Medical advice to runners
Journal: British Journal of Sports Medicine (1984)

MEDICAL ADVICE TO RUNNERSIf you have any medical problems, discuss these with your general practitioner.This advice sheet supplements anything he or she says.See your doctor if you have any medical problem which makes it risky for you to run or take part in the marathon. TramingMuscular aches and pains occur most commonly after an increase in training.* Increase training gradually so that you do not suffer prolonged exhaustion.* Intersperse days of heavy mileage with one or two days of lightertraining, so that your body can replace its muscle glycogen.* If you have flu, a feverish cold, or a tummy bug, do not train until fully recovered.Then start gently and build up gradually.* Do not attempt to catch up on lost mileage after illness or injury.This may cause further damage.* To reduce risk of injury train on soft surfaces (parkland, footpaths, etc) when you can, especially on days of light training.Vary routes and run on varying cambers-hills, etc. Alwaysface the oncoming traffic, especially in the dark.If you cannot run 15 miles comfortably a month before the marathon you will not manage a marathon in safety, or enjoy it.Please do not run on this occasion. Diet* Eat what suitsyou.* Large doses of supplementary vitamins and minerals (such as iron) are not essential and produce no benefit ifyou are on a good mixed diet, but additional vitamin C in small doses is reasonable when fresh fruit and vegetables are in short supply.* Training helps you to sustain a high level of muscle glycogen.Before you run the marathon decrease your intake of protein (meat) and increase your intake of carbohydrate (pasta, bread, potatoes, cereals, rice and sweet things), especially for the last three days, which is when you should be reducing your mileage and resting.(Unless you reduce the protein you will not eat enough carbohydrate.)* Carbohydrate (glycogen) depletion and then loading does not help all runners and can make your muscles very heavy.You must replace fluids lost in sweat; otherwise your body becomes dehydrated and less efficient.* Drink plenty of fluids after training and during races, especially in the first half of the marathon.* Alcohol is dehydrating.A pint of beer produces more than a pint of urine.Spirits have a worse effect.So take plenty of non-alcoholic drinks, especially before the race and in hot weather.* Drink enough to keepyour urine pak straw colour and abundant.Clothing * When training in the dark be seen.Wear white clothing and reflective flashes or bandoliers.Runfacing the traffic.* Wear comfortable clothing.Natural fibres such as wool and cotton are kinder to the skin than artificial fibres.Trendy shorts with sewn on trimmings can rub your groins until they bleed.* Find shoes that stay comfortable for long periods.On the day * Do not run ifyou feel unwell or have just been unwell.Most medical emergencies occur in people who have been unwell but do not wish to miss the start.If you feel feverish, have been vomiting, have had severe diarrhoea or any chest pains, or otherwise feel unwell, it is unfair to you, your family, and the marathon support staff to risk becoming a medical emergency and you are unlikely to do yourself justice.Thereare manyothermarathons.Ifyou surrender your certificate of entry to the marathon office you will be guaranteed a place next year.* If you have any medical problem which might lead to an emergency, such as fits, diabetes, put a cross on the front ofyour number (well away from the bar code) and write details on the reverse of the number, especially your medication.* Wear appropriate clothes for the weather.On a cold wet day you can become very cold if you slow down or walk.A hat and gloves prevent heat loss and are easily carried.* If it is hot, wear loose mesh clothing, start slowly, run in the shade, and drink whenever you can.* Start the race well hydrated (urine looks pale) and drink regularly as you lose a lot offluid "insensibly."This will help you feel better late in the race and may prevent cramp.At the finish * Do not stand about getting cold.Go straight to the baggage area and change into warm dry clothing.* Do not trust your clothing to someone else.Use the baggage system, get dressed, and then go to the reunion area.Foil blankets do not stop you from becoming cold. Medical aidTrain sensibly.Follow this simpleadviceand you will probably not need medical aid.The medical aid posts are generally situated 50 to 100 metres downstream of the drink stations and at the finish. 0If you drop out make for an aid station.Make sure your relatives knowyour running number.