Over the weekend, an Australian athlete was pictured with faeces on her legs, after experiencing a bowel movement during a HYROX fitness competition in China. While such incidents are relatively common in high endurance sports, it has sparked heated debate and raised questions over hygiene and fairness in the competition. It's also prompted broader questions over the benefits, and the short and long term risks associated with pushing the physiological limits of the human body.
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HYROX race organisers have promised immediate changes to competition rules, after Australian athlete Joanna Wietrzyk experienced a bowel movement during the international race in China, before winning.
The competition, which can take between one and two hours combines 8km of running with exercises such as rowing, sled pushes and wall balls, and is carried out in indoor exhibition halls.
The incident has triggered significant backlash online, with some arguing it affected other racers' ability to compete in a safe and hygienic environment, and critics have questioned why officials did not intervene, given HYROX imposes penalties for other acts such as spitting and nostril clearing.
The co-founder of the global sport, Moritz Fürste, apologised on Monday [[14 September]], issuing the following statement, pledging to make immediate changes:
"I apologise to all that were directly or indirectly affected, as well as to everyone who felt like we did not handle the situation like we should have...HYROX made a mistake by not reacting immediately during the race. We started improving event processes, plus making rulebook changes immediately. As of this moment, there are new rules and procedures in place to prevent situations like this from happening again."
The incident has sparked global headlines, but it's not unusual for athletes competing in high-endurance events to experience gastrointestinal symptoms during competition.
UNSW Lecturer in Nutrition and Dietetics, and Exercise Physiology Mark Booth says it's also not unheard of for athletes to continue competing despite soiling themselves.
During the 2005 London Marathon, eventual winner Paula Radcliffe stopped and relieved herself in view of TV cameras, and French race walker Yohann Diniz continued walking for many kilometres during the 2016 Olympics, despite soiling himself.
Mr Booth says while it's less common in shorter resistance competitions like Crossfit and HYROX, in longer events, especially ultra-endurance events such as 50 kilometre runs, it's a regular occurrence.
"You just have to get on YouTube and have a look at any Hawaiian Ironman, any ultra-endurance events, and you're going to see many, many, many, many, many athletes soiling themselves and continuing their event. It's quite common in the ultra-endurance events. It's happened for decades and decades and decades. It just hasn't happened in that sport, I think."
Bec Hoschke, a former professional triathlete and Ironman champion who now coaches endurance athletes in Sydney, says while not uncommon, such incidents can have significant impacts on mental wellbeing.
"It can be an enormous amount of stress and, and pressure on someone who, um, you know, certainly didn't plan for something like this to happen. And certainly in, in younger years of, of, you know, being a professional athlete, it's an enormous load for someone to, to carry and process."
The incident has also prompted broader questions about what draws people to high-endurance and resistance sports, and the potential risks associated with pushing the physiological limits of the human body.
Sports and exercise scientist Tony Boutagi says one of the key reasons people become involved in competitions like CrossFit and HYROX is to meet like-minded people.
"These events now are open to everyone, and it creates a community. And I think that's why CrossFit and Hyrox have become incredibly popular, is that they created a tribal community around like-minded people, especially a lot of younger people where they meet."
Ms Hoschke says as an endurance coach, she's seen first-hand the widespread, positive impacts endurance sports can bring.
"There's a lots of positive impacts that can, um, can flow on to the health and wellbeing and the, the physical fitness of, of a person that can complement their, their sporting journey, but also the, the, the skills that you learn from endurance sport that you can apply in everyday life."
But, experts warn high-intensity resistance and endurance sports also come with serious health risks without adequate preparation and training.
John Hellemans represented New Zealand at several world championships and the 1990 Commonwealth Games, and coached some of New Zealand’s best known triathletes.
He now works as a doctor.
"Yeah, it's pretty extreme from a, from a medical and physiological point of view what they are doing. They're certainly pushing the boundaries and go beyond the boundaries of, of your physiology, what your physiology can handle. So, they use their, their stubbornness and their mind to overcome that particular obstacle really. So, it's a very fine line for them between succeeding and reaching their goals, um, and, you know, breaking down."
Mr Boutagi says it's important to remember wherever there are potential benefits, there are also risks if overdone.
"You'll improve all aspects of muscle, bone, connective tissue. That's the wonders of exercise. But if you do too much too soon, especially across highly demanding activities, you then increase the risk of bone stress injuries. You increase the risk of connective tissue injuries like, tendinopathies at the knee, the hip, the shoulder. Very, very common. You can increase the risk of having true muscle damage issues, which is called rhabdomyolysis, and that's essentially where a muscle is challenged so aggressively that it, uh, breaks down and secretes blood in, basically, breakdown products into the blood, and that becomes fatal"
Mr Booth says common injuries are caused by inappropriate progression during resistance training, including lifting too much weight in too short a time.
He says while the risks of musculoskeletal injuries are relatively well known, some of the risks related to diet are less reported.
He says some of the most serious health risks can be linked to under-fueling.
"Chronic training for these sorts of events requires, uh, an exceptionally higher energy demand than most of us. And when we don't meet our energy demands consistently over a long period of time, there's a, a syndrome called, um, relative en-energy deficiency in sport. Um, this is quite serious. It's, it's probably more common than we understand, and it, um, causes all sorts of endocrine disturbances, so estrogen in females, uh, testosterone in males. That impacts menstrual, um, function in females and, and has a, a knock-on effect to, um, reduced bone density."
He says the best thing a person can do to ensure they're protecting themselves from such risks, is to work with professional trainers and dietitians.
"Most of those long-term risks in particular, but also the short-term GI distress, um, is really around the nutritional interventions to support, um, uh, participating in, in, in extreme events like these. So, getting a proper training nutritional plan and then an actual race competition plan from a highly skilled sports dietitian is the number one thing that they can do."
Ms Hoschke says support should be at the heart of anyone's experience with endurance sport.
"So whether that's getting, um, an individual coach or you, you find a, a group that, um, that, that fits in with your schedule and you can learn from a group environment. I think that's just an enormous, um, asset to have to help you in your, in your journey and to learn and grow in the particular sport and to do it safely. Yeah, I think, I think that's my-- the, the biggest tip that I can give anybody, just to, to have your A-team around you."
