PLAN FOR SUCCESSFULLY COMPLETING A MARATHON

BY VANCE ROGET, M.D.

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1.  PREVENT INJURIES:

            EQUIPMENT:  shoes & socks you’re used to;  double-tie shoes;  gloves if cold; hat/visor;  sunglasses & sunscreen.

            HEAT ILLNESS/DEHYDRATION (*see below for symptoms):  drink before thirsty (including day before race); water and sports drink (GU2O) need fluids, calories, and electrolytes.

2.  FINISH:

            PACE YOURSELF:  even effort & time/mile;  aim for “negative splits” (i.e. 2nd half faster than 1st);

            STRETCH & WALK AS NEEDED:  tightness & fatigue precede cramps;  don’t stop too long -- better to walk through aid stations and keep moving while eating/drinking;

            FOOD (carbo-gels, etc.) and FLUIDS to keep energy up.

3.  HAVE FUN:

            KEEP RELENTLESSLY POSITIVE ATTITUDE:  e.g. focus on your ability to run, your feeling of fitness, and how your hard work is paying off in health and many other ways;

            ENVISION THE FINISH:  with associated overwhelming pride of accomplishment, the food, massage, family & friends, etc.;

            RUN WITH A FRIEND, MUSIC, FOCUS ON FUN ENVIRONMENT;

            RELAX & move efficiently.  My mantra:  think “strong, light, & relaxed”.

*HYPERTHERMIA/HEAT EXHAUSTION/HEAT STROKE:

                These conditions can cause death, kidney failure and brain damage.  Symptoms of impending heat injury include:  nausea, vomiting, headache, dizziness, faintness, irritability, extreme fatigue, confusion, weakness, and rapid heart rate.  Impending heat stroke may be preceded by a decrease in sweating and goose bumps on the skin, especially chest.  Heat stroke may progress from minimal symptoms to complete collapse in a very short period of time.  The faster the pace, the more heat is produced (so slow down if feeling hot, and other symptoms).

                If signs of heat exhaustion occur:  get in shade, drink more cold fluids (if alert & swallowing OK), apply ice or wet towel to body (face/head, neck, armpits, groin);  elevate legs if feeling dizzy or lightheaded.  CALL FOR HELP.

RISKS ASSOCIATED WITH LOW SODIUM:

            Low sodium levels (hyponatremia) in marathon & ultramarathon runners have been associated with severe illness requiring hospitalization.  It is important for long-distance athletes to use fluids containing electrolytes to replace the water and salts lost during exercise -- WATER ALONE IS NOT SUFFICIENT, as water intoxication and possibly death may result.  This problem may actually worsen after the race, as the low-electrolyte-containing fluid which has been accumulating in the stomach is absorbed.  Potassium and calcium replacement may also be important, although these levels change less with fluid loss and replenishment.

IF WEATHER WILL BE HOT:

                Before event, drink 2-3 large glasses of fluid up to 2 hrs. before start; then 5-10 min. before, another 1-2 cups of water or sports drink.

                During hard exercise, or hot weather, drink 3-4 cups (1 full cup is 8 oz.) per hour, or every 5-6 miles if you run a 12 or 10 min./mile pace, or at least 1 cup every 2 miles.