Tips and advice for runners training for Baltimore Marathon

Dr. John Senatore, chief of podiatry services at Union Memorial Hosptial
Dr. John Senatore, chief of podiatry services at Union Memorial Hosptial (Kim Hairston, Baltimore Sun)

There is more to training for a marathon than running a few laps around the track. Finishing 26.2 miles, or even getting to the starting line, takes attention to some details about eating and hydrating, miles covered, and aches and pains. Dr. John Senatore, avid runner and chief of podiatry in Union Memorial Hospital's sports medicine department, talks about what to do — and what not to do — as next week's Baltimore Running Festival approaches.

What should runners, particularly first-time marathoners, do in the last week before the race so they feel good on race day?

All marathoners need to taper (gradually decrease) their weekly mileage starting at least two weeks prior to the race. 26.2 miles is a long way, and fresh legs are a must to finish.

When the weather turns cool, how should runners adjust their intake of water and sports drinks before and during the race?

Runners are easily fooled by temperature. Studies have shown that temperatures above 60 degrees actually place more stress on a runner's body even though you may feel very comfortable. Avoid the common mistake of starting out too fast because of the cool temperature and burning out too soon.

The most important intake of sports drink actually takes place 10 minutes before the race begins, when 8 to 10 ounces should be consumed. After that, 5 to 6 ounces should be taken every 5 miles or so during the race. Incidentally, one ounce is considered to be a normal, regular swallow of fluid. Don't forget to utilize this sports-drink-intake pattern during your long training runs, too. All gels should be consumed with plenty of water to prevent dehydration.

If a sports drink is not used then water needs to be taken on a regular basis throughout the run. If you are thirsty during the race then dehydration has set in and you are in trouble. Fluid intake is a vital part of your long training run and must be monitored and adjusted accordingly. Never use a new sport drink or gel the day of the race.

I understand "carbo-loading" with pasta is now recommended two nights before. So what should runners eat the night before? And what should runners eat before and during the race so they're fueled but don't get sick?

Carbs, carbs and more carbs. Do not wait two days before the race to start eating a carbohydrate-rich meal. Everyone is different and some may have a difficult time with pasta, so experiment with other carbohydrate-rich foods. Again, your long training runs are a practice for the marathon. This is when you are teaching your body to "run long" and find out what type of fluid replacement works for you. Carbo-loading with fluids and food (bagels, bananas) the morning of the long run is part of the training process and can be adjusted as needed. Just eat and drink the same for the race.

A lot of stores are pushing compression sleeves, knee braces and other equipment, but are these a good idea and for what kinds of pains?

If a knee brace is needed to run, then running a marathon is not a good idea. The body was not meant to run 26.2 miles on two good legs, and any pre-existing injury will definitely be exacerbated in a long run. Again, I cannot stress enough, do not try anything new (including socks or compression sleeves) the day of the race!

As runners get into higher mileage, how can they tell the difference between discomfort and a real injury? And when should they stop running and seek medical attention?

A true injury will be around for several days to several weeks. Muscle or joint discomfort will dissipate after a day or so of rest. Never run through an injury or try to adjust your gait to avoid placing stress on the injured body part. Seek medical attention as soon as possible; there may be a simple solution to getting back on the road and training again.

Chocolate milk is getting a lot of attention as a recovery drink these days. Is it really that good, and what are some other good recovery foods and drinks?

Do not mix sports drinks with other things during the race.

If you consume a sports drink and water during a marathon, you'll end up with a very diluted solution in your gastrointestinal system; this will slow absorption of carbohydrate and leave you short of energy in the late stages of the race.

If you consume a sports drink and gel during the race, you'll end up with a stomach full of molasses, which will empty into your small intestine slowly, retard absorption of carbohydrates and increase your chances of ultimately developing a massive case of diarrhea. You should consume a sports drink—and nothing else—during the race.

Last tips?

Do not over-train. Run smart, not more.

It takes about three-four weeks to recover from a long run of 18 to 20 miles or so. This means, obviously, that no runs of 18 miles or longer should be conducted during the month leading up to a marathon. Do not try to squeeze in one — or even two — long runs during the three-four weeks before the big race.

If you undertrain for a marathon, you may never make it to the finish line, but if you overtrain, you may not make it to the starting line.