Tens of thousands of runners take part in major running events in the country, which makes it imperative for race organisers to do their best to anticipate injuries. — Photos: Kuala Lumpur Standard Chartered Marathon
RUNNING has become such a popular hobby that race slots for running events – especially longer distances like 21km and the 42km marathon distance – are often snapped up as soon as registration opens.
But beyond the fun and excitement of participating in a road race with friends or to perform one's personal best, the most important consideration during a race is to run safely.
Emergency physician Dr Jeewadas Velummylum Baladas says that above all, conditioning and listening to the body is vital.
"I cannot emphasise this enough: It is important to prepare oneself physically before a distance running event. Conditioning the body through consistent training helps to improve overall performance, reduce the risk of injuries, build cardiovascular endurance, adapt to various terrains and weather, and overcome mental challenges," he adds.
Insufficient training can result in a lack of confidence and mental strength to overcome the challenges of the race, and the inability to handle various race conditions. "It can also cause your pace to be inconsistent, which can severely impact your ability to finish the race," he says.
No matter the distance, it takes between 12 and 20 weeks before a race to prepare and familiarise oneself with the route, distance and inclination. "You need to study the route. If the race route is hilly and you practise on flat surface, then your body may not be equipped to perform on race day," he says.
"Good nutrition throughout the training period is also important, as well as having healed well after a previous injury, with adequate rehabilitation," he says.
"Ideally, every participant should do a medical check-up before participating in a running event and declare his or her past medical history to the organiser," he adds.
"When you register for a run, don't put your body into a systemic shock. Instead, train consistently and build your mileage and speed slowly," he says.
Dr Jeewadas says despite runners' preparation and aim, on race day, it is important that they put safety first. — Pantai Hospital Kuala Lumpur
Underdoing and overdoing
"It can also lead to overuse injuries like stress fractures, muscle strains and ligament damage on race day," he adds.
"If you overdo your training, your performance can take a dip due to physical and mental exhaustion, which in turn, gives rise to issues such as burnout, depression, insomnia, irritability and anxiety," he says.
The setbacks of overtraining goes beyond physical health. "Excessive training can weaken the immune system and disrupt hormone levels, affecting metabolism, mood and overall health," he says.
Above all, Dr Jeewadas says, balance is key. "A well-thought-out training plan is critical to ensure gradual increases in mileage and intensity, adequate rest and recovery, incorporating strength training, and ultimately listening to your body to monitor your physical and mental health," he adds.
He says whether it is an event or solo weekend run, the risk of injury is increased if one is not well-prepared with gradual progression within the training plan.
"However, the risk is slightly higher in an event due to various reasons. The excitement and competitive atmosphere can lead runners to push themselves beyond their usual capabilities, more than they would during a normal weekend run," he adds.
Other factors include crowded condition which could lead to unnecessary jostling, tripping and accidents. Unfamiliar terrain and adverse weather conditions, nutritional and hydration challenges, cumulative mental and physical fatigue may also lead to injury.
Taking part in running clinics is a good way to prepare oneself before a race.
Organisers' part
On the other end of the spectrum, Dr Jeewadas says race organisers should do their very best to anticipate injuries and incidences during race day.
He says according to sports governing body World Athletics, there are different kinds of injuries at different points of a race and organisers should prepare accordingly for them.
"In the early part of the race, there is a risk of stampede since many people are flagged off at the same time. As the race progresses, the middle of the race sees illnesses related to heat and humidity, including dehydration and heat stroke," he adds.
"And at the end of the race, there are risks of cardiac-respiratory events, especially when runners push themselves beyond their abilities during the last leg to clock a desired finish time," he says.
Dr Jeewadas says in any running event, organisers should have enough manpower for emergency.
"There should be a team of trained medical personnel that are stationed at the main medical bay – segmentised to critical, semi critical and non-critical areas – and in smaller medical tents at regular distances across the route for immediate emergency care to runners,"
"There should also be emergency physicians, medical doctors, nurses, paramedics, physiotherapists and ambulance teams deployed on that day," he adds.
Having enough resuscitation equipment such as the automated external defibrillators (AED), coupled with ease of deployment, is critical in case of an emergency.
"There will be doctors who will be running this year's Kuala Lumpur Standard Chartered Marathon (KLSCM) with mobile AEDs. They would act as the first line of defence in case of an emergency, and if successful, this method could potentially be emulated by other run organisers," he says.
This year, KLSCM and its organiser Dirigo Events are working with Pantai Hospital Kuala Lumpur on emergency medicine for the two-day event.
"Organisers should also coordinate and communicate with nearby referral hospitals that are willing to receive acute emergency cases on race days," he adds.
There are risks of cardiac-respiratory events towards the end of a race, especially when runners push themselves.
No pain, no gain?
Dr Jeewadas says despite their preparation and aim, it is important that runners put safety first.
"If you have chest pain and dizziness, it's best to pull back, stop running but keep walking. If the condition gets more severe, call for help from passers-by or a nearby medical personnel," he says.
In races like the KLSCM, safety measures include having a medical station every 2km along the race route.
"If you feel tired but are still able to maintain form and pace, and your breathing is controlled and steady, you might be able to push a little more. If your mindset is positive and if you still feel energetic, especially towards the end of the race, that would be a good time to push a bit harder," he says.
"However, if you have sharp, severe or persistent pain, especially in the joints, muscles or bone, it’s better to stop to prevent serious injury. Dizziness, shortness of breath and muscle cramps are also clear indicators for a runner to slow down or stop and seek medical attention," he concludes.
