MEDICAL
7 PREVENTION CAMPAIGN
Here’ s what runners can do to prevent themselves from ending up in a situation where they are in need of medical attention.
Prevention is Better than Cure: The CMA has embarked on a preventative education campaign to runners. This campaign has been carried through to the roadshows, on the website, newsletters and at the registration points. It now also includes the compulsory pre-race medical screening questionnaire, which has to be completed by every runner as part of the entry process. This is a simple yes / no type questionnaire, where a positive answer will result in the runner being sent advice on what steps should be taken to avoid them requiring medical attention on race day.
Awareness on Race Day: We urge runners to be aware of any unusual symptoms that may develop during the race, e. g. chest pain, dizziness, severe nausea, unusual shortness of breath, change in running style, confusion and disorientation. If this happens, stop running and seek medical attention. It has become apparent over many years that people feel it is more important to finish the race than be concerned about their health.
Assisting Other Runners: As introduced in 2008, a medically-orientated enforcement of the rules will be applied. As the name and the origins and ethos of the Comrades Marathon implies, it is a personal battle to finish, and the support and encouragement of one’ s fellow runners is an intimate part of the race. However, this could, and has, led to runners being helped, even carried by fellow runners, when they should have stopped running and sought urgent medical help. Again, we will enforce the rule that any runner who is unable to move forward under their own power, i. e. being carried by other runners, will be prevented from continuing, medical attention will be called for, and that runner’ s race will be over.
8 EXPERT ADVICE
The Comrades Marathon Association’ s chief race doctor, Dr Jeremy Boulter, has been at the helm of coordinating the event’ s extensive medical, emergency, first aid and physiotherapy response to assist runners over 48 years. He says,“ The main concerns we usually treat on race day are exhaustion, dehydration, some over-hydration, and any arising acute medical problems experienced on the route. Most musculoskeletal problems will only surface the following day, and will need treatment then.”
With his extensive experience in race-day emergencies, Dr Boulter offers these points of sound advice to runners on the day: 1. Make sure you’ re adequately trained and prepared. 2. Don’ t run if you are ill or have been ill with influenza in the two weeks prior to Comrades Day.“ If your symptoms were experienced above the neck, it’ s probably okay to run, but if they were below the neck, don’ t chance it. If you’ ve had a fever with aches and pains, a chest infection or coughing, and you’ re still on treatment, don’ t attempt the race,” advises Dr Boulter. 3. Make sure you drink enough fluids on the route. 4. Eat enough food to keep you going during the race.
Runners Urged Not to Pop Pills!
In a race as long and challenging as the Comrades Marathon, runners may be tempted to take medication such as painkillers, anti-inflammatories or muscle relaxants during the race. Dr Boulter expands on why it’ s so important that runners do not self-medicate along the way.“ Every year we have patients coming in and we can pinpoint those whose medical problems were caused by painkillers, anti-inflammatories or muscle relaxants, which can lead to serious problems,” he says.
“ Runners may be tempted to take the medication because they’ re getting sore, but you can’ t expect to run from Durban to‘ Maritzburg and not feel pain. Medication has sideeffects, though. Non-steroidal anti-inflammatories cause inflammation of the stomach. When you run, your stomach function is reduced because blood is diverted to essential organs like your heart, lungs, brain and muscles, which means that whatever you take sits in the stomach for longer, which could cause inflammation.”
“ These medications can also affect blood flow to the kidneys, so if you are somewhat dehydrated and take non-steroidal anti-inflammatories, you can further compromise the function of the kidneys and end up in acute renal failure. It’ s not just the known side-effects of the medication that can cause problems, but also the effects of running that sort of distance.”
9 HEALTHY RACE PLAN
The CMA would like to appeal to runners to demonstrate a great degree of selfresponsibility, by making sure that they are adequately prepared to run the Comrades Marathon. The following is a list of the basic principles every runner should adhere to:
• Do drink enough.
• Do eat if necessary.
• Do listen to your body.
• DON’ T run if you are not fit enough or not properly prepared.
• DON’ T run if you have been sick or on anti-biotics three weeks prior to the race.
• DON’ T take ANY medication during the race.
• DON’ T be afraid or ashamed to bail.
It is important to remember that medical attention is retroactive, i. e. we only respond when a runner is in trouble. It is still the responsibility of the runner to take care of his or her own health. And remember, the aim is to enjoy the race and finish in a reasonably healthy state.
Images: Comrades Marathon Association & courtesy Netcare 911
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