LA Leggers
Sports Medicine Update: Marathon Preparation and Post Race
As the LA marathon is just around the corner we at Paulseth and Associates
Physical Therapy want to provide a few tips that may make it easier for you
to achieve your goal of completing this year’s LA marathon! Since fatigue is
the primary deterrent to meeting your goals, here are a few pointers.
1. Supplementation:
So now the training is over, and it is necessary to De-train or taper for at
least 2 weeks prior to the race. This doesn’t mean stop all activities but you
have time to concentrate on Protein, followed by Carbohydrate loading in
your diet. You can also save your muscle glycogen, which is the primary fuel
during the race by resting or going on shorter walk/runs. Utilization of this
substrate can be supplemented by eating high energy bars/goo etc or
whatever you have been using throughout your training during the race.
Studies show that this can enhance endurance capacity if you snack at
regular intervals of 30 to 45 minutes during the race. Also, energy drinks
that are not too high of a percentage in carbs and electrolytes can be
effective. If the concentration is too high it will slow gastric/stomach
emptying and feel uncomfortable during the race.
Caffeine can be useful in moderation or it may cause excessive urination
urges. It helps to facilitate cAMP which is the basic energy unit for ATP that
we need to provide smooth muscular action and ward off potential
cramping. It also increases energy to some degree.
Of course fluids during the race are vital, even if you don’t feel
thirsty. Dehydration can lead to muscle cramping and or muscle strains. It
causes decreased blood volume, increased heart rate, and impedes heat
loss, all of which cause marathoners to slow their pace , lead to injury, or
drop out of the race. According to the ACSM, you should drink 3-8 fluid
ounces of a sports beverage (5-8 percent carbohydrate with electrolytes)
every 15-20 minutes when exercising greater than 60 minutes. You want to
try to match your fluid loss with intake of water and/or electrolyte drinks.
Do not drink just WATER! Depending on the weather…warmer/humid
weather will lead to further fluid loss, so make sure you hydrate
accordingly. Hyperthermia can also happen in colder damp weather too.
Heat injuries including heat exhaustion is a medical emergency and occurs
when we stop sweating. In the early stages you may feel light-headed, dizzy
or nauseated. It can advance quickly with:
 Confusion.
 Dark-colored urine (a sign of dehydration)
 Dizziness (low blood pressure upon standing)
 Fainting.
 Fatigue.
 Headache.
 Muscle or abdominal cramps.
 Nausea, vomiting, or diarrhea
 Weak, rapid pulse
If this happens to you be sure to stop all activity and rest, move to a cooler
place, drink cool water or sports drinks, and seek immediate medical
attention. It is very serious if body temp > 104 degrees.
2. Flexibility/ stretching/ activation:
We have written about several stretching techniques in this newsletter
over the season. On a day separate from running it is important to gain
normal balance and range of motion in most of your joints. On race day,
before a run, or if cramping occurs, it is safer to utilize dynamic stretches. In
particular kick outs for the hamstring and calf, walking lunges for the hip
flexors and quads, and knee-chest for back and gluts are beneficial. Try to
do them also during the race easily during your slower walk breaks! These
techniques also help to activate the primary muscles that you use during
the race. Normal muscle function is vital to efficiency and helps to eliminate
excessive aberrant motions that we must ward off in non-useful planes of
motion. These can lead to injury.
If you have been doing resistance training during your training, you need to
curtail it for a couple of weeks. If you haven’t even doing just body weight
exercises can provide strength gain through neurological mechanisms in
just 2 weeks that can help reduce injury and improve run/walk efficiency.
We recommend lunges, step downs from a short step, single leg dead lifts,
and bridges or bridge marches daily (2 sets of 20 reps/ day or to your limit).
3. Run/Walking Efficiency:
During the race it is vital that you adhere to pace that you trained at.
Efficiency is affected by cadence/ stride length and minimizing vertical
displacement. Hence fatigue will be reduced. Further, keep arm swing in
line with the direction of walking or running to reduce unwanted rotations
that the feet must counter. Keep knee separation and prevent foot x-over
or there will be increased stress to the hip, back and IT bands.
If an injury occurs during the race, be smart about it, there is always
another race if you can’t complete this one, your overall health and well
being are much more important than finishing this one race.
During the race monitor your urine output and color since it is a good way
to check on hydration levels and over-exertion. One such malidy that can
occur in marathons is called Rhabdomyolysis. When muscle is damaged as
with a significant amount of running, a protein called myoglobin is released
into the bloodstream. It is then filtered out of the body by the kidneys.
Myoglobin breaks down into substances that can damage kidney cells and
can lead to acute renal failure. Dark, red, or cola-colored urine, decreased
urine output, and general weakness typify this condition.
Blisters may occur, especially in warmer/humid weather where you’re likely
to sweat a bit more. You can also get them on wet days however. The
challenge is to try not to change your mechanics/gait of running, can lead
to other injuries. To mitigate this problem try to wear appropriate
socks/liners, apply Vaseline around high wear and friction points- ie
between toes, etc. You can always find a medical staff person for a BandAid or tuff skin/second skin along the course if needed.
Following the race you can expect post race soreness. To reduce this make
sure have adequate cool down to minimize blood pooling and
cardiovascular accident. ACSM recommends at least a 3-5 min cool down to
prevent blood pooling. Cool down includes continued jogging, walking, and
dynamic stretching. Massage can be helpful since it flushes the active
muscles and promotes recovery. It is also important to have some form of
post race treatment to address any mild or serious injury, tightness, or pain.
Treatment can help to reduce tightness in areas that then leads to
increased compressive and shear forces at various joints later. Finally, make
sure to adequately hydrate and refuel post race as well with proteins and
electrolytes.
Please NOTE:
 WE WILL BE HAVING CLINIC HOURS AT OUR CLINIC IN CENTURY CITY
THE DAY BEFORE THE RACE FOR INDIVIDUALS SEEKING TREATMENT
PRIOR TO THE RACE. Please call for an appointment at 310 286-0447
 WE WILL ALSO BE AT THE DOUBLE TREE HOTEL AFTER THE RACE FOR
INJURY ASSESSMENT AND TREATMENT
Best of luck with your LA Marathon!