My doctor told me that I should get in shape. That I should improve my fitness level, but how do I do it? I see other people out running and it looks really fun and I would like to do it. How far should I run? How hard should I run? Are these questions that you’ve probably asked yourself? Are these questions that you wonder if you’re doing correctly? I would like to take the opportunity and try to answer some of these questions.

The first thing that I think any new runner should understand is that patience is not a virtue in running, it is a must. If you started up running and have not prepared your body, you are going to have some problems. Remember that the biggest most powerful engine in the world will not make a car go fast if the chassis and body is not capable of utilizing that power. Our bodies are the same, we need to prepare our bodies for a running program. In this article I don’t want to go through step-by-step approach for preparation, instead I would refer to a return to sport type of clinic that would be able to do a gait analysis and give the athlete a thorough evaluation to determine if there are deficits in balance and flexibility before the athlete starts a running program. There are a couple of quick evaluations that each athlete could perform to determine their balance or stability. One such test would be how long are you able to stand on one leg without moving and trying to regain your balance? If you stand on one leg and begin to bend at the knee does that knee go straight up and down over the foot or does it deviate inward or outward? Make sure both legs are tested. These 2 things, the one legged stand and the one legged squat are simple and did not inclusive but can give you an idea of your stability or balance. If you are unable to stand for 3 minutes without needing to touch and adjust, simply continue practicing one leg it stands until you’re able to do so. If you notice that your knee either deviate to the inside or to the outside when you do will one leg at squat I highly recommend some physical therapy to get some specific exercises to improve the muscles necessary to prevent future injury. Balance or stability usually responds very quickly and you will probably notice significant improvement in your balance within a 2 to three-week period.

Mobility or flexibility is also important, how flexible are you? Remember that being overly flexible is as dangerous and causes as much increased risk for injury as being less flexible. A simple test for heel cord flexibility can be done by placing your foot on the ground with toes touching a wall and flexing the knee forward to see if your knee can touch the wall without the heel coming up; if you’re able to do that, are you able to do it 3 inches from the wall and still keep the heel down and touch the knee to the wall? The other muscles and tendons that should be checked are those of the hip flexors. These are the muscles that are in front of the hip and are slack most of the day as we sit at our jobs. Kneel down on one knee, inside a door jamb, such that the femur (thigh bone) of the leg you or kneeling on is vertical and the tibia (shin bone) of the opposite leg is vertical. In this position, you’ll naturally have a bit of space between your lower back and the doorjamb. Tilt your pelvis backwards (keeping the upper back against the doorjamb) so that the hollow between your lower back and the doorjamb disappears. Do you feel a stretch? If the answer is no, you likely have all the hip extension you need. If there are deficits in flexibility, it would be a good idea to visit a physical therapist who can give you some stretching exercises to be able to improve this mobility. Generally speaking improvement in mobility takes 6-9 weeks of consistent stretching before you get a significant and noticeable improvement.

After you have determined that you have adequate balance and flexibility you can start your running program. Now the key to an injury free running program is to remember FIT. “F” stands for frequency, “I” stands for intensity, “T” stands for time. These are the 3 changes that the body recognizes when it comes to exercises. My recommendation is that you always start training frequency first. That means if you’re currently not running at all, start a running program at twice a week, if you fully recover (no soreness or fatigue) and have no difficulty with this you can move that up to 3 times a week then 4 times a week and 5 times a week. I am a fan of a running program that has at least 2 days off for recovery, when beginning, for the first year, 3 days a week would probably be safer. During the recovery days you would still be able to continue to work on flexibility and balance. There are also some strength exercises that can be done. Noticed that I did not mention how long or intense each of the sessions should be, that is because it is somewhat variable but I would recommend very brief and very low intensity running sessions, something like 10 minutes or so per session. If this does not seem to be tough enough then time (how long each exercising session lasts) would be the next aspect of the running program that you could start working on. The rule of thumb is do not increase the overall weekly time more than 10% in order to reduce injury. What is the longest time we should be trying to strive towards? That is fully dependent upon your goals. If it is for fitness, then I recommend going for about 1 hour per exercise session. That would be if there are 3 exercise session per week which would be about 180 minutes per week. If it is for racing or some other reason I would recommend discussing that with a coach. You can also look up more training programs online. Remember the rule of thumb of never increasing more than 10% at a week. Once you have gotten to the 180 minutes of exercise per week now intensity can be introduced. Up to this point the intensity should be fairly low so that you can actually sing a long with your music as you are exercising (very good breath control). When introducing more intensity, brief moments of that 60 minutes would be used to increase that intensity rate where it would be very difficult to maintain breath control well enough to sing but you are still able to talk. Again, similar to time, do not increase any more than 10% per week and be patient as the body develops improved fitness.

