The science of marathon running

Running the Boston Marathon takes months of training, and it can take a toll on elite marathoners and novice athletes alike. Vector checked in with some of the experts in the Boston Children’s Hospital’s Sports Medicine Division to learn more about how science can aid marathon runners, prevent injury and illness and facilitate recovery. Hover over the icons below for some basics.

Chocolate milk: A no-brainer for maximizing recovery

The most rapid way to maximize recovery after an endurance run is to consume carbohydrates in a 4:1 ratio within 30 to 60 minutes of completing the marathon. The enzyme glycogen synthase is most active within this time frame; it synthesizes glycogen — the body’s main source of energy during activity — from glucose in the body. Chocolate milk has become a favorite of runners and athletes since it provides the perfect 4:1 ratio of carbohydrate to protein. —Laura Moretti, MS, RD, clinical nutrition specialist

ABCs of PEDs

Performance-enhancing drugs (PEDs) seem to be ubiquitous in the competitive running world. Erythropoietin (EPO), a peptide hormone produced by the kidneys, increases the number of red blood cells. Endurance athletes have turned to EPO because more red blood cells mean more oxygen and greater aerobic capacity. But excess red blood cells can clog the arteries and increase the risk of stroke or heart attack. Hence the ban on PEDs, including EPO. —Tom Vorderer, DPM, podiatrist

The science of injury prevention

Multiple studies suggest that 30 to 40 percent of runners suffer some sort of injury every year, and 50 to 75 percent of running injuries are considered overuse injuries. Common running injuries include runner’s knee, shin splints, stress fractures, Achilles tendonitis, plantar fasciitis, muscle pulls and Iliotibial Band Syndrome. Recent studies showed that gait re-training can reduce symptoms and improve performance runners with exercise-induced lower leg pain.

Pierre D’Hemecourt, MD, director of the Runners’ Clinic and Dai Sugimoto, PhD, director of Clinical Research at The Micheli Center for Sports Injury Prevention

Beat the heat

Six medical teams, each with designated duties, man the Boston Marathon finish line to ensure the runners’ health and safety. But these teams can’t control one factor — weather. Studies show ­that running-related heat illnesses track upward in a near straight line with heat/humidity on race day. Some runners increase fluid to prevent hyperthermia, but this can result in serious water logging and hyponatremia, low blood salt concentrations that can cause seizures and death. Learn water requirements during long runs, and to avoid hyperthermia on a hot day, slow down rather than drink more. —Lyle Micheli, MD, director Boston Children’s Sports Medicine and finish line volunteer since 1975

Learn more about research and innovation in the Boston Children’s Orthopedic Center.