4

hours are considered endurance athletes but those in activity lasting more than 4 hours are

considered ultra-endurance athletes; this includes Ironman triathletes and ultra­

marathoners (Fink & Mikesky, 2013).

Although both distances can be considered to be on the extreme end of distance

running, the environments in which they are run are very different. Marathons are road

races that typically have thousands of runners participating in the event. The courses are

usually lined with spectators and often have huge pre and post-race expos associated with the event. Ultramarathons are typically trail races run in scenic environments, varying

from mountains to deserts, with participants potentially having to endure extreme weather

and terrain conditions. Ultramarathons, because of their locations, often do not have many spectators along the course, if any, and have far fewer participants, usually no more than a few hundred people for the larger events. Marathons, due to their large number of participants, have pacing groups and it is rare to have competitors running by themselves

along the course. In an ultramarathon it is not uncommon for participants to be running in

solitude for a large portion of the race. Even fueling stations for these two types of events are different. Marathon stations usually offer orange slices, Gatorade and water, whereas a fueling station at an ultramarathon offers these same items but usually will have other non traditional fueling items such as cookies, chips, and candy (Western States

Endurance Run Foundation, 2016). 4

Although there is research that examines the physical and psychological characteristics of endurance athletes, these studies tend to use only marathon runners, a broad category of “long distance runners”, runners grouped with triathletes, or compare individual sports to team sports (Nia & Besharat 2010; Egloff & Gruhn, 1996). In comparison to the amount of studies done using marathon runners, there are few studies that have focused on finding out what motivates ultramarathoners and/or how they view themselves and the sport (Knechtle, Rust, Knechtle, & Rosemann, 2012). The major question that arises from looking at the current research is whether the physical and psychological characteristics of these runners are similar enough to group marathon and ultramarathon runners into one category or do they need to be considered different entities. More research needs to be done on ultramarathon runners and the sport of ultramarathons, as there are major gaps on all fronts of the literature. As participation in both marathons and ultramarathons continues to grow and many of the participants being recreational vs. elite, understanding the physical and mental characteristics of these runners will help health care providers, coaches, sports psychologists and others better understand their clientele and their health, training and psyche needs as well as what aspects of research are needed. 5

Marathon Runners

Physical Characteristics

In the 2016 Olympic Marathon the top male runner ran at a sub 5 minute mile pace with a 15 km sprint finish whereas the top female runner kept close to a 6 minute mile pace through the finish. (NBC Universal, 2016). Top marathoners are often asked about their training style, training volumes, or even the diets they consume, with the hopes that one of those aspects will be a standout against another and may provide some insight as to how they are able to achieve their top finishing times. Probably most notable to anyone watching a marathon event is the body composition that most top marathon runners tend to have. The top runners of the world, even though different ethnicities, all tend to look very similar having long slender legs and lean bodies, often indicating a lower body mass index (BMI) (Lucia et al., 2006). The population of marathon runners is only made up of a fraction of elites. Can these common anthropometric characteristics be found in recreational marathon runners as well? If so it may be information that could be helpful to coaches or trainers to know where to focus on potential muscle development for their clients or even physical therapists or doctors who may be treating these athletes.

A study looking at recreational female marathon runners found that a lower calf circumference was one aspect of a prediction of a faster marathon time (Schmid et al.,

2012). Another study looking at male recreational runners found lower body fat percentage to be one of the indicators of a faster marathon performance (Tanda & 6

Knechtle, 2013). A study done by Christensen and Ruhling in 1983 looked at anthropometric characteristics of non-elite female marathon runners and concluded that women distance runners appeared to be lower in body weight and lower body fat percentage than the average female with the lower body fat percentage being similar to that of male distance runners. The problem with this study is their use of the term

“average” body type. The term “average” body type is subjective and may not be applicable from one study to the next.

Tanda and Knechtle discuss the importance of looking at the anthropometric measurements of recreational runners. With registration fees often over the $100 mark and marathon coaching costing anywhere from $50-$200 a month it would be advantageous for those investing in these races, often times recreational runners, to have a good indicator of how they may fare in these events (Runner’s World, 2015). Having tests done to find out VO2 max or lactate threshold, which are thought to be a way to predict performance, can be expensive and or not available to the average marathon runner (Till, E, Armstrong, S, Harris, G, Maloney, S, 2016). Knowing how anthropometries may play a part in performance is an easy way for new runners to estimate how they may fare in their 26.2-mile race. By looking at the anthropometries and how they relate to ultramarathoners as well may be and indicator of how someone might do if deciding to make the shift from marathon to ultramarathon 7

Psychological Characteristics

Although individuals may meet the anatomical and physiological characteristics that are typically seen in marathon runners, there is more that is required to continue running mile after mile. Motivation is key in long distance running, as it requires diligence to stick with a long training program. There is research that has looked at psychological characteristics of marathon runners in hopes of better characterizing these participants. The problem with these studies is they are often comparing runners to athletes of other sports or to non-athletic individuals. These studies also tend to use a large variety of tools from different personality questionnaires to interviews etc., which makes comparing various studies difficult.

Morgan and Costill (1972) measured levels of introversion-extraversion, neuroticism-stability, anxiety and depression in marathon runners. They had nine marathon runners complete the Eysenck Personality Inventory, the IP AT 8-Parallell-

Form Anxiety Battery, and the Depression Adjective Check List. It was found that marathon runners scored lower on anxiety but were within normal values for all other categories. The problem with this study is that the norms that were used for comparison were that of other athletic sub-groups and not of other runners. Sports differ in the type of demands that are asked of the athlete. This being said, the score comparisons in the

Morgan and Costill study do not lend themselves to us furthering our understanding of these athletes in a bigger context. This study is also over 40 years old and it’s hard to say if these findings would still be applicable to runners today as the sport of marathon 8

running has evolved over the past 40 years. Hanson et al. did a study in 2015 that used a sport specific tool and compared results to runners of other distances. Half marathon, marathon and ultramarathon runners were compared using the Motivations of

Marathoners Scale (MOMS). The MOMS includes four categories of motivation: psychological, achievement, social, and physical. Marathoners were found to have higher levels of extrinsic motivation than that of ultramarathon runners specifically scoring in a higher range on weight concern. The focus on weight concern for marathon runners may lend itself to the idea of an ideal body type for marathoners, which may not be present in ultramarathons.

In addition to understanding psychological characteristics of runners it’s critical to try to understand why these individuals chose to begin running and more so what has kept them involved in the sport of marathoning. A study done by Goodsell, Harris, and

Bailey (2013) looked at motivation for marathon running throughout the lifespan, more specifically developing motivations from when the participants started running to what has kept them involved in the sport. The study found that most of the participants decided to run a marathon because of social influence. The motives for continuing to run varied by age groups and ranged from making friends to mental and physical well-being. This study also noted that social support was a big motivator for all age groups. The motivation of social support can be seen in the large crowds of spectators cheering runners on at marathon events and the many training programs being offered that have socializing and training intertwined. 9

Ultramarathon Runners

Physical Characteristics

In comparison to the research on the physical characteristics for marathon runners, there is little research looking into the physical aspects of ultramarathon runners.

