Long distance running is a popular method of improving cardiovascular fitness. In addition to running for health and fitness, thousands of runners enjoy competing in races throughout the United States. For beginners and competitive runners, there are several things to remember that will make your run more rewarding.

Routine physical examination
Before beginning any exercise program, you should have a complete physical examination. Long-distance running can be physically demanding, and it is not appropriate for everyone. Develop a running and exercise program based on the advice of your physician.

Running shoes
Selecting a good running shoe will help you avoid running-related injuries. Make sure the shoes you buy are comfortable. You should also consider the construction and wear characteristics. Inspect the shoe for symmetrical design and quality workmanship. Select shoes made for the shape of your foot and your running style. if you have low arches or flat feet, choose shoes with additional heel support. If you have high-arched feet, look for shoes with shock absorption either in the heel or the front of the shoe, depending on your running style. People with Achilles tendinitis need shoes with good flexibility and more height within the heel wedge.

Gradually break in new shoes over 1 to 2 weeks. Discard the shoes after 500 to 750 miles of use. Although the treads may appear to be in good shape, the shock absorbing features wear out after 500 to 750 miles of typical use.

Flexibility
Runners who do not have flexible leg muscles are more likely to injure muscles and tendons. To avoid these injuries, you need to maintain flexible hamstring, quadriceps, and calf muscles by stretching each of these muscle groups for 5 minutes before and after each run. Do not bounce while stretching because you can injure your muscles.

Training
Gradually increase your weekly mileage and carefully choose the running terrain to match the event for which you are training. Avoid running more than 5 consecutive minutes during your first uphill workout. Instead, add 1 minute of uphill training with each successive workout to build up stamina.

Always warm up for 5 to 1 0 minutes before running at your full pace. A slow-paced warm-up raises your pulse to between 1 00 and 1 20 beats per minute. Cool down for 10 minutes after running to slow your pulse rate to 120 beats per minute.

New runners, especially those who are overweight or large, should avoid the temptation to overtrain. Overtraining is associated with running longer distances or more often than your body is capable Of doing. increased stresses on your joints from the impact of running can cause back, hip, knee, and foot problems. To avoid overtraining run 3 nonconsecutive days a week and bicycle or swim on the days you do not run. include rest days between hard workout days to allow your body to recover.

Fluid requirements
Water is the most important nutrient runners need. You must consume enough fluid to enable your body to sweat while you exercise. When sweat evaporates, it disperses heat and regulates body temperature. Dehydration prevents your body from regulating body temperature, and it leads to fatigue and decreased athletic performance.

Because thirst is not a sensitive indicator of fluid requirement, runners need to drink water before they become thirsty. Avoid caffeinated, carbonated, or sugary beverages because they actually worsen dehydration. if you are competing in a race, you should consume 20 ounces of water 2 hours before the race. Fifteen to 30 minutes before the race, consume 16 ounces of water. During the race, consume 4 to 8 ounces of water every 1 0 to 1 5 minutes.

Precompetition meal
The precompetition meal should provide energy to help maintain adequate blood sugar levels and should not cause gastric distress. ideally, a 500-calorie meal high in complex carbohydrates and low in fat should be consumed 4 hours before a race. Complex carbohydrates, such as bread, cereal, pasta, and fruit, are the best sources of energy. These foods are usually emptied from the stomach into the intestines within 2 to 3 hours. Avoid simple sugars, excessive fiber, or carbonated beverages.

Competitive running can be a rewarding way to enjoy staying physically fit. Proper training is essential for avoiding injuries. Before beginning a running program or competing in an organized race remember to undergo a routine physical examination; obtain an appropriate running shoe that fits well; maintain maximum flexibility; train sensibly, especially when just starting out; and observe proper nutrition and fluid requirements.

Joseph Martino, M.D.
Atlanta, Georgia