Another Solid Reason Not to Do a Mud-Obstacle Run

Endurance races that involve electrical shocks, ice baths, and pools of stagnant farm water are acutely popular. No one tells you about the bowel infections.
A man swims through mud underneath electrified wires during a Tough Mudder in Vermont (Jessica Rinaldi/Reuters)

On October 12, 2012, public health officials at Nellis Air Force Base outside Las Vegas, got an unsettling call. Their medical center’s emergency department reported that in the last three days, three active-duty military had come in with vomiting and bloody diarrhea. All said they had recently fallen face-first in mud, during a Tough Mudder obstacle-course event on a nearby cattle ranch in the town of Beatty the week prior.

Mud is a standard part of any Tough Mudder, the substance for which the race is named. Actually, I shouldn’t say race.

"The Tough Mudder is not a race," participants chant as part of the Tough Mudder Pledge taken in unison at the starting line of each 10-to-12-mile course. They also pledge to "overcome all fears" and not to whine ("kids whine"). Nowhere, though, does their pledge mention enduring infectious diarrhea. But it is a very real risk in this sort of event, the U.S. Centers for Disease Control and Prevention (CDC) now says.

In response to these three cases, Nellis Public Health mobilized local and state officials in an investigation, the results of which were released yesterday by the CDC. The team ultimately identified 22 similar cases tied to that October 2012 Mudder, most likely caused by infection with the fecally transmitted bacterium Campylobacter coli. 

As the CDC reported there was a statistically significant association with "inadvertent swallowing of muddy water while competing" and Campylobacter infection. The investigators found no association with drinking water or eating food provided by event organizers. Participants did report seeing cattle and swine on or near the course on the day of the run.

A Tough Mudder "Mud Mile" obstacle in Osnabrueck, Germany, 2013 (Wolfgang Rattay/Reuters)

Lieutenant Colonel Chad Claar, the public health flight commander at Nellis Air Force Base who led the research, told The Washington Post he suspects there were many more cases; the 22 they found are only those who got sick enough to seek out medical care.

In the four years since Tough Mudder events began springing up around the world, more than a million people have taken part. In case you’re not among the million, or the millions more who’ve seen some promotional YouTube montage set to Mumford and Sons and interspersed with textual platitudes about truly living, the event is marketed to young professionals listless in the face of the inescapable encroach of grown-up/office life. The real world is isolated and predictable and annoyingly safe. Tough Mudder is about adventure, teamwork, and overcoming all fear. Beyond mud, there are electrical shocks and ice baths. Tough Mudder describes the "Arctic Enema" obstacle thusly:

"Some athletes use ice baths for recovery, but your muscles aren’t going to be relaxed after a swim in this frigid dumpster. Climb right into the floating iceberg abyss—don’t overthink it. When you’re submerged, find the mental and physical strength to swim through the ice, under a wooden plank and pull yourself out on the other end. You’ll come out feeling like shrink-wrapped leftovers straight out of the freezer. Emphasis on the shrink." That’s a joke about male genitals. Also emphasis on don't overthink it.

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James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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