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The list of issues and injuries that an ultrarunner can face while racing is lengthy. Blisters, chafing, cramps, muscle strains, knee pain, heat illnesses, and altitude sickness are just a handful of the possibilities. Perhaps none of these potential problems, however, are as prevalent and impactful during ultramarathons as nausea and vomiting. Indeed, practically every ultrarunner has their own tale of yakking on the side of a trail or into an aid station trashcan. For some, it's an unlucky one-off event, but for others, recurrent nausea consistently mars their ability to perform up to their expectations.

The reason so many ultrarunners get stricken with nausea is undoubtedly multi-faceted, and to be honest, there is not a cut-and-dry singular explanation. Still, we do have some clues as to why the prevalence of nausea and vomiting is up to 2-3 times more common in these races than much shorter distances. Let's take a look at what the research says about the possible culprits as well as some of the strategies you can try to deal with this troublesome symptom.

Just How Common Is Nausea?

Beyond the anecdotes, what exactly do we know about the prevalence of nausea in ultrarunners? Before we get to some data on that question, it's important to recognize that surveys used to gather this information quantify nausea differently. In addition, the occurrence of nausea is likely to vary with temperature and humidity, elevation, and the length of a race. As such, it's a bit foolhardy to throw out a single estimate of nausea and think that it applies to every ultrarunning scenario.

Caveats aside, some of the relevant data tells us that nausea incidence clearly increases with race duration. Dr. Martin Hoffman, professor emeritus in the Department of Physical Medicine and Rehabilitation at the University of California, Davis, has overseen several studies on this topic, and in some cases, up to 6 out of 10 runners experience nausea during an ultramarathon. To give you some perspective, consider that around 10% of regular marathoners typically suffer from nausea.

Now, some of these cases of nausea are quite mild or transient, meaning they won't hurt performance much. Still, up to half of cases can be severe enough to impact ultrarunning performance. In fact, one of Hoffman's investigations found that nausea or vomiting was the leading reason for racers to drop out of the Western States 100-mile Endurance Run. During a regular 26.2-mile marathon, a runner suffering from nausea near the end of the race is likely to grit their teeth and finish. In contrast, the thought of having to suffer for another 20, 30, or 50-plus miles while feeling queasy is, very understandably, too much for some ultrarunners to cope with.

Multiple Causes

The puzzle of why nausea is so common during ultrarunning is difficult to solve, in large part because there are multiple physiological changes occurring simultaneously over the course of an ultrarace. It's also incredibly tough to match the demands of an ultrarace in a laboratory, so mechanistic studies looking at the origins of nausea during super-prolonged exercise are few and far between.

Even with the scientific uncertainty, we do have some decent guesses as to what's provoking the urge to spew in so many ultrarunners. During prolonged exercise, you secrete hormones like adrenaline and glucagon into your blood that allow your body to liberate fat stores, make glucose, and maintain your blood sugar levels. Arginine vasopressin, a fluid-conserving hormone, is also released so that you can reduce urine production. Blood levels of endotoxins (sort of invader molecules that seep through your gut's walls) and inflammatory molecules can also surge. And finally, you've got muscle breakdown products, like urea and creatine kinase, spilling into your bloodstream. All these substances can stimulate what's called the chemoreceptor trigger zone in your brainstem, which communicates with another brain region called the vomiting center.

Long story short, you've got a cocktail of substances circulating in your bloodstream that act as a potent trigger for nausea. The concentrations of all these substances tend to increase over time during prolonged exercise, which may help to explain why nausea becomes much more common in the latter half of ultraraces.

A Nervous Gut

The release of stress hormones like adrenaline can also occur even before you take your first official stride during an ultra. Throughout the history of sport, many athletes have been plagued by precompetition anxiety severe enough to induce vomiting. Bill Russell, perhaps the best center of all-time in the sport of basketball, reportedly vomited before many of his big games. There's also a moment in the Steve Prefontaine biopic Without Limits that perfectly captures what prerace nerves can do to even the most elite athletes. In the scene, Prefontaine is seen puking under the grandstands before his race against other running greats like Frank Shorter and Gerry Lindgren, even as the crowd chants his name.

These anecdotal accounts are also beginning to be backed by research. Just this year, two of my colleagues and I published an investigation that found anxiety to be associated with the occurrence of nausea in endurance race competitors. The study, published in the European Journal of Sport Science, had 186 endurance-trained individuals document their life stress and anxiety as well as the gut symptoms they experienced during one of their recent races. A subset of the subjects also reported how anxious they felt on race morning. Ultimately, racers who reported higher levels of general anxiety had over three times the odds of experiencing significant levels of nausea during competition. Further, those who reported lots of anxiety on race morning had over five times the odds of experiencing substantial in-race nausea.

