Let Common Sense Lead the Way

Between a third and a half of the 23,000 runners competing in Sunday’s L.A. Marathon will be first-timers, rookies bouncing along on padded shoes, faith, and raw determination. After months of obsessive training, no one wants to quit in front of friends, family and the other million or so spectators.

In all, it’s a recipe for pushing oneself through the pain--to worse pain and injury, doctors say. Over several hours of running, a mild chafe can turn to a flaming rash. A blister can become a crippling wound. And every marathon has its share of cramps, twisted ankles and crashes to the pavement.

Serious health problems are rare, but they do happen, said Dr. Rudra Sabaratnam, a family physician at City of Angels Medical Center and medical commissioner for the race. In its 17 year, the L.A. Marathon has had no deaths, but there have been heart problems. Last year, a man suffered a heart attack at mile 18 and was rushed to Cedars Sinai Medical Center, where he was treated and released.

“I tracked him down later and talked with him to find out what had happened,” Sabaratnam said. “He was a middle-aged guy who hadn’t really trained for the race. The most he had run was seven to eight miles, and he just wasn’t prepared.”

Sabaratnam said that runners who feel any unusual pain or soreness--especially chest pain, in older people--should stop and seek medical attention. Race officials have set up eight medical stations along the course, starting at Mile 6, and several more stations at the finish.

The weather is usually the biggest health concern. Two years ago, huffing and puffing through a chilly rain, several runners developed hypothermia, race officials said. Hypothermia occurs when the core body temperature drops to 96 degrees or lower and cannot restore itself. Metabolism slows, the heart beats irregularly, blood flow to the brain decreases, and if the body isn’t warmed there’s a risk of loss of consciousness and death. The runners who felt the chill in 2000 recovered soon after.

Still, if it looks cool or windy or wet out there, race officials are adamant: Dress warmly. You can always peel off layers, if needed

If it’s sunny and hot, dehydration is the greater threat. Sabaratnam recommends drinking eight to 16 ounces of water in the two hours before the race starts (8:45 a.m.), and downing equal amounts of water and sports drinks at fluid stations along the course.

As for food, doctors advise carbo-loading in the days before the race--eating more than your usual amount of pasta, bread and cereals (the body stores carbohydrates for endurance activities)--and taking some nourishment for the run itself.

Distance runners often pack nutrition gels or bars, for example, for lightweight snacks.

“You’re burning a lot of energy, and you need to replenish every hour or so, I would say,” Sabaratnam said.

Resist the urge to collapse immediately after the race, doctors advise. A sudden halt will not only cause muscles to stiffen (you sit down and can’t get up) but also cause a drop in blood pressure that can make you dizzy or disoriented.

A good, long walk of a quarter to half mile is a much better transition to normal living. (Heart attacks can strike after the race, but doctors say they are rare.)

For those who are inspired to shoot for 2003 by the spectacle of this year’s race, long-distance runners recommend setting aside seven months for preparation.

Start slowly, running or walking a half-hour to 45 minutes, three or four times a week. Once a week, take a longer run, whatever’s comfortable at first, two miles or 10. Then extend that long run a little at a time until you’re doing at least 20 miles, once a week.

Finally, in the few weeks preceding the marathon, cut down the routine by half or more, and take it easy.

“You’re about to run 26 miles,” Sabaratnam said. “Give yourself a little break before that.”