Dr Dora Papadopoulou may be Greek of origin but she has a special place in her heart for the UK and the British Spartathlon Team, just as anyone who has run Spartathlon has a special place in their heart for Dora.
If you don’t know the name, for the last decade Dora has been the main Sports Medicine Consultant in the medical tent that all athletes have to pass through at the end of the race. She’s also a bundle of positive energy, who shares her love of Spartathlon with anyone she meets.
We asked her to tell us why she feels so strongly about the race. As usual, she over-delivered massively. In the following Q&A she gives amazing advice on what ultra-runners should do to look after themselves, how to best work with her and her team when you are led to the medical tent just after King Leonidas status (you all have to do it!) and how indeed she became such an integral part of our BST.
She also offers great support and insight for aspiring female Spartathlon entrants and wise advice about heat acclimatisation.
We hope that you find this Q&A fascinating, helpful in terms of your Spartathlon planning and that you get to feel why we have all cherished working with her over the years.
Interview by David Bone
Dora you are a well loved and very much respected part of the British Spartathlon team (BST). Can you share how your relationship with this iconic event and the BST first originated?
Many years ago, I attended a World Sport Congress in Sparta and hence came across Spartathlon. I was attracted and inspired by the history behind it. You can tell that not only was I intrigued but that I fell in love. Ten years ago, when I was doing a Masters degree in Sports Injuries at the University of Sheffield Hallam, I had written a paper related to the runners tendons pathology. I was desperate to connect my work to this event, so I could let people know about Spartathlon. I wrote an article entitled ‘Come back to Spartathlon after a patellar tendon rupture of a 40 year-old-male Ultramarathon runner’.
In the last few years I felt more and more connected and excited about the BST. I’m always checking the results and the timings of the BST athletes and feel proud to see any of you ‘kissing the king foot’. Last year I wrote an article about Spartathlon in the magazine of the British Association of Sport and Exercise Medicine (BASEM) and some of BST athletes published their reports there too.
I feel that I am connected with Spartathlon for life and with the BST we continue to be inseparable.
Could you kindly tell us a little bit more about your medical background and how you first started in the running scene
I am an orthopaedic surgeon dealing with sports injuries and I am working as a Consultant in Sport and Exercise Medicine. I have been involved in sport events for almost 20 years including the Olympic Games since 2000. I am involved with national, European and international sports medicine associations and I enjoy teaching sports medicine and sports injuries in universities.
How did you become so passionate about sports medicine?
I was an athlete myself. I sustained an injury when I was 12, falling from a balance beam in a sports gymnastics competition. In those days, we didn’t have specialist doctors around and I ended up with a broken nose that was never treated properly. Since that day I knew what I want to do in my life.
However, I was a passionate athlete too and wanted to know everything about sports. Hence, completing a sports university degree. At that time sports medicine wasn’t an official speciality, and therefore, I was initially trained as an orthopaedic surgeon. I was working with sport injuries and teaching sports medicine at university. Many specialisations, diplomas, masters and doctorates followed after this to be able to be the doctor of the BST today.
What are the main issues you come across in the medical tent at the end of the race?
One of the common issues we often face in the medical tend is hyponatraemia. Low blood sodium concentration (Na+) which develops in the body during and after the race from overhydrating with water.
The most common problem though is postural hypotension. During the race an athlete’s heart rate and blood pressure are high, the muscles are contracting providing the pump effect to your blood vessels and hence the blood is circulating. Once you stopped all these mechanisms decreasing. You then have sudden decrease of your blood pressure and this is what causing fainting and collapsing. This is the reason we are trying to keep people in the medical tent and provide medical attention until we are sure that they have recovered.
Spartathlon in 2018 was pretty epic in terms of the impact of Cyclone Zorba – how did that impact things for you and your team of medics and what you saw from a team injury point of view?
Working with sports injuries for almost 20 years and with Spartathlon for about 10 years, I must say that this year was extremely adventurous, and we faced the type of wilderness that we only face in ‘expedition medicine’ environments and certainly not in classical sports medicine events.
On the one hand it was hard and stressful to manage it and on the other hand we believe that the participants and their crews should never feel this. We want to provide the best possible care whilst always trying to keep people calm.
We had to deal with totally different types of injuries and illnesses this year. After the weather worsened, we had to continuously communicate between us to ensure the safety of all the athletes and their supportive teams. Looking back now I can tell that it was quite scary.
In normal years we treat all the athlete’s outdoors – something that wasn’t possible this year. The covered areas were limited, and the needs of medical care increased. We had high amount of hypothermia this year and we desperately needed to create warm indoor facilities. Thankfully, we managed to make available the facilities of the General Medical Council in Sparta in order to host athletes that needed more care. We had to send few athletes to the hospital but luckily no one stayed ‘too long’.
We usually think about heat conditions when we think about Spartathlon. What are the normal injuries that you see in these conditions and what advice would you give runners who are considering running in extreme heat.
