The B.A.A. and the Boston Marathon medical team urge all runners to consult their individual physician to educate themselves about medical issues and risks relating to the marathon. Only a physician who is familiar with your personal medical history, your current health, your medications, and your specific medical condition(s) and risk factors, can advise you as to whether you are fit to run the Boston Marathon safely and the precautions and preparations you should take.
Hopkinton - Medical Teams are available at the Athletes Village handle last minute needs. A full medical staff from the Metro West Medical Center will be available to answer medical questions or concerns.
On-course - The American Red Cross supplies medical aid stations at 26 locations, strategically located along the course. Each tent is staffed with a variety of medical professionals. Basic first aid is provided, along with assistance for any medical situation requiring transport to one of four hospitals along the route.
The B.A.A. will also position Disaster Managment Administrative Teams (DMAT) that will be located in Natick, Wellesley, and Newton. These tents will be staffed with physicians and nurses and can offer a higher level of care to our runners.
Medical Bus Program - Medical sweep buses, positioned along the course, will pick up athletes at Red Cross and water stations. (Following the last runners, buses pick up athletes between stations, when flagged down.) Staffed by medical volunteers who may provide first aid, an ambulance will be called to transport athletes in need. A runner may rest on the bus while the bus is parked at a station. However, once the bus begins to move, the runner's timing and scoring chip will be removed, after which time the runner may not re-enter the course to complete the marathon. Many buses do not return directly to the finish area; rather, they may make other stops along the course to pick up additional runners.
Finish Line - Medical teams are located at the finish line, and the our main medical tent on Dartmouth Street. Additional members of the medical team are located along recovery zones leading to the family meeting area. Medical personnel can be identified by their red volunteer jackets: if you are injured or feeling ill, please seek out a member of the medical team for assistance.
Massage Therapy Services - Massage therapy is offered to the athletes on a limited, first-come first-served basis. Treatments may last from five to fifteen minutes and focus on the specific need at that time. Pre-event massage is offered inside the Hopkinton High School gymnasium at Athletes' Village on race morning. Post-event massage in Boston is offered at the Dorothy Quincy Suite inside the John Hancock Building at the corner of Berkeley and Stuart Streets near the family meeting area. Expected wait time for a massage varies with the number of volunteer massage therapists available at the time.
At the Finish - During any prolonged physical activity, the body's blood supply is usually re-directed to the extremities and away from internal organs. Runners should continue to walk after finishing the race. Standing still or stopping can cause you to feel nauseous, dizzy and weak. Walking may help re-direct your blood to vital organs, so it is often advisable to keep moving. But in any event, if you think you need help, ask one of the medical personnel for assistance.
HYDRATION, DEHYDRATION AND HYPONATREMIA
The B.A.A. and the Boston Marathon medical team have provided each registered runner with a brochure, which accompanies this Welcome Booklet. The brochure, entitled "The Right Way to Hydrate for a Marathon," has been developed by the American Medical Athletic Association and offers important information relevant to athletes of all abilities. However, it is important for runners to be aware that there are many risks involved in running a marathon. Also, it must be understood that a runner's susceptibility to a particular risk will depend on a number of different factors, including factors unique to the individual runner. In addition, medical knowledge and medical therapies relating to long distance running are continuing to evolve and develop. For instance, one of the risks which is receiving attention is hyponatremia, and there are studies which indicate that females and those taking nonsteroidal anti-inflammatory drugs (such as Advil, Motrin, Aleve, ibuprofen, naproxen etc.) may be particularly susceptible to this risk. Unfortunately, no one study is definitive or comprehensive. Therefore, the B.A.A. and the Boston Marathon medical team urge all participants to read publicly available materials and to educate themselves fully about the medical risks associated with running a marathon as well as professional recommendations about training, nutrition, hydration and injury-prevention. For further information, you might visit websites such as that of the American Running Association at www.americanrunning.org and the many "Running-Related Brochures" and "Fitness Links" referred to there, consult leading professional publications on these subjects, and consult your own physician.
Preparing for cold weather
Marathon Monday in New England can be cold and rainy, so runners must dress properly. Approximately 60% of body heat is lost from the head. Wear appropriate clothing. At the 17-mile mark (entering Newton) when crossing Route 128 and when descending Heartbreak Hill at 21.5 miles (leaving Newton), you may experience strong, cold, cross winds. If you are certain that you will not need your cold weather clothes, put them on the baggage buses provided prior to the start in Hopkinton. Change out of wet gear as soon as possible. Mylar® blankets will be available at the finish. These blankets help the body retain a limited amount of the body's own heat, but they are not designed to keep you warm for a significant length of time. Seek out family and friends to assist you. Traditionally, the family meeting area can be cold and windy; a plan to find a post-race support group should be an important part of every runner's pre-race checklist.
