Medical Advice
- By Doug Kurtis
Free Press Columnist

The Detroit Free Press Flagstar Bank Marathon is less than three weeks away. I asked Dr. Scott Eathorne, the marathon medical director, recognized as one of the area's best sports medicine specialists, to discuss some of the common medical problems he has witnessed during the marathon.

Cramping, dehydration and hypothermia are the big three concerns at the finish line.

�Aside from blisters, bloody nipples, sore muscles and tendons, which often don't require medical attention after the race, cramping is the most common presenting complaint in the medical tent. Most runners respond to stretching and oral hydration.  Massage therapy can also be quite helpful�, according to Dr. Eathorne.

Weather plays a role in hypothermia cases.  Fortunately, October in the Midwest usually presents moderate conditions.

�Circumstances that may put a runner at risk for environmental injury include obesity, poor conditioning, and lack of acclimatization, prior heat injury, dehydration, sleep deprivation, and some medications (water pills or diuretics, some antidepressants).  Illnesses that include fever, upper respiratory symptoms, and diarrhea in the week prior to the race may also be a risk factor.� 

Proper training, experience and recognition of early symptoms, appropriate clothing, and adequate hydration can often help prevent serious injury. 

Runners should not hesitate to come to the medical tent if they think they may have a problem. Dr. Eathorne has witnessed, �Exercise-associated collapse to be a relatively common condition in marathoners that typically occurs after completion of the race.  Runner may feel dizzy, lightheaded, and even pass out.  This may be due to the sudden stop in muscle pumping action of running and pooling of blood in the legs. They generally respond well to leg elevation and oral hydration with no long-term effects."

Hyponatremia, a serious, potentially life-threatening condition seen in endurance athletes, is a relatively uncommon condition seen at the Free Press Marathon.  This occurs from drinking too much fluid. Inexperienced female runners with low body weight, exercising over four hours in extreme temperatures have been the most susceptible to hyponatreamia.

Dr. Eathorne suggests paying attention to early symptoms. �These may include lightheadedness, nausea, and swelling (puffy fingers).  Later symptoms may include headache, vomiting, cramps, difficulty breathing, and confusion."

Water and Gatorade is offered at virtually every mile on the course. So the question becomes how much of each to drink and when. Per Dr. Eathorne, �There are as many theories as to the "ideal" fluids and hydration strategies as there are sports drinks on the market.  Race day is never a good time to figure out your fluid strategy.  This should be done over the course of your training and take into consideration level of conditioning.�

To help determine the right amount of fluid St. John's Health web site has marathon tips that describe a method for determining one's sweat rate. Go to: www.stjohndoctors.org/pam/running for this and other running medical advice.

New this year: In addition to start, finish and on course EMS coverage, two Runner First Aid stations will be available at mile 17 and 21 to address minor medical concerns.