Inside the Life of a Physio at a Multi-Day Ultra Running Event

Behind every ultra runner pushing through the miles, there’s a team working just as hard to keep them going. 

At WhyWeRun, that role belongs to specialist running physiotherapist Sophie Vecchione, who leads the therapy team through long days of blister care, injury management, and everything in between. Here’s a look at what being a physio at a multi-day ultra really involves.

WhyWeRun definitely isn’t your typical race!

Founded by endurance athlete Lewis Robling, the event was born out of a desire to create something different from the medal-chasing, time-focused culture of much of modern running. Instead, WhyWeRun is about human connection, community, and pushing yourself in some of the most breathtaking landscapes Wales has to offer. 

The five-day event covers 250km along the beauty that is the Pembrokeshire Coastal Path, where runners face huge elevation, unpredictable weather, and the mental challenge of coming back day after day. With no medals or official times, the focus is on supporting each other to the finish, making it one of the most unique ultra-running experiences out there.

If you’re part of the running world on socials, there’s a good chance you’ve come across Sophie, better known as @RunFreeRehab. With over 35,000 followers, she’s built a strong reputation as a physiotherapist who helps runners stay healthy, injury-free, and ready to take on big challenges. But Sophie’s own journey into trail and ultra running started relatively recently. 

Back in 2022, after renovating a campervan and setting off around Europe, she gave running another shot. This time with the help of a coach. A trail half marathon soon followed, and from there her love for the sport snowballed.

When WhyWeRun was founded, Sophie was invited to join as lead physiotherapist, and she’s been part of the event ever since. Now, she heads up the therapy team, working side by side with paramedics and volunteers to keep runners moving through one of the toughest but most rewarding weeks of their lives.

If you think running a multi-day ultra sounds tough, try being on the physio team. It sounds pretty damn busy. The alarms go off around 5am, sometimes earlier, to get runners prepped before they set off. Blister care and taping become the morning routine, making sure feet can carry people through another long day on the trails.

Once the runners disappear into the hills, it’s time for a quick breakfast before the day truly begins. Injuries, niggles, and illnesses don’t wait for a convenient moment, and as competitors complete their loops back at base camp, Sophie and her team are there to treat whatever comes their way. They coordinate closely with the on-course ambulance crew, who manage emergencies out on the trails, while the physios hold down the fort at camp.

Breaks are rare and usually involve sneaking off for a short walk or run to fight off cabin fever. By the time the final runners are back, the work is far from over. Every athlete needs checking in, treatment, and reassurance before getting some rest. It’s often 10 or 11pm before Sophie’s team calls it a night, rounding out a gruelling 17-hour day before doing it all again.

For Sophie, the work starts well before the runners arrive. As lead physio, she runs pre-race talks on recovery and fuelling, with RED-S (Relative Energy Deficiency in Sport) being a major concern in the ultra world. She also reviews every medical form to flag potential issues and makes sure the team is stocked with enough kit to last the week, from endless rolls of tape to all the blister-care essentials.

Once the event begins, Sophie works closely with the paramedics to manage injuries and illnesses. They take the lead on blister popping (a glamorous task), while her physio team handles ongoing treatment and recovery. It’s a partnership that keeps the whole event moving safely.

While treating blisters and sore knees is a big part of the job, Sophie says a huge element of her role is supporting runners mentally. Five days of running is as much a psychological test as it is a physical one. She often finds herself listening, reassuring, and helping athletes reframe their struggles.

What makes WhyWeRun unique is its atmosphere. There aren't any medals, no times, no pressure for PBs. That culture of support means when someone is flagging, fellow runners often rally around them. Sophie describes it as one of the most moving parts of the event.

Blisters are the most common complaint during the event and with the often wet and unpredictable Welsh weather, it’s no surprise.

Sophie and her team see plenty of musculoskeletal issues too, including patellofemoral pain, ITB irritation, and tibialis anterior flare-ups, mostly caused by the event’s relentless elevation. Surprisingly, rolled ankles are rare, *touch wood*!

To tackle these challenges, Sophie relies on a few trusty tools. Kinesiology Tape and Zinc Oxide Tape are her go-tos, offering versatility for both injury prevention and treatment. And she swears by Pre-Tape Spray, which is a small but crucial addition that keeps tape in place through mud, sweat, and miles. 

Between careful monitoring, hands-on treatment, and the right kit, Sophie’s team keeps runners moving and helps them finish the event safely.

For all the long hours and constant treatment, it’s the small, shared moments that make the event special. One highlight for Sophie was last year's final day’s 5km loop, with runners, volunteers, and crew all heading out together at sunrise. Running, walking, laughing, and even singing together captured the spirit of the event perfectly.

It’s a reminder that while physio work is crucial, the heart of WhyWeRun is the community. Helping runners safely navigate both the physical and mental challenges is what makes those long days worthwhile.

And that's it! This year's event takes place between the 15th-21st September. If you want to learn more or ask a question to Sophie, get in touch! We're happy to help.