I have found that when using these principles as stated above running can be a very enjoyable, relatively inexpensive, and injury free activity.

1. Gradual Progression-- There is a general guideline when it comes to the progression of your training as you increase the distance of your long runs and overall weekly mileage: The 10% Rule. This means increase your long run and overall weekly mileage by no more than 10% each week. While this has not been scientifically proven to reduce injuries, it is a well established, tried and true element of most training plans. Following this helps to reign in the more ambitious of us who tend to push ourselves a lot harder than we should. Also, if you are a completely new to running, it is wise to start with more realistic goals of finishing a 5k, then a 10k, and then a half marathon before considering tackling the full 26.2 miles of a marathon. While it is possible to go from the couch to a marathon, a very small percentage make it--most are derailed by burn-out, fatigue, and/or injury.
2. Training Plan--Especially if you are new to marathon, it is wise to follow a training plan. These can be found online at many sources (runningtimes.com, runnersworld.com, running.competitor.com, to name a few). You can even find plans tailored to the type of runner you are, from beginner to more advanced. Keep in mind that most plans are 20-24 weeks in length and have scheduled runs or cross training workouts most days of the week. Also, it would be wise to be running a certain weekly mileage (at least 15-20 miles) in the months prior to even beginning it. In addition, you may want to alter it a little bit and give yourself more time than the allotted number of weeks. Build in extra days or weeks for yourself that you may need to miss due to family, work, travel, illness, or injuries. This way you won’t feel stressed if you have to miss a few days here and there. And remember that everyone is different--what works for your running buddy won’t necessarily work for you.
3. Nutrition--Just because you are training for a marathon doesn’t mean you can gorge on burgers, fries, and sweets! Sure you’re burning a lot of calories, but it is important to fuel “the machine” properly in order to stay healthy and maximize your training. Healthy whole foods is the answer. You can still indulge of course, but all things in moderation. Also, it’s important to take in calories while exerting yourself for over 60-90 minutes, and especially if you’ll be out there for well over 3 hours. This improves performance and prevents the dreaded bonk. You can practice how you will take in calories during the race while on your long training runs. It’s a huge mistake to enter race day and eat or drink new products your stomach and intestines are not used to--most of those marathons end badly, and not necessarily at the finish line. Find out what they will have at the feed stations so you can start using those products in your training in order to get used to them before the race. Or, if they don’t have what you like or are already accustomed to, you will need to take your nutrition with you.
4. Drink to thirst--While staying as hydrated as possible during a marathon is important, preventing overhydration is more important. Up until recently the standard advice on hydration in marathons was drink X amount of fluids every Y minutes. The new standard is to drink to thirst. Everyone should be a little dehydrated at the end of the race, and this is not such a terrible thing. Those who win marathons are 2-4% dehydrated at the finish; so that means us mere mortals can handle a little fluid depletion as well. If you have your system down where you know your sweat rate and thus drink accordingly and it works well for you, then by all means continue on. But for those of you just getting into the marathon game, don’t fall into the trap of overhydration. The potential result of it is what is called Exercise-Associated Hyponatremia (EAH), hyponatremia being the medical term for low sodium concentration in your body fluids. When athletes overhydrate they dilute out their electrolytes, especially sodium, resulting in hyponatremia which can then lead to nausea, fatigue, dizziness, and ultimately--if severe enough--death. Granted, it takes a lot of fluids to get to that point, but unfortunately it has happened many times over. So drink as you go, but let your thirst guide you. Again, a good time to practice this is on your long runs. And if you’re worried about getting overheated (hyperthermia), dump some water over your head instead of drinking it--this is much more effective for cooling you down.
5. Race Plan--It is important have a race plan coming into race day, but it is more important to be realistic. Have a goal pace in mind based on your training but adjust as needed according to how you feel. Just because you might feel a little sluggish early on does not mean the whole race is shot. One mile you can feel poorly, but then the next you may perk up. Stay positive, and keep taking one step at a time. On the flip-side, if you feel great early on, try to reign yourself in a little bit--overexertion in the first few miles will inevitably catch up with you later on. Practice your pacing during your tempo and long runs. Also, have a plan for your nutrition and hydration and stick with it as best you can. When you’re in the last few miles and your quads and calves are so sore and tired you don’t think you can take another step, the last thing you’re going to feel like doing is eating something. Bonking is a terrible experience and can be avoided by sticking to your nutrition plan. Another way to reduce the stress of race day is to have all of your gear ready to go the night before, and plan to get to the start line in plenty of time. Arrange your morning meal as well, and get up early enough to take in some calories 2 to 3 hours before the race start. Most important--do the best you can to get lots of sleep the week before the race.
