Runner Info/

Medical Tips

Keck Medicine of USC wants your marathon experience to be a healthy one. Check out these tips for running your best race!

Post-Race Recovery: Tips for Getting Back on the Road
By Dr. Sharon Orrange, Assistant Professor of Clinical Medicine at Keck Medicine of USC

SharonOrrangeCongratulations on running the Los Angeles Marathon! In addition to the pride you’re probably feeling, you may be experiencing a few aches and pains and fatigue even a few days after the race. That is normal, but it’s important to recognize the toll that a marathon takes on the body and take steps that will help you recover and safely resume running again.

As expected, muscle soreness is often the biggest issue for runners following a long race like a marathon. It’s important to understand the difference between normal soreness and a potential injury, such as a stress fracture. If it has been one to two weeks since race day and you still have a hard time bearing weight on a sore limb or foot, consult your physician. For general soreness:

• Rest and get plenty of restorative sleep
• Stretch daily
• Do 20-30 minutes a day of strengthening and lower impact exercises (yoga, swimming, biking) for the first week following a marathon

It’s important to return to running slowly. Wait a week and then limit your running to 4-7 miles, gradually building your mileage. Listen to your body. If a long run seems or feels exhausting, don’t do it. Also, wait at least two weeks to run a half-marathon and one month to run another marathon.

Blisters and black toenails are also common post-marathon conditions. Treat blisters after the race by avoiding friction and leaving them open to the air if possible with sandals or open-toed shoes. If you have to wear shoes, donut-shaped moleskin or loosely taped gauze will help. For larger, more painful blisters try Bacitracin ointment and avoid rubbing alcohol. Blisters need to heal on their own so avoid cutting or poking at them and do not remove the flap of skin covering the blister.

Unfortunately, there is no treatment for black/bruised toenails. The nail will often fall off in time, but it may grow out on its own and be replaced by normal nail. Resist the urge to remove the nail and simply protect it by wearing shoes that have plenty of room for the affected toe. Or, wear open-toed shoes.

Skin chafing is one of the main reasons runners seek medical attention during the race. For men, the issue is irritation from clothing rubbing against the nipples, while women experience similar problems between their thighs. There are ointments designed to minimize this friction while running but if you suffer from chafing after the race is over, treat it with creams or ointments designed to soothe irritation until the affected area heals. Vaseline or Aquaphor are good for this.

The road to recovery is built on taking good care of your body and being sensitive to how you feel in the days and weeks following a marathon. Refueling with fluids, carbs and rest will give you the best chance to bounce back quickly and get you back to running again.

Top Tips on Healthy Clothing Choices for the Marathon
By Glenn Ault, associate professor of clinical surgery at the Keck School of Medicine of USC
and medical commissioner of the ASICS LA Marathon

Glenn Ault

What you wear during the marathon can make the difference between a challenging race and a miserable race. The tips below can help make your race experience a good one.

1. Wear shirts made of a “technical” fabric that wicks away moisture from the body. Avoid cotton, which soaks up moisture.
2. Wear socks made of thin fabric that wicks away moisture.
3. If the weather is cold, consider wearing a cap or jacket made of breathable fabric.
4. Wear layers you can shed if it warms up during the race.
5. Have a friend bring some dry clothes and socks for you to wear after the race is over.



Top Tips for Runners Recovering from Cold and Flu
By Sharon Orrange, assistant professor of clinical medicine, Keck School of Medicine of USC

SharonOrrangeIt’s cold and flu season, and even the healthiest runner might come down with something during training or just before the race. Here are some important tips to help you to come back strong.

Stuffy nose and sinus pressure

  • For sinus and nasal symptoms, you can do nasal irrigation before your runs and up to the morning of the race. Options include neti-pots, SinuCleanse or squeeze bottle rinses such as Neil-med sinus rinse. Adding over-the-counter Claritin (Loratadine) will help nasal symptoms, although the only downside is a slightly dry mouth. Be cautious about using Claritin-D or Loratadine-D, which is sudafed and may make you jittery and raise your blood pressure.


  • A persistent cough and chest tightness will make training for the marathon much harder.
  • If you have a congested, rattling chest, over-the-counter Mucinex will help clear it up.  Mucinex helps loosen phlegm and thin bronchial (airway) secretions. Take it with a full glass of water.
  • If your cough is from post-nasal drip (you may notice the sensation of liquid dripping down the back of your throat) options listed above like Claritin (Loratadine) will help.
  • A dry cough can persist as long as eight weeks after your infection goes away. That persistent cough, similar to asthma, is caused by airway inflammation. A visit to your doctor for a steroid inhaler will help resolve it.
  • Talk to your doctor about using an inhaler such as Albuterol (proventil). Inhalers can be used 30 minutes prior to exercise up to the morning of the race.

Staying healthy before the race

  • Avoid some over-the-counter cold and flu medications close to race day. Sudafed can raise blood pressure and make you jittery and Claritin, Allegra and Zyrtec may dry your mouth. Zinc lozenges taken within the first 24 hours of an illness have been shown to help speed up recovery.
  • Vitamin C (200 mg a day) has been shown to prevent colds in marathoners.
  • Dry air cracks the mucous membranes, your first line of defense. Warm mist room humidifiers in the bedroom may help, as will drinking 0.5 ounces of water per pound of body weight a day up until race day.
  • Hydrate. Illness, especially respiratory illness, increases the water you lose from your respiratory tract and skin during fever, cold and flu. Drinking water before during and after the race is key.
  • And remember, wash your hands frequently.


