Medical Information-

Koz Enterprises, Inc. and The Marathon/Triathlon Medical Team want you to have a safe race. Please read the important information below and have a great race!
 

Course & Finish Medical Stations
There will be medical personnel on the course and at the finish.
 

The doctors will NOT offer post-event massage in the finish area. Post-event massage has been shown by medical studies to be contraindicated within the first 2 hours after running races such as these; it does not prevent post-event muscle soreness. Research has shown that from 2 hours post-finish on is the most effective time for post-event massage. While, our finish line medical teams will have therapists incorporated within the teams to assist in relieving cramps and to assist in first aid measures for our runners; they will not be giving post-event massages.
 

Start Line Medical Services
Should you have any last minute needs; a full medical staff will be at the start available for you. Please do not hesitate to ask questions in between warming up and stretching.
 

The Rules About Fluids
When the weather is steamy or your body is down a quart and the workout is far from over, it's a bad time to begin wondering if you've had enough to drink lately. You need to drink. On a warm day, racers are at risk for dehydration if they don't drink as described below. Not drinking may lead to early fatigue or heat illness. 

For simple re-hydration on an average day, water does the job; however, sports drinks have made the issue more complicated than that. As Medical Director, I credit the research done by Dr. Lewis Maharam MD, he has found evidence that states that the sugar and salt in those drinks form an "active pump" that gets water into the body faster than the unassisted process - simple diffusion of water. The additional salt is advantageous to help hold onto water and maintain proper blood sodium levels. Practice with fluid replacement drinks. Don't use/do anything new on race day that you haven't practiced with.

Here are some practical tips for deciding how much to drink both during training periods and on race day:

 
Fluids On Race Day
Water and sports drinks provide you with fluid, by far the most important nutrient your body needs to finish a event healthy! Follow these recommendations and you will prevent dehydration! BUT DON'T OVER-DRINK! Remember, too much is as bad as too little.

Use your urine color as a guide (see below):

Drink at least 16 ounces of fluid 1-2 hours before the race.

Drink another 16 ounces of fluid in the hour before the race.

Check your urine 1/2 hour before the race…if clear to dark yellow…you are well prehydrated…if dark and concentrated…drink more fluids!

During the race drink no more than 1 cup (8-10 ounces) of fluid every 15-20 minutes along the way - that does not mean a cup at EVERY water station. Water/Sports Drink stations are located throughout the course.
 

DO NOT take any product with ephedra in it. Ephedra increases your risk of "heat illness." It should not be used while training or on race day!

 Too Much Fluid Can Be Harmful
Most athletes understand the importance of drinking fluids, but some don't understand that drinking too much can be harmful as well. Overhydrating can lead to a dangerous condition known as hyponatremia (low blood sodium). Runners or walkers out on the course for long periods, losing lots of sodium in sweat, are at risk. Overzealous drinkers who drink lots of water in the days prior to the race and then stop at every fluid station along the course also may risk hyponatremia. This condition can lead to nausea, fatigue, vomiting, weakness, sleepiness, changes in sensorium and in the most severe instances, seizures, coma and death.

 
To avoid hyponatremia follow these easy guidelines:
 

1. Follow the fluid recommendations.
2. Try not to drink more than you sweat.
3. Include pretzels or a salted bagel in your pre-race meal.
4. Favor a sports drink that has some sodium in it over water, which has none.
5. In the days before the race, add salt to your foods (provided that you don't have high blood pressure or your doctor has restricted your salt intake).
6. Carry a small salt packet with you, and during the last half of the race, if you feel that you have been sweating a lot or that it's a warm/hot day, consume that single packet.
7. After the race, drink a sports drink that has sodium in it and eat some pretzels or a salted bagel.
8. Stop taking non-steroidal anti-inflammatories 24 hours before your race and do not start again until a minimum of 6 hours after finishing the race. 
   

Weigh In Daily
Step out of bed every morning and onto the scale. If you're anywhere from 1% to 3% lighter than yesterday, re-hydrate by drinking 8 ounces of fluid for each pound lost before training again. Between 3% and 6% lighter, re-hydrate and back off that day's training intensity. Over 7%, get to the doctor.

 
Drink During Daily Workouts
Two hours before your workout, drink about half a quart. Drink again as early as 15 minutes into the session, but keep the doses small - 4 to 7 ounces.

And After Workouts?

Weigh yourself right before and after workouts. For every pound you lost, drink a pint of electrolyte replacement fluid watered down to whatever strength you like.

 

Prep For The Heat
Take ten days to two weeks to get used to warm weather, building workout intensity and duration gradually. Favor more intensity in cooler morning hours over easier work during the heat of the afternoon. Monitor core body temperature, which should stay below 102.2º F immediately after a workout. Higher than that, your performance is going down. Unfortunately, an oral thermometer isn't precise enough, and doesn't take the right reading. Core means core. Get out the rectal thermometer, and get used to it. Avoid lengthy warm-up periods on especially hot and humid days. No supplements with ephedra during training or on race day; taking ephedra increases your risk of heat illness.

 

Pain Relievers
Recent medical research has shown that non-steroidal anti-inflammatories (NSAIDs) like Advil, Motrin, Aleve, ibuprofen, naproxen, etc. may be harmful to runners' kidney function if taken within 24 hours of running; acetaminophen (Tylenol®) has been shown to be safe. These NSAID’s are thought to increase the possibility of hyponatremia while running long distances due to their decreasing blood flow to the kidneys and interfering with a hormone that helps the body retain salt. Therefore it is recommended that on race day (specifically beginning midnight before you run) you do not use anything but acetaminophen (Tylenol®) if needed until 6 hours after you have finished the race, are able to drink without any nausea or vomiting, have urinated once, and feel physically and mentally back to normal. Then, an NSAID would be of benefit in preventing post-event muscle soreness.

 

Finish Tips
During the race, blood has been re-directed to your legs, away from your internal organs. This is "normal" physiology that you should know about. YOU MUST CONTINUE TO WALK AFTER FINISHING YOUR RACE…MOVE FOR AT LEAST 20 MINUTES! If you don't walk and stop or sit down, the blood flow to your internal organs will not rapidly be re-directed to the pre-race state. You would then feel nauseous (not enough blood flow to the stomach) and throw up, as well as feel very dizzy and weak! Walking helps to re-direct your blood and bring you back to your "everyday" physiology. Drink fluids slowly at the finish and certainly not until you have adequately "walked it off!"

 

Questions?
The Medical Team is here to help! We're here for you! At each and every medical station on race day will be sports medicine professionals to help you along the way.

 

Yours in health,

 

*Special Thanks goes out to Lewis G. Maharam, M.D., FACSM for his help in making this medical information packet and general guidelines available to our racers.