Lack of Awareness of Fluid Needs Among Participants at a Midwest Marathon

Brown S, Chiampas G, Jaworski C, & Passe D (2011). Lack of Awareness of Fluid Needs Among Participants at a Midwest Marathon Sports Health: A Multidisciplinary Approach, 3 (5), 451-454.

Participation in marathons has increased from 25,000 runners in 1976 to 425,000 runners in 2008. This growth in popularity has attracted runners with various levels of experience, fitness, and knowledge about potential complications of marathon running. Brown et al. examined the experience of the typical marathon participant in the 2007 Chicago Marathon regarding the potential complications of running a marathon and hydration status. Surveys were completed by 419 runners during the Marathon Expo held two days before the marathon. The survey asked about demographics, number of previous marathons, extent of training for this marathon, history of injuries, previous use of medical tents at marathons, and hydration preferences. 34% of the runners reported never running a marathon before and 17% had a history of one marathon. 153 (37%) of the runners that completed the survey reported a history of at least one injury during the current running season (78% were defined as minor). Among the 278 participants who completed a previous marathon, 54 (19%) reported needing the medical tent: 17 (32%) runners for dehydration, 10 (19%) runners for cramping, 6 (11%) runners for musculoskeletal injuries, and the remainder for various health issues (i.e., vomiting, bleeding, heat- or cold-related illnesses, and hyponatremia). Overall, 55% and 64% of participants reported that they were not concerned with musculoskeletal injuries or hyponatremia; respectively. 89% reported no knowledge of their sweat rate and 68% reported that they did not weight themselves to assess hydration status. Over 81% of participants reported not having a method to address hydration status. The authors concluded that “most participants were inexperienced, lacked concern for injury or hyponatremia, and were not using methods of hydration assessment.”

This study is important because it clarifies the level of experience, knowledge, and perceptions among marathon runners. A few decades ago, marathon runners were primarily elite athletes but participants are becoming more diverse. This inexperience may lead to an increased burden on medical teams. The 2007 Chicago Marathon had 48,463 registrants (according to the article) but only about 29,000 participants finished the race. Furthermore, despite new record times in 2011, the average finish time has increased from 4:20:22 (2000 to 2002) to 4:37:14 (2009 to 2011; data verified here) in less than a decade. It would be interesting to see how this study’s data compares to other marathons or how the perceptions of runners relate to who utilizes the medical tents at that marathon. As a medical community that emphasizes injury prevention, we need to play a more active role in educating this population about proper hydration, training, and injury prevention. This may require us to be more proactive by promoting sound advice and guidelines in trade magazines, injury prevention workshops, and attending marathon expos. While marathons may be a once a year event for the medical community that serves a marathon, we should engage the running population all year. This could be a great opportunity for sports medicine to influence a large physically active and highly motived community before they come in with stress fractures, tendinitis, heat-related illness, or other conditions. I know when I talk to a runner they often have questions or stories. When was the last time you spoke to a recreational long-distance runner (that didn’t attend the school you worked at)?

Written by: Jeffrey Driban
Reviewed by: Kyle Harris