Medical Takeaways from the 2024 Boston Marathon (HOT HOT HOT!!)

Monday, April 