The Art of Running

Michael G. Ciccotti, MD November 8th, 2012

Running is a sport that requires very little equipment and can be done at any time. Just lace up your sneakers and you’re ready to go! But running in any competitive fashion requires much more focus and effort, particularly if you are considering taking on the challenge of an endurance race such as the upcoming Philadelphia Marathon.

As a long time runner and participant in multiple marathons across the country, I know all too well what goes into participating in this type of race. As a former Orthopaedic Consultant and Orthopaedic Medical Director for the Philadelphia Marathon, I have seen all that goes into the race from a medical prospective… as well as what awaits those who are not prepared for such an athletic endeavor.

In order to prevent the type of injuries that can occur with running a marathon, it is important to consider three key points:

Proper running attire. This begins with your shoes. The ideal running shoe provides shock absorption, motion control and stability. In addition, it is appropriate to monitor the wearing of our shoes as common running shoes will lose approximately 60% of their shock absorption capability after 250-500 miles of use. A runner who puts in 20 miles per week should therefore consider buying new shoes after 3 to 6 months of use. Runners with flat feet, high arched feet, unstable ankles or other foot problems may benefit from an orthotic shoe insert (commercial, off the shelf or custom-made). In addition to shoe wear, lightweight breathable clothing prevents the buildup of perspiration and allows for optimal body heat regulation during training and competition. Lightweight running hats, head covers and ear covers can shield the runner from the sun and heat in high temperatures and are excellent for avoiding frostbite in cold weather.

Training Program. It is essential that any runner who is going to participate in a distance race, particularly a half marathon or marathon, consider an appropriate training program. Such programs are available through discussions with coaches, athletic trainers or numerous local, regional and national running organizations. One such program is named TEAM Philly Race Training. Access to this program is readily available through the Philadelphia Marathon website. Running “too much, too fast, and too soon” is one of the hallmarks of training error and injury. The mileage run should be gradually increased on an individual basis. Over-distancing without adequate stretching, rapid changes in mileage, and insufficient rest between training sessions can all lead to injury and prevent one from participating in the Marathon.

Running the race. It is essential that the runner be well-hydrated in advance of race day. Recommendations on appropriate pre-race hydration are also available on the Philadelphia Marathon website. Water is readily available on race day to all athletes at frequent intervals. Athletes lose 2 percent of body weight before becoming thirsty, and satisfying thirst only replaces 50 percent of the fluid that is needed. Both water and electrolyte solutions are readily available, and electrolyte solutions are more helpful for endurance events such as a marathon.

Hydration is particularly important for races during high temperatures. The scheduling of the Philadelphia Marathon in November most often results in ideal running temperatures to prevent such injuries as heat cramps, heat exhaustion, or even heat stroke. But despite cooler, dryer weather conditions, these heat-related injuries can occur and hydration status is essential.

Following these basic principles of “the art of running” will help you to more thoroughly enjoy the amazing accomplishment of participating in such an endurance event. So lace up your shoes and get ready for the Philadelphia Marathon!

Michael G. Ciccotti, M.D., director of the Sports Medicine Team at the Rothman Orthopaedic Institute, serves as Head Team Physician for the Philadelphia Phillies and St. Joseph’s University.

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