This may be due to the fact that in relation to the marathon, the ultramarathon is still evolving and gaining in popularity and research is focused more on trying to find out the potential effects participation in such events may have on the human body. Beat Knechtle has been the primary researcher on the front of looking at the anthropometric characteristics of ultramarathoners. His studies have shown a great variety of characteristics of ultraendurance runners but have done so by separating out participants based on their race distance instead of encompassing them into a broader category of ultramarathoners. His studies have focused on characteristics such as body mass, body fat percentage, limb length, limb circumference, BMI and skinfold thickness (Knechtle et al.,

2009, 2012, 2014).

In one of his earlier studies Knechtle found that body mass, BMI and upper arm circumference were negatively associated with race performance. This study used participants of a multistage race and had no direct comparison to that of another group besides previously researched anthropometric characteristics of long distance runners.

This study also only included male participants (Knechtle, Duff, Welzel, & Kohler, 10

2009). One of Knechtle’s other studies found that body fat percentage negatively affected performance unless under a critical value of 15%. He also found that a large amount of body fat doesn’t mean the participants won’t necessarily finish the race but that it would make it harder to reliably predict race-finishing time.

The variance in characteristics that has been reported for ultramarathon runners is best seen in a literature review done by Knechtle (2014) that found different anthropometric characteristics varied in their influence on race performance. This varied not only with length of the race but with gender as well. Skinfold measurements appeared to be related to performance for male 100 km ultramarathon runners but had no effect for male multi-stage or 24-hour ultramarathon runners. Female ultramarathon runners of any distance were not incorporated into this comparison. Circumference of upper arm affected race performance for both male and female 100 km ultramarathon runners whereas thigh circumference only affected the male 100 km participants and calf circumference only affected the female 100k participants. Female participants again were not represented for multi-stage or 24-hour ultramarathons and only the male multi-stage ultramarathon runners were affected by upper arm circumference. Length of both upper and lower limbs did not have any affect on the ultramarathon groups represented. Body mass had an affect on both male and female 100 km ultramarathoners and male multi­ stage and 24-hour ultramarathoners, but surprisingly there was no effect for 161 km male or female ultramarathoners. Body mass index had an affect on male 100 km ultramarathoners, male and female 161 km ultramarathoners but no affect on female 100 11

km, male multi-stage or male 24-hour ultramarathoners. Based on the results of this study, there appeared to be no general claims that could be made about ultramarathon runners as a whole except that they tend to vary in their anthropometric characteristics and which characteristics could potentially affect performance or not.

A large portion of Martin Hoffman’s research utilizes participants of the Western

States 100 Mile race, which is considered by many as the top ultramarathon event in the

United States (Hoffman, 2008). One of his studies focused solely on BMI of participants of the Western States race and found that BMI varied greatly between the runners. Many of the runners from this study had a BMI of over 25 and some even over 30, which would categorize them as overweight or obese. Although this study didn’t measure body composition it was suggested that the greater BMI values were due to greater fat stores and more muscle mass and that there may not be an advantage to being lean for ultramarathons as there is in the marathon. Contrary to Hoffman’s findings, Rust et al. in

2012 found minor differences in limb circumference and skinfold thickness of ultramarathoners but was not predictive of performance and therefore could not be compared to similar research for marathon runners.

Psychological Characteristics

Participation in ultramarathon events is spent in a majority of solitude. It’s reported that ultramarathoners get psychological and emotional rewards from participation in their events, which stems from pushing their limits in extremely difficult 12

situations (Krouse et al., 2011). Using the Temperament and Character Inventory test, runners of the TransEurope Footrace, a multi-stage ultramarathon with the goal of covering 2789 miles in 64 days, were found to be more self-transcendent and have a higher transpersonal identification and spiritual acceptance (Freund et al., 2013). These individuals were also less harm avoidant and more explorative (Freund et al., 2013). The runners in this study however were compared to a control group which was made up of individuals who had not competed in long distance running events and on average were only engaging in exercise for about 2.5 hours week. Although there appears to be a transcendent experience that these individuals have, there is still little literature that looks at what psychological characteristics these individuals have that help get them through such physical and mentally taxing events. The research that has attempted this has looked at personality, mood, motivation, sport orientation, etc. but all the studies appear to use varying methods of measurement and typically use participants from a single race which only encompasses ultramarathoners of a single distance. In a study done by Hanson et al., marathon and ultramarathon runners’ motivations were compared using the Motivations of Marathoners Scale (Hanson et al., 2015). Although the tool used may have been designed for marathoners, results found ultramarathoners were more intrinsically motivated and scored highly in personal goal achievement, health orientation and self­ esteem. These findings agree with other studies, which found ultramarathon runners to be more focused on personal goals and less on competition (Acevedo et al., 1992; Simpson,

Post, Young, & Jensen, 2014; Krouse et al., 2011). One study found that female 13

ultramarathoners scored lowest on social motives and recognition as motivators for participation and that their goal orientations were centered on task mastery. These common findings suggest a potentially different mental approach to running ultramarathons compared to that of marathons.

While many studies have used various forms of questionnaires to try to assess the psychological make up of ultramarathoners, others have used interviews in hopes to allow runners to further explain their thought process. One study interviewed participants not only before and after a 125 km race but also at different points during the race (Holt, Lee, Kim & Klein, 2014). Most interesting from the interviews was the runners thoughts on quitting. Participants noted having thought about giving up or being aware of how uncomfortable they were, but never actually considering giving up.

Another study, which looked at participants in a 100-mile race, incorporated free- response answers and found ultramarathoners reported the event as a “mental roller coaster” and the necessity for a “never-give-up attitude”. One participant noted “you can’t know what’s enough until you find out what’s more than enough” (Acevedo et al.,

1992). These findings suggest that ultramarathoners are willing to push past limits that others may find difficult and are very focused on achieving their personal goals. This could be important for those interacting with participants at a race. Participants may need to stop due to physical complications that could put their health in danger but may be unwilling to stop due to their persistent nature. 14

So Why Run an Ultramarathon?

To individuals not familiar with these types of races they may just be seen as

“long distance running events”, but then why is it that only some runners choose to continue past the marathon distance and others do not? Many studies have made

suggestions as to why individuals may decide to participate in ultramarathons both for physical and psychological reasons. A study done by Knechtle et al. in 2012 looking at masters long distance athletes suggests that runners may move to longer distance races as they lose speed due to aging. This theory is interesting considering the average age for ultramarathon participants tends to be individuals 35 and older. Millet et al. suggests the reason some people may make the shift to ultramarathons is because they have larger leg mass, which is normally detrimental for marathon performance, but may not be as much of a hindrance or may even be advantageous for ultramarathons. Hoffman (2008) looked at the BMI of ultramarathon runners and suggested that there might be value in being less lean for these types of events. The higher BMI he found, in comparison to that of marathon runners, may be due to higher fat stores and larger muscle mass, both of which could be advantageous in an ultramarathon event due to not only the terrain but the energy demand as well. Jeukendrup et al. makes the claim that skeletal muscle contractions are fueled by fat and carbohydrate during exercise. He suggests fat is quantitatively the most important fuel for most endurance exercises (Jeukendrup &

Aldred, 2004). Endurance exercise training produces a change that includes a decrease in carbohydrate use and an increase in lipid oxidation (Carter, Rennie, & Tamopolsky, 15

2001). This, in turn, allows for glycogen sparing. Could this adaptation in addition to having a higher BMI, due to fat stores, allow for a runner to continue past the marathon distance without “hitting the wall”? It is important to note also that ultramarathons are often run at paces much slower than that of marathons, which may put them in a zone closer to optimal fat utilization (Kraemer, Fleck, & Deschenes, 2012).

