“The greater the obstacle the more glory in overcoming it.” – Molière

On May 17, emergency physician Sudip Bose, MD, FACEP, FAAEM, along with three nurses and two other physicians from his emergency department at Medical Center Hospital in Odessa, Texas, each paid a $190 entry fee to spend the day slogging across muddy streams, crawling in mud under barbed wire, running up 40-degree inclines, and jumping over fire pits, among other barriers, in a nine-mile endurance race. The occasion was the Spartan Super in Austin, Texas. For Dr. Bose, who was a state-ranked mile runner in high school and won physical fitness awards during his military service, the race was an “all-around fitness event and a great way to build camaraderie within our department.” He also pointed out that the ailments he treats as an emergency physician bring home the importance of staying fit and healthy.

Dr. Bose and his team are part of a growing trend of Americans incorporating obstacle races into their fitness goals. According to the Los Angeles Times, such events have become more popular than marathons, with an estimated 1.6 million participants in 2013 who signed on to test their physical and mental stamina. While major events such as Tough Mudder, the Warrior Dash, the Spartan races, and the Volkslauf (with the motto “Pain Is Good”) offer different course and obstacle configurations, they share common themes of physical and mental challenge and often emulate the military training model.

Events such as Tough Mudder’s Boa Constrictor, where racers crawl through a series of pipes, and Electroshock Therapy, where participants run through an obstacle field hung with electrified wires, are designed to elicit a maximum fear factor. The Artic Enema, for example, entails jumping into frigid water and swimming under a wooden plank before pulling oneself out of the water.

Howard Mell, MD, MPH, chair of ACEP’s EMS Section, pointed out that such events are actually “haunted-house scary” and that obstacle races pose no greater risk to participants than do more standard marathons. “These types of obstacle courses have been done for years in the military and by SWAT teams as they prepare for what they do,” he noted. “[These events] are for ‘weekend warriors’ doing the same. There will be broken bones, bruises, cuts, and scrapes, and there are going to be a couple of people who give themselves angina because they’re just not in the condition to do these things. But the same can be said of a marathon.”