While most marathoners will finish the race, happily don their participatory medal and head home, hundreds of runners will have to go straight from the finish line to the medical tent. Some injuries will be minor; others might require a trip to the hospital. Many runners expect that simply going the 42.2-kilometre distance is going to beat up the body no matter what they do. But that's not true, experts say.
"It's a long way to go, but a lot of it has to do with preparation," says Padraig McCluskey, medical director of the GoodLife Victoria Marathon.
Lowell Greib, medical director of the GoodLife Fitness Toronto Marathon, puts it this way: "If you're prepared, odds are you're not going to be injured."
Along with John Bessonette, an advanced-care paramedic in Halifax and medical chair of the Scotiabank Blue Nose Marathon, the medical professionals walk us through the most common race-day injuries and, more importantly, how to avoid them.
1. Traumatic diarrhea, a.k.a. runner's trots
Cause: "Activity in general, but running in particular, tends to promote stuff moving through your bowels," Dr. McCluskey says.
Recovery time: Thirty minutes. Consume electrolytes as soon as you feel able to.
Prevention: "You need to plan for how you are going to ensure your bowel is mostly empty so you don't have this problem," Dr. McCluskey says. The details of that plan are up to you, but he recommends a diet high in fibre to do what you have to do before the race starts.
Cause: "The most common reason why people vomit would have to do with taking in more fluids than their bodies are able to process," Dr. McCluskey says.
Recovery time: Rest for an hour.
Prevention: Practise your race-day fuelling strategy on long runs. "It becomes really important when you're doing your long runs to practise exactly the [liquids or foods]you plan on taking in your race," Dr. McCluskey says.
3. Bleeding nipples
Cause: The constant rubbing of your shirt against your nipples can make them tender. They may chafe and begin to bleed.
Recovery time: Up to one week, depending on severity. Use lanolin cream to ease the pain.
Prevention: "A Band-Aid is a cheap way to prevent it," Mr. Bessonette says. But try out a long run with Band-Aids covering your nipples first, to make sure they stick. If they fall off, opt for duct tape.
4. Lost toenails
Cause: Feet can swell during a run, which means your toenails begin digging into the shoe. "The majority of runners run into some toenail issues at some point," Dr. McCluskey says.
Recovery time: One to two months.
Prevention: "You want to have a shoe that you're comfortable with, that you've tried out on some of your longer runs. And you need to keep your toenails trimmed," Dr. McCluskey says.
Cause: Prolonged exposure to cold weather.
Recovery time: Up to one hour.
Prevention: "Make sure that you have a set of clothing at the finish line," Dr. Greib says. "A lot of people aren't prepared that way." Pack a long-sleeved shirt, socks, extra shoes, a sweater and even a blanket to have ready at the finish line. You don't want to lose more calories from shivering than you did from running.
6. The wobbles
Cause: Neuromuscular fatigue. "Basically, your little nerves that allow for you to balance properly are so fatigued that they're not firing properly," Dr. Greib says. This can cause your legs to shake and buckle under you.
Recovery: Less than 10 minutes.
Prevention: Keep moving after the race. Walk around a bit so your body can adjust. "That's why finishing chutes are so long," Dr. Greib says. "It forces people to keep moving rather than just stop."
7. Achilles tendon rupture
Cause: "Usually it's a progressive injury," Dr. Greib says. "There's got to be some underlying weakness before it ruptures."
Recovery time: Two months, "plus a ton of rehab time," Dr. Greib says.
Prevention: "Be aware of your body. Usually there are indicators that are predecessor signs to a major injury. Do you feel Achilles pain? Do you have the normal range of motion in your foot?" If things feel off during training, go see a physician.
Cause: Most likely mild dehydration. "One of the signs and symptoms [of dehydration]is a headache," Mr. Bessonette says, though he adds that several factors could cause a headache. Still, it's a good idea to start taking in more fluids.
Recovery time: Several hours. Take some over-the-counter pain medication to aid recovery.
Prevention: Stay hydrated, but also develop a good sense through training of when to ease your pace. "Know your body. Don't push goals too hard," Mr. Bessonette says.
9. Massive blisters
Cause: Shoes that fit poorly and allow the foot to move around inside too much can cause blisters – as can wet feet, Mr. Bessonette says. "The biggest one I ever saw [covered]the entire sole of a person's foot."
Recovery time: One to four weeks. Help speed it up by staying off your feet as much as possible.
Prevention: Avoid puddles and make sure you're wearing shoes that have been broken in and fit snugly, Mr. Bessonette says.
10. Dehydration, overhydration
Cause: Insufficient fluids or over-consumption of fluids.
Recovery time: For dehydration, 24 hours. Gradually drink fluids until urine runs clear. For bloating from drinking too much water, refrain from having too much post-race.
Prevention: "The cause of dehydration is that you haven't built a plan," Dr. Greib says. "The plan should be, at least, drink to thirst. Listen to your thirst receptors and just drink to that." A helpful rule of thumb: The darker your urine is, the more dehydrated you are. Pay attention in training and adjust accordingly.