JLPC Article - Avoiding injury when distance running
  There are three distinct phases of distance running:

1. Preparing for the run
2. During the run
3. After the run

  Cutting back your mileage before the race will lead to an improved performance. This is called tapering and   needs to begin about a month before a marathon. Research has shown positive effects including greater   muscle glycogen or energy storage abilities.

  It also improves your mental awareness for the big day. Tapering should occur in something like the following   stages manner :

• Week 1 : 75% usual mileage
• Week 2 : 50% usual mileage
• Week 3 : 30% usual mileage
• Week 4 : 15% usual mileage

  For the first 3 weeks continue the hard training patterns but reduce the easy sessions, in the last week interval   pacing should be emphasised.

Nutrition at 7 days to go

  With the taper, you will decrease your calorific burning, therefore you need to cut back on calorie intake. Lessen   by about 100 calories for every mile you take off your schedule. Go for low-fat, high-carbohydrate foods.

  At 4 days pre-race, your carbohydrate percentage needs to increase to about 65% (about 500g a day).   Remember that carbohydrates don’t have to be filling starches like potatoes, and that sports drinks also   provide a good source.

  The day before, eat frequently in small amounts and choose foods that you know agree with you. The night   before meal should be 800 – 1000 calories and be high carbohydrate, low-protein and low-fat.

  The morning meal on race day should be eaten 2- 4 hours prior to the start and include foods which are easily   digestible, these tend to be low-fat and fibre.

Fluid load

  Start 2 days pre-race so as to minimise dehydration through sweating during the race.
  You need to practice to drink a lot. Monitor your urine colour. A pale straw colour is good, a dark amber is a   sign of dehydration. Remember thirst is not a good indicator of hydration.

  Consider sports drinks in order to kill both the nutritional and fluid birds with one stone! Avoid alcohol and   caffeinated drinks as both are diuretics. Alcohol also interferes with liver glycogen metabolism and could   reduce your muscle energy stores.

Flexibility

  Tapering your mileage doesn’t mean tapering your stretching. It is vitally important to the efficiency of the   muscles for them to be flexible.

  Muscular stretches for each major muscle group should be performed before and after each run. A stretch   session can also be used as a rest day session. Each stretch should be held for 20 seconds and repeated 3   times, and each session should last for about 15 minutes.

Clothing and footwear

  Do not go to the shops and buy a spanking new outfit to run for the big day! New clothes may rub or labels can   irritate. Shorts may chafe the skin.

  Shoes should be worn in so as to help avoid blisters. They should have at least 50 miles of use, but not so   much that they lose their shock absorption.

  For the same reason do not apply Vaseline or any other creams to the feet which may increase their   movement within the shoes thereby increasing friction and the likelihood of blistering.

Injuries and niggles

  Do not ignore a niggle – it will not "run off". Most injuries during marathon training are caused by training   errors.

  These can be within the runner such as poor flexibility or foot biomechanics or outside the runner such as   unsuitable footwear, running on hard, cambered or too soft surfaces, or sudden increase in mileage.

  Your Chartered Physiotherapist will be able to assess the seriousness of any problem and treat it, advise you   on your training regime and also on how to maintain you fitness whist you recover from your injury.

During the run
Hydration

  Is the most important factor! If you’re new at drinking on the move, then stop to ensure you drink a whole   cupful at every drinking station. Even if you’re not feeling thirsty drink at every station. Your body controls its   temperature from the inside out.

  Throwing a cup of water over your head may feel fantastic but will have little effect if you are over-heating. You   must put the fluids inside. Try to drink both water and sports drinks to replenish your energy stores as you run.


Safety

  Running a marathon can be dangerous. The most common serious illness is heat exhaustion. Know the   signs. If you experience any of the following, stop running and immediately seek help:

• Lightheadedness
• Unexpected shortness of breath
• Confusion
• Nausea
• Vomiting

  Muscle cramps and exhaustion are lesser signs that more fluid is vitally necessary. Remember a dehydrated   muscle is more likely to strain.

Pace

  Start the race slowly or the last few miles will kill! An early fast burst will significantly deplete your muscle   energy stores. One suggestion is to run the first 3 miles at a slower than race pace and build up over the next   couple of miles.

After the run
Warm down

  Take advantage of the army of volunteer physiotherapists and masseurs for a warm-down massage. This will   help with your circulation and prevent some of the post-exercise toxin build up that occurs.

  Alternatively find somewhere to rest with your knees and feet up, so that they are higher than your hips. Again   this helps with the leg discomfort by aiding the venous drainage from your legs towards your heart.


Damp clothing

  Try to change quickly into warm and dry clothing to help minimise heat loss.

Refuelling

  Immediately after finishing you may not feel like eating solid foods. Instead spend the first hour or so drinking   a sports drink and/or water. Your fluid intake needs to replace all that you have lost in sweat.

  Drink approximately 2 cups (plastic beaker) for every pound of sweat you lose. (Therefore weigh yourself the   morning of the race!)

  It is important to eat a meal at about the 2 hours mark. Choose foods that will enter your system quickly such   as bread, bagels and dried fruits. Grazing every couple of hours is a good idea if you cannot bring yourself to   eat a bulky meal.

  Perhaps aim for about 50g of carbohydrate each time adding up to 600g (2400 calories) in 24 hours. In   general, ensure a good carbohydrate intake for the first week after the race to help the muscles recover   themselves.


Recovery

  If the marathon is a one-off, and you usually prefer another form of exercise, then you don’t have to be   concerned about returning to running. However, it is advisable to have a complete rest from all exercise for a   week after the race.

  No matter how well you’ve prepared for the race, there is likely to be some muscle soreness. This tends to   resolve spontaneously by about day 5, however it can be temporarily relieved with heat, ice, massage or gentle   stretching. Start back running at week 2, with what would be easy running to you. Work up from here.

  © Copyright 2001-2003 , Josephine Lawson Physiotherapy Clinic

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