Medical tips

Get a check-up

If you've never done much running, that doesn't disqualify you from running a marathon. But you might want to aim first for a less daunting goal — like a half marathon.

Before you get started, you may want to check with your doctor to make sure your body — particularly your heart — can handle the stress of a marathon.

Regardless of how long you've been exercising, there are certain warning signs and risk factors that should be evaluated before beginning a new workout program — especially one as intensive as marathon training.

If you're experiencing any of the following symptoms, you should definitely see a doctor before diving into marathon training:

  • Chest pain, shortness of breath or excessive fatigue with exercise
  • Unexplained passing out or near fainting spells
  • Prior history of a heart murmur
  • Elevated blood pressure

Also see a doctor if you have any of the following risk factors:

  • A first-degree relative (mother, father, sibling) who either died or was disabled from heart disease prior to age 50
  • Specific knowledge of a family history of cardiac disease
  • Personal history of coronary artery disease (if you're over age 35)

Pick a marathon training plan

Following a training plan will help ensure you're physically prepared for the physical (and mental) rigors of a marathon.

Four to five months before your race, select a training plan that mixes shorter weekday runs with long, slower runs on the weekend.

These plans — which can be found online, either free or for a small fee — vary in distance and intensity, depending on whether you're a novice or experienced endurance runner.

  • New runners might start with weekday runs of mostly five to eight kilometres.
  • Advanced runners may start with runs of ten to 13 kilometres, with some speed workouts mixed in.
  • Most plans include four to six outings each week, including one longer weekend run that starts at about ten kilometres and gradually rises to twenty one or more in the weeks before the race.

Try running five days each week and occasionally twice a day if you don't have time for a long midweek outing.

Pace yourself

The challenge of marathon training is figuring out just how far and how fast you should run.

  • Running more weekly kilometres may better prepare you to run 21km, but it also increases your risk of injury. If it's your first marathon, a conservative approach — with fewer weekly kilometres — is probably a wise one. Many runners fall into the pitfall of increasing their mileage too quickly or running on too many consecutive days. It is often a mixture of the two that leads runners to develop overuse injuries, the most common type of injury that marathoners develop during training.
  • There's a lot of truth in that old adage, "Slow and steady wins the race." Running your weekly long runs at a slower-than-normal pace can better prepare you for the marathon by keeping you on your feet a good bit longer.
  • Marathon experts suggest you should run your long run at least 50 seconds to a 90 seconds per kilometre slower than your planned marathon-day pace.

Rest is a crucial component of marathon training, enabling runners to recover from heavy distance.

Find a shoe that fits

Go to a specialty running store and ask for advice on what shoe works best for your foot, gait and body type. It's OK to care about color and style, but fit and shoe type will mean more on those extra-long runs.

Look for the following:

  • Runners with high arches typically need neutral-stability shoes.
  • Runners with medium arches should seek out stability shoes.
  • Low arches? Get high-stability, or motion control, shoes.
  • Larger runners should also consider shoes with extra cushioning, as more weight equals a little extra wear and tear on their bones and joints.

Once you've found the right shoes, break them in by taking them out for a few shorter runs.

Experts recommend replacing running shoes after about 500 kilometres, but some shoes may hold out longer. Many runners like to get two pairs of shoes and rotate them throughout marathon training.

Take a break

Nearly all training plans include days off and so-called "cutback" weeks with reduced distance, all designed to give runners' bodies some badly needed breaks. Rest is a crucial component of marathon training, enabling runners to recover from heavy distance.

  • Even if your schedule calls for a run, if you're feeling achy or worn out, take the day off.
  • Cross-training is key, as it helps strengthen muscles that provide stability and efficiency while running. This includes strengthening of the upper body and core, along with hip-stabilization exercises. These exercises are important because they help to control alignment of the body while running and prevent breakdown of proper running form.

Stay hydrated

Make sure you have fluids close at hand throughout your training.

  • Water is fine for shorter runs, but you'll need sports drinks to help replenish your electrolytes on longer outings of ten or more kilometres, maybe even less in hot or humid weather.
  • Don't overdo the water: Drinking too much can cause hyponatremia, a relatively rare but potentially fatal condition in which sodium levels in the body become dangerously diluted. This condition seems to be most prevalent in runners with a slower pace who are consuming excessive water.

Energy gels (or blocks or bars), meanwhile, provide a welcome glucose boost to help sustain you when you hit double-digit kilometres. Also, recovery meals after long runs will help replenish the body's energy stores in preparation for continued training.

Join a group

Those long weekend outings seem a lot easier when you're surrounded by like-minded runners. Most large and mid-sized cities — and even smaller communities — have running clubs or marathon training programs that welcome newcomers.

Running with a group helps you stay motivated, maintain a consistent pace and learn practical advice from more experienced runners. Plus you might make some new friends. Check with your local area to find a group near you.

Heed the pain

Just about every runner experiences a few aches and pains during marathon training. Common running injuries include the following:

  • Plantar fasciitis, which involves pain in the bottom of the foot
  • Patellofemoral pain syndrome, also known as runner's knee
  • Iliotibial band (or IT band) syndrome, which typically involves swelling and pain on the outside of the knee

The trick is to distinguish a minor strain from a potentially serious injury.

  • If you're suffering chronic discomfort while running, particularly if the pain gets worse the longer you're on your feet or lingers while you're off them, stop and take some time off.
  • If the discomfort is not getting better, see a sports medicine doctor or your primary care physician. It is best to seek care when the pain is starting to affect training, as that's the ideal time to identify and start fixing a potential problem.

Treatment options may include relative rest, activity modification, therapeutic exercise or a physical therapy program.

While taking a break from training can be disappointing and frustrating, it's better than abandoning your marathon goal altogether. More often than not, you'll be back on the running path in no time.

Race day

Do not run if you feel unhealthy or sick; feverish, vomiting, severe diarrhoea or chest pains. There will be many other marathpons in future, so consider your state of health first.

Dress appropriately. If the weather is hot, wear loose mesh clothing, start slowly and, if possible, run in the shade. Start the race well hydrated (urine looks pale) and take fluid at regular intervals when possible, most especially in the first half of the race when you may not feel thirsty, as you lose a lot of fluid insensibly. This will help you feel better late in the race and may prevent cramp. Cramp is most common in runners who have not trained sufficiently or are dehydrated. Do not gulp large volumes of liquid during or after the race. You may fall ill from drinking too much or too fast.

On completion of the race, do not stand about getting cold. Keep walking, especially if you feel dizzy, and drinking to replace lost liquid, change into warm, dry clothing, and then go to the reunion area. Keep on drinking and have something to eat. Some runners feel faint more than half-an-hour after finishing the race, often because they have taken insufficient fluid at the finish and/or not eaten anything.