Ultramarathons are, most of the times, a solitary sport. Some studies found ultramarathon runners to be more task oriented than ego oriented (Krouse et al., 2011). It has been suggested that individuals’ achievement orientation may differ in different achievement settings (Gill & Williams, 2008). Comparing a more task orientation for ultramarathoners with a more extrinsic, social motivation for marathoners may be an indication that supports the idea that these two groups be considered separate rather than under the umbrella of long distance runners. Simpson et al. found in their interviews with some ultramarathoners that those involved in ultramarathons may be looking to challenge themselves and do something they didn’t think was possible. They also discovered that many ultramarathoners found the ultra community to be crucial in that there was a greater variety in ability and running backgrounds that allowed for a more supportive environment that was less focused on competition. 16

Where Do We Head Next?

There is a large body of research that has looked into marathon running, its

participants, and the physical effects on the body. With ultramarathons gaining popularity

over the last few decades there is little research in comparison to that of its marathon

counterpart. The bulk of the research that has been done on ultramarathons focused on potential health consequences of participation. Although it is important to research the physical and mental effects of such rigorous exercise we must start at the beginning and first understand who makes up these ultra runners. There is a lack of research that really focuses on understanding what, if anything besides the miles, separates some runners from transitioning to ultra running while others are fine with reaching their max by participating in marathons. There are also only a handful of studies that have been done to compare ultramarathoners and marathoners directly. A few studies have compared anthropometric and training characteristics between the two groups of runners but tend to either use participants from one set ultramarathon distance or encompass ultramarathoners in a broader category of ultra endurance athletes including other sports such as swimmers and triathletes (Rust, Knechtle, Knechtle & Rosemann, 2012; Tanda &

Knechtle, 2015; Knecthle et al., 2014). There are even fewer studies that have directly compared psychological characteristics of marathon and ultramarathon runners within the same study. One study did so but also included half marathon participation comparisons as well (Hanson et al., 2015). What these studies lack is the combination of both physical and psychological comparisons between marathon and ultramarathon runners within the 17

same study. They also fail to truly encompass ultramarathon runners because they have

focused on participants from a single race for each study whereas in reality there are

many options for race distances when it comes to ultramarathons. The purpose of this

study was to better understand marathon and ultramarathon runners and to see what

similarities or differences the two groups have in terms of anthropometric measurements

and psychological factors such as identity, goals, and motivations. Understanding the

foundations of who makes up the sport of ultra running will not only help future research

understand this sport and its participants, but can help coaches and other health professionals better serve their clients specific needs.

Methods

Participants

Participants (n = 28) were marathon (n = 14) and ultramarathon (n = 14) runners from the San Francisco Bay Area. Participants were recruited via flyers posted at local

running stores, fitness centers and community centers around the San Francisco Bay Area

(see appendix C). The researcher contacted local running training groups and running meet-up groups about going to speak to the runners about the research and what they could expect with participation. The researcher also talked to running and sport store managers, training group leaders, fitness center managers and community center leaders, to ask permission to post and hand out materials about the research project as well as to talk to members of their group and facility. 18

Upon contacting the primary researcher, runners that were interested in participating were asked if they met the inclusion criteria. Both marathon and ultramarathon runners had to be recreational runners and could not be considered elite status. This meant that participants could not be earning their livelihood through sponsorship or prize money (Rust et al., 2012). All participants had to be 18 years or older. Marathon runners must have run two marathons or more in the past five years and cannot have run a race longer than 26.2 miles. They also must have completed or plan to complete a marathon in 2016. Ultramarathon runners must have run two or more ultramarathons in the past five years; in which one of the races was 50 miles or longer.

They must also have completed or plan to complete an ultramarathon in 2016.

Study Design

For participants who met the inclusion criteria, an appointment was scheduled at a time, place and date that were convenient for them. At that time, participants were emailed an Exercise History Questionnaire (see appendix B) to complete prior to arriving at their appointment.

Anthropometric measurements were taken upon arrival. Mid-thigh circumference, mid-calf circumference, upper arm circumference, and body mass were taken as well as

7-site skinfold measurements. Circumference measurements were taken using a Gulick tape measure (Baseline tape measure, Medline, Northfield, IL). Skinfold measurements were taken using skinfold calipers (Baseline skinfold calipers, Medline, Northfield, IL). 19

The 7-site skinfold measurement included the following locations: pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac and front thigh. Body fat percentage was

calculated from the 7-site skinfold testing (American College of Sport Medicine, 2013).

Participants reported their body height. Body mass was measured using a portable digital

scale (Conair Thinner scale, Conair, East Windsor, NJ). BMI was calculated using

reported body height and body mass measurements.

During the second half of the appointment with the researcher, subjects participated in a semi-structured interview that lasted from 20-45 minutes (See appendix

A for interview guide). The interview was recorded on two different recording devices to ensure there was a back up if one device failed. Before the interview, the researcher asked each participant demographic questions and explained to them the nature of the interview. The researcher indicated that follow up questions would be used if clarification was needed after the completion of the interview. The primary researcher, to ensure reliability, conducted all measurements and interviews.

Data Analysis

IBM SPSS Statistics version 24 was used to analyze all quantitative data. A

MANOVA was conducted for all physical body composition measurements and to look for main and interaction effects of running group (marathon or ultramarathon), gender

(male or female) and age (45 and under or 46 and over). Univariate analysis was run for any interaction effects that were significant. Statistical significance was set at P < 0.05. 20

Qualitative data was analyzed using grounded theory. Answers to the interview questions were transcribed and coded into different categories agreed upon by the investigator and a thesis committee member. Answers to each question were analyzed individually for all participants. The responses were categorized three different times to allow for an end result of common themes for each interview question.

Results

Fourteen marathon and fourteen ultramarathon runners, (age: 44.71 ± 12.26 and

46 ± 11.61 years respectively) completed all aspects of the study. Participant characteristics are noted in Table 1 and 2.

Thigh Circumference

Results from the MANOVA identified a significant main effect, in terms of a pairwise comparison (p = .002), for age on thigh circumference (Wilk’s Lambda = .593,

F(5,16) = 2.145, p = .106) with run group and sex having no overall significant effect

(Table 4).

Calf Circumference

Results from the MANOVA showed no overall main effects of run group, sex or age (Wilk’s Lambda = .715, F(5,16) = 1.28, p = .322) but found a significant interaction effect of sex and age (p = .029) for calf circumference. Univariate testing found female runners 45 and under to have larger calf circumference than female runners 46 and older

(p = .0063) (Table 4). 21

Upper Arm Circumference

Results from the MANOVA identified a significant main effect for sex on upper arm circumference (Wilk’s Lambda = .247, F(5,16) = 9.757, p = .000) with males having a larger upper arm circumference than females (Table 4).

