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Run 2014 Marathon? Boston Strong — But Many Bodies, Not So Much

Runners start the 117th running of the Boston Marathon, in Hopkinton, Mass., Monday, April 15, 2013. (Stew Milne/AP)
Runners start the 117th running of the Boston Marathon, in Hopkinton, Mass., Monday, April 15, 2013. (Stew Milne/AP)

Please don't call me a lily-livered traitor to my town. Truly, Boston is strong. It's just that many of our knees or hearts or assorted other body parts may be weak.

I understand the galvanizing defiance that says, "Let's show them! I'll run the Boston Marathon next year as part of the hugest field of runners ever, all of us demonstrating that terror will not triumph!" I'm deeply impressed by the widespread sentiment I'm hearing on the street — my street of non-elite athletes, that is — of determination to run the marathon for the first time next year.

But I feel compelled to say: For many people, that's a great option. But for many people, it's not. And for some, from a health point of view, running the marathon may hurt you more than it helps the city. (A friend in the "I must run next year" camp has been begged and begged again by her husband to please, protect her body and refrain.)

Before I get into the physical pros and cons of marathons, I'd also like to add these words of caution and restraint from Marc Davis, communications manager for the Boston Athletic Association: The marathon organizers are aware of the incredibly high demand to run next year, he said, but there is, for lack of a better term, a "language barrier" between "how you get into this event and how people think you get into this event."

'Please, people, don't just show up.'

"In the end, there's a certain structure we have to this event that will not go away no matter what," he said. And "the very essence of the Boston Marathon is the qualifying nature of it. It's going to disappoint a large group of people, but this isn't just a marathon to sign up for, this is a marathon you have to qualify for, and we're not going to change that basic premise no matter what."

Here's your reality check: In order to qualify if you're a male between 18 and 34, you need to make a time of three hours and five minutes; then the scale slides and at the other end of the range, it's five hours and 25 minutes for women 80 and older. (Note to self: Hey, maybe if I train for decades...)

Also, sure, it would be great to thumb our noses at terror by running 100,000-strong instead of the current field of 27,000, but that could be a logistical nightmare. "We're not starting on a two-way, three-lane gi-normous bridge like the New York City marathon starts on," Davis said. "We're starting in a small township," along single-lane roads.

'Running long distances is going to be very revealing — and what it’s going to be revealing of are your shortcomings.'

Perhaps the race's board of directors, when they next meet, will decide to restructure the race somehow, he said, but the message for now is "Please, people, don't just show up," don't run unregistered. Practically, it could create problematic crowding, and on principle, "You don't just walk into a Patriots game without a ticket just because you want to see it."

Now for the health side. I spoke with Prof. Michael Bergeron, executive director of the National Youth Sports Health & Safety Institute, a professor of pediatrics and researcher at the University of South Dakota. His bottom line: No matter what the advertisement says, “You can’t ‘Just do it,’ especially not a marathon, if you are not ready for it.”

That is to say, without question, running can be very good for your health.

Indeed, he said, most adults should focus on “improving and maintaining their cardio-respiratory fitness for the rest of their lives — and that means aerobic exercise, like running and cycling. How important is this? It's safe to say it’s becoming increasingly clear that it — your cardio-respiratory fitness — is a huge, if not the biggest, determinant of your long-term health, well-being and, frankly, risk of dying. So it’s in no small way something you should try to do,” and federal guidelines suggest at least 150 minutes a week of moderate to vigorous physical activity, most of it aerobic.

That said, if you run more than 15 to 20 miles a week — which training for a marathon eventually requires — “you’re doing it for some other reason besides fitness. You might say, ‘Yes, I’m doing it for Boston.’ Now you get into other issues.”

And here’s the rub: Running distances long enough to train for and actually trying to complete a marathon is going to be “very revealing — and what it’s going to be revealing of are your shortcomings.”

Shortcomings? Yes. Such as:

• Your fitness level: “It will reveal just how unfit you are.”