Top Foot Injuries for Marathon Runners
By Timothy Charlton,
assistant professor, Department of Orthopaedic Surgery, Keck Medicine of USC

Charlton, TimothyIn the months leading up to the marathon, and during the marathon, many runners encounter injuries to the foot. Following are some of the most common foot injuries and the best way to treat them:

1. Tendinothapy: This may occur on the Achilles tendon near the heel and the peroneal tendon that runs on the outside of the ankle and ends at the level of the foot. Both result in tenderness and are difficult to treat but icing to reduce inflammation and decreasing the amount of mileage can help.
2. Plantar fasciitis:
Runners suffering from plantar fasciitis feel tenderness on the bottom of the foot. Classic symptoms are pain in the first step of the day. Treatments include ice, anti-inflammatory treatment and a night splint, which can initially be difficult to get used to when sleeping, but is very effective.
3. Overpronation:
Runners with overpronation will feel tenderness on the inside of the ankle. The key is correcting the alignment of the foot. Control running shoes and soft athletic orthotic inserts can help solve this problem.
4. Blisters and toenail loss:
Runners may notice toenails with blood underneath. The toenail will probably fall off and may be tender and slightly painful. Avoid running until the tenderness stops. Protect blisters from further friction with a special blister bandage and keep the area clean to avoid infection.

If you experience troubling or serious pain, see your physician. Take good care of your feet and you stand a good chance of recovering well after the race.


Preparing for The Race Course:  10 Tips for Your Best Running Experience
By Dr. Seth Gamradt, Director of Orthopaedic Athletic Medicine, Keck Medicine of USC and Team Physician, USC Athletics

Seth Gamradt

You have trained for months running the streets of the city but few marathoners train on the race course itself, and it is difficult to simulate race conditions prior to the event.  There are a number of factors to consider and plan for when it comes to race day.  Here are 10 tips to help you improve your ASICS LA Marathon experience.

Logistics:  Know and double-check your plan for parking. Also, calculate your travel to and from the ASICS LA Marathon start and finish lines.  Don’t let a pre-race traffic snafu compromise all of your hard work and training.  Allowing adequate time for warm-up and stretching will ensure a good start.

Fuel:  It is critical to fuel your body before the race.  Eat high carbohydrate meals (80 percent of intake) for several days prior to the race to build up your store of glycogen, a crucial energy source for your body.  On the morning of the race try to eat a 500-800 calorie breakfast 2-3 hours before the race.  Limit fiber to avoid mid-race gastrointestinal upset.  Predictability is key:  eating foods you know and that worked well on your long training runs is critical for a calm stomach and high energy on race day.

Shoes:  It seems obvious, but avoid changes in equipment on race day, especially shoes.  Wearing your tried and true runners will help to prevent the foot pain and blistering that are common in long-distance running.

Hydration:  Before the race, pay attention to urine color, aim for light yellow as a sign of adequate hydration.  Although sweat rates vary from runner to runner, a good guideline for hydration is 6-8 ounces of fluid every 20 minutes.  Avoid over-hydrating, which can lead to stomach upset.  Make sure your race-day hydration consists of energy drinks containing carbohydrates and electrolytes and water.  Consuming water alone during the race can lead to hyponatremia, which is caused by dilution of the blood’s sodium level and can be very dangerous.

Energy Gels/Bars:  Commercially available pre-packaged carbohydrate sources are an important fuel source in triathlon and distance running.  Again, familiarity is key to avoid race- day stomach upset, so stick with energy snacks you’ve consumed during your training.  Consume one 45-60 minutes (with water) after the race starts and every 45-60 minutes thereafter.

Lubrication/Skin Protection:  Lubricate sensitive areas with anti-chafing, anti-blister products.  Believe it or not, severe blistering or chafing can end your race prematurely. For sun protection, apply sports sunscreen that protects against UVB and UVA rays at least 30 minutes before running, and consider wearing sun protective clothing made specifically for running.

Pace:  The adrenaline of the race start will lead to the possibility of starting too fast.  Begin your pace near or slower than your typical pace from your long training runs to avoid a late race flame out.

Temperature:  There can be a significant temperature increase during the race from cool at the start to warm (even hot) at the finish. Pay attention to race-day weather forecasts and consider layering your clothing to accommodate temperature fluctuations.  Most importantly, wear what has been comfortable for you on long training runs.

Pain:  You may experience pain, soreness, muscle ache and fatigue on race day from training.  If you typically take non-steroidal anti-inflammatory drugs (NSAIDs – Advil, etc.) or acetaminophen (Tylenol) before training runs, do not change this on marathon day.  However, if you have not been using these over-the-counter medications, race day is probably not the time to experiment.

Danger Signs:  As mentioned, some soreness is expected on race day.  However, if you begin to experience sharp pain with each step, swelling in a joint, escalating pain anywhere in your body or you begin to limp, it is not advisable to push through these types of symptoms and finish the race.  In addition, confusion, light-headedness, chest pain, and shortness of breath all can be signs of a significant medical issue—seek medical attention immediately.

Completing the ASICS LA Marathon is an important goal you have set for yourself. Make sure you do the things on race day that support the training you have done up to this point and you will have the best opportunity to hit the finish line feeling like a winner!