Body Mass Index

Results from the MANOVA identified a significant main effect for sex on BMI

(Wilk’s Lambda = .247, F(5,16) = 9.757, p = .000) with males having a larger BMI than females (Table 4).

Body Fat Percentage

Results from the MANOVA identified a significant main effect for sex on body fat percentage (Wilk’s Lambda = .247, F(5,16) = 9.757, p = .000) with females having a larger body fat percentage than males (Table 4).

Interviews

For the interview question “what does your running mean to you?” response percentages can be seen in table 5. For the interview question, “If someone were to ask you to describe marathon runners and ultramarathon runners what would you tell them”, response percentages can be seen in table 6. Responses to whether marathoners had considered running an ultramarathon or not can be seen in table 7. Goal response percentages can be found in table 8. 22

Exercise History Questionnaire

All but three of the total participants noted having participated in sports and activities other than running both in the past and currently. A list of mentioned activities can be found in table 3.

Table 1. Marathon Runners’ Characteristics

Characteristics Value

N 14 (females = 10, males = 4)

Age (years) 44.71 ± 12.26

Height (m) 1.69 ±.0093

Weight (kg) 63.97 ± 11.71

Ethnicities 86% Caucasian 14% Hispanic

Average Max Mileage 44.14 miles

Average Min Mileage 18.93 miles

Average Years Running 16.11 years

Highest Education Level High School 1 Some College 1 Trade School 0 Bachelors 4 Masters 5 Doctorate 1 PhD 2 Table 2. Ultramarathon Runners’ Characteristics

Characteristics Value

N 14 (females = 5, males = 9)

Age (years) 46± 11.61

Height (m) 1.73 ±.011

Weight (kg) 70.25 ± 11.53

Ethnicities 79% Caucasian 14% Asian 7% Hispanic

Average Max Mileage 91.79 miles

Average Min Mileage 28.71 miles

Average Years Running 14.5 years

Highest Education Level High School 0 Some College 0 Trade School 1 Bachelors 5 Masters 6 Doctorate 0 PhD 2 24

Table 3. Alternative Activities in which Subjects Participated

Alternative Activities Swimming Skiing Cycling Volleyball Yoga Gymnastics Weight lifting Rock climbing Hiking Snowboarding Triathlon Ballet Soccer Rowing Basketball Softball Baseball Football Backpacking Ice skating Crossfit Surfing Wrestling Crew Tennis Racquetball Cheerleading Stand up paddleboard Aerobics Kayaking Rugby Cricket

Table 4. Anthropometric Measurements

Female Male Runners Runners Marathon Ultra Runners Runners <45 yrs. old >46 yrs. old Runners Runners

Thigh 47.4 ± .89 49.12 ±.987 50.59± .95* 45.93± .92* 48.23 ±.92 48.29± .95 Circum. (cm)

Calf Circum. 35.50 ±.76** 36.79 ± .84 37.14± .81** 35.15± .79** 35.86± .79 36.42± .81 (cm)

Upper Arm 26.27 + .79* 30.76 ± .88* 29.28± .85 27.75± .82 29.03± .82 28± .85 Circum. (cm)

BMI (kg/m2) 22 ± .66* 24.14 ±.735* 23.83± .71 22.31± .69 23.14± .69 22.99± .71

Body Fat % 18.69 ± 1.15* 13.30 ±1.28* 15.41±1.23 16.58±1.20 15.90±1.19 16.09±1.23

Data represented as mean ± standard error *p < 0.05 mean difference significantly differed between sexes, age groups or run groups ** significant interaction effect 25

Table 5. What Does Your Running Mean to You

Marathoners Ultramarathoners Physical 25.37% 3.61% Social 5.97% 4.82% Psychological 55.22% 40.96% Identification 10.45% 10.84% Efficiency 2.98% 0% Experience 0% 39.75%

Table 6. Describe Marathon Runners and Ultramarathon Runners

Marathon Marathon on Ultramarathon on Ultramarathon on on ultramarathon Marathon Ultramarathon Marathon Anyone 35.38% 6.89% 9.37% 3.59% Time Focused 7.69% 0% 11.45% 0% Disciplined 12.30% 14.94% 7.29% .60% Competitive 4.62% 0% 2.08% .60% “Typical” Body Type 9.23% 20.69% 10.41% 5.39% Obsessive 4.62% 1.14% 0% 0% Event Type 9.23% 12.64% 18.75% 19.76% Intensity 10.77% 11.49% 7.29% 4.19% Men vs. Women 1.54% 2.30% 0% .60% Natural at it 3.07% 0% 1.04% .60% Temperament 1.54% 11.49% 3.13% 10.17% Mentality 0% 13.79% 1.04% 4.79% Identity 0% 4.60% 0% 1.20%

Table 7. Ultramarathon Consideration

Marathon Yes 57.14% No 42.86% 26

Table 8. Future Running Goals

Marathon Ultramarathon Time Focused 29.41% 7.40% Races 23.53% 40.74% Other Activities 5.88% 7.40% Involve Others 11.76% 3.70% Running Health 20.59% 11.11% Win/Improve 2.94% 11.11% Performance Change Intensity 5.88% 18.51%

Discussion

The aim of this study was to better understand marathon and ultramarathon runners and to see what similarities or differences the two groups had in terms of anthropometric measurements and psychological factors such as identity, goals, and motivations. Although some research has looked at both of these groups separately, there is little research comparing the two within the same study. In addition, the studies that have looked at the two groups lacked a combination of both physiological and psychological measurements in one study. Even more lacking is a fully inclusive categorization of ultramarathon participants. The studies that used ultramarathon runners have only used participants from a specific race, which only incorporates a fraction of ultra runners from a specific distance. Ultramarathons encompass not only set distance races, but set timed races as well. Therefore, the understanding of ultramarathon runners can be better understood by incorporating runners from a larger variety of ultramarathon events. 27

Education Levels and Exercise History

Almost all of the participants, both marathon and ultramarathon, have obtained a bachelors degree or higher, with a few having obtained a doctorate or PhD. To achieve a degree in higher education requires an individual who is determined and can set goals.

These same traits are necessary to train for and complete a marathon or ultramarathon. In a study done by Anthony Holly (2014) motivations for ultra runners were looked at in context to how it compared to their work motivations. It was suggested that going from one life stressor to the next, as in from a working environment to running an ultra, would teach these individuals life skills such as working through difficult situations that could translate to other aspects of their lives. Although Holly’s study was done with just ultramarathoners this same concept could be applied to those training for a marathon. In an application sense, this information could be useful for employers looking for these same traits in future candidates. If employers have applicants who note they run marathons or ultramarathons, these applicants may have valuable qualities attained from their training and racing that can be applied to their work environment.

