Jan 19 2017 : The Economic Times (Delhi)
Marathon on Mind? - Here's Your Health Checklist
Figure out your fitness level and risks, and train and eat right before getting into those running shoes, writes Megha Reddy S
Noted gynaecologist and laparoscopic surgeon Dr Rakesh Sinha (59) collapsed while on a morning run in Mumbai recently, just a month after he was certified medically fit. He had run four international full marathons and was preparing for the Standard Chartered Mumbai Mara-thon. It is debatable whether running led to his death, but the incident has sparked concerns over distance running, which is fast attracting both the young and the old.

India has nearly 200 marathon running events listed for this year. With each passing year, more and more people are participating in such events.However, many of them may not be physically prepared for marathon running, and that could be dangerous.

Before any exercise, and specially marathon running, it is necessary to seek a doctor's approval. Following a standard protocol of tests, which involves full-body screening and checking the BMI, blood pressure, blood sugar levels, vitamin profile and iron deficiency , is important.

“We need to be sure that our infrastructure is in a position to support the activity. Our cardiovascular system needs to be structurally and functionally normal. We need to have trained the right amount in the right manner over the right period of time,“ said Dr Girish Godbole, consultant interventional cardiologist at Bengaluru's Vikram Hospitals. Godbole has run several halfmarathons himself.

Dr Jai Babu, cardiologist at Narayana Health in Bengaluru said, “If there is a strong family history of heart ailments, it is better to go for heart screening.“

Fitness expert Deckline Leitao offered a general advice that could come in useful for all those who want to take up distance running. “Be fit to run and don't run to be fit,“ he said.


Training for a marathon should be planned for six months to a year before the event. Leitao referred to a principle called progressive overload training. It means that one should increase the distance or time or difficulty in running progressively .

First you walk, then you speed walk or brisk walk, then you jog slowly and only then you can start distance running.“This is the most abused principle.Pushing hard the whole time is one of the biggest mistakes we commit. It is about running right,“ he said.

If your body feels broken down and if you feel any pain during an exercise, then it may not be a healthy sign.Don't push yourself if you are in pain.If you are in pain, consult a doctor immediately .

“Running is good, but treat it like an exercise. Follow it as an exercise and you are on the right track,“ Leitao said.

Besides, choose your gear wisely . Take professional help for this.


Diet and sleep are also very important.Poor diet leads to reduced energy levels and this can add to the strain on your body . It is always advisable to consult a dietician and eat right if you are preparing for a running event.

For runners, sleep is just as important as food and exercise.

A pre-workout meal rich in carbohydrates is recommended. We should also keep in mind the timing of running before a meal since an early morning run requires a different type of diet compared to an evening run. There will be a slight difference in the way our body will respond to running in the morning after fasting for eight hours.

“The main aim of marathon running is to be able to prolong it. We have to be conscious that glycogen stores in our liver will be less in the mornings. It is unhealthy to run on an empty stomach since our energy will be less,“ said Dr Bharathi AV , nutritionist at JustRight Weight Loss Solutions.

“A pre-workout snack is very important and it should be essentially carbohydraterich food. Rice-based items, wheat-based food, fruits and potatoes are recommended. The diet also varies with the timing of running. How much we have and what we have is very critical,“ she said.

For a normal person, 30-50 gm of carbohydrate is more than enough. It is recommended to eat 30 minutes to an hour before a run. The aim is to reduce exhaustion, especially early exhaustion, while running.

“Fluids are recommended only when there is perspiration, when the temperature is very high and when there is a lot of fluid loss. In order to replenish those fluids, runners are advised to have sips of water. If there is electrolyte dysfunction, it is recommended to have coconut water, lime juice or fruit juice,“ said Bharathi.


Running improves leg endurance, but marathons do come with some problems.“There are risks associated with marathon running since it is mostly held in cities where people run on roads or on concrete surfaces. This has a bad impact on the knee, lower back and ankle joints since they run on cambered roads (middle of the road is higher and the edges are lower),“ said Leitao.

Distance road runners are especially susceptible to Iliotibial band syndrome (ITBS), which is mostly characterised by pain on the outer side of the thigh. This happens because one leg is in a higher position than the other on the road.

“You can avoid ITBS by changing the direction of running. It is important to share the load on your legs,“ said Leitao.

The less physically conditioned a person is, the less conditioned the muscles are and the impact of road running is severe in such cases.

“One has to condition the body by running itself and also by doing specific exercises to strengthen the core muscles.Hence, physically being conditioned is very important before taking up running,“ he said.


The most common running injuries are related to the knee and feet. ITBS, patellar tendon pain (runner's knee) and lower back pain are the most common.

ITBS pain is an inflammation for which icing helps, as does resting. Patellar tendon pain is an injury to the tissue connecting the kneecap to the shin bone. It is a short-term injury and gets resolved within days to weeks. Lower back pain mostly goes away on its own in two to four weeks.Physical therapy and pain relievers can help. Ankle injury is not that common unless you twist your ankle while running.Overuse injuries are, however, common among distance runners.


After a long run, good icing provides relaxation. Feet elevation, optimum water intake, fortnightly full-body massage, meditation and static stretching help speed up recovery .


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