These are correlations, so it's hard to definitively prove that these athletes' nausea issues were completely due to anxiety. That said, other lines of evidence support the idea that this relationship is at least partially cause and effect. Plus, most of us have had our own out-of-sport run-ins with gut distress stemming from worries and anxieties, whether they be from a first date, a medical procedure, or an interview.

Sweltering Heat and Altitude

Environmental conditions also play a major role in development of nausea during ultras. Some of the most prominent ultramarathons in the world (e.g., Western States Endurance Run, Badwater Ultramarathon, Marathon des Sables) are held in sweltry conditions. When researchers ask runners to exercise in the heat, the incidence of nausea can quadruple in comparison to exercise carried out at the same intensity in more mild conditions.

Besides the heat, another environmental factor that many ultrarunners deal with is altitude. Nausea is a well-known symptom of acute mountain sickness, with written accounts going back at least several hundred years. Add exercise to the mix, and you can start to understand why nausea is a big issue for competitors at races like the Hardrock 100 and the Khardung La Challenge, which has the highest elevation of any ultrarace in the world.

Fueling: A Delicate Balance

One other notable contributing factor to nausea is in-race fueling. The nutritional demands of ultrarunners can far outpace those of other athletes competing at shorter distances. For those ultrarunners who are looking to push the boundaries of what their bodies can do, they might end up consuming carbohydrate at rates of 60-90 grams per hour. That's roughly equivalent to 3-4 sport gels per hour! Even lesser amounts of carbohydrate (30-60 grams per hour), though, can pose a significant challenge to the gut's capacity to digest and absorb fueling.

In short, fueling during an ultramarathon often takes place on a knife's edge. Too little can lead to a bonk and even nausea if your blood sugar gets too low, while too much foodstuff can also provoke the gut and induce queasiness. With that in mind, it's critical that ultrarunners practice their fueling strategies multiple times throughout the weeks leading up to a race. Ideally, at least some of these gut-training sessions would be done at a pace similar to race-pace and in similar environmental conditions that an athlete expects to compete in.

Strategies to Quell or Avoid Nausea

Given all this information, you might be wondering how to best avoid the nauseous fate of so many ultrarunners. First, you should accept the fact that there is likely no ironclad way to completely eliminate the risk of nausea during an ultra. There are just too many potential causes. That being said, you do have the power to minimize your risk of being stricken with severe nausea. And for some athletes, it will be important to take a multi-pronged approach as opposed to relying on a single strategy. Below are my top five tips for reducing the odds of tossing your cookies during your next ultra.

Acclimate to the heat and altitude if your race is held under those conditions. Likewise, employ cooling strategies (e.g., drinking cool beverages, putting some ice in your cap or shirt, dousing yourself with cool/cold water, etc.) throughout a race that's held in sweltering conditions.

If you suffer from prerace nerves, try techniques like slow deep breathing or mindfulness. Better yet, consult with a sports psychologist.

Avoid both overhydrating as well as underhydrating. During a single-stage ultramarathon, some amount of weight loss is normal (due to the loss of energy stores), so you shouldn't be drinking so much that you weigh the same or more after a race as before the race. On the other hand, large body mass losses (e.g., >5%) may be a sign that you're underhydrating.

Train your gut! If you plan to push the boundaries of food and fluid intake during the race, of course it makes sense that you should practice your nutrition plan during some of your longer training runs. Much like other organs in your body, the gut is adaptable.

Try ginger. I'm generally not a purveyor of supplements, but if the above mentioned strategies don't do the trick for you, there is at least one nutritional product that has shown some anti-nausea properties in settings outside of exercise: ginger. To be specific, these anti-queasiness effects have been most often studied in nausea occurring during pregnancy, motion sickness, and chemotherapy. No supplement is without risk, and many products sold in the U.S. are of questionable quality, so anyone looking to use ginger supplements-or any other supplement for that matter-should do their research and consult with their healthcare provider as well.

Most Olympic marathoners spend their youth focused on running. They join track clubs, compete in national championships, and pursue the sport from an early age.

Julia Mayer’s journey was very different.

Today, Mayer is Austria’s marathon record holder, a multiple national record holder on the roads, and an Olympian. Yet for much of her athletic life, running was not her primary sport.

For 16 years, she played soccer.

Then she discovered something that would change her life.

“I noticed that I was really fast in the fun runs and that it was really, really fun,” Mayer said when reflecting on her transition from soccer to distance running.

