Rachel Entrekin has won 20 races in a row and didn't use a watch until last year. The physical therapist turned full-time ultra runner specializes in distances over 20 hours, where success depends on solving problems one mile at a time.

She's frank about balance: you can't do it all, so you decide what drops temporarily. For her, leaving oncology rehabilitation meant focusing on running full time. Now sponsored after years of running competitive races on gas station snacks, she finally has resources to prove herself at the races everyone wants her to run.

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Rachel started running in college to explore Birmingham, Alabama on foot, working her way up from half marathons to her first full marathon in 2009. For three years, she ran lots of marathons and trained in between. In 2013 she jumped to trails, discovering the Southeast scene where aid stations had candy and Mountain Dew instead of just Gatorade.

Her breakout came at I'm Tough in 2019. She finished sixth overall, got the course record, and crossed at 24:04 without a watch, carrying a plastic water bottle she'd found in her car.

"I remember crossing the finish line. It was just an absence of imposter syndrome, which was a new feeling for me because people had been telling me, oh, you're really good at running. But I just hadn't really believed them."

The honest answer about balancing career, training, and family? "It's not pretty."

The biggest change came from dropping obstetrics with its brutal schedule of nights, weekends, holidays, and 72-hour calls. Now she does GYN only. Before, she felt she was doing all roles poorly. The regular schedule and sleep pattern changed everything.

You can't balance it all. Decide what drops temporarily, knowing you can pick it back up later.

For years, Rachel ran races on gas station snacks and whatever she grabbed before the start. Her fueling strategy was nonexistent until she started working with Precision Fuel and Hydration sports scientist Emily in January 2025.

Emily never shamed her for terrible record keeping. When Rachel got food poisoning before her second race and couldn't eat for 100 miles, Emily worked with what little information she had. She'd gently suggest trying 30 grams an hour and meet regularly during Cocodona prep.

At Cold Water Rumble 100, Rachel's only goal was staying on top of fueling to make Emily proud. She won, set the course record, and beat all the men.

The shift has been mental as much as physical. She'd avoided liquid calories but now loves them after seeing the performance difference. At Cocodona this year at mile 250 with only a 10K left, she recognized she was getting negative and ate a grilled cheese. It was the best grilled cheese of her life and gave her the best finish line experience ever.

Rachel doesn't make winning a goal. At Cocodona this year, she wanted to not be miserable at mile 135 like she'd been the previous year and to fuel better. Both were process oriented, both about the experience.

"It is fine to go after a golden ticket, but you have to have something else too because what if you have the best race of your life and still get third? You can only control your own day."

She went through a period of tying happiness to placement. Then came a stomach bleed at Cascade Crest, a DNF after cutting her hand, and the Tahoe Rim Trail FKT attempt with Jeff Meyer that didn't finish but was too fun to be upset about. That taught her that if your only value is placement, running does the opposite of building confidence.

Cascade Crest is the last time she hasn't won. Since then, she never makes winning the goal. Maybe it's staying within four hours of Courtney at Cocodona, but that goal itself means being in second.

Last summer, Jonathan bailed on Mount Massive due to air quality and planned a short run in Leadville. Rachel and Kevin were heading up the mountain. Kevin Goldberg stuffed Jonathan's pack with their gear, Rachel gave him fuel, and off they went.

They bushwhacked off trail at 12,000 feet in a hail storm, found the trail at the top, ran out of water, refilled from a stream, and made it work.

Rachel's advice: say yes to adventure you're prepared for. She doesn't put herself in dangerous situations anymore after making enough mistakes and being lucky to survive them. But when she runs with someone faster, she doesn't get mad if she can't keep up. She takes something from the situation to apply later.

"There is exactly one person in the world who is the best, and it's probably not us."

Rachel's won 20 races in a row, but not at the uber competitive races like Western States. For years, she couldn't afford travel or take PTO from her oncology director job. She won 100 milers off gummy bears and prayer because that's what she had access to.

People have opinions about her race schedule. She feels like she's demonstrated competency, just not at the races everybody wants her to run. Now with sponsor support, she's running races like KIATI to prove a point: good performances are good performances regardless of location.

"I've won 20 in a row. While I might not win KIATI or UTMB, I'm a pretty good bet, I think."

Ten years from now, she wants to be proud she took chances when they were offered. She's been given resources she didn't know to ask for. It's her responsibility to use them.

You can't balance everything, so choose what drops temporarily. Balance is a myth. Success means deciding which area receives less attention for a period, knowing you can pick it back up later. Dropping obstetrics gave Rachel regular schedules and sleep, enabling better performance in the roles she kept.

Fuel consistently to protect your mindset. When you're not eating enough, you get negative. Anytime Rachel starts asking where the next aid station is, that's the signal to eat immediately. The grilled cheese at mile 250 wasn't about calories for the final section, it was about mental clarity to finish strong.

Process goals create freedom when outcomes are uncertain. Making winning a goal means feeling bad if you have the best race of your life and get third. Rachel's Cocodona goals were not being miserable at mile 135 and fueling better, both process oriented and within her control.

Motivation follows action. You don't have to be motivated to start, you just have to start. If you tell yourself you can't do something, you're right. But if you try it without knowing if you'll finish, you give yourself the possibility of succeeding.

Say yes to adventure you're prepared for. Put yourself in situations where you're forced to grow. Running with faster people, trying intimidating races, and accepting invitations that push your comfort zone reveal what's possible.

Running on any schedule is valid if it produces results. Rachel won races for years without the "right" resources or race schedule. Good performances matter regardless of whether they happen at Western States or a local 100 miler she could actually access.

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Jon is a runner, cyclist, and podcast host from Boston, MA, who now lives in Boulder, CO. For The Long Run is aimed at exploring the why behind what keeps runners running long, strong, and motivated.

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