For avid runners, training for the next marathon never stops. While it's important to focus on running faster or farther, Houston Methodist physicians encourage runners to expand their training regimen and are providing the following tips for training and protecting the entire body.
• Brain -- "Runners preparing for a 26.2 mile race need to be well rested," said Dr. Aparajitha Verma, medical director of the Sleep Disorders Center at Houston Methodist Hospital. "For seven to 10 days before the marathon, runners should set a standard bedtime and wakeup time that provides them with seven to eight hours of sleep. Also, avoid alcohol and caffeine as they prevent peaceful sleeping."
• Heart -- "If a runner has cardiac risk factors, the intensity of a marathon can be dangerous," said Dr. Colin Barker, cardiologist at the Houston Methodist DeBakey Heart & Vascular Center. "Runners should be cleared by their doctor before running a marathon. After this has occurred, they should start their runs off slowly and gradually increase their speed to help the heart acclimate to the work."
• Stomach -- "If a long distance runner ingests too much water, the serum sodium level can decrease, which in turn can cause an individual's cells to swell," said Dr. James Muntz, Houston Methodist internist. "This condition called hyponatremia can be prevented by eating foods with high sodium content and drinking sports drinks for a few days before a marathon."
Muntz adds that during the marathon, a good rule of thumb is to drink about one cup of fluid every 20 minutes. If you need to drink more, choose a sports drink that contains some salt. Left untreated, hyponatremia can be fatal. Early symptoms can include vomiting, loss of appetite, headache, restlessness/fatigue, abnormal mental status, muscle weakness, or convulsions. Muntz advises runners to seek immediate medical attention if they experience any or all of these conditions during or shortly after a marathon.
• Hip -- "Increasing your flexibility and strengthening the core, glutes, hip, and thigh muscles can help improve or even eliminate hip pain in runners," said Dr. Joshua Harris, orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine. "For example, try incorporating yoga or Pilates into your training routine. Both of these exercise regimens can strengthen your hips and can help prevent pain and injuries."
• Knee -- "Runners should strength their gluteus muscles through side leg raises," said Dr. Vijay Jotwani, a primary care and sports medicine physician with Houston Methodist. "This muscle group stabilizes the pelvis and help support the knee. You should also stretch your hamstrings and IT bands for at least 45 to 60 seconds each after every run. This will allow the muscle fibers to stay stretched as you increase your mileage."
• Feet -- "Many runners will have a foot-posture assessment completed at a store and will select their running shoe base on the employee's recommendation," said Dr. Pedro Cosculluela, Houston Methodist foot and ankle specialist. "Studies have shown that forcing the foot into a specific posture increases the risk for injury. It is better to select the shoe that best fits you and is most comfortable. Also, orthotics can decrease the impact stresses for long distance runners, so picking up a pair of over-the-counter orthotics can help prevent injuries."
• Hand -- "If you've fallen while running and injured your hand, you should visit your doctor if your wrist is still tender or if you're not able to much weight on it after five to seven days," said Dr. Evan D. Collins, hand and upper extremity specialist at Houston Methodist. "Your doctor can order an X-ray to determine if the injury is a wrist sprain, crack, or fracture."
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