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Behobia / San Sebastián official website - 58 Edition

58 Behobia - San Sebastián 2023

Signs and symptoms questionnaire

Corazón hecho con cordones de zapatillas deportivas

Acceso al cuestionario


Sportsmen and sportswomen are the healthiest members of our society and have a much lower risk of contracting cardiovascular diseases, some cancers, diabetes and dementia than people of the same age who do not sport. This is due to the fact that frequent physical exercise reduces considerably the risk of contracting many diseases among old people such as heart attacks, angina, heart failure, strokes, high blood pressure, obesity, type II diabetes, osteoporosis, arthrosis, and rheumatoid arthritis, several types of cancer, depression, dementia, fibromyalgia and dependency.

Moreover, physical exercise is a very good tool, sometimes the best, to treat all these diseases, once they have been diagnosed. For this reason, many Scientific Associations and Public Institutions recommend and promote physical exercise among people of all ages.

Although the benefits of physical exercise far outweigh the risks, on rare occasions some sportsmen or women have a heart condition or even die suddenly and unexpectedly while practicing sport or just afterwards. The majority of these sudden deaths are due to heart problems and they are more frequent among people who train less than 3 days a week than in people who train more often. The risk of these sudden deaths among competing athletes is very low, however, for the last few years studies have been run to find the most appropriate and effective way of detecting and treating people with a greater risk of sudden death during competition.

There is currently a wide-ranging debate among different internationally recognised Scientific Associations (European Association of Cardiovascular Prevention and Rehabilitation: EACPR; American Heart Association: AHA; American College of Cardiology: ACC; American College of Sports Medicine: ACSM) on the real incidence of sudden death in competition compared to that of a sedentary population. Whether it is appropriate to have a medical check up prior to a sports competition, the type of assessment or check up to perform, its value for money, the negative consequences of false positives (when a mistaken medical diagnosis might wrongly prevent an athlete from doing their favourite sport) or the priority of allocating public funding to detecting and preventing this problem. This debate means that there is no unanimous opinion on which is the best, most practical and effective way of detecting these sudden deaths. As an example, a work recently published in the European Heart Journal studied the number and type of serious accidents that occurred between 2006 and 2012 during endurance running races in the Paris region (512,000 athletes). These races require a medical certificate to enter. The study results showed that the number of incidents or serious diseases that took place in those races was no less than the ones seen in races where a medical certificate was not required to participate.

Although there is no all-round unanimity, bearing in mind the opinion of the previously mentioned Scientific Associations, one fast and simple frontline prevention measure to try and detect which athletes are at risk from a heart attack or sudden death during the event is to respond to a questionnaire on warning signs and symptoms. For this reason, the Behobia-San Sebastián race organisation recommends that all participants in this race should answer the signs and symptoms questionnaire before signing up. This questionnaire has been drawn up by the Behobia-San Sebastián Medical Advisory Committee working from recommendations provided by the aforementioned Scientific Associations. No medical supervision is required for this YES/NO questionnaire. The American College of Sports Medicine (ACSM) recommends that a person can compete if they have been training at least three days a week, 30 minutes per day, at a moderate to high intensity, for the last three months and they have answered "NO" to all the questions on the questionnaire. On the contrary, if there are any "YES" answers on the signs and symptoms questionnaire (3 to 13 questions), all the Scientific Associations recommend that the athlete should visit a sports doctor or a cardiologist for a check up. The signs and symptoms given in the questionnaire should also be taken into account during the race because, should they appear, it is advisable to stop and see a doctor.

The questionnaire is voluntary, anonymous and personal; it will only be recorded on the registration form whether it has been completed without matching the participant with their answers. If it was not possible to complete it in the moment you are making the resgsitration, we recommend you to do it later on through the website.


Javier Barrera (Rehabilitation Physician, Osakidetza, and experienced runner-19 BSS and 24 marathons), Esteban Gorostiaga (Sports Physician, Director of CEIMD -Government of Navarra-); Xabier Valencia (Rehabilitation Physician, Osakidetza); Zigor Madaria (Cardiologist, Osakidetza and IMQ), Félix Zubia (Critical Care Physician, Osakidetza and Red Cross -in charge of medical care for runners in the BSS since 2002-), Jose I Emparanza (Clinical Epidemiologist, Osakidetza).


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