This summer we followed from afar with admiration and amazement as a group of support staff and female footballers took on Mount Kilimanjaro. Not only did they attempt to hike to an altitude of more than 5000m, but would aspire to break the Guinness Book of Records for the highest altitude game ever played. The Equal Playing Field initiative aims to raise awareness and funding for women’s football development. One member of the team was the US Women’s National Soccer Team High Performance Coach, Dawn Scott. Dawn was tasked with monitoring the wellbeing of the players on the climb with the medical staff and even using GPS units during the game. With so much to cover from such an extraordinary achievement, Dawn has kindly written a three-part series for Sports Discovery, as follows:

 

1. The Preparation
2. The Record Breaking Game
3. The Data

Equal Playing Field is a growing collective of people seeking to challenge the inequalities women face in sport, and to promote the development of football. It has grown from the dreams of two co-founders (Laura Youngson and Erin Blankenship) to a budding movement across five continents. They first discussed the idea of this project two years ago, and gradually recruited more players and support staff to take part in the challenge. Laura Youngson said “I got tired of being told you can’t do that because you’re a girl, so I decided to stop complaining and to do something about it.”

 

The World Record match was part of Equal Playing Field’s “Altitude Football Project”, in partnership with Football for Peace. Together the organizations seek to run a series of training clinics with local teams and partners in 15 countries over the next two years in the lead up to the 2019 Women’s World Cup. The aim of the climb was to break the Guinness Book of Records for the highest altitude game ever played, as well as the highest women’s game. In order to do this, the aim was to complete a full 90-minute, 11-a-side FIFA regulation game, officiated by female FIFA referees at an altitude of 5714m, more than 1750m higher than the highest stadium in the world (Club Bamin Real Potosí in Bolivia which is at an altitude of 3960metres/12992 ft.). The target was to complete the match at Kibo Crater which stands at 18,871 ft. (5751meters). In total 29 players from 20 countries, as well as two coaches, four medical staff, 19 support staff and a documentary team and BeIN Sports TV crew - 64 people in total - took part in the challenge.

 

The Support Team & Altitude Preparation

To support the group climbing, there were an additional 300 guides (who led the trek each day) and porters (who carried all of the gear, with a maximum of 20kg each). Their support was incredible and the challenge would not have been possible without them. At times, it was slightly embarrassing as they sprinted past us on the mountain carrying our gear, while we trekked more slowly! And that was actually the daily advice from the guides as they regularly yelled ‘POLE, POLE’ to us which translated means ‘SLOWLY, SLOWLY’.

 

As one of the dangers of doing this climb, and with altitude generally, is that you try to ascend too fast giving your body less chance to adapt to the increasing levels of altitude. As altitude increases, the total barometric pressure and partial pressure of oxygen decrease, resulting in hypoxia, which may be associated with decreased exercise performance, increased ventilation and symptoms of light-headedness, fatigue, altered perceptions and sleep disorders. Although the risk increases with altitude, some susceptible individuals may experience symptoms of altitude-related illness beginning as low as 2,500 m (8,200 ft.). Every year, nearly 1,000 people are evacuated from the mountain, and around 10 deaths are reported. Approximately 40% (12,000) of Mt. Kilimanjaro’s climbers turn back before making it to the summit, so the advice from the guides throughout the trek was imperative for success in terms of reaching the summit and actually completing the game.

 

The Way to the Top

There are seven main Kilimanjaro routes that you can use to trek the highest mountain in Africa. The advice from the guides, due to the number of people and varying levels of physical status of the group, was to follow the Lemosho route as this has a more gradual incline and increase in altitude, so gives the body longer to adapt during the ascent. This meant it would take 7 days to ascend to the summit, then 2 days to descend back to the base.

 

 

Below is an overview of the daily itinerary:

Day 1    Arrive at Kilimanjaro Airport, transfer to Arusha base camp (4,551ft.)

Day 2    Practice game v Arusha All-Stars

Day 3    Bus transfer to Londorssi gate (7,742ft.)

Lemosho Trailhead (7,800ft.) to Forest Camp (9.500ft.) -Trek 4 hours

Day 4    Forest Camp to Shira Camp (12,200ft.) – Trek 6 hours, with an additional 2-hour hike to acclimatize to higher elevation

Day 5    Shira 1 Camp to Shira 2 Camp (12,600ft.) – Trek 4 hours

Practice match (7 v 7 due to flat surface available) at 12,500 ft., then an additional 2 hour trek to experience higher elevation

Day 6    Shira 2 Camp to Barranco Camp (12,950 ft.) – Trek 4 hours

Day 7    Barranco Camp to Karranga Camp (13.100ft.) – Trek 6 hours

Day 8    Karranga Camp to Barrafu Camp (15,200ft.) – Trek 8 hours

Day 9    Barrafu Camp to Stellar Point (18,870ft.) to Kibo Crater (18,871ft.) to Uhuru Peak (19,340ft.), back to Barrafu Camp (15,200ft.)