What began as curiosity quickly became a passion. She eventually made the bold decision to leave soccer behind and focus entirely on running. It was a move that surprised many people around her, but Mayer believed she had found her true athletic calling.

The decision proved to be the right one.

Within a few years, Mayer developed into one of Europe’s top marathon runners. Her steady improvement carried her from local races to the international stage, where she began rewriting Austria’s record books.

She now holds Austrian records in the marathon, half marathon, and road 10K. Her marathon best of 2:26:08 established her as the fastest female marathoner in Austrian history. Her performances in the half marathon and 10K have further cemented her place among the country’s all-time great distance runners.

Her rise culminated with qualification for the 2024 Olympic Games in Paris.

Competing in the Olympic marathon represented the realization of a dream. On one of the most challenging marathon courses ever used for the Olympics, Mayer ran courageously against the strongest field in the world and finished 55th in her Olympic debut.

Behind the scenes, success has come through extraordinary dedication. During marathon preparation, Mayer trains twice a day and covers approximately 200 kilometers, or 124 miles, each week. The workload demands discipline, patience, and a deep commitment to continuous improvement. 

What makes her story especially inspiring is not simply the records or the Olympic appearance.

It is the fact that she found her greatest talent later than many elite runners.

In a sport where athletes are often identified at a young age, Mayer’s journey serves as a reminder that potential does not always reveal itself early. Sometimes it takes years of experience, a willingness to try something new, and the courage to follow a different path. 

The former soccer player who once chased a ball across a field is now chasing history on the roads of Europe.

And according to those closest to her, her best performances may still be ahead.

For runners of every age and ability, Julia Mayer’s story delivers a powerful lesson: it is never too late to discover what you are capable of.

From soccer player to Olympian, her journey proves that remarkable achievements can begin when least expected.

Megan Keith produced the performance of her career in Oslo on Thursday night, shattering one of Scotland’s longest-standing distance running records and cementing her place among Britain’s greatest female 3000m runners.

The 24-year-old clocked a sensational 8:28.35 over 3000m, breaking the Scottish outdoor record that had stood for nearly four decades. In doing so, Keith eclipsed the previous mark of 8:29.02, set by Scottish legend Yvonne Murray back in 1988, ending a record reign that had lasted 38 years.

Keith’s breakthrough run was more than just a national record. The performance also propelled her to third on the UK outdoor all-time list, placing her behind only two of Britain’s most celebrated distance runners — Paula Radcliffe, who leads the rankings with 8:22.20, and Laura Weightman, whose 8:26.07 remains the second-fastest outdoor mark by a British woman.

The significance of Keith’s achievement is amplified by the calibre of athletes she now joins in the record books. For decades, Murray’s mark stood as one of Scottish athletics’ most untouchable records, surviving generations of elite competitors. Keith has now succeeded where many outstanding runners have fallen short, announcing herself as one of the leading distance talents in British athletics.

Her time also compares favourably with the best performances produced indoors. Olympic medallist Laura Muir ran 8:26.41 indoors in Karlsruhe in 2017, underlining just how exceptional Keith’s outdoor effort in Oslo truly was.

The run continues a remarkable rise for the Scottish star, whose progression over recent seasons has transformed her from a promising prospect into a genuine force on the international stage. Running with confidence and composure against elite competition, Keith demonstrated both the speed and endurance required to challenge the very best in Europe and beyond.

With the World Championship season gathering momentum, Keith’s record-breaking display sends a powerful message. Not only has she etched her name into Scottish athletics history, but she has also established herself as a serious contender in one of the sport’s most competitive events.

In Oslo, Megan Keith did far more than break a record. She ended a 38-year wait, climbed into the upper echelon of British distance running, and delivered a performance that may prove to be a defining moment in her career.

British middle-distance talent Phoebe Gill took another significant step forward in her return to top form, producing a determined victory over 800 metres at the Meeting de Marseille in France on Wednesday.

Competing in challenging, wind-affected conditions, the 19-year-old demonstrated both resilience and composure as she held off a late charge from Switzerland's Veronica Vancardo to secure the win in 2:00.81. Vancardo finished just three hundredths of a second behind in 2:00.84, underlining the fiercely contested nature of the race.

While the margin of victory was narrow, the result represented another encouraging milestone for Gill as she continues to rebuild momentum following her injury setback. The young Briton showed impressive race awareness and strength in the closing stages, maintaining her advantage despite the difficult conditions that made fast running a challenge throughout the evening.

The Marseille triumph adds to a growing body of evidence that Gill is steadily progressing toward her best form. Earlier in her comeback campaign, she clocked 2:01.50 for 800m in Bydgoszcz before demonstrating her versatility with a strong 4:05.53 performance over 1500 metres at the BMC Grand Prix meeting in Trafford.

