Important information for training and competing on race day
The B.A.A. and the Boston Marathon Medical Team urge all runners to consult their personal physicians prior to training and running the marathon. Traditionally, distance running is a safe and healthy form of exercise, but there are inherent risks associated with running extreme distances, especially if you have certain pre-existing medical conditions. Only a physician familiar with your personal medical history, current health status, medications, and your pre-existing risk factors can advise you as to whether you are fit to run the Boston Marathon. Taking these simple steps and heeding the advice of your personal physician will give you the ability to make the right decisions and enjoy a healthy race.
Medical Services - The Start in Hopkinton
The Start Area will have two medical tents that can offer assistance with most last minute medical needs. Band-Aids, Vaseline, a pre-race stretch, or just a word of encouragement can be offered by our medical team. Please complete two very important tasks before leaving the Athletes’ Village: 1.) Write your current or pre-event weight on the back of your bib. This figure may help us determine if you’ve been over-drinking during the event. 2.) It is also very important that you complete the emergency contact information on the back of your bib. Information such as allergies, medical conditions, and two emergency telephone numbers should be included. If possible, one of the emergency contact numbers should be that of someone waiting for you near the finish.
Medical Services - On-course
The Boston Athletic Association provides 26 medical stations strategically located along the course. Each tent is staffed with a variety of medical professionals, offering basic first aid to those in need. Course medical coverage is supported with ambulances and EMS bike teams provided by Fallon Ambulance, American Medical Response, and Cataldo Ambulance Company.
Sweep Medical Bus Program
Medical sweep buses are positioned along the course at aid stations. These buses are available to runners who cannot finish the race and/or may have a minor medical problem. Each bus is staffed by medical volunteers who are available to provide first aid. A runner may choose to rest on the bus while it is parked at a first aid station. However, once the bus begins to move, the runner is no longer an official entrant and you will not be given an official finish time. Once on the bus, the runner may not re-enter the course to complete the marathon. Medical Sweep buses are required to travel from aid station to aid station and do not travel directly to the finish area in Boston. Once you arrive in Boston, you have the option of seeking care in our medical tents or entering the gear check area to pick up your clothing.
Medical Services - Finish Line/Finish Area
Medical teams are located at the finish line and the main medical tent, which is located on Dartmouth Street. A second tent/facility is located farther down on St. James Street at Berkeley Street. Additional members of the medical team are staffed along recovery zones leading to the Family Meeting Area. Medical personnel can be identified by their white volunteer jackets. If you are injured or feeling ill, please seek out a member of the medical team for aid.
After You Cross the Finish Line
During any prolonged physical activity, the body’s blood supply is usually redirected to the extremities and away from internal organs. Runners should continue to walk after finishing the race. Standing still or stopping can cause nausea, dizziness, and weakness – normally resulting with a runner passing out. Walking will help redirect your blood to vital organs, so it is advisable to keep moving. In any event, if you think you need help, ask one of our medical personnel for assistance.
Participants are solely responsible for any medical expenses incurred from preparing and participating in the Boston Marathon. These expenses including; ambulance transfers to area hospitals during or after the marathon, hospital admissions, lab work, and any follow up care needed to address your injury or illness.
Together with the American Red Cross and the American Heart Association, the Boston Athletic
Association presents a video of “hands only” CPR. To view the video and learn more, go to: http://youtu.be/pjY5d7zupVY
HYDRATION, DEHYDRATION, AND HYPONATREMIA
The B.A.A. and the Boston Marathon Medical Team have provided registered runners information on proper fueling through various participant newsletter e-mails. It’s important for runners to be aware that there are many risks involved in running a marathon. It must also 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. Medical knowledge and medical therapies relating to 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 (a little more than males), runners with a slight build, runners that take over four hours to complete the course, and those taking nonsteroidal anti-inflammatory drugs (such as Advil, Motrin, Aleve, ibuprofen, naproxen, etc.) may be particularly susceptible to this risk. This is usually associated with weight gain. One suggestion for runners is to measure their weight before and after a training run. One should finish a long run at about the same weight or up to 2% below their pre-run weight. Changes above or below these levels may be predisposed to hyponatremia or hyperthermia, respectively. It’s your responsibility to understand your specific fluid needs and not over drink before, during, or after the event. 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 educate themselves fully about the medical risks associated with running a marathon. One common misperception is that a runner should drink more on a hot day to avoid hyperthermia. The best method is to slow down the pace. It is also common for a over hydrated who does not feel well at the finish, to think they are dehydrated and continue drinking which could lead to seizures and death. It is usually safe to drink once one has voided.
