Event Details :: Medical Information
Medical Information
The Chicago Distance Classic is dedicated to providing a safe environment for all its participants and spectators. Please read the following to help you help us to keep everyone safe and healthy race day.
The Medical Team is a group of volunteer medical personnel dedicated to providing rapid assessment of medical needs and administering acute first aid and immediate services to the runners and walkers of the Chicago Distance Classic. The team is made up of volunteers to assist you in every way possible to finish the event. The following tips, services and guides are presented here to help you achieve just that.
- Start, Course & Finish Medical Stations
- Fluids: Rules on how much to drink
- Running Doc's Tips For Race Day
- Too Much Fluid Is Bad
- Pain Relievers
- Running Doc's Finish Tips
- Medical Information Label
- Do you have questions?
- About our Medical Directors
Start, Course & Finish Medical Stations
There will be 1 medical station at the Start, 2 on the course and 2 at the finish. Look for the Medical Station sign and sports medicine volunteers wearing RED T-shirts for complimentary help before, during and after the race.
Should you have any last minute needs, a medical staff will be at the start available for you. Please do not hesitate to ask questions in between warming up and stretching.
Post-event massage will NOT be offered in the finish area. Medical studies have found post-event massage within the first two hours after running/walking an endurance event to be harmful; it does not prevent post-event muscle soreness. Research has shown that at least two hours after you finish the races is the most effective time for post-event massage. If you care to schedule a post-event massage privately after you have left the finish expo, it is your individual responsibility to do so, and we suggest you do this ASAP since massage therapists will become booked on race day evening quite quickly!
Fluids: Rules on how much to drink
You need to drink. But how much? The International Marathon Medical Directors Association (IMMDA) published guidelines which we suggest you read and use to remain healthy and safe on race day:
- How Much Fluid Should I Drink During Endurance Events?
- It is IMMDA's desire to educate and ensure that participants consume proper amounts of fluids during endurance events to remain healthy and perform well. Too much or too little may bring about health concerns and/or poor performance.
- What should you drink?
- If your event or workout is longer than 30 minutes you should drink a sports drink instead of water. The added carbohydrates and electrolytes speed absorption of fluids and have the added benefit of energy fuel and electrolytes. There is actually decreased benefit to watering down or diluting sports drinks or alternating sports drinks with water.
- How much should you drink?
- Drinking too much or too little can be of risk to health and performance. Hyponatremia (low blood salt level due to abnormal fluid retention from overdrinking) and dehydration (due to net fluid losses from under drinking) are conditions easily adverted by understanding your individual body needs. Just as you have a unique face and fingerprint, your body's need for fluid is individual as well. Body weight, gender, climate and sweat rate are just a few variables that individualize your needs. It is normal to lose a small amount of bodyweight during a marathon: bodyweight will re-equilibrate over the next 24 hours through the consumption of sodium and fluids with meals. A weight loss of more than 2% or any weight gain are warning signs that justify immediate medical consultation and indicate that you are drinking improperly.
- Try to drink to thirst.
- This advice seems way too simple to be true; however, physiologically the new scientific evidence says that thirst will actually protect athletes from the hazards of both over and under-drinking by providing real time feedback on internal fluid balance. If you are not thirsty, try to refrain from drinking. Do not feel compelled to drink at every fluid station nor follow the cues of other runners - their fluid needs are probably very different from your own. If you are "over-thinking" and feel you cannot rely on this new way of thinking, experiment in your training with one of these other ways realizing each has its own cautions as well.
Approximation of Fluid Replacement
There are individual variations: "one size does not fit all." IMMDA members endorse thirst as the best scientifically supported method for you to use. These alternate methods may not take into account changes in ambient conditions, running speed and terrain, which can change your level of thirst.
Runners and walkers who are interested in the endurance "experience" rather than pursuing a "personal best" performance must resist the tendency to over-drink. Runners/walkers planning to spend between 4-6 hours or longer on the course are at risk for developing fluid-overload hyponatremia and usually do not need to ingest more than one cup (3-6 oz: 3 oz if you weigh approximately 100 lbs and 6 oz if you weigh approximately 200 lbs) of fluid per mile. Athletes should avoid weight gain during an event.
Some participants may find that adjusting their intake to pace or time is easier for them as shown below but remembering thirst is the best method:
| Finish Time Race Pace |
Fluid Intake Rate | Fluid Intake Total |
| < 4 hours* | 10-12 oz / 20 minutes | 3.5-4.0 liters |
| < 8 minutes/mile | 30-36 oz / hour 1000-1250 ml / hour | |
| 4-5 hours* | 8 oz / 20 minutes | 3.0-3.5 liters |
| 9-10 minutes/mile | 24 oz / hour 750 ml / hour | |
| > 5 hours* | 4-6 oz / 20 minutes | 2.5-3.0 liters |
| > 10 minutes/mile | 18 oz / hour 500-600 ml / hour |
* Marathon Finishing Time
Adjust the rate of fluid intake to race pace: slower race pace = slower drinking rate; maximum intake of 500 ml/hr (4-6 oz every 20 min) for runners with greater than 5 hour finishing times (10-11 min/mile pace). Weight monitoring is also important: if you gain weight during your workout or event, you are drinking too much!
