Page 133 - JSOM Summer 2022

An Ongoing Series

Obstacle Course Events
Hazards and Prevention Measures

Joseph J. Knapik, ScD

ABSTRACT
This article reviews hazards associated with obstacle course for particular types of advanced military training like the Spe-
events (OCEs) like the Spartan Race and Tough Mudder, cial Forces Assessment and Selection course. Recently, obsta-
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which are becoming increasingly popular, and provides strat- cle course events (OCEs) have becoming increasing popular in
egies to mitigate these hazards. In seven studies, the overall the civilian sector. The first mass participation OCE was the
weighted incidence of participants seeking medical care during Tough Guy Competition conducted in the English village of
OCEs was only 1.4% with ~6% of these requiring higher level Perton in Staffordshire in 1987. Since 2010, other OCEs have
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medical care at a hospital. Nonetheless, 27% of participants been developed and become extremely popular in the United
self- reported ≥1 extremity injury. Common OCE medical States (US) and elsewhere. OCEs typically involve running on
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problems included sprains/strains and dermatological injuries rough and muddy terrain and negotiating a series of physically
(abrasions/laceration/blisters); the ankle and knee were com- demanding obstacles. Obstacles can involve scaling high walls,
mon injury locations. There are reports microorganism infec- balancing on narrow beams, swimming through very cold wa-
tions during OCEs, associated with ingestion of contaminated ter, climbing high ladders, and/or swinging on bars or rings
water and mud. On military obstacle courses, ~5% were in- over water. While running is involved in all these challenges, it
jured, but this activity has the highest injury rate (injuries/hour is negotiating the obstacles that is the focus. The popularity of
of training) of all major testing or training activities. Ankle these events is underscored by the fact that efforts are under-
sprain risk can be reduced with proprioceptive training and way add obstacle course racing to the Olympics. 5
prophylactic ankle bracing. Knee injury risk can be reduced
with exercise-based programs that incorporate various com- Examples of OCEs are the Spartan Race, Tough Mudder, and
ponents of proprioceptive training, plyometrics, resistance Rugged Maniac, although there are others such as the Zom-
exercises, stretching, and shuttle/bounding running. Reducing bie Mud Run, Warrior Dash, Civilian Military Combine,
abrasions and lacerations involve wearing low friction cloth- Mud Hero, GORUCK Challenge, and Wolf Run. The Spar-
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ing, gloves, and prophylactic covering of skin areas prone to tan Race had 4 major options including the Spartan Sprint
abrasions/lacerations with specific protective materials. Re- (~5 km, 20 obstacles), Spartan Super (~10 km miles, 25 ob-
ducing blister likelihood involves use of antiperspirants with- stacles), Spartan Beast (~21 km, 30 obstacles), and Spartan
out emollients, specialized sock systems, and covering areas Ultra (50 km, 60 obstacles). In 2022, 124 Spartan events are
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prone to blisters with paper tape. Reducing infections from scheduled worldwide, with 55 in the US. Some examples of
microorganism can be accomplished by protective covering Spartan obstacles are shown in Figure 1. Another example
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open wounds, rinsing off mud post-race, and avoiding inges- of an OCE is the Tough Mudder in which over 6 million indi-
tion of food and drink contaminated with mud. These chiefly viduals have participated to date. The Tough Mudder includes
evidence-based injury and illness prevention measures should a 5-km option, popular 10-12 mile option, and even 12- and
minimize the risks associated with OCEs. 24-hour options. The 10- to 12-mile courses generally have
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20-25 obstacles, examples of which are shown in Figure 2.
Keywords: infection; obstacle course events; injury In 2022, 25 Tough Mudder events are listed across the US.
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A final example is the Rugged Maniac, a 5-km event with 25-
obstacles, some of which are described and depicted in Figure
3. In 2022, there are 26 events Rugged Maniac events sched-
Introduction
uled in the US. 11
Military personnel are no strangers to obstacle courses. Virtu-
ally every Soldier has gone through obstacle courses in basic OCEs are typically conducted outdoors in remote areas with
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training and timed obstacle course completion is a requirement participants encountering environmental extremes (heat/cold),
Correspondence to joseph.j.knapik.ctr@mail.mil
MAJ (Ret) Joseph J. Knapik served over 50 years with the US military as a wheel vehicle mechanic, medic, Medical Service Corps officer, con-
tractor, and Department of Defense civilian. He is currently a research physiologist at the US Army Research Institute of Environmental Medicine
and an adjunct professor at Uniformed Services University (Bethesda, MD) and Bond University (Robina, Australia).
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