Sports Medicine Expert at OU Health Shares Ways to Avoid Injuries During Races, Marathons

Participating in 5K and 10K races, half-marathons and full marathons should be a fun and rewarding experience but preparing for a race safely should be a top priority, especially if you are new to running or are running your first marathon.

OU Health primary care sports medicine physician Dr. Michael McCoy. M.D., CAQ-SM, assistant professor in the Department of Family and Preventive Medicine at the University of Oklahoma College of Medicine, says overexertion and untreated injuries can lower run times and lead to worsening problems. He shared tips on how to get the most out of your marathon or race training, pointing out it’s not just about how fast you finish the race, but about avoiding injury and having fun too.

“Consistency with your training plan is important,” he said. “Whatever protocol you have been following throughout your training cycle, the important thing is to remain consistent with that. Most of these standardized training programs all have a little bit of tapering towards the end so you can save that energy for race day. A lot of people think that they really need to push themselves at the end. The main thing is to maintain your level of fitness and build your energy stores for race day.”

Staying healthy while running goes miles beyond training. Taking proper precautions when it comes to hydration, proper stretching, pain management and even what socks you wear can make the difference between crossing or not crossing the finish line.

Gearing Up for a Marathon

Marathons are a running event with an official distance of 26 miles and 385 yards, usually abbreviated to 26.2 miles. These events, often a road race, are exceptionally long and require great endurance. Because a marathon is considered the ultimate running challenge, be sure your body is ready. Marathon runners, ideally, should:

• Have been running for at least a year
• Be able to run 15 to 25 miles a week comfortably
• Have previous experience running one or two 5K race
• Have at least 18 weeks to train

“Again, overexertion toward the end, like you are cramming for the test or trying to get more hay in the barn, should be avoided,” Dr. McCoy said. “If you overexert yourself before race day, you're going to struggle with your times.”

Many experts recommend a tapering off period, usually the last 21 days before the marathon. During this time, runners should train less and rest more by reducing their weekly and long-run mileage. Stretching properly before and after a race is also necessary. Dr. McCoy recommends dynamic stretches before running and an active cool-down after crossing the finish line.

“Pre-race, don’t try a new warm-up routine. During your training, try to incorporate active/dynamic stretching before your runs,” he said. “Some studies have shown that lower blood circulation combined with static stretching can lead to more injuries. You don’t have as much elasticity when you first start warming up as when you've been running for a while. Active warm-ups help to increase blood flow and gently increase range of motion versus forcing a stretch on muscle fibers with static stretching. Not properly warming up can lead to injuries both before and after a race.”

Keep Hydration Steady and Constant

Hydration is one of the keys to a successful dash across the finish line. Dr. McCoy advised proper hydration begins four to five days before the race.

“It’s about making sure you're maintaining an adequate level of hydration,” he said. “You want to have very light yellow to almost clear urine, and you want to urinate fairly frequently. That's a good way to assess your hydration status.”

On race day, especially on hot and humid days, runners should add a bit of salts and electrolytes to their fluids so they are replacing what they are sweating out, Dr. McCoy said. However, runners should “drink to thirst” and not over-hydrate.

“Some people can sweat up to four to five liters during a race and other people might not sweat as much. Rely on your training program and how you've been drinking leading up to the race,” he said. “Try to maintain that amount. The bottom line is not deviating from race day what you've done from your training. But, if you notice you're thirsty, then it’s a good time to go and hydrate.”

Dehydration is a serious concern, he added. If a runner is feeling more fatigued than normal or feeling light-headed, dehydration may be to blame.

“Someone who is mildly dehydrated can have a 10% performance loss from their typical run,” Dr. McCoy said. “They can have headaches and mild focus issues as well as cramping in their lower extremities.”

Fueling Up for Race Day

To prepare for marathon day, Dr. McCoy advises runners to eat enough, but not heavily. Heavy carb loading or big meals can make a runner feel sluggish and could cause stomach upset, resulting in slower run times.

“Proper nutrition for a race starts more than the day before the race day,” he said. “My brother is a known carbo loader, but you don't do that right before the race. That starts four to five days beforehand. You can stick to complex carbohydrates, but most importantly, fuel yourself with things that you know your body tolerates well.”

Simple carbohydrates like bananas and oranges are good choices to snack on while running, and many runners use gel packets or tablets with carbohydrates and electrolytes built in.

“Just don’t try anything new,” Dr. McCoy said. “If you use bananas and oranges and stuff like that before, stick with that. You don't want to upset your stomach on race day by trying something that you've never done before.”