For a more highly motivated runner/walker who desires a numeric "range," a fluid calculator can provide an estimate of body fluid losses as a generalized strategy for fluid replacement. Participants concerned about peak performance are advised to understand their individualized fluid needs through use of this fluid calculator but ALWAYS defer to physiologic cues to increase fluid intake (thirst, concentrated dark urine, weight loss) or decrease fluid consumption (dilute or clear urination, bloating, weight gain) while participating. It is also important to recognize that if you use this method in one climate and then travel to a different climate for your event, the humidity will change your sweat rate and therefore your fluid needs.
Fluid calculator to calculate sweat rate:
- Weigh nude before the run.
- Run/walk at race pace for one hour. (One hour is recommended to get a reliable representation of sweat rate expected in an endurance event.)
- Track fluid intake during the run or walk; measure in ounces.
- Record nude weight after the run/walk. Subtract from starting weight. Convert the difference in body weight to ounces.
- To determine hourly sweat rate, add to this value the volume of fluid consumed (in Step 3).
- To determine how much to drink every 15 minutes, divide the hourly sweat rate by 4. This becomes the guideline for fluid intake every 15 min of a run.
- Note the environmental conditions on this day and repeat the measurements on another day when the environmental conditions are different. This will give you an idea of how different conditions affect your sweat rate.
Good luck in your training. Experimenting with your fluids can be a fun exercise. Remember to keep in mind that the consumption of beverages and foods containing sodium or carbohydrate should be guided by the goal to minimize loss of body weight and prevent weight gain.
Running Doc's Tips For Race Day
- Check your urine ½ hour before the race… if clear to yellow (like light lemonade) …you are well prehydrated… if dark and concentrated (like iced tea) …drink more fluids! If clear, you have drunk too much!
- During the race drink when you are thirsty… and no more. Never more than 1 cup every 20 minutes.
- 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! Stay away from dehydrating agents such as cold medicines, anti-diarrhea products, and sinus meds which all can lead to dehydration; you may take them again a few hours after finishing the race.
Too Much Fluid Is Bad
Most athletes understand the importance of drinking fluids, but some don't understand that drinking too much can be unhealthy 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 fluids 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 PLEASE follow these easy guidelines:
- Follow the fluid recommendations.
- Try not to drink more than you sweat.
- Include pretzels or a salted bagel in your pre-race meal.
- Favor a sports drink that has some sodium in it over water, which has none.
- 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).
- Carry 2 small salt packets with you, eat one just before starting and the second during the last half of the race.
- After the race, drink a sports drink that has sodium in it and eat some pretzels or a salted bagel.
- 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.
Pain Relievers
Medical research has shown that non-steroidal anti-inflammatories (NSAIDs) like Advil, Motrin, Aleve, ibuprofen, aspirin, naproxen, etc. are harmful to runners' kidney function if taken within 24 hours of running; only acetaminophen (Tylenol®) has been shown to be safe. These NSAIDs increase the possibility of hyponatremia while running/walking 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/walk) 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.
Running Doc's 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!"
Medical Information Label
On your running number is a "Medical Information" label. PLEASE fill that out now. This will help us to help you should the need arise. Thank you.
Do you have questions?
The Medical Team is here to help! The Medical Information Booth at the Expo within the Hilton Hotel where you pick up your participant bib is being staffed by our Sports Medicine Advisory Team to answer individual questions. Stop by. 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.
We all wish you a great race and a great day!
About our Medical Directors
Lewis G. Maharam, MD, FACSM
Runner's World columnist, affectionately called the Running Doc is the world's premier running physician. He is medical director of the New York Road Runners, ING New York City Marathon, all of Elite Racing's Musical Marathons, and The Leukemia & Lymphoma Society's Team in Training program. Dr. Maharam also serves as Chairman of the Board of Governors, International Marathon Medical Directors Association. The Running Doc has a private practice in Sports Medicine in NYC (1-866-RUN-NYMD). We are excited that Dr. Maharam has come to Chicago to lead our Medical Team for this event. You can meet him at the Expo Medical Information booth and hear him speak at our expo seminars.
David A. Birnbaum, MD, FACSM
Dr. Birnbaum specializes in sports medicine and pain management right here in Chicago. After playing world class tennis in college, Dr. Birnbaum went to on specialize in Sports Medicine at Harvard. He has served as a voluntary physician at the Olympic Training Camp in Colorado Springs and is a founding member of the Board of Directors of the American Board of Sports Medicine. Writing extensively on sports medicine topics, he has served as a columnist for Gymnastics Today and Addvantage Magazine. Dr. Birnbaum is now in private practice in South Barrington, a suburb of Chicago (847-382-4466). We are proud to have Dr. Birnbaum volunteering his time for this event and the local running and walking community.