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2008 ACSM Conference - Marathons

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A regular participant on the RWOL forums who uses the screen name, ExPhysRunner (EPR), is a professional exercise physiologist. In May, 2008 he attended a national conference of the American College of Sports Medicine and posted the following on the Marathon Race Training Forum concerning two subjects discussed at the conference….hot weather marathons and minimum criteria for marathon participation. The post generated a lot of interest and constructive discussion. The following is ExPhysRunner’s original post and a couple of comments/replies that it generated. I have archived it here with EPR’s permission.


2008 ACSM Conference – Marathons



Hot Marathons

I just returned from the American College of Sports Medicine (ACSM) national conference. I attended several sessions regarding marathons. One session was about three hot marathons in 2007: Lakefront (Milwaukee), Twin Cities and Chicago. The medical director (MD) from each was on hand to discuss the events of the day.

The Chicago MD noted that people thought the marathon should have started earlier. Well, the temperature as measured by Wet Bulb Global Temperature (a measure that includes air temp, humidity and radiant energy) was the same at 8am as it was at 7am and 6am. However, I do not recall his noting that had they started at 7am that more people would have been off the course at 11:15am when they decided to call the race. He also noted incidents of once the announcement was made to stop the race that people became agitated and even mildly violent. People just did not want to stop. Well, you know there will never be another marathon to run (sarcasm). This was their only chance in their entire life. As a side note, I was in Chicago that weekend teaching a clinic. When I walked out the door, I thought “I feel for the folks running the marathon”. I ran at noon that day and it was very tough.

Somewhat related, they decided to stop it in part because at 11:15am they had had only ~1100 finishers. On a normal year ~4000 have finished by that time. He also noted that about 50% of the runners are charity program runners. This was astonishing to me.

The Twin Cities marathon MD suggested that each marathon create guidelines for itself on when to cancel a race before it starts. He noted that you cannot wait until race day to make that decision. That makes sense. The emotion of the day will keep a lot of race directors (RDs) from canceling a race, or at least cancelling it for the masses (not the elites). He does not think there should be a temperature that applies to all marathons as each is different. For instance a marathon could be hot but the month leading up to it is hot so runners, for the most part are acclimatized. However a late fall marathon that gets a sudden (and it was sudden in 2007) rise in temperature should have a plan.

Minimum Criteria presentation
I was really looking forward to this session. There were the usual stats about age and gender changes in the marathon (older participants and more women participating) plus the note that mean finish time has increased by ~45 minutes over the past 30 years.

The Houston MD noted that he thinks that new runners should work their ways up to the marathon (hear, hear). The following are my notes from his talk. He said that he hopes to have this posted on the Houston Marathon web site in some form soon.

Year 1
The goals of year 1 include:
Habituation to running and 6 to 12 months of running 3 to 4 times per week.
Learn concept of effort and recovery
Perhaps gait analysis to look at running biomechanics
Goal: 5K/10K at end of year.

Year 2
Run 3 to 5 times/week
Learn periodization
Learn pacing skills
Increase intensity such as intervals and hills
Aim for marathon at the end of year 2

Year 3
Decide on a marathon
6 to 9 months of focused marathon training (group training can be beneficial)
Learn hydration needs for runs <1 hour; understand how heat and humidity can affect hydration (EPR note: also I think they need to learn how heat and humidity affect pace).



Another forumite posted:


Does he (the Houston MD) think the average person needs three years to prepare to complete a marathon or just that much time to do well? That sounds excessive.

EPR’s response:

I am not sure. You would need to ask him that.

My answer is that a person can finish a marathon on far less, but that the risks are higher. Remember the study from Boston that so many decried as running marathons were bad for you when in fact the data showed that low mileage runners 40 mpw or less) tended to show more cardiac issues than higher mileage runners. In essence, the study supported the case for more miles in prepping for a marathon.

As for data, no the MD was basing this on his experiences. I agree with his time line on the whole. I would go with running more races in year 1 for experience.



