With nine weeks to go until the Boston Marathon, our medical team offers you important information for training and competing on race day. Although the B.A.A. and its affiliates make every effort to provide a safe and memorable marathon experience, successful completion of this race requires careful preparation on the part of each participant. Part of this preparation is attention to health and safety. Here's some basic information about the health risks that may be associated with marathon participation. Individuals with underlying health issues are at increased risk for medical complications during the running of a marathon. While medical problems occurring during marathon running are relatively rare, they can be serious enough to result in death or long-term impairment. The majority of serious marathon-related health complications are caused by pre-existing cardiovascular conditions. Specifically, diseases of the heart muscle, heart valves, and coronary arteries may increase the risk of adverse health events during strenuous exercise. These conditions can exist for years without warning symptoms until they trigger a serious health event. Environmental stresses such as heat and cold may play a role in aggravating these underlying diseases. Preventative medical attention prior to training and racing may reduce the risk of a health tragedy caused by underlyingcardiovascular disease. Each Boston Marathon participant assumes full responsibility for his or her health on race day. Although marathon-related health complications may not be completely preventable, certain pre-race measures may reduce each runner's risk of tragedy. The B.A.A. medical committee and its affiliates suggest the following steps be taken by each Boston Marathon runner prior to training: 1.) Consult your Doctor: Discuss your plans for marathon training and participation with a professional health careprovider. Your health care provider should be familiar with diseases relevant to athletes AND with the physiologic stresses inherent in marathon running. Your medical provider may wish to conduct some form of cardiovascular disease screening prior to participation. The appropriateness and actual type of pre-participation screening must be determined by a competent medical professional and may vary among athletes based on factors including age and your medical history and medications as well as your family history of sudden death and cardiovascular disease. 2.) Listen to your Body: Pay close attention to your body during your marathon training. Symptoms suggestive of underlying cardiovascular disease that are experienced during marathon training should be taken seriously. These include: sensations such as chest pain,pressure,squeezing, or tightness. Other symptoms include shortness of breath out of proportion to activity, palpitations, lightheadedness, dizziness, or fainting that occurs during or after exercise. Any of these should be reported immediately to your personal physician. Failure to attend to such potential warning signs may increase the risk of a serious health complication during subsequent training and competition. 3.) Train Intelligently: Participation in a marathon places significant stress on the body and specifically on thecardiovascular system. The primary goal of training and race preparation is to ensure that your body can safely handle this stress. Safe and effective physical preparation involves gradual increases in exercise volume with eventual exposure to runs of a similar duration, intensity and environmental exposure to the actual marathon. Ultimately, training should involve runs that closely approximate anticipated race day effort. Working with asports medicine health care provider, experienced coach, orathletic trainer is an excellent way to ensure that your training plans are optimized.