Trek 6 hours to Stellar Point (18,870ft.), build the field (go ahead support staff), complete the match at Kibo Crater (18,871ft.), trek to the summit (19,340ft.) – descend back to Barafu Camp

Day 10  Barrafu Camp to Mweka Millenium Camp (12,500ft.) – Trek 3 hours

Day 11  Mweka Millenium Camp to Mweka Gate (5,370ft.) - Trek 5 hours

Bus transfer to Arusha

Day 12  Depart Kilimanjaro Airport

 

Preparing for Kilimanjaro

Many of the players had around 12 months’ notice to physically prepare for the challenge, although most had competed in football at a decent level so they had a good baseline of general fitness. Everyone taking part in the challenge was given a physical plan to follow prior to the climb in order to optimize their physical preparation, the main emphasis being a strength and endurance base, with practice hikes for duration/elevation when possible. Everyone was also given comprehensive medical information in relation to the risks involved, vaccinations necessary and recommendations for medication that would be necessary and/or beneficial. The other essential part of the preparation was making sure you had the right equipment to deal with the terrain, variable weather, cold sleeping conditions, while also meeting the restrictions of the 10kg weight limit!

 

I only confirmed my involvement three weeks before the event, so it was a last-minute scramble for me to make sure I was prepared from a physical perspective but also with all of the gear I needed! Also, part of my reason for getting involved was that I was extremely interested in the physical well-being of the players during the ascent, as well as the impact the altitude would have on physical match performance. Following some research of what could be more affected/of interest to monitor, Ellie Maybury, my colleague at U.S. Soccer, and I set about developing a simple wellness form (see below) combining some of the questions from the Lake Louise Questionnaire. The Lake Louise Scoring System (LLSS) was designed to evaluate adults for symptoms of acute mountain sickness (AMS). Additionally, with the assistance of Brian Moore from Orreco, I managed to secure GPS units and sleep watches for all the players, to monitor some of those aspects of performance and recovery, throughout the trek. I was also asked to coach one of the teams, since one of the coaches had to pull out last minute due to work commitments.

 

 

 

 

 

 

 

 

 

 

 

Gearing Up, Training Up

Four days before we all met up in Tanzania I was traveling back to Los Angeles from Oslo as the U.S. WNT had just competed in Norway. I was a little anxious as a lot of the players and staff doing the challenge were messaging about starting their journey to Tanzania, while I still had a journey back to L.A. (5,000 miles and nine time zones!), and I still needed to finalize my equipment!

 

Part of the biggest challenge in the preparation was first finding hiking boots that were comfortable and breaking those in ahead of the climb, as we would literally be living in the boots for the nine days of hiking. The ones I got were causing me issues around my ankles due to the higher support I wasn’t used to, so fortunately the medical team with our U.S. team in Norway helped me figure out how to pad them a bit, and thankfully gave me a supply of plasters and padding in case I did suffer from blisters! I would then find an hour each day during camp to do some additional preparation, by wearing the boots while walking on a 10-20% incline on the treadmill, which certainly got me a few odd looks from other gym users! Again, the players had mixed opportunities in terms of how they could prepare, as some were coming from California where there was little opportunity to experience or train at very high levels of altitude. Other players had the opportunity to complete hikes at higher altitudes and gauge how that felt, as well as physically prepare the body a bit more.

 

One Day to the Climb

Once everyone had arrived at the base camp in Arusha, there was a briefing session from the organizers and guides, since this was the first time we had all been together. On the first morning, I briefed the players on the wellness forms, how and when to complete those, gave out the sleep monitoring watches, and gave the players an overview of the GPS units, and the purpose, we would be using during the matches.

 

That morning we played a practice game against a local team in Arusha, so the players could get to know each other on the field and experience how a mild level of altitude (4,551ft.) felt during the game. This was also an attempt to get a baseline match for comparison to the match at the summit, of the physical performance of the players using the GPS data. The rest of the day was spent packing up the gear and making final preparations for the start of the trek the next day. That evening we were also split into five groups, and that would be who we would trek, eat and breathe with for the upcoming 10 days!

 

 

Everyone was also briefed on the importance of nutrition and hydration throughout the trek, and were given a daily supply of electrolytes to help with hydration. With increasing altitude, it was likely that for some people appetite would be reduced, however it was essential to refuel regardless to be able to keep trekking every day. The other challenge would be sleep, since we would be camping every night and it would get colder the higher up the mountain we climbed, so it was important everyone knew what to expect and to make sure they had layers and a warm enough sleeping bag to deal with that. Also, the camp sites along the way up the mountain would be basic with no shower facilities, the porters would be carrying porta-loos, but for washing we would receive a bowl of hot water at the start and end of each day for a quick wash. That night there was an opportunity to have a final shower at the camp facility, so there was immediately a long queue!

 

The next day started with a six-hour bus journey to Lemosho Gate to complete final registration, and a final weigh in of our bags. We were all allowed to pack a bag weighing 10kg total, including sleeping bag and mat, which our allocated porter would carry each day. We also took a day pack which we would carry ourselves during the trek each day, which contained essentials such as water, snacks, extra layers, rain jacket, medical kit, medication, trekking poles as the terrain was so variable each day and anything else that wouldn’t fit in your overnight bag! Once we got to Lemosho Trailhead we split into our five groups, and then trekked off to the first camp getting our first glimpse of the Summit as we did! This was both exciting and overwhelming at the thought of what was to come.

 

Look out for Part 2 to find out how the climb and the game went…

 

References

Hackett PH, Roach RC. High altitude medicine. In: Auerbach P, ed. Wilderness medicine: Management of wilderness and environmental emergencies. 3rd ed. St. Louis MO: Mosby, 1995;4