Participants were asked to fill out an exercise history questionnaire that asked about previous sport/activity participation throughout their life. Only 3 participants out of the total 28 noted no sport/activity participation prior to their first marathon or ultramarathon. For those that noted prior activity involvement there was on average 4 other sport/activities that they participated in previously or were participating in currently. This point could be advantageous to physicians, trainers or other health care 28

providers who may have a patient or client who has a running injury or is experiencing burnout from race training. Most running injuries are because of repetitive activity (Jin,

J., 2014). Those who run more than 40 miles a week, less than the average maximum for both marathon and ultramarathon runners in this study, and those suddenly increasing the distance of their running, such as may be seen with a transitioning to ultra, have a higher likelihood of obtaining a repetitive use injury. Some suggestions to avoid these overuse injuries are to incorporate 1- 2 days of doing activities other than running (Jin, J, 2014).

Since the subjects of this study noted participation in other activities, coaches or health care providers should not shy away from suggesting participation in other activities as a means to potentially avoid repetitive use injuries or prevent training burnout.

Circumference, Body Mass Index, and Body Fat Percentage Measurements

In this study, there was a main effect of age on thigh circumference with runners

45 and under having a larger thigh circumference than runners 46 and older in both marathon and ultramarathoners. There was also a simple effect shown with female runners 45 and under having larger calf circumferences than female runners 46 and older.

This may potentially be due to a loss in muscle mass as there was no significant main or simple effect or age on body fat percentage. As individuals age there is usually a decline in both muscle strength and power. This is linked to a loss in muscle mass and more of the remaining muscle fibers being type I (Kraemer et al., 2012). The smaller thigh circumference in the runners 46 and older and the smaller calf circumference in female 29

runners 46 and older in this study may potentially be demonstrating the loss in muscle mass portion of the aging process. Although runners already tend to have a larger portion of type I vs. type II fibers it may be this extra shift in losing more type II fibers that lends itself to the more ultramarathoners being in their 40’s, 50’s and 60’s. Although fiber types were not examined in the participants of this study it would benefit future research to look at how younger runners compare to older runners in type I and type II fiber type distribution and how that differs or is similar between marathon and ultramarathon runners. This may lend itself to older marathoners considering switching to ultramarathon as they get older and are considering not being able to keep up the marathon. Having them understand that their aging may actually benefit a switch to ultramarathon could potentially keep them active instead of ending their involvement in running.

The main effect of gender on upper arm circumference, with men having a larger upper arm circumference than females, could be explained by the fact that on average men tend to have more muscle mass than women, especially in terms of upper extremities

(Janssen, Heymsfield, Wang, & Ross, 2000). A larger muscle mass, larger height or overall heavier weight may have been factors for the main effect of men having larger

BMIs than females. Because there was no race group difference for upper arm circumference and BMI these measurements likely do not need to be focused on in future research.

This study also found women to have a higher body fat percentage than that of males. On average women tend to have a higher body fat percentage than males even 30

outside of the athletic frame of reference (Kraemer, Fleck, & Deschnes, 2012). Because there is no run group or age difference that was statistically different, it may be that body fat percentage doesn’t hold as much significance in identifying these two groups of runners.

Interviews

When asked what running meant to them, a majority of both marathon and ultramarthon participants explained that it had a psychological meaning in regards to being therapeutic, being personal thinking time, and allowed them to clear their minds and relieve stress. A marathon participant explained it as, “it’s definitely my happy place, it calms me down, it takes me away from everything” while another noted, “it’s my stabilizer, it’s my place where I meditate”. Ultramarathoners explained it as

“First words that come to mind are freedom, a way to relieve stress, a

way to meditate. I tend to, you know, with the stress of life and work

when I go the distance I get to a place where there is no longer

anything in my mind. At the beginning of a run I have lots

of thoughts going through, like you know that don't even make sense. I

just let all that come in and out, in and out, and eventually there's

nothing there. I get to a zone and that's why I call it a meditative

zone. There's nothing there I'm just going through the motions”

The difference between the two groups is that marathoners also said that running to them had a physical importance in terms of keeping them healthy and staying in shape. The 31

ultramarathoners on the other hand, attributed the experience itself to being important.

They expressed that being able to appreciate the beauty of the environment, the

challenge, accomplishment and the transcendence and bigger meaning of it all was a big portion of what running meant to them. One ultramarathoner described,

“I appreciate the beauty of the landscape and the environment that I'm in

and I don't listen to music for that reason. It bothers me so you know and

that's when I start hearing the birds, and smelling the trees and hearing the

footsteps, it’s just such an amazing experience when I get to that stage so

that you know and alone, in a long description and that's what running

means to me. It sort of mirrors life and all the challenges, the ups and

downs but it does allow me to de-stress because I'm going to appreciate

what I have in life and not focus on what I don't have and to appreciate

nature and what I have so close to me, here, living in the San Francisco

Bay Area its like wow, it's like the perfect place.”

It’s important to note the difference between a physical and experience meaning for these two groups of runners. For coaches taking on clients in either of these groups its important to know what their focus is in participating in these sports. If a coach is trying to motivate a ultra runner they may fair better by focusing on how the runner feeling during training and making sure they have scenic training routes. For a coach who has a marathon training client, they may want to focus more on how the person is fueling themselves, how they are feeling physically during the training process. This could potentially include keeping track of things such as weight, VO2 max and other possible 32

indications of physical adaptations to running. Regardless any coach or trainer working with either of these athletes needs to remember that this is a form of relaxation, stress release, and meditation. Therefore, it is essential to incorporate that into their training as well, so that training does not turn a psychological outlet into a burden.

Participants were asked, “If someone were to ask you to describe marathon runners and ultramarathon runners what would you tell them?” The idea was to see how both groups saw themselves and other runners. Marathoners overwhelmingly tended to agree that anyone could become a marathoner. One marathon participant said, “A marathon runner could be any type of person. [They] don’t have to be super fit, I mean yes in the sense that you have to train but I mean anyone pretty much could run a marathon as long as you train”. This being said, many of them did say that those that are continuous marathoners are more disciplined and intense individuals. Ultramarathoners had a different view of marathoners and saw them as individuals who were more focused on time and speed with one individual noting, “I would probably say marathoners are probably focused on time. They’re focused on speed, they’re focusing on their own performance against other people and I feel like they are very competitive”.

Ultramarathoners also noted there being a “typical” marathon body type, which was centered around being lean.

In terms of ultramarathoners, they identified themselves more based on the characteristics of their event as well as their temperament. One ultra runner said, 33

. .1 think there's more of a sense of.. .you versus the

environment or the course and everybody can have trouble with that, you

know? It's so long that you know things even for the best people that

did the best training something can still go wrong. That doesn’t happen so

much with marathons. If you follow your plan and you do that stuff you’re

probably going to put in a pretty good time. You can be super top level in

ultras and go out and something goes wrong and it doesn't work out for

you and you know you're walking or crawling along and you know people

help you and stop you know they won’t run by you and go oh I cant stop

I’m on my timing for you know. Everybody stops and helps you.”

In addition to seeing marathoners as having a “typical” body type, ultramarathoners also view themselves as having a “typical” body type characterized by thicker, heavier, and stronger bodies. Marathoners agreed that ultramarathoners had a

“typical” body type but saw these individuals as being very lean, fit and more muscular.