Those performances have highlighted not only her improving fitness but also her ability to compete across multiple distances as she carefully builds her season. The Marseille victory now provides further confirmation that the European junior star is moving in the right direction.

Gill emerged as one of Britain's most exciting middle-distance prospects through a series of breakthrough performances as a teenager, earning widespread recognition for her fearless racing style and remarkable maturity. Injury temporarily interrupted that upward trajectory, but her recent results suggest she is steadily rediscovering the form that made her one of the sport's brightest young talents.

With each race, the signs of progress become increasingly evident. Winning in difficult conditions and under pressure from a quality field is often a stronger indicator than a fast time alone, and Gill's latest success demonstrated exactly those qualities.

As the summer season gathers pace, the Marseille victory offers another confidence boost for the British teenager, whose return continues to gain momentum. If her recent progression is any indication, Gill could soon find herself back among the leading names on the European middle-distance circuit. 

The NCAA Track and Field Championships delivered a moment few could have predicted as Ja’Kobe Tharp produced one of the most astonishing performances in the history of sprint hurdling, rewriting the record books in spectacular fashion.

Competing in the opening round of the men’s 110-meter hurdles, the Auburn star stunned the athletics world by clocking an incredible 12.75 seconds, becoming the first athlete ever to break the 12.80-second barrier. In doing so, he eclipsed the long-standing world record of 12.80 set by Aries Merritt in 2012, a mark that had stood as one of the sport’s most revered achievements for more than a decade.

What makes Tharp’s breakthrough even more remarkable is the scale of his improvement. Entering the championships, the defending NCAA and U.S. champion had recorded a season-best of 13.05 seconds. Yet under the brightest spotlight, he unleashed a performance that exceeded every expectation, slicing an extraordinary 0.26 seconds from his personal best in a race that instantly became one of the greatest ever run.

The achievement sent shockwaves throughout the track and field community. While Tharp arrived in Eugene as one of the leading contenders for the NCAA title, few envisioned a performance capable of redefining the limits of the event. Instead, the American hurdler delivered a race for the ages, combining flawless technique, explosive speed, and impeccable rhythm from the first hurdle to the finish line.

The historic run not only secured his place in athletics history but also transformed the outlook of the championship. With the world record now in his possession, Tharp advances to the final as the overwhelming favorite, carrying momentum that could make an already unforgettable weekend even more extraordinary.

For years, the 12.80 barrier appeared untouchable. On a stunning day at the NCAA Championships, Ja’Kobe Tharp proved otherwise, producing the kind of performance that reminds fans why sport remains so unpredictable. In a matter of seconds, he turned a routine qualifying round into a landmark moment that will be remembered for generations.

The world record no one saw coming is now a reality—and Ja’Kobe Tharp is the man who changed history.

A new chapter in middle-distance running may have begun in Oslo after American teenager Cooper Lutkenhaus produced one of the most remarkable performances of the season, narrowly defeating reigning Olympic champion Emmanuel Wanyonyi in a thrilling men's 800m contest at the Diamond League meeting.

The 17-year-old sensation shocked a world-class field by crossing the finish line first in a race that came down to the smallest of margins. After an intense battle over the final metres, Lutkenhaus held off Wanyonyi by just one hundredth of a second, producing a dramatic finish that left the packed stadium in disbelief.

From the opening lap, the pace was relentless as the leading contenders positioned themselves for a fierce showdown. As the athletes entered the home straight, Wanyonyi appeared poised to unleash his trademark finishing kick. However, Lutkenhaus refused to be intimidated, matching the Olympic champion stride for stride before producing a perfectly timed lean at the line to secure a historic victory.

The result marks a breakthrough moment for the young American, who continues to establish himself as one of the brightest talents in global athletics. Defeating an Olympic champion at a Diamond League event is a feat many athletes spend entire careers pursuing, yet Lutkenhaus achieved it before reaching adulthood.

For Wanyonyi, the narrow defeat does little to diminish his status as one of the world's premier 800m runners. The Kenyan once again demonstrated his exceptional class and competitiveness, pushing the race to a world-class standard and forcing his young rival to deliver the performance of a lifetime.

Beyond the result itself, the race offered a glimpse into what could become one of the sport's most exciting rivalries in the years ahead. With established stars and emerging talents now pushing each other to new heights, the men's 800m continues to evolve into one of athletics' most captivating events.

On a memorable night in Oslo, the spotlight belonged to Cooper Lutkenhaus. At just 17 years old, he stood toe-to-toe with an Olympic champion and emerged victorious, announcing himself to the athletics world in spectacular fashion.