I've always been a runner, and lately I've been considering running a marathon. What tips can you offer?

Answered by: Robin West, MD UPMC Sports Medicine
Dr. West is one of only a few women in orthopaedic surgery and sports medicine in the country. Besides working with many local high schools, Dr. West is a team physician for the University of Pittsburgh basketball team, the head physician for Carnegie Mellon University, and an orthopaedic consultant to the Pittsburgh Steelers. After competing in high school and college athletics, she participated in a triathlon. Recently she competed in a California marathon called Escape from Alcatraz.

Do your homework. It's important to understand what it takes to complete the 26.2 miles of a standard marathon. Explore the Internet or find books that discuss what a marathon is and what kind of training it entails.

You have to be ready to devote time to it and be willing to sacrifice to a certain extent whatever else you might be doing, including work and family activites, or other hobbies. It is going to take about 10 hours a week to start training for it, especially for beginners. When I train, I generally spend about an hour or two a day.

You will also have to change your diet to accommodate the increased caloric expenditure. It’s difficult to say how much the average person will burn. It depends on body size, how fast you’re running, and how many miles you are running. But it is important to keep up with your weight and monitor how it fluctuates.

The ideal weight to shoot for depends on the person who is running the marathon. Some people want to lose weight or get in shape. A person who wants to lose 20 pounds and then run a marathon will train differently than someone who is in pretty good shape but just wants to push him or herself to the limit physically. So, it is important to think about your goal.

Running to lose or maintain weight

Generally a human being needs about 2,000 to 3,000 calories a day, depending on body size. Therefore, someone who wants to lose weight needs to remember to take in fewer calories than the average daily requirement. You have to burn about 3,500 calories to lose a pound. This can be done through exercise or diet. Calculate that into your plan. Trainers usually recommend losing a pound a week as a reasonable goal. That means consuming about 500 calories less per day than you are currently consuming.

If you are already at a good weight and simply want to get in shape, eating habits should be dictated by how you’re feeling. If you feel like you are running well and your energy level is OK, that will be a good indicator of how much or how little you will need to eat. I definitely had to increase my caloric intake during phases of my exercising to maintain proper fuel levels. But there was no science to it. I recommend that you eat when you’re hungry, and try to eat a very balanced diet. When you are training for an endurance race, you should be getting about 60 to 70 percent carbohydrates in your diet throughout training because it provides more energy. These are complex carbohydrates, not sugars. Carbohydrates convert to energy quickly. Fat and protein take a little longer. But it is still important to get a balanced diet.

Gear

As you begin training, it is important to consider purchasing a good pair of running shoes, as well as any appropriate clothing depending on whether you are training in the winter or summer. I suggest that beginners go to a good running store and seek help in picking out a proper shoe. Shoes are important because everyone is built differently. Some people are hyperpronated, or flatfooted, while others have high arches. You need to be assessed by someone who has expertise in this area, such as an orthopaedic surgeon, podiatrist, or the local running store.

Wear breathable fabric, and layer the clothes to adjust to either winter or summer running. Dress in clothing that makes you comfortable. I have some friends who will run in their shorts in the snow. I prefer to be warm, which is also important in helping to prevent sprains.

Conditioning

With conditioning, it’s important to start out at your base. Figure out how far you can run. Can you run one mile or ten miles? Once you understand what your base is you can begin building from there.

In determining your base, listen to your body. Try running for one-half mile and see how you feel. Remember, ultimately you will need to run 26.2 miles in order to do a marathon. Therefore, while it is important to establish a base and start from where you are, try to constantly strive to achieve your best.

There are many types of marathon training programs available online or through books specially devoted to the subject. Some say to run 80 miles a week, while others say it is sufficient to run 15 miles a week and build from there. I recommend a gradual build up. Most proven programs suggest that runners-in-training remember not to increase their mileage by more than 10 percent per week. If you are running 20 miles one week, your goal should be to run 22 miles the next week, rather than suddenly deciding to shoot up to 40 miles. If runners push themselves too hard during training, they set themselves up for injuries that can dramatically set them back.

It is also important to vary your training. Try combining endurance training with hill training and some sprints. I recommend doing two to three hard days a week and then alternating those with easier, lighter days. The hard days are usually longer or faster. The easier days may include a slow run. You also don’t need to always run. Try biking or swimming on some days, and include days of rest. Take one day a week where you do nothing, and allow your body to take a break. Good hydration, good nutrition and diet, and proper sleep are all important.

Know your limitations

I don’t believe marathon running is necessarily meant for everyone. It is a long distance for anyone to run, and not everyone’s body can handle it. Certain people are not going to be able to do it because they aren’t built right for it. They may be too big, have very flat feet, knock-knees, or other physical conditions that may not be conducive to long-distance running, including asthma or heart problems. Unfortunately, many of these individuals will still try to run and many end up repeatedly injuring themselves. It is important to understand your limitations.

If it is right for you, marathon running can be wonderful. I think it is a mental game more than anything else. It provides a great sense of satisfaction and accomplishment. In addition, when we train our bodies to run long distances, it naturally releases endorphins, or chemicals that can be very uplifting physically and mentally. A similar kind of inner sensation can be achieved with many different types of exercise. Our bodies were meant to move, so whether you run or walk, just remember to get out there and move. Exercise is great medicine.

For more information on running marathons, visit the UPMC Sports Medicine website.

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