Heat exhaustion is also a serious concern. Oklahoma’s spring, summer and fall weather can be unpredictable, swinging from boiling hot to ice cold. If you start to feel sick while running, get a headache, cramps or feel dizzy and sweaty, you may be suffering heat exhaustion.

Heat exhaustion is serious, and help is required as soon as possible. Those with possible heat exhaustion should lay down in a shady spot with their legs raised, take regular sips of a sports drink and get medical attention.

Be Aware of Pain in the Body

Because marathons are such a challenge, most runners will feel some discomfort and soreness. If that discomfort causes intense pain during the event or lasts more than several days, an injury could be to blame.

Determining whether the discomfort you’re feeling during or after your run is a typical case of muscle soreness or if an injury has occurred can be difficult. However, pain from injury has some features that are different from soreness or typical discomfort.

Aches and discomfort have the following typical features:

• Tender or burning spots during running, but dull when resting
• The pain occurs within the first one to three days of exercise or during exercise
• The pain and discomfort get better after two to three days
• The pain is only felt in the muscles

Features of pain caused by injury include:

• A sharp and acute pain while exercising and at rest
• The pain doesn’t go away on its own or lessens in any way
• The pain goes deeper than muscle into the joints or bones

Because everyone feels and tolerates pain differently, it’s crucial to assess your symptoms to make sure an injury isn’t masking itself as soreness. Everyone has an off day, but if your performance consistently suffers due to the discomfort, you may have an injury.

If you’ve had to change your gait or your form because of pain or to lessen its impact, you may need to see a specialist. Continuing to run improperly could cause an injury to get worse or cause new injuries. While it’s natural to feel tight and sore at the beginning of a run, especially if you rigorously train often, pain that becomes worse during a run may be the sign of an underlying injury.

If a sharp pain accompanies swelling in your legs, feet or ankles, an injury could be to blame. Inflammation that does not recede quickly or if you have trouble walking normally or completing daily activities are good cause to contact your sports medicine physician.

“Minor discomfort is something that every runner has experienced before. If you can keep running and maintain an adequate pace, I think that's something that you can continue to work through,” Dr. McCoy said. “But if you notice that your performance is steadily dropping and your thoughts continue to fixate on whatever ailment you are feeling, you need to check with the medical staff at the race.”

Additional Safety Tips for Race Day

Wear sunscreen – Sunscreen should be applied every day during training and during the race, clouds or sun, rain or shine. Runners sometimes avoid sunscreen because of the risk of it getting into the eyes due to sweat, but baby sunscreens are an excellent alternative. You can also apply sunscreen from the eyes down, so it won’t drip, and wear wraparound sunglasses with UV-protective lenses. A visor or running cap with a brim can help protect the forehead.

• Wear what you typically wear – Race Day is not the day to break in your new running shoes or wear socks and clothing you’ve never tried before. Avoid clothing that chafes or invest in gels and creams that can reduce chafing. Dress for comfort, temperature and prevention of friction injuries.
• Don’t skip water stops – Dr. McCoy knows it can be tempting to skip a water stop if too many people are stopped at the same time, but keeping hydrated is too important to the success of a race. Alternatively, drinking too much water too fast is just as dangerous, especially just before running. Instead, take small amounts of fluid at water stops throughout the race.
• Care for blisters - If you get a blister and the skin is still intact, do not pop it. Cover the blister with proper blister care bandages. If the skin has broken, cover it with a clean, dry, non-adhesive dressing.
• Avoid cramps - Maintain sufficient levels of salts and fluids and remain well hydrated.
• Stretch adequately before and after the race - Take time to warm up and stretch thoroughly before the race and add more stretches when you have finished. If you get cold quickly after the race, cover with a foil blanket or jacket.

“I’m going to repeat myself one more time - don't do anything new that you haven't done before in training,” Dr. McCoy said. “Don't race in new shoes that you just bought specifically for the race. And whether you are new to running or a veteran of many races, the sports medicine team at OU Health is ready and eager to help with whatever issues or improvements you may need.”

Sports Medicine Expertise Close to Home

With a variety of training plans available for beginner, intermediate and advanced athletes, a sports medicine specialist can help design a specific training plan for your level. Whether you’re a professional or amateur athlete or you live an exercise-focused life, your training, conditioning, activity and competitive performance may lead to musculoskeletal injury or strain that can put you on the sidelines.

Sports medicine physicians, fellowship-trained orthopedic sports medicine physicians and specially trained therapists at OU Health in Oklahoma City, Edmond and Tulsa provide extensive evaluation, testing and diagnosis for a wide range of sport-related injuries, including concussion, in a comprehensive sports medicine program trusted by elite athletes, competitive marathon runners, the region’s top baseball and soccer college teams, NFL players and university and national sports teams across the country.