It’s very important for runners to determine hydration needs prior to the race. However, as a rough guide, if you’re a fast runner on a pace of less than 3:30:00, drinking about 16 oz. per hour is usually adequate. If you’re on a pace to finish in more than 4 hours, about 8 oz. per hour is usually adequate. There are frequent water/Gatorade stations along the course for your convenience. However, it’s not necessary to stop at every station. This could result in over-hydration. It is also very important to not over-hydrate at the end of the race. Rehydration should be gradual over the next 24 hours. Two ways to continually monitor your fluid status in training are to measure your weight, stripped down, before and after a run. You should gain no weight and typically lose up to 2% of your body weight. After determining your fluid needs, stick to this plan during the race. The second is to make sure your urine stays yellow, not clear (overhydration) and not dark like apple juice (dehydrated), both are key indicators when determining your hydration status.
Preparing for cold weather:
April in New England can be cold and rainy, so runners must dress properly. Approximately 60% of body heat is lost from the head. Please wear appropriate clothing. At the 17-mile mark (entering Newton) when crossing Rte. 128, you may experience strong, cold, crosswinds. After you finish the race, change out of any wet gear as soon as possible. Heatsheet® Blankets will be available at the finish. This product helps retain body heat, in the event of cold weather, or reflects radiant heat, in the event of warm weather. Our best advice is to seek out family and friends to assist you. Traditionally, the Family Meeting Area can be cold and windy; a plan to find post-race support groups should be an important part of every runner’s post-race checklist.
Preparing for warm weather:
Of all the adversities that runners and marathoners face, heat is the number one offender. This is because it can bring on two conditions that can negatively affect your performance: overheating and dehydration. At times, the unpredictable nature of Boston’s weather, especially in April, can offer warmer than normal temperatures, placing runners at risk for the potential of exercise induced heat illness. The degree of risk is determined by two key factors, heat and humidity. Simply stated, when both factors are present runners are encouraged to slow down from their normal pace. If you are experiencing an illness (fever) or cold, your risk factors will increase. Deciding not to run when temperature extremes are present or stopping if heat illness becomes an issue is vital to your safety. 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. The symptoms of impending heat illness include weakness, heat sensation on the upper body, a feeling of being light headed, confusion, blurred vision, shortness of breath, nausea, vomiting, a generalized sensation of tingling in the neck and shoulders which can progress to disorientation, profound weakness, and collapse.
- Public address announcements stating the risk of heat illness or hypothermia will be made in Hopkinton at both the Athletes’ Village and at the starting line. Be aware that extreme weather changes may occur after the start of the race.
- Fluids are available before, during, and after the race. The medical team suggests you drink a pint of fluid two hours before the start and then take fluids along the course at regular intervals and as needed based on personal experience. Note: medical problems can arise from excessive (hyponatremia), as well as insufficient intake of fluids. Both water and Gatorade Endurance Formula will be available at each aid station along the route. Gatorade will help replace some of the minerals lost during exercise, but will not prevent hyponatremia. If you feel ill along the course, we strongly recommend that you seek medical attention at one of the American Red Cross First Aid Stations.
- Twenty six (26) American Red Cross First Aid Stations are located along the route and mobile emergency vehicles are positioned for transport to major medical centers. Teams of medical personnel are located at the finish line to assist participants in need of attention, and these teams are supported by a larger medical station located just past the finish line at the corner of Boylston and Dartmouth Streets.
- If you are feeling ill and experiencing medical problems, you are strongly urged to withdraw from the race. Red Cross, local EMS, and buses staffed with medical personnel will pick you up at any of our Red Cross First Aid Stations or along the route. Participants will be transported to the Finish Area at the rear of the primary medical tent. In some cases you may be transported to a local hospital for follow-up care. We ask that you have hospital staff contact us once you arrive.
The responsibilities of every participant:
- Consult your physician before starting any exercise program. If you have a known personal or family history of heart problems regardless of how insignificant you feel this is (such as mitral valve prolapse), you should obtain a medical consultation from a physician trained in the area of exercise and related heart conditions. If you suffer from exercise induced chest pain, shortness of breath, dizziness or passing out, you should also consult such a physician before training or running in the marathon. The extremes of this competition place much stronger stresses on the heart than normal daily activities or recreational running.
- Fill out the emergency information on the reverse of your bib number, including medical history and your pre-race weight.
- Listen and understand the meaning of local weather forecasts. Know the risks of participating in extreme temperatures of either range and plan accordingly. Both heat related injuries and hyponatremia are life threatening conditions. Adjust your race and hydration plans. DO NOT OVER DRINK!
- 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. Learn to judge your fluid intake by your weight changes with running and in different conditions.
- 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. If you notice a runner in distress, ask if help is needed. When appropriate, obtain assistance from our course medical groups, or local fire, police, and EMS personnel.