Marathoners also agreed that ultramarathoners seem to be more laid back but also described them as having a mental component to their race that wasn’t seen in marathons.

They noted that these individuals were driven and could push themselves to extreme limits. One marathoner noted

“They're a really laid back group, but yet there's some inner

drive that goes way beyond what a marathoner has. They're vigilance,

their diligence, their obsessive-compulsive nature probably. They're

so much more driven. And I think that they've learned to embrace 34

discomfort and disease so much more than the average marathoner.

They embrace it. [Our son] talks about that's what makes him

complete. There's something about that with pushing the limits, it's

way more.”

Although both these groups seems to have a good understanding of who the other runners are there were misconceptions about each group that coaches and trainers working with these individuals as well as the runners themselves need to beware of. A trainer or coach may avoid working with an ultramarathon runner because they may not understand the mental component to the sport or may not know how to push them to a limit that would challenge them. They would need to be aware that ultramarathoners are more focused on the experiences and completion and not necessarily on increasing their speed. On the other hand ultramarathoners may avoid working with a coach who had never run an ultramarathon because they may fear that the coach could potentially be too focused on time and may want to attain a leaner body composition.

One aspect that hasn’t been looked at in any study is why some runners decide to transition to ultramarathons while others do not. Almost all of the ultramarathon participants in this study had run a marathon previously, so the question was what made them take that next step. During the interview ultramarathoners were asked to explain how they got involved in ultramarathons. Likewise, marathoners were asked if they had ever considered running an ultra and if so or not what the reasoning was. For the ultramarathoners there was no single stand out reason as to what made him or her decided 35

to transition to ultra. Answers varied from friends, to bad break ups, to wanting the next challenge after a marathon, to reading about it in a magazine and wanting to try it. The wide variety of reasons for deciding on ultramarathons means that there can’t be a generalization about these runners and their decision to participate in ultramarathons.

When the marathon participants were asked about having ever considered running an ultra 8 of the 14 runners said yes. When asked what had stopped them from making the transition into ultramarathoning, answers ranged from it being too much of a time commitment, to needing others to do it with them, to being scared about injury or whether their bodies could handle it. The 6 marathoners who said they had not considered running one said that ultras were a huge commitment, they tended to like the speed of the marathon, and for others they thought the marathon was already challenging enough that they didn’t need to add any more mileage onto it. As a coach or trainer, the variation in both the marathon and ultramarathoners response indicated the importance of getting to know the runner is that you may potentially be working with in order to best tailor a program to their specific needs and wants.

Another aspect that hasn’t been discussed in other research is whether or not these runners ever consider quitting while running races and what would be the situation in which they would potentially quit. One study looked at thoughts during “hitting the wall” for marathoners but even more curious is what happens to the ultra runners who are going far beyond the “hitting the wall” moment (Buman, Omli, Giacobbi Jr. & Brewer, 2008).

All participants were asked if they had ever thought about quitting during a race. Almost 36

all participants had said they were aware at some point of their discomfort but never considered quitting. This agrees with responses from runners in the study done by Holt in

2014. Both groups had similar answer such as “I’m not a quitter”, “I told people I was doing it”, or “I had already made it this far”. The major difference in responses is that some of the ultramarathon runners had a bit more extreme answers with many of them saying that they would not quit a race unless they had broken bones, their bodies were shutting down or if they physically had to be dragged off the course. One runner responded,

“Unless you’re going to pull my body off the course or I’ve got some

really bad life threatening disease thing there’s no reason for you to stop,

you can keep going. If you do give in that one time when you could have

gone then I think the subsequent time would be easier to make excuses

unless it’s dire life or death there’s no reason to”

This response was similar to one from a participant in Holt’s study who explained:

“You never want to quit. You want to be pulled off the race. You push yourself to the limit. And you say, “I’m not quitting”... I guess that’s in the ultra runner mentality... If you make the cut-off time you’re going on, no matter what you’re feeling like unless you collapse and fall down.” (Holt et al., 2014) 37

The importance of this difference is that these ultramarathoners may have a more extreme pain threshold or may ignore the signs their body is giving them in what potentially could be a dangerous or even deadly situation. This could potentially be something that coaches and especially physicians need to consider. Pain is our body’s way of telling us that there is some sort of actual or potential tissue damage (Goodman and Fuller, 2015). If they are working with athletes who regularly will push past extreme pain, they need to be aware these athletes could possibly do further damage not only during training, but also in recovery.

At the end of the interview participants were asked what their goals were and where they hoped their running would go in the future. The most common answers for the marathon participants were that they had specific time goals they wanted to hit, there were specific races or number of races they wanted to do, as well as wanting to continue to run healthy. The ultramarathon runners had specific races they wanted to run as well.

The other common response that ultramarathoners had was wanting to change the intensity of their training and racing and either take a break or just run more relaxed and casually. Coaches for both these groups of runners should take note of the differences in goals for each group. The commonality being that both groups of runners have a goal of a specific race in mind but coaches should be aware that if they are dealing with ultramarathoners they may want to focus on the goal of completion instead of focusing on a time goal. 38

Limitations

There were multiple limitations to this study. The first limitation is that the time

of day that body measurements such as weight and limb circumference were taken, were

scheduled at different times of the day so these measurement times were not

standardized. Due to working around the schedules of both the researcher and

participants, sessions ranged from early morning to evening. It’s possible that having a

session later in the day could have altered weight measurements taken as multiple meals

may have been consumed by that time. Secondly, due to location restrictions the group of

runners that participated were only from the San Francisco Bay Area. Another limitation

was that participants were asked to report their height as opposed to measuring it.

Because locations of sessions varied it was hard to have a means of measuring height to

bring to each meet up. Lastly, due to time and resource constraints the number of

participants had to be limited. Had the researcher been able to extend the length of data

collection there may have been more participants involved.

Conclusion

The lack of stand out results in terms of run group having an effect on

anthropometric measurements suggests that the physical comparison of marathon and

ultramarathon runners is one of lesser importance. Future research should focus on the psychological comparison of these two groups of runners. With the difficulty of both

these groups being able to fully understand each other’s identities, it is especially

important for anyone working with these athletes to be aware of any misconceptions or 39

biases they may have about these types of runners. Based on the variation in answers, there does not appear to be a common reason for why some runners transition from marathon to ultramarathon, while others do not. Coaches and trainers need to be aware that both groups enjoy the therapeutic aspects of running both these events, but marathoners enjoy the physical aspects while ultramarathoners are more interested in the experience as a whole. It’s also important for any coach, trainer, health care provider, etc. to recognize that ultramarathoners may push themselves to limits that surpass a point of injury, therefore should be monitored during training and competition. Future research should focus on understanding more about the participants of these two types or events, as there is still much to be explored. 40

Resources

American College of Sports Medicine. (2013). ACSM’s Guidelines for Exercise Testing

and Prescription Edition 9. Philidelphia, PA: Lippincott Williams & Wilkins, pg.

67 -69

Acevedo, E., Dzewaltowsi, D., Gill, D., & Noble, J. (1992). Cognitive Orientations of

Ultramarathoners. The Sport Psychologist. 6, 242-252

Boston Athletic Association. (2016). Results & Commentary: 2016 Boston Marathon.

