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Health Tips brought to you by U.S. HealthWorks Medical Group. Our experienced medical experts provide information here that we hope will broaden your healthcare knowledge.

Recent statistics show that marathons seem to be growing in popularity throughout the U.S. More than half a million runners have participated in marathons each year since 2010, with the total growing every year.

But, if not properly trained or prepared, people can get seriously injured. Today, we talk to Dr. Anuruddh Misra, our sports medicine expert and medical director for U.S. HealthWorks in South San Francisco, about marathons and what kinds of injuries they can cause. Dr. Misra is double Board Certified in Sports Medicine and Internal Medicine.

Q: We continue to see an increased interest in marathons in the U.S. What is the origin of marathons as we know them today?

A: The term marathon originates from Ancient Greece in reference to the legend of Pheidippides, a Greek message carrier, who was sent from the “Battlefield of Marathon” to Athens to announce that the Persians had been defeated in 490 BC. It is said that he ran the entire distance without stopping and then died, hence the distance of 26.2 miles of full marathons (and 13.1 of half-marathons) today.

Q: What is your experience with marathons as a sports medicine physician?

A: I was first introduced to the science of runners during my post-doctoral work with a mentor of mine, Dr. Michael Fredericson of Stanford University, who is widely published on this topic and is well-known as an authority for this group of athletes. I covered the Stanford University Annual Cross Country Invitational several times with him and his medical team.

Since then, I have gained extensive experience providing medical care during marathons for the past 10 years – from post-doctoral training to my Sports Medicine fellowship to my practice. I have covered events as a medical director with my mentor and colleague, Dr. Anthony Luke of the Orthopedic Institute & Sports Medicine at University of California – San Francisco, for The San Francisco Marathon, Escape from Alcatraz and The Rock ‘n’ Roll Marathon.

Q: What are some common injuries that can result from running half or full marathons?

A: The most common marathon injuries span the entire spectrum of all organ systems and include injuries such as:

  • Musculoskeletal injuries (i.e. knee injuries, ankle sprains)
  • Skin disorders (i.e. chafing, blisters)
  • Cardiac fatalities (approximately 1 in 45,000 will die of sudden cardiac death, most of which happen at the finish line —perhaps Pheidippides was such an example)
  • Pulmonary distress (i.e. exercise-induced asthma)
  • Metabolic issues, such as hyperthermia and exercise-induced hyponatremia

Q: Can these injuries be avoided with proper training, or can they happen to any runner whether they’re well-trained or not?

A: Proper training is essential to prevention. Most of the runners I have attended to over the years sadly “bit off more than they could chew,” and the distance was simply too much for their level of physical fitness and preparedness. Usually more experienced runners are less prone to injury, with the number of years running being inversely related to incidence of injuries as they tend to be better at listening” to their bodies compared to less experienced runners.

With that said, while proper training is key, even the most experienced runners can (and often do) come down with some of the most common injuries mentioned above.

Q: How long should someone wait after an injury before trying to run another marathon?

A: A runner must be 100% recovered from injury or illness prior to getting started on the preparation for another marathon and that time period will vary from person to person. I conducted research on this topic with Dr. Fredericson, and we published a review article in 2007 speaking exactly to this point. In this article, which you can read here, you will find reference to some of the other common injuries seen in runners.

Q: What is the risk of running without proper training and/or recovery time?

A: Running without proper training is a serious risk force multiplier for all injuries, musculoskeletal and otherwise. For example, the cardiovascular risk during exercise is elevated a hundredfold for a sedentary person when they engage in sudden, vigorous exercise, hence the need to have the correct training program for said individual. In deciding to be a runner, one of the most important first steps is to confirm an appropriate graduated training program. This is essential to achieve one’s maximum potential while concurrently lessening the potential hazards which are commonly seen with running.

To that end, Mr. Fauja Singh of the United Kingdom stands apart as an example of an extremely experienced runner who ran marathons not only through into his 90s, but even beyond the age of 100! In fact he is currently 104 years old and recently completed yet another marathon in the recent months of this year. Mr. Singh is an inspiring example of exercise potentiating longevity in concert with the healthy life style he leads otherwise.

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