Son Goes Pale Mid-Race, Vomits After Every 1600/3200 – Anyone Been Through This?

Is he holding his breath?

Have you tried avoiding all solid foods within three hours of the race? If the race is in the afternoon, have you tried avoiding any large meal on the day of the race? Normal race day nerves can slow digestion.

You say you've tried hydration. What do you mean by that? I will take a few sips of water a half hour before a race, but as the race time approaches, I typically just swish some water in my mouth and spit it out. Racing with 8 or more ounces of water sloshing around in my stomach makes me sick. Has he tried avoiding anything more than a few sips of water in the half hour before the race? If not, he should try it.

It's much harder to throw up if the stomach is empty.

If he has already tried those steps, the next thing to consider is hyperventilation.

dallasarearunnerman, I see that you're new to the forum. This is what passes for humor here.

To answer your question, it could be a vagus nerve response, but I think the most likely causes listed in my previous post should be addressed and ruled out first.

I have a friend that throws up after ever race, it's not completely uncommon. Throwing up 45 minutes after a race might be a concern, but it's just honestly something you have to deal with.

The fact that you haven't mentioned if it happens during/after hard workouts makes me think it's a race only thing.

I'd say that it's probably it's not impacting his performance/recovery. I'm not sure what "going white/pale" means, but I doubt that's much of an issue.

Defective valve at the top of the stomach? I've coached multiple athletes with same symptoms who were eventually diagnosed with this valve issue.

Common issue, aside from vomiting, was regular and serious heartburn/GERD. Docs said that this symptom was their tipoff to do some checking of the structural aspects of the stomach rather than other issues.

Good luck

Is this issue limiting his performance? I have an athlete who does this, but no idea what causes it. There seem to be no lasting effects and it rarely happens in practice. Since he's the youngest of 4 runner kids, his parents don't think it's a big deal, and certainly aren't interested in spending lots of money on doctors to diagnose the problem. It seems like there's always one kid on any team who is a puker and I guess that's your son.

When I was a competitive HS runner I had similar issues. My Dad (not a pushy parent) would always say he knew when I was trying 100% in a race as I would turn completely pale, I was not aware of this while running. In the final few hundred meters of races as the pace upped I would very frequently begin to retch and sometimes vomit. I was often left with a choice of slowing down slightly, or vomiting mid race while running. In an important race I would choose the latter. I would very frequently vomit after the race was over. The sensation of wanting to vomit would disappear after 30 sec. I should say that this would happen when I was very fit and well trained, and I was competing at a decent level. I’m now a doctor and can’t come up with a “pathological” I.e. very concerning reason for why this happened. I doubt it was to do with reflux as one poster suggested. I imagine it was a physiological response to lactic build up, (there are some data showing the lactic acid build up may correlate with nausea levels during anerobic exercise). However sports medicine is not my specialty so I’m not sure. It would be prudent to get your kid checked out, but hopefully there is nothing serious going on. If he sees a sports medic it might be worth asking if there is any evidence that bicarb supplements could help with this type of nausea.

Echoing this. I ran competitively from grade 7-10 mostly focused on the 800m/1500m, cross country in the fall, and would experience very similar symptoms and often vomited in practice doing high intensity intervals, and at the end of intense races. Coaches would always just encourage me to drink more fluids and push out my eating window even further prior to practice/races. Zero improvement when following these methods, still felt horrible and vomited. I was very illiterate when it came to sports science, and I now suspect my running coaches at the time were too(one was a good 50+ lbs overweight, the other one was a chain smoker).
Got back into running a couple years ago(early 30's now) and early on I would experience similar symptoms VO2 max track workouts. Did some internet research(lol) and learned about really increasing my weekly mileage at low intensity, monitoring heart rate zones with a chest strap. Granted, I'm running 50+ mile weeks now and running marathons and half marathons. Not training for anaerobic races like the 1600/3200m. I can now handle very intense VO2 max workouts and long threshold runs without feeling like I need to vomit everywhere any time I push the effort.
Lactic acidosis is a real thing, and might contribute to the vomiting your son is experiencing during these races. Hard for doctors to draw blood and test for issues that only present during anaerobic efforts. Might want to look into a sports clinic that provides VO2 max and blood lactate testing - this could strongly inform training paces that are manageable but still allow for continued progress in speed. Good luck!

Certainly could be a physical thing, some people are just more prone to vomiting post-race. But, I think this could be psychological. You say he's not visibly nervous, but it's possible he's putting in a big effort to mask his emotions pre-race. Nervous energy, adrenaline, etc can build and build, and then when he finishes racing there's a "release".

Young distance runners can put themselves under tremendous pressure. Boys especially will go to great lengths to cover it up because they don't want to be viewed as "weak".

Vasovagal syncope. Have had two athletes deal with this. Unfortunately, I haven't yet found any solution, other than to race infrequently.

Galen Rupp has the best doctors and coaches in the world, but he still vomits after his races pretty often.

No, it's not. We don't produce "lactic acid".

I dealt with this for most of my career. Particularly in events longer than 800 meters and shorter than 5k. There were two things that helped me. (1) Avoid going out hard. Shoot for the 2nd half of the race to be faster than the first half. (2) Keep walking after you finish the race until the exhaustion and nausea are gone. If you can't keep walking, lay down and elevate your feet.

What’s his height and weight? When I was too skinny I experienced similar problem with vomiting after races, it got better when my BMI approached 20.

Floberg Syndrome

Lactic acidosis is a real medical condition. it can be a result of not being able to process and clear lactic acid(lactate) fast enough.... This is something humans experience. Acknowledging that intense exercise is not the only cause of lactic acidosis as there are many others. Maybe cross reference some, or any, literature first before contradicting someone with incorrect statements

This guy is correct, I think. I've had two very serious athletes and very type A personalities suffer from vasovagal issues, and it's very rough to see. The closest thing to a solution I've found is to start very conservatively and try to finish strong. As in, shoot for a 10-second negative split in every 3200. If he has a 9:45 goal, it probably has to look like 4:58-4:48 rather than even splits. Good luck!

Vasovagal response. Possibly hiatal hernia/GERD. Have him seen by a physician.