After seeing hundreds of runners running the Bellingham Bay Marathon on Sunday, September 28th, I started thinking about marathon injuries. There is no doubt that the body faces a physical challenge while training for and completing the 26.2 miles in a marathon. It is important to train well in advance of the marathon and be prepared for the common injuries that can occur during the race. Having an understanding of symptoms to look for, how to handle them, and whether it is safe to finish the marathon can be an important tool to keeping yourself healthy.
Foot blisters are a common reaction to running long periods of time with socks rubbing against running shoes. Assuming that you trained for the race, you may have already experienced blisters and know which shoes, socks, drying agents, covering pads, and lubricants have worked to keep them at bay. If you feel a hot, sore spot early in the race it is best to stop and pop the blister and cover it with a disinfectant, and a gel bandage or moleskin pad.
2. Black Toenails
Black toenails are a result of a blister or blood pooling under a toenail. During a marathon, this is usually caused by repeated banging of the toenail against the front of the running shoe. The best prevention is to buy a well fitting shoe and tie the laces tight enough that they keep your heel in place. You may not notice the blackened toenail until after the marathon; note that you will likely lose the nail and have it grow back over the course of three to five months.
Chafing is when skin rubs against skin and is made more painful with the salt from sweat. Common areas for chafing are underarms, nipples, under-breast area, groin, and thighs. You will likely already have experienced chafing during training so pay attention to your problem areas and keep them dry with cornstarch or moist with petroleum jelly, or roll-on silicone products.
4. Upset Stomach and Nausea
With all the bouncing up and down, an upset stomach is common during a marathon. In the 48 hours leading up to the marathon be careful what you eat or drink. Avoid spicy foods, alcohol, foods that you don't tolerate well, or unfamiliar foods. Limit caffeine right before the race. During the race only consume energy snacks or liquids that you used successfully during training.
Pay attention to feelings of dehydration during training. Weigh yourself before and after a long run to ensure that you have neither lost nor gained weight. Make sure that you have ample access to water during the race. Watch for symptoms of dehydration including dry mouth, fatigue, dizziness, stomach ache, back pain, headache, irritability, and decreased urination. If you experience these symptoms you should slow down or stop and drink a sports drink until the symptoms subside.
Hyponatremia is the opposite of dehydration; it is when a person drinks so much fluid that the body doesn't have time to eliminate it. The concentration of water dangerously dilutes the salt concentration in your cells. Watch for signs of hyponatremia that include nausea, headache, cramps, confusion, slurred speech, bloating, and swollen hands. If you are experiencing these symptoms, stop and do not continue the race until the symptoms subside.
7. Sunburn and Windburn
Being outside for a prolonged period of time exposes your skin to a lot of sun and wind (if it is windy). Even on a cloudy day you should protect your face and the top of your head with a billed hat and apply sunscreen to any exposed skin. Keep your lips hydrated with lip balm. On windy days you can wear a Buff neck gaiter to wear as a balaclava or scarf for extra wind protection.
8. Muscle Cramps
Muscle cramps can occur from long periods of exertion and from the strain of using the same posture and gait for several hours. The risk for muscle cramps is exacerbated by dehydration and depleted salt levels. If you experience a muscle cramp during the race, stop and gently stretch and massage the cramped muscle. Drink a sports drink to replace salt and fluid levels in your body. Be aware of your posture during the race, stay hydrated, and change your stride or pace throughout the marathon to help prevent muscle cramps.
9. Hitting the Wall
"Hitting the wall" or completely running out of energy stores in your muscles is more common in competitive marathon runners than in slower runners or marathon walkers. Drinking sports energy drinks and consuming energy gels or other energy snacks every throughout the marathon can help prevent energy loss.
10. Sprains, Strains, and Stress Fractures
Muscle exhaustion can lead to a trip or fall and a sprain, strain, or fracture. If you experience sudden, sharp pain, stop immediately and seek the help of course volunteers.
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