Grand to Grand Ultra

Written  by Dr. Josh Mularella, DO, FACEP, FAWM, DTM&H - Medical Director, G2G & M2M

ONE WEEK TO GO!!! You have put in the miles. Your gear and shoes are broken in. You have chosen your meals/snacks and everything fits in your pack. And, of course, you have thoroughly reviewed the G2G Medical Corner and all the medical posts on the Checkpoint Blog! At this point you have time to sit back and reflect on your training and your upcoming time at G2G.

This last blog post will review some of the issues I have seen over my past 7 years at G2G. The less issues you have as a runner is less work for me in the medical tent, so please pay attention :)

hand sanitizer


The most common cause of vomiting/diarrhea in the backcountry is poor hygiene. There will also be plenty of hand sanitizer available near the new composting porta potties, the hot water for meals and at each checkpoint. PLEASE WASH YOUR HANDS! I strongly encourage you to bring some with you out on the course as well.



Getting proper rest at G2G is vital. A few years ago it was very cool during the day, which made for great running conditions, but got quite cold at night and many runners weren’t prepared and slept horribly. Not surprisingly, we had the same percentage of DNFs that year even without the heat. Furthermore, I can almost guarantee that someone either in your tent, or next to your tent, will snore. Tentmates will be tossing and turning on their crinkly ultralight air mattress and others will inadvertently shine their headlamp right in your face. If you are a light sleeper you may want to consider ear plugs and maybe medication to help you sleep.



Believe it or not the desert not only gets quite hot but also sunny! Large portions of the course have no shade. You NEED to either cover yourself completely or wear sunscreen and reapply throughout the day. Suntan lotion will be available at checkpoints but will not be available in the morning. Behind the knees is a commonly missed (and hence burned) area. Keep an eye on each other… if someone is looking a little pink then let them know before it’s too late. Side note: there was a runner a few years back that ran with an umbrella… I thought it was a little ridiculous at the time but maybe he was on to something!

prickly pear


Get ready for a lot of off road track at G2G! The first two stages especially have a lot of cacti you need to keep an eye out for. Those spines can go right through your shoe and can be difficult for us to remove in the medical tent.

tape rash


The issue that comes up most towards the end of the week is issues with chafing. There isn’t much we can do in the medical tent for chafing in the groin/thighs (though I hear Trail Toes works great!!).

Even worse, however, is chafing from your backpack. The weight of the pack and constant movement while running can actually rip the skin off your shoulders and low back. I have seen some ingenious solutions in the past such as using socks or a cut up mattress to cushion the straps. We can tape the areas to decrease further friction but that won’t help with your pain.

If you haven’t done something like this before, I HIGHLY RECOMMEND pre-taping your shoulders and back so this doesn’t happen. We are happy to help you with this that first night on the north rim of the Grand Canyon after briefings… but please bring your own tape.

pretaping 1


And as always, if you have any questions/concerns please feel free to email me at This email address is being protected from spambots. You need JavaScript enabled to view it.. You can also check out the G2G Medical Corner.


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