6. Recovery--Recovery is an extremely important element in training. It seems paradoxical, for when we think of training, we do not always picture ourselves on the couch. We all want to prepare as much as possible, and resting does not seem to fit into that scenario. However if you don’t allow for recovery, you run the risk of not only injury but also Overtraining Syndrome. Overtraining Syndrome can leave you feeling drained, unmotivated, getting sick all the time, and depressed. If you feel this coming on, you need to take a rest week or two to recover. To prevent it, have at least one rest day each week and build a “rest week” periodically into your training plans (if they’re not already built in) where you run less mileage and have fewer intense sessions. Also, follow a taper plan leading up to the race. There is little you can do in the last 2-3 weeks that will have a positive influence on your marathon. However, there is plenty that can be detrimental. Have confidence in the work you’ve put in--it will pay off. Nutrition is very important for recovery as well. Ingesting carbs and protein after each tough session helps you to recover faster and prepares you for subsequent runs. It’s been shown that the sooner you can take in carbs and protein after a workout, the better you replenish your glycogen (which is the storage form of glucose in our muscles and liver) and the better you recover. It’s recommended to eat after a run within 2 hours, but ideally within 30-45 minutes.
7. Shoes--Find a comfortable pair of shoes. It may require trying on a few pairs, but this is perhaps the most important thing you can do to for a successful completion of a marathon. Use the various foot type-shoe pairings to give you a rough guide, but comfort is the most important element. Most running store personnel are very good at figuring out which type of shoe is best for your foot. Running stores typically have treadmills for you to use for testing out shoes as well--take advantage of this. Walking around is helpful but does not replicate your running stride. Also, buy your running shoes about one size bigger than you normally wear. This allows for the swelling that occurs with long distance running and prevents the bruising that can affect the tips of your toes, especially if you are running downhill. It might also allow you to keep all of your toenails. But by all means, don’t buy a new pair of shoes to wear right before the race itself. Buy them at least a few weeks before the race to break them in and make sure they fit well and are comfortable. At the same time, it is best not to have an old, worn down pair of shoes, this can lead to injury. It is recommended to replace them every 300-500 miles.
8. Core Strength -- There is plenty of research data out there on the importance of core strength and balance for injury prevention in running. This particularly applies to the hip and pelvic muscles--problems here can translate into injuries down the kinetic chain (hip, knee, ankle, foot). In addition, strength and balance at the ankle and foot can help prevent injuries in those areas as well. It is fairly common for runners to have injuries to the tendons around the ankle. To help prevent this include in your weekly strength training balance exercises. Balance on each foot for 30-60 seconds a few times each week and this will help not only strengthen the muscles in the foot and lower leg but also improve balance. Good core and balance programs can be found at the popular running websites such as those mentioned above under “Training Plan”.
9. Listen to your Body--Know when to rest and when you can push through. Small aches that pass after a few seconds or last no longer than 1-2 days can be written off as insignificant. Pain that forces you to stop in the middle of a run and/or persists despite a few days of rest ought to be evaluated by a physician skilled in musculoskeletal diagnosis, such as Sports Medicine or Orthopedic Surgery. It is best to catch injuries early. A little rest and rehab early on gives you the best chance for a quick recovery so you can get back out on the road pain-free. Ignoring it and pushing through increases the odds that you’ll worsen the injury and have a long, drawn-out bout with it. The longer injuries persist, the longer it generally takes for them to heal.
10. Enjoy the PROCESS! There are far too many variables when training for a marathon for everything to go absolutely perfect. Despite flawless preparation, things may not all fall into place. The more important aspect is the running lifestyle and the lessons you learn about yourself and what you are capable of--which is often so much more than what you thought possible. Enjoy the training, enjoy the outdoors, enjoy the friendships and camaraderie. And above all, have a deep appreciation for the physical ability that makes it possible for you to even consider running a marathon.