A third forumite posted:


Yeah, I was wondering this as well. Is there evidence that the "run to finish in 5+ hours" group sustains a greater percentage of injury during the marathon event than do the BQ chasers?

Certainly as one extends one's time one becomes susceptible to either hyponatremia and dehydration, however, in San Diego yesterday the meds were occupied with the elites (two collapsed at the finish) and every group following. Good thing they had a supply of stretchers and ambulances on the premises.

EPR’s response:

From what I gathered, no one has gathered stats on injuries, but let's consider other aspects:
1) How many couch to marathon folks get injured training for the marathon and never show up at the start line? Compare that to more experienced runners? What happens to the former? Do they quit or keep running? My bet is that the experienced runners make adjustments but keep on running at a higher rate than the couch potatoes.
2) Even very fit people can have injuries or die during a race. Actually a great place to have a cardiac event is at the end of a marathon. Medical personnel is there; when was the last time you were on a training run where medical staff was present?
3) For all of the above, nothing was mentioned of injuries or deaths. In fact, deaths during marathons are extremely rare even in folks that are not all that fit and run a marathon so the recommendations are not just aimed at these medical issues.

The rate of heat illness may actually be higher in 5K/10K races that in marathons. For one thing marathons are generally run in more moderate conditions. For another, the 5K and 10K intensity is very high so heat can build up quickly. In the marathon, the intensity is low and heat can often be dispersed even if the exposure is long. Also, people may self-select to slow down in a hot marathon whereas in a 10K/5K they may figure "I'll be done soon enough so I will just hammer it".

The Houston MD is a podiatrist (I just recalled this) and mentioned the number of injuries he sees in training. My guess is that he thinks that a slower progression would reduce the likelihood of many of these injuries is logical. My own experience in coaching former couch potatoes is that the rush to get into shape leads to injuries. If the pace of increasing mileage was more blunted, the injury risk would be reduced. Intuitively, makes sense.

Chicago is looking to start to gather some stats on finish time and medical issues. I am thinking of getting our local marathon to start to gather some data.

A few interesting other notes:
50% of the runners at Chicago were associated with a charity. Some of these, I am sure are quite capable runners. In fact in 2006 I was in one of the first corrals (sub 1:30 half marathon group) and saw at least a dozen TNT runners.

Since 1988 TNT has raised over $850 million. That is quite an incentive to get people to the marathon (or other events) even if not physically prepared. One of these days, TNT is going to have a person die and it is going to get sued over it. I base this on 1) with the numbers it is bound to happen 2) I am not sure what, if any, screening TNT does for health and 3) lawyers.

I like the 3 year plan. I do not see any marathon instituting or policing such a plan (not sure how one could realistically do it), but I think it makes sense to get people to think critically about it.

The first marathon I ran had a cut off of 4 hours for the official course. This was 1989. In today's marathoning world fewer than half the people would have finished. The median finish time has slowed by ~45 minutes over the past 30 years.

The impact being that races feel compelled to keep the course open longer. This costs money (so think about that when you are paying $100 for that marathon). Also, for a race starting at 7am that means that you have a lot of runners still on the course from 11am to noon when temperatures are usually going to be near their highest of the day). That can be added danger for the participants.

I am all for people being fit and healthy, but one can meet any organizations standards for physical activity in training for a 5K or 10K. I certainly do not think all these folks going from the couch to the marathon in 6 months are necessarily doing themselves any good and the risk may far outweigh the benefits from a health perspective.

It would be cool if all the marathons could and would collect data on its participants for



Jim2 note: I strongly concur with EPR’s comments related to rushing into a marathon prematurely…..the “couch to marathon in six months” syndrome. Many people do it successfully. But many more incur injury along the way and don’t make it to the race day starting line or they have such an unpleasant marathon experience that they get disillusioned. A longer term buildup to the marathon, whether it's one, two or three years, can result in a more satisfying outcome, as well as many pleasant experiences along the way while training for and racing shorter distances, as EPR discussed. For more related comments, see When To Run The First Marathon.