I’m a big fan of mud runs, those increasingly popular races that pit participants against obstacles along a muck-ridden course. I’ve had a blast running, climbing and crawling in numerous races. I also have a mud run battle scar: a raised welt where barbed wire clipped my right knee.

It seems I’m relatively lucky, though. In recent years there have been reports of mud-borne stomach bugs, skin rashes and even cases of flesh-eating bacteria. Several mud run-related deaths have been reported.

It seems that running from obstacle to obstacle on rough terrain, scrambling over walls and under barriers and trudging or swimming through large pits of muddy water is just about as hazardous as it sounds. 

Here are the most common risks and how to keep yourself safe during your next mud run.

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Risk #1: Heat and cold

Hypothermia (in cold weather) and heat exhaustion (in hot weather) are risks any outdoor athlete faces, but wet mud could increase them. 

Safety steps. The American College of Sports Medicine recommends doing at least some of your training outdoors in weather that’s similar to what you’ll experience on race day so that you’re acclimated to the heat or cold. Come to the event well hydrated and prepared to stay that way: Bring your own water bottle and take advantage of water stations along the course. Seek help if you start to feel dizzy, lightheaded or very hot or cold. (According to Tough Mudder, one of the largest organizers of mud runs, only 2 percent of participants seek medical aid at their events.) Have clean, dry clothes waiting for you at the finish line.

Risk #2: Strains and sprains

In my experience, minor cuts, abrasions and bruises are par for the course when it comes to mud events (though maybe I’m just clumsy). More serious injuries such as muscle strains or sprains, particularly of ankles and knees, are also common. According to Tough Mudder spokesperson Jodi Kovacs, these are most likely to occur during running portions of a race. Even experienced runners are at risk because “the body has to respond to various terrain,” explains physical therapist Bryce Taylor, owner of Halo Rehab and Fitness in Indianapolis.

Safety stepsTrain. A mud run is not an event you can just get up off the couch and do. In your workouts, include exercises that challenge your core stability, your upper body strength and your endurance, advises Taylor. Drills using medicine balls, cable machines, battle ropes and sandbags will get you more ready than dumbbells and barbells. Do some practice runs on trails to get your body used to uneven surfaces. During the race, skip any obstacles that seem beyond your capabilities — they don’t hand out a bonus medal because you gimped across the finish line on a twisted ankle.

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Risk #3: Tummy troubles from "poop soup"

In recent years, mud runs have been associated with several outbreaks of campylobacter and norovirus, two common causes of gastrointestinal illness. “These bugs, as well as salmonella and E coli, are present in the intestines of farm and wild animals,” says Barbara Mahon, MD, a medical epidemiologist at the Centers for Disease Control and Prevention. “When you add water to make mud and animal feces are present, you create a poop soup that could cause infection if ingested.”

Mahon says it’s not known how common it is to get sick; only outbreaks, in which more than one person gets sick and can attribute it to the mud run event, are reported. “Sometimes people don’t seek medical care, or if they do, it’s not recorded as affiliated with the mud run, so you have an undercount,” she says. “We really don’t know the actual risk, but we think people should know that it can happen.”

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Safety steps. Check that the organizer has a policy in place to reduce these risk and has chosen a location where there aren’t a lot of animals. Keep your mouth shut tight when going through water obstacles. Rinse and spit before drinking water throughout the race to reduce the chance of swallowing mud, Mahon suggests. Wash your face as soon as possible after the race. If you get sick, even if you’re not ill enough to see a doctor, report it to the race organizers and your local health department.

Risk #4: Skin rashes

Search the Internet and you’ll find numerous accounts of mysterious “dash rash” and other skin conditions post-race.

“Mud isn’t exactly clean and because it’s moist it can be a breeding ground for harmful bacteria,” says dermatologist Joel Schlessinger, MD, CEO of LovelySkin.com. “Contaminated mud can lead to skin inflammation and irritation. It’s also easy to contract skin infections like follicular dermatitis in a mud run environment.”

Safety steps. Shower as soon as you can after the race with soap. At the very least, hose yourself down with clean water and change into clean, dry clothes. “If you have cuts and scrapes on your skin, the risk of infection increases,” Schlessinger says. “If you’re in a situation where you suffer a scrape in a muddy environment, it’s important to thoroughly clean and cover the affected area as soon as possible,” he says.

Amy Roberts is a certified personal trainer. She writes about fitness, health and a variety of other topics for many well-known publications.