Preparing for warm weather
Occasionally, the weather in April can be warmer than normal, placing runners at risk for heat illness. Further, it is not unusual to experience a warmer than normal day through much of the course, then - approaching Boston, beginning at Mile 20 - to experience a much cooler sea breeze. It is not uncommon for participants to experience both ranges of temperature on the same day.
The degree of risk is determined by both heat and humidity. If it is a hot day, but the humidity is low, the dryness of the air enhances the body's ability to keep body temperature appropriately regulated by the cooling effect of sweat evaporation. However, this occurs at the expense of becoming dehydrated. If the body cannot keep in heat balance by increasing heat loss, the body often responds by decreasing the amount of body heat produced. Simply stated, runners are encouraged to slow down or stop. Failure to do so can result in a rapid rise in temperature to dangerous levels, which may damage the heat regulatory mechanism in the brain. This is heat stroke, which will result in damage to organs such as the liver, brain and kidneys. The symptoms of impending heat illness include weakness, heat sensation on the upper body, lightheadedness, confusion, blurred vision, shortness of breath, nausea, vomiting, a generalized sensation of tingling on the neck and shoulders which can progress to disorientation, profound weakness and collapse.
How the Boston Marathon medical team may assist you:
- Public address announcements stating the risk of heat illness or hypothermia may be made in Hopkinton at both the Athletes' Village and at the starting line.
- Fluids are available before, during and after the race. The medical team suggests that you drink a pint of fluid two hours prior to the start and then take fluids along the course at regular intervals and as needed based on personal experience.
Note: medical problems (hyponatremia) can arise from excessive fluid intake. Water and Gatorade® are available on the course. Runners should have a complete understanding of their individual fluid needs aas they pertain to exercise intensity and temperature variables.
- If you feel ill along the route, seek medical attention at one of the American Red Cross First Aid stations or DMAT tents.
- If you feel you are experiencing a medical problem, or need to withdraw from the race for any reason, a bus staffed with medical personnel will pick you up at any American Red Cross First Aid station or along the route. Participants will be transported to the finish area at the rear of the primary medical tent.
The responsibilities of every participant:
- Consult your physician.
- Fill out the Emergency Information and Medical History form on the reverse of your bib number.
- Listen to the weather forecast. Know the risks and plan accordingly when running during hot or cold conditions. Both heat-related injuries and hyponatremia are life threatening conditions. Adjust your race and hydration plan accordingly.
- Develop and implement your individual plan for hydration. Be prepared to adjust your plan given the weather conditions and how you are feeling during the race.
- If you experience or feel you are about to experience a medical problem, ask for help immediately. It is foolish and dangerous to abuse your body.
- Help your fellow participants.
PERFORMANCE ENHANCING AGENTS AND THE MARATHON
For many runners, the Boston Marathon is an inherently competitive event. It is this drive that pushes us to train hard and to prepare fully for race day. Unfortunately, this drive has also lead to increasing popularity of both illicit performance enhancing drugs and legal, over-the-counter performance enhancing supplements over recent years. The Boston Athletic Association’s medical team strongly discourages the use of any such items.
The US Anti-Doping Association (USADA) in conjunction with the World Anti-Doping Association (WADA) publishes a detailed list of substances that are banned from use during organized competitive athletics. These lists are generated to maintain a fair competitive environment AND to protect the health and livelihood of athletes. The Boston Athletic Association’s medical team encourages all marathon participants to familiarize themselves with these lists and to abstain from the use of all included items.
If a substance is called a supplement it means that the product has not been definitively evaluated by the US Food and Drug Administration (FDA), then this means that the safety and efficacy have not been fully reviewed. Specifically, this means that the use of these substances during the physiologic stress of marathon running is unknown and may be significant enough to cause serious medical illness or death. Serious side effects stemming from supplement use can include: hypertension, irregular heart beats (that can be fatal), heart attacks, blood clots, seizures, strokes and death. Milder side effects can include: headache, dizziness, irritability, anxiety, tremor, and psychosis. Many of these substances also diminish the ability to regulate your heat and fluid balance.
The small potential performance improvements that may accompany the use of illicit drugs or legal supplements are not worth the risk. Please run safe, run fast, and run clean.