Injury patterns and levels of care at a marathon

Prehosp Disaster Med. 2008 Nov-Dec;23(6):519-25. doi: 10.1017/s1049023x0000635x.


Introduction: Marathons pose many challenges to event planners. The medical services needed at such events have not received extensive coverage in the literature.

Objective: The objective of this study was to document injury patterns and medical usage at a category III mass gathering (a marathon), with the goal of helping event planners organize medical resources for large public gatherings.

Methods: Prospectively obtained medical care reports from the five first-aid stations set up along the marathon route were reviewed. Primary and secondary reasons for seeking medical care were categorized. Weather data were obtained, and ambient temperature was recorded.

Results: The numbers of finishers were as follows: 4,837 in the marathon (3,099 males, 1,738 females), 814 in the 5K race (362 males, 452 females), and 393 teams in the four-person relay (1,572). Two hundred fifty-one runners sought medical care. The day's temperatures ranged from 39 to 73 degrees F (mean, 56 degrees F). The primary reasons for seeking medical were medication request (26%), musculoskeletal injuries (18%), dehydration (14%), and dermal injuries (11%). Secondary reasons were musculoskeletal injuries (34%), dizziness (19%), dermal injuries (11%), and headaches (9%). Treatment times ranged from 3 to 25.5 minutes and lengthened as the day progressed. Two-thirds of those who sought medical care did so at the end of the race. The majority of runners who sought medical attention had not run a marathon before.

Conclusions: Marathon planners should allocate medical resources in favor of the halfway point and the final first-aid station. Resources and medical staff should be moved from the earlier tents to further augment the later first-aid stations before the majority of racers reach the middle- and later-distance stations.

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / physiopathology*
  • Female
  • First Aid / classification*
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Physical Exertion*
  • Prospective Studies
  • Running / injuries*
  • Young Adult