I can talk for days about this but it’s helpful to focus on running in extreme heat.
It is well-known that running in the heat induces thermoregulatory and main physiological strain that can lead to impairment in the exercise capacity of endurance athletes. One of the most important interventions an athlete can adopt in order to optimise their performance and to reduce the physiological strain is heat acclimatisation (HA). This in simple terms means that you should start heat exposure training over (at least) two weeks. In addition to this, athletes should initiate training in a ‘euhydrated state’ to minimise the dehydration during the training.
Many universities offer heat acclimatisation chambers to athletes that need HA training. Cooling strategies and cooling systems can facilitate heat loss and can increase heat storage capacity before competing in the heat. Recovery periods between events are essential. Even very simple procedures like resting in a cool place during the race can make the difference.
How do you think things are changing in the endurance running scene? Are runners getting better prepared and are you seeing less injuries?
Certainly, there is change to the endurance running scene. As we all know endurance running became very popular over the last few years.
With the growing population of endurance runners, the number of running related injuries has increased. There is an impressive study from The Netherlands where it was reported that the number of running injuries doubled from around 350,000 in 2010 to 710,000 in 2014 within the running population. However, the injuries we see among experienced endurance athletes are very encouraging. Even though there are not clear injury prevention programmes for endurance runners, the scientific knowledge of the athletes has improved significantly.
Most of the BST athletes I meet nowadays are very well educated and familiar with the risk factors that can lead to an injury. You have more knowledge regarding your training, biomechanics, equipment and nutrition than the athletes had decades ago. I believe that your personal efforts for better understanding is what has made the difference in this scene.
Do you have any stories about Spartathlon and the BST team that you wish to share?
Every story related to Spartathlon is a unique loving story for me. It would be unfair if I shared just one story only. I have seen athletes getting married and bringing their children to the race a few years later. I have met Spartan kids running after athletes and years later I’ve met them as Spartathletes themselves. I was recognised by a Spartathlete during the Olympics in Rio two years ago. I have laughed and cried so much with many of you in the BST and certainly I am now bonded with you for life
This year we saw Cat Simpson produce an inspirational performance that you were very impressed with. What do you think about the fact that the BST team was made up of 24 men and Cat and do you think things can change so that more females can be encouraged to enter?
Cat’s performance was amazing! I was so impressed with her confidence while she was running, and she finished in such a good state. She has the right attitude and discipline for Spartathlon. Cat is a trained nurse and I am sure that through her medical training she went through many ways to develop her daily discipline. I think that this was the main source of power for her and the engine which helped her to reach her running goal. Of course, she had a very supportive team as well.
I am not sure why this year we didn’t have many female athletes but don’t forget that last year (2017) we had amazing female runners as well. Certainly, we need to get them back next year.
As a woman working in a very male-dominated profession (being an orthopaedic surgeon and within the military) I can tell that having more female athletes in the teams is an essential balancing element. I cannot see anything that should stop a female athlete to be a Spartathlete.
I would say the opposite, there are some elements that are better expressed within female athletes. They are adapted to work hard with pleasure, they are very good in organising their routine and they don’t argue with their plans. They only need to be inspired by others and set their goals.
Do you run? Do you have any dreams to run ultramarathons?
Obviously, I am a person who loves sports and physical activities. Although my main sport was sport gymnastics, I was involved in skiing, swimming and athletics as well. I had a period of my life where I literally used to live for the training. I haven’t been marathon runner but it is not a surprise that I started my endurance career doing cross country running and cross country skiing.
You live in Lincolnshire, England – do you love it there?
Indeed, we live in a cottage in the Lincolnshire countryside…. As I used to say “in the middle of nowhere”.
Years ago, I walked to this cottage for some reason and I said that one day I am going to live in this house. Even though my job is pretty much related to specific institutions you cannot find in the countryside, I am more than keen to commute to work than giving up the opportunity to live in such a remote and beautiful area. Lincolnshire is not a famous area to live but there are so many unexplored beauties around. Now after so many years I feel local and try to support all the local events as much as I can. I am proud that the British Association of Sport and Exercise Medicine central base is in Doncaster and hence we try to organise sport and scientific events in the area.
If there was one thing our readers could do to help you Dora – what would that be?
I am big fan of clear and ethical sport and being Greek, Olympism for me is my philosophy of life. So I advocate that people keep being the best version of themselves, be kind to themselves and to others and have a sport ethos”. The BST means a lot for me and as I always say is the team of my heart. I hope this quote from the International Olympic Committee’s charter will inspire and inform past, present and future Spartathletes:
“Olympism is a philosophy of life, exalting and combining in a balanced whole the qualities of body, will and mind. Blending sport with culture and education, Olympism seeks to create a way of life based on the joy found in effort, the educational value of good example and respect for universal fundamental ethical principles.”