From The Inside Triathlon Archives: Iron Docs

  • By Jené Shaw
  • Published Mar 9, 2012
  • Updated Oct 31, 2014 at 4:37 PM UTC

Want to race well in the heat? The pioneering work of the Hawaii Ironman doctors can help you.

This story was originally published in the January/February, 2012, issue of Inside Triathlon magazine

In 1981, Dr. Robert Laird was asked to lend a hand at a triathlon moving from Honolulu to the Big Island of Hawaii. As a local pediatrician with a background in competitive swimming and running, his friend thought he would be good to have around in case anything happened during the swim. Laird showed up with a stethoscope and stood by the finish line, not really knowing what to expect. That was the extent of the Ironman Hawaii medical tent that year.

During the early days of Ironman, the guidelines for medical care simply didn’t exist—the sport of triathlon was new and no one yet knew the limits of the human body. Many of the things athletes were experiencing shocked Laird, who returned to serve as medical director in 1982 (and every year thereafter). He almost quit after a particularly bad race, when faced with a tent full of athletes seizing and vomiting without enough volunteers or beds to keep up with demand.

“I’m a pediatrician, so this was not something that I was prepared for,” Laird said. “I just thought, ‘This race is not a reasonable thing to put your body through.’”

As we all know, the race grew fast—it swelled from 326 competitors in February 1981 to 850 in October 1982—so fast that the medical team ran out of supplies at almost every race in the early to mid-1980s. Laird realized early on that to host a race of this magnitude he would need more logistic and medical support. Kona’s hospital and emergency room were too small to staff the event (to this day the hospital has less than 100 beds); they were going to need medical staff from elsewhere.

The solution was to create a sports medicine symposium to bring medical professionals to the island. In the days leading up to the event, they would discuss endurance-specific issues, with the option to volunteer in the tent on race day. The race’s rising reputation attracted top experts from around the world who were eager to see first-hand what the body went through when it endured 140.6 miles of exercise.

Naturally the medical conference raised lots of questions about every aspect of endurance exercise. What better way to answer those questions than to study the best athletes racing the toughest race in the most excessive conditions? The Kona medical tent made for the ultimate exercise physiology lab. Laird had already started to keep statistics in 1982, including everything from finishing rates to the amount of IV fluids administered and the number of athletes hospitalized, and future research would only further quantify and qualify what happens when racing in extreme conditions. Over the last 30 years, research findings in the Kona medical tent have paved the way for correctly diagnosing and treating endurance athletes who have undergone an extreme physical test, and many of the treatment methods used in triathlons and marathons today were pioneered at Ironman Hawaii.

“When we first started, there was just no information on endurance athletes,” Laird said. “Now there’s a huge wealth of it. One of the main contributions we’ve made over the years is to serve as a teaching laboratory on Ironman day. Most of your main researchers have been in the Kona medical tent here at least once. That’s probably one of the things I’m proudest of—the dissemination of information on how to treat an athlete in distress.”

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Jené Shaw

Jené Shaw

Jené Shaw is a contributor for Triathlete magazine, a six-time Ironman finisher and a USAT Level 1 certified coach

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