Retrieved from http://www.baa.org/races/boston-marathon/results- commentary/2016-boston- marathon.aspx

Buman, M., Omli, J., Giacobbi, P., & Brewer, B. (2008). Experiences and coping

responses of “hitting the wall” for recreational marathon runners. Journal of

Applied Sport Psychology. 20(3). 282-300

Carter, S., Rennie, C., Tamopolsky, M. (2001). Substrate utilization during endurance

exercise in men and women after endurance training. Am J Physiol Endocrinal

Metab, 280, E898 - E907.

Egloff, B., & Jan Gruhn, A. (1996). Personality and endurance sports. Personality and

Individual Differences, 21(2), 223-229.

Fink, H., Mikesky, A. (2013). Practical Applications In Sports Nutrition. Burlington,

MA: Jones & Bartlett Learning, pg. 362

Freund, W., Weber, F., Billich, C., Birklein, F., Breimhorst, M., et al. (2013). Ultra­

marathon runners are different: Investigations into pain tolerance and personality 41

traits of participants of the transeurope footrace 2009. Pain Practice, 13(7), 524-

532.

Gill, D., Williams, L. (2008). Physiological Dynamics o f Sport and Exercise. Champaign,

IL: Human Kinetics, pg. 125

Goodman, C. & Fuller, K. (2015) Pathology Implications for the Physical Therapist.

St. Louis, Missouri: Elsevier Saunders. Pg. 57

Goodsell, T., Harris, B., Bailey, B. (2013) Family Status and Motivations to Run: A

Qualitative Study of Marathon Runners. Leisure Sciences, 35, 337-352

Hanson. N., Madaras, L., Dicke, J., Buckworth, J. (2015). Motivational differences

between half, full, and ultramarathoners. Journal o f Sport Behavior. University of

South Alabama.

Hoffman, M. (2008). Anthropometric characteristics of ultramarathoners. International

Journal o f Sports Medicine, 29(10), 808-811.

Holly, A. (2014). Understanding perceptions of motivation among ultra marathon runners

in ultra distance running and in the workplace.

Holt, N., Lee, H., Kim, Y., & Klein, K. (2014). Exploring experiences of running an

ultramarathon. Sport Psychologist, 28( 1), 22-35.

Janssen, I., Heymsfield, S., Wang, Z., & Ross, R. (2000). Skeletal muscle mass and

distribution in468 men and woman aged 18-88 yr. Journal o f Applied Physiology,

89(1), 81-88.

Jeukendrup, A., Aldred, S. (2004). Fat supplementation, Health, and Endurance 42

Performance. Nutrition, 20, 678 - 688. D01:10.1016/j.nut.2004.04.018

Jin, J. (2014). Running injuries. JAMA, 312(2), 202

Knechtle, B., Duff, B., Welzel, U., & Kohler, G. (2009). Body mass and circumference of

upper arm are associated with race performance in ultra endurance runners in a

multistage race-the isarrun 2006. Research Quarterly for Exercise and Sport,

80(2), 262-268.

Knechtle, B., Rust, C., Knechtle, P., & Rosemann, T. (2012). Does muscle mass affect

running times in male long-distance master runners?. Asian Journal o f Sports

Medicine, 5(4), 247-256.

Knechtle, B. (2014). Relationship of anthropometric and training characteristics with race

performance in endurance and ultra-endurance athletes. Asian Journal of Sports

Medicine, 5(2), 73-90.

Kraemer, W., Fleck, S., Deschenes, M. (2012). Exercise Physiology: Intergrating

Theory and Application. Philadelphia, PA: Lippincott Williams & Wilkins, pg

46 -50, 243-245

Krouse, R , Ransdell, L., Lucas, S., & Pritchard, M. (2011). Motivation, goal orientation,

coaching, and training habits of women ultra runners. Journal o f Strength and

Conditioning Research, 25(10), 2835-2842.

Lucia, A., Esteve-Lanao, J., Olivan, J., Gomez-Gallego, F., San Juan, A., et al. (2006).

Physiological characteristics of the best eritrean runners - exceptional running

economy. Applied Physiology Nutrition and Metabolism-physiologie Appliquee 43

Nutrition Et Metabolisme, 31(5), 530-540.

Millet, G., Hoffman, M., & Morin, J. (2012). Sacrificing economy to improve running

performance-a reality in the ultramarathon?. Journal o f Applied Physiology,

113(3), 507-509.

Morgan, W., & Costill, D. (1972). Psychological characteristics of the marathon runner.

Journal o f Sports Medicine and Physical Fitness, 12(1), 42-46.

NBC Universal. (2016). Track and Field M en’s Marathon. Retrieved from

http://results.nbcolympics.com/track-field/event/men- marathon/phase=atm099100/index.html?intcmp=r#l-schline-calltoaction

Nia, M., & Besharat, M. (2010). Comparison of athletes’ personality characteristics in

individual and team sports. Procedia - Social and Behavioral Sciences, 5, 808-

812.

Road Runners Club of America. (2016) History o f the RRCA. Retrieved from

http://www.rrca.org/about/history/

Running USA. (2015, May 15). 2014 Running USA Annual Marathon Report. Retrieved

from http://www.runningusa.org/marathon-report-2015?returnTo=annual-reports

Runners World. (2015, July). Why You Need a Running Coach. Retrieved from

http://www.runnersworld.com/marathon-training/why-vou-need-a-running-coach

Rust, C., Knechtle, B., Knechtle, P., & Rosemann, T. (2012). Comparison of

anthropometric and training characteristics between recreational male

marathoners and 24-hour ultramarathoners. Open Access Journal o f Sports

Medicine, 2012,121-129. 44

Schmid, W., Knechtle, B., Knechtle, P., Barandun, U., Riist, C., et al. (2012). Predictor

variables for marathon race time in recreational female runners. Asian Journal of

Sports Medicine, 5(2), 90-98.

Simpson, D., Post, P., Young, G., & Jensen, P. (2014). "It's not about taking the easy

road": The experiences of ultramarathon runners. Sport Psychologist, 28(2), 176 - 185.

Tanda, G., & Knechtle, B. (2013). Marathon performance in relation to body fat

percentage and training indices in recreational male runners. Open Access Journal

o f Sports Medicine, 2013, 141-149.

Tanda, G., & Knechtle, B. (2015). Effects of training and anthropometric factors on

marathon and 100 km ultramarathon race performance. Open Access Journal o f

Sports Medicine, 6, 129.

Till, E., Armstrong, S., Harris, G., Maloney, S. (2016). Predicting Marathon Time Using

Exhaustive Graded Exercise Test in Marathon Runners. Journal o f Strength and

Conditioning Research, 30(2), 512-517.

Western States Endurance Race Foundation. Aid Stations. (2016).

Retrieved from http://www.wser.org/course/aid-stations/

Western States Endurance Race Foundation. Qualifying Races. (2016).

Retrieved from http://www.wser.org/qualifying-races/

Western States Endurance Race Foundation. Results 1974-present. (2016).

