Medical and Training Advice to Marathon and Half-Marathon Runners.

Welcome to the Shakespeare Marathon. The intention of this advice section is to help you prepare for a successful day and a performance you can look back on with pride. The advice is given in good faith to help you enjoy the day.
If you have any medical problems that you fear may interfere with your training programme, or make it risky to take part in the half-marathon or marathon then discuss them with your medical practitioner or a local sports medicine practitioner. This advice section supplements anything he or she may say.

Training.
Remember the principle of training is to gradually increase the intensity (e.g. number of hills or speed) and duration (e.g. distance) making sure that you have a recovery or rest time in order for the body to recover. Therefore:
Increase training gradually so that you do not suffer excessive fatigue; make sure you build in rest days and try and not have a sudden increase in intensity or duration of your runs. There is a training schedule at the end which you may find helpful as a general guide.
- Muscular aches and pains occur most commonly after an increase in training.
- If you have flu, a fever, or a tummy bug, avoid training until fully recovered. Training or racing while you have a temperature or the flu can put you at risk from heart inflammation which may be irreversible. Rest until you are better then start at a lower mileage and intensity and build up gradually. It can be counterproductive to try and catch up on lost mileage because it may cause further problems.
- To reduce risk of injury train on soft flat surfaces whenever you can (parklands, footpaths, fields etc.) and vary routes and cambers.
- Injury. Do not attempt to train if you are carrying an injury. Seek advice from your doctor or a sports medicine practitioner. Replace running with biking or swimming if possible while you recover.
- If you cannot run 15 miles comfortably before a full marathon or 9 miles comfortably before a half marathon you may not be fit enough to enjoy or manage the distance in safety.

Diet.

- Eat what suits you.
- Large doses of supplementary vitamins and minerals (such as iron) are not essential and produce no benefit if you 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 the competition, decrease the intake of protein (meat) and increase your intake of carbohydrates ( pasta, bread, potatoes, cereal, rice, and sweet things), especially for the last three days immediately prior to the event, 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 feel very heavy because water is retained with each molecule of glycogen.

Fluids.
- The recommendations on fluid replacement have changed considerably over the last few years. Although you need to replace fluids lost in sweat there is a well recognised danger of drinking too much fluids which may reduce your blood sodium levels and make you unwell. This problem is more likely to occur if you are running for more than 4 hours, take on more fluid than you lose, are female with relatively little experience of endurance competing or if you are taking none steroidal anti-inflammatory tablets.

 

- Aim to drink  NO MORE THAN 400-800 ml/hour during the race with the higher rates for the faster, runners or competing in warm environmental conditions and the lower rates for slower runners/walkers completing marathon races in cooler conditions. There is more up to date advice on this website: http://www.usatf.org/groups/Coaches/library/hydration/IMMDAAdvisoryStatement.pdf

 

- Try and train to drink while you run - quite a difficult art without choking!!!

- The sports drinks with 6% carbohydrate concentrations are designed to provide calories in a form that can be absorbed with a decent proportion of fluid. You will need to experiment to find one that suits you.
- Alcohol is dehydrating. A pint of beer produces more than a pint of urine and spirits have an even worse effect. Drink non-alcoholic drinks before you train and immediately afterwards.

- Weighing yourself before and after your training runs will give you some idea of your fluid losses; hotter conditions will mean higher fluid loss and cooler conditions lower fluid loss. Do not drink too much; your body is designed to cope with a degree of dehydration; see the above website for more in-depth advice.

Clothing.

- When training in the dark, be seen. Wear white clothing and reflective flashes or bandoleers and face on-coming 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 groin until they bleed. Vaseline applied to these areas can protect the skin.
- Find shoes that are comfortable over long distances. Remember the shock absorbency of your shoes will diminish as they get older. Beware of high heel-tabs rubbing your Achilles tendon. Try alternating between more than one pair of running shoes.

On the day.

- Do not run if you feel unwell, have a fever, have had diarrhoea, vomiting or chest pain within the previous 48 hrs. Most medical emergencies occur in people who have been unwell and who do not wish to miss the start. You will certainly not perform well and you will put yourself and your future running at risk as well as being a problem for your family and the medical support staff.
- If you have a medical problem which may lead to an emergency, such as fits, diabetes, asthma or if you are on any medication e.g. blood pressure tablets put a cross on the front of your number and write details on the reverse of your number, together with your medication.
- Wear appropriate clothing 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 can be carried if not worn.
- If it is hot wear loose mesh clothing, start slowly, pick out the shade on the course, drink early.

At the Finish.

- Do not stand about: This will certainly make you blood pressure go low and you are likely to faint. Keep walking or sit down for a few minutes. You will tend to get cold once your muscles stop working so. Go to the storage area or wherever your clothes are stored and change into warm, dry clothing. Foil blankets do not stop you from getting cold.
- Drink as soon as you can because your body will be short of water and sugar; sports drinks, cereal bars, or your favourite post training snack.

- If you feel faint lie down.


Medical Aid.

- Train sensibly and follow this simple advice and you will have done a lot to avoid the need for medical aid.
- If you drop out make for a feed station where you will be ferried back to the finish. St. John Ambulance Brigade supported by an experienced medical team of doctors and nurses will be in attendance.

 

Dr Terry Gasper, M.R.C.P., Dip Sports & Exercise Medicine, MFSEM

 

 

 

 

 




Training Regime for the Full Stratford Marathon.

Based on a 15 mile per week base for 1 month (December).

NB Figures are in miles.

Be flexible; long runs may be switched to Saturdays, Sundays or other days. Novice marathon runners gradually build up long runs and complete at least three runs of 18-20 miles prior to the marathon. Do not attempt to run long every weekend. Plan to do your long runs well in advance so you can get them in every other weekend. This training schedule is for guidance only and for the novice marathon runner. They are based on the Runners Handbook and the Competitive Runner’s Handbook from the New York City Marathon Runners handbook by Bob Glover. Cut back mileage when ill, injured, overtrained, or when going into or out of other races. Do not attempt to make up lost mileage. Using shorter distance races e.g. the Stratford Roman 9, will give you valuable experience on pace, fluid replacement, and clothing.

December for 4 weeks: 15 miles per week.

Weeks to go

Mon

Tues

Wed

Thurs

Fri

Sat

Sun

Mileage Weekly

16

OFF

3

OFF

3

OFF

6

3

15

15

OFF

3

OFF

3

OFF

8

3

17

14

OFF

3

OFF

4

OFF

10

3

20

13

OFF

3

OFF

3

OFF

3

13

22

12

OFF

3

OFF

6

OFF

8

3

20

11

OFF

3

OFF

3

OFF

3

15

24

10

OFF

4

6

4

OFF

10

3

27

9

OFF

3

3

3

OFF

18

3

30

8

OFF

5

4

5

OFF

3

13

30

7

OFF

4

3

3

OFF

3

20

33

6

OFF

6

6

6

OFF

12

5

35

5

OFF

4

4

4

OFF

3

20

35

4

OFF

5

4

5

OFF

12

4

30

3

OFF

5

5

5

OFF

18

OFF

33

2

OFF

4

6

4

OFF

6

5

25

1

OFF

4

4

4

OFF

2

26.2

14+RACE