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					Knowing where to get your Medical Advice on Marathon Running

Successfully training for and completing a marathon is certainly about
practice, stamina, fitness and running technique. But as any experienced
marathoner would tell you, or even a podiatrist would, success at a
marathon is all about knowing how to avoid injury, and healing well when
(and not if) you get one. The organizers of the Boston Marathon a couple
of months ago brought in sports medicine experts for debates and lectures
on marathon running; the topic in particular this time was "The use of
biomechanics to predict running injuries". The expert podiatrist from a
Harvard hospital who took the podium had an interesting and intriguing
line of thought on injury management for marathoners - special stretching
exercises are the key to injury avoidance and injury healing. If you
learn how to stretch the right way, and if you learn to do it regularly,
and if you learn to run the right way, you have the upper hand on the
whole injury problem.

According to the doctor, the right gait for marathon running involves
going forward with the heel striking the ground before the toes with each
footfall. A gait in which a runner has his toes hit the ground first on
each footfall, is just an invitation to injury. Simple changes in gait,
muscle tension and warm-ups, are all that one needs to avoid running
injuries, or to heal existing injuries. As demonstrably successful as the
doctor's theories are, the mainstream in sports medicine doesn't really
accept his opinions as scientifically sound just yet. One of the doctor's
most important injury prevention regimens involves a great deal of
carefully orchestrated stretching. There are studies underway now trying
to determine if the doctors stretching theories really hold water.

The doctor's opinion about how to let your heel hit the ground first, is
not usually accepted in the scientific circles. Scientists who challenge
the theory argue that it depends entirely on how fast one is running
whether it is the heel that should hit the ground first or the toes. Both
kinds of gait are valid, they argue, depending on the speed at which the
marathon running takes place. Seeing how there are such conflicting
expert opinions on what constitutes the right running gait, where do
marathon runners turn to for the best advice? Sports medicine is one of
those exotic medical specialties where there is little regulation, and a
lot of imagination at work. Any doctor with a vague grasp of sports
medicine could start a sports clinic and call himself an expert.
Sometimes, the only way a patient can tell if a doctor is any good is by
how much of a wait there is at the office behind other patients. This is
what choosing a sports specialist is reduced to usually.

Since there is so little regulation in sports medicine practice, it seems
to fall to the athlete himself finding out what the state of the art is,
in marathon running science. There are athletes who pore over websites by
sports medicine authorities like the American College of Sports Medicine
for the latest scientific coverage on the subject. People who don't do
all their homework, end up believing all the hype, and end up following
fads that get them into trouble. Take for instance the shoe inserts they
call orthotics that podiatrists design and sell. The podiatrists happen
to make a lot of money on these accessories. Some sports medicine
"experts" freely sell them to every patient, and ask that they wear them
walking and running. This kind of advice can be murder on a marathon
runner's knees. When my doctor prescribed me orthotics for marathon
running after a stress injury, I found that it made me impossibly slow;
and then I pulled a hamstring.

Marathon runners can be especially vulnerable to incompetent advice. When
a doctor authoritatively tries to change the way your gait is, or tries
to change the length of your stride, you go and believe him. Gait
changing training rarely works. A gait that is unnatural to you can
actually leave you worse than before, and put your marathon running
career on hold for a very long time.

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