Retrieved from http://www.wser.org/results/ 45

Appendix A

Marathon Interview Guide:

1. What does your running mean to you?

2. If someone were to ask you to describe marathon runners and ultramarathon runners what would you tell them? □ Besides race distance, do you think there are any major differences between ultramarathon and marathon runners?

3. Tell me about your journey with running, where did you start? □ Motivations □ First race □ Solo or with others

4. Where are you now in your running journey? □ Motivations □ Most recent races □ Solo or with others

5. What do you see for your running journey in the future? □ If not mentioned: Have you ever considered running an ultramarathon? o IF YES: What has kept you from doing an ultramarathon? 46

Ultramarathon Interview Guide:

1. What does your running mean to you?

2. If someone were to ask you to describe marathon runners and ultramarathon runners what would you tell them? □ Besides race distance, do you think there are any major differences between ultramarathon and marathon runners?

Tell me about your journey with running, where did you start? □ Motivations □ First race □ Solo or with others

4. Where are you now in your running journey? □ Motivations □ Most recent races □ Solo or with others □ If not explained: How did you get involved in ultras?

5. What do you see for your running journey in the future? 47

Appendix B

EXERCISE HISTORY QUESTIONNAIRE Comparison of Anthropometric and Psychological Measurements of Marathon and Ultramarathon Runners

The following questions are designed to obtain information regarding physical activity and exercise history. Please answer all questions and provide as much information as you possibly can. This questionnaire, as well as any other family medical information you provide, will be kept confidential and will not be shared with any unauthorized person or organization unless you specifically request us to do so.

Name:

Date Completed:

Date of Birth:______Age:

mm-dd-yy

Sex: M F

Major Events/Sports:

Major Awards/Best Performances: 48

Exercise History Age 10-20

Describe the exercise(s) that you usually participated in (e.g., running, cycling, swimming, skiing, weight lifting). Include the type of training (e.g., long duration, interval training, etc...)

How often did you exercise (days/week)?

At what intensity did you typically exercise? Light Moderate Hard OR Pace_____ On days that you did exercise, how long did you usually exercise (hours)?

Did you participate in competitive sports? Yes No_____ If yes, what sports did you participate in?

If the sport was a team sport, what position did you play?

If the sport was an individual sport, what event(s) did you participate in?

What was your best time or performance?

Did you win any awards? Yes No______If yes, what awards did you win?

Did you have any significant time off from your exercise program? Yes No______If yes, why (planned, injury, other circumstances)?

How long did you have time off?

Did you participate in any physical activity outside of your training (work, transportation, recreational, etc...)? If yes, please describe. 49

Exercise History Age 20-30

Describe the exercise(s) that you usually participated in (e.g., running, cycling, swimming, skiing, weight lifting). Include the type of training (e.g., long duration, interval training, etc...)

How often did you exercise (days/week)?

At what intensity did you typically exercise? Light Moderate Hard OR Pace On days that you did exercise, how long did you usually exercise (hours)?

Did you participate in competitive sports? Yes No_____ If yes, what sports did you participate in?

If the sport was a team sport, what position did you play?

If the sport was an individual sport, what event(s) did you participate in?

What was your best time or performance?

Did you win any awards? Yes No______If yes, what awards did you win?

Did you have any significant time off from your exercise program? Yes No______If yes, why (planned, injury, other circumstances)?

How long did you have time off?

Did you participate in any physical activity outside of your training (work, transportation, recreational, etc...)? If yes, please describe. 50

Exercise History Age 30-40

Describe the exercise(s) that you usually participated in (e.g., running, cycling, swimming, skiing, weight lifting). Include the type of training (e.g., long duration, interval training, etc...)

How often did you exercise (days/week)?

At what intensity did you typically exercise? Light Moderate Hard OR Pace On days that you did exercise, how long did you usually exercise (hours)?

Did you participate in competitive sports? Yes No_____ If yes, what sports did you participate in?

If the sport was a team sport, what position did you play?

If the sport was an individual sport, what event(s) did you participate in?

What was your best time or performance?

Did you win any awards? Yes No______If yes, what awards did you win?

Did you have any significant time off from your exercise program? Yes No______If yes, why (planned, injury, other circumstances)?

How long did you have time off?

Did you participate in any physical activity outside of your training (work, transportation, recreational, etc...)? If yes, please describe. 51

Exercise History Age 40-50

Describe the exercise(s) that you usually participated in (e.g., running, cycling, swimming, skiing, weight lifting). Include the type of training (e.g., long duration, interval training, etc...)

How often did you exercise (days/week)?

At what intensity did you typically exercise? Light Moderate Hard OR Pace______On days that you did exercise, how long did you usually exercise (hours)?

Did you participate in competitive sports? Yes No_____ If yes, what sports did you participate in?

If the sport was a team sport, what position did you play?

If the sport was an individual sport, what event(s) did you participate in?

What was your best time or performance?

Did you win any awards? Yes No______If yes, what awards did you win?

Did you have any significant time off from your exercise program? Yes No______If yes, why (planned, injury, other circumstances)?

How long did you have time off?

Did you participate in any physical activity outside of your training (work, transportation, recreational, etc...)? If yes, please describe. 52

Exercise History Age 50 +

Describe the exercise(s) that you usually participated in (e.g., running, cycling, swimming, skiing, weight lifting). Include the type of training (e.g., long duration, interval training, etc...)

How often did you exercise (days/week)?

At what intensity did you typically exercise? Light Moderate Hard OR Pace On days that you did exercise, how long did you usually exercise (hours)?

Did you participate in competitive sports? Yes No_____ If yes, what sports did you participate in?

If the sport was a team sport, what position did you play?

If the sport was an individual sport, what event(s) did you participate in?

What was your best time or performance?

Did you win any awards? Yes No______If yes, what awards did you win?

Did you have any significant time off from your exercise program? Yes No______If yes, why (planned, injury, other circumstances)?

How long did you have time off?

Did you participate in any physical activity outside of your training (work, transportation, recreational, etc...)? If yes, please describe. Appendix C Are you a marathon or ultramarathon runner?

W e are looking for marathon and ultramarathon runners to participate In a study looking at physical and psychological characteristics of both groups of runners.

Participants must meet the following requirements:

MARATHONERS: ULTRAMARATHONERS: - 18 years or older - 18 years or older - Must have run 2 or more marathons in the - Must have run 2 or more past 5 years ultra marathons in the past 5 years. One of those races must have been - Must have completed, be training for, or a 50 miler or longer. have a planned marathon in 2016 - Must have completed, be training - CANNOT have run a race of a distance for, or have a planned greater than 26.2 miles ultramarathon in 201 6.

If Interested in participating or finding out more about the study please contact Katie Enriquez at 650-704-3963 or [email protected] s* r j* * III its s r ? S f ? S f f 111 % r H i IP ? ! • • Iff £ = 3 ? 1 S’ jQ* m i | i Ul Hi 1 <&i « # j r m § 3 i § 3 % 3 1 §3 % IS iff « 9. N i y i is «*> 0. N mo m US w 5 Z a* - f*4ft & m n-?» «ft 4ft f y m c i 9 s 1 c I | b b * f i a. c c c 1 1 *■