• Your biomechanics: “If you have any kind of foot or knee mal-alignment or weakness in the hip, for example, even very subtle deficiencies are going to be highlighted as discomfort, pain and ultimately play out as a barrier to you finishing or even going very far without hurting yourself. When you run a short distance you can usually get away with almost anything. As the distance increases, reality presents itself more clearly. You start getting up to distances like a 10K or higher, any sort of mechanical or physiological disadvantage is going to be more greatly revealed.”

Prof. Michael Bergeron
Prof. Michael Bergeron

“The body has a nice way of telling you or even forcing you to stop,” Bergeron continued. “Excessive fatigue, energy depletion or even exhaustion-related collapse is actually a nice safety valve, before you get into more serious trouble. But if you have the mental fortitude — and I don’t mean that in a good way, in this case — to power through the pain…you could get yourself into a situation where you’ve really hurt yourself: a stress fracture, a ligament tear, or dangerously overheating. Any kind of mechanical or physiological disadvantage or limitation that you have as a novice or recreational runner — and believe me, you have them — that’s going to be underscored progressively and more emphatically as the race goes on.”

If you’re not already a serious runner, Bergeron recommends finding a way to run a much shorter distance than a marathon to get fit, be strong and show support.

He’s particularly concerned about people who delay training and try to jump into a marathon late. For non-runners determined to do the marathon, smart and progressive training should begin immediately, he said.

“For a lot of people, the marathon is achievable; but you need to understand that it takes a very long time of progressively working up to it, and not only adding distance, but adding deliberate and regular recovery time appropriately into your training schedule and strategy,” he said.

Bergeron suggests following the training plan guidelines provided by Runner’s World to get started.

“If you’re not really going to commit to a long-term supervised (or at least well-informed) process of getting there, if you’re not going to give it that full year or so, then don’t do it, because you’ll get in trouble and will likely be disappointed,” Bergeron said.

In particular, “If you have underlying medical issues, like, say, a heart issue, you should know that, although the overall risk is low, some people die from sudden cardiac arrest in marathons not necessarily because running the marathon is bad per se, but that distance was eventually too much stress for a person who may have felt okay under all other more typical and shorter physical activities. You could get away with it if the distance or the time were much shorter, but if there’s any underlying pathology — your heart or other things, or perhaps if you’ve not fully recovered from previous injuries — the marathon is very revealing. A lot of things have to be in place to do this successfully, to survive it unscathed.”

Are there, I asked, certain people he’d particularly like to beg, “Please don’t do this!”?

“If you’ve never run before,” he said, “and you think you’re in a lot better shape than you are. The same people who jump into extreme conditioning programs, thinking they can do it after seeing the commercials. That mentality of ‘Hey, I’m 40 but I feel like I’m 20, and I used to do that. And I’ve never run before but how hard can it be?' That attitude. It’s a little different being determined and aggressive in a business deal versus being overzealous and aggressive in training and running a marathon.”

So is there a particular alternative to the marathon he’d suggest?

“Maybe your personal statement should be that you are going to live healthier and stronger and thus live better and longer,” he said. “Live better in your own personal way, which is a personal statement that you’re part of this community that is stronger because of this. You’re not a contributing factor as much if you’re hurt or you kill yourself on the racecourse trying to make a point.”

I’d like to share my own personal decision. I work out daily, including a weekly run, but my body always lets me know after even three miles that it doesn’t like running. There’s no way I’m going to train for a marathon. But we’ve written before about findings that when bystanders know CPR, they do indeed save lives. So I've resolved that before I help line the streets of the 2014 marathon, I’ll take a CPR refresher as well as a full-fledged first-aid course. At least I’ll know how to tie on a tourniquet if it’s ever needed.

Readers? Your plans? And any questions for Prof. Bergeron or the marathon organizers?

This program aired on April 24, 2013. The audio for this program is not available.

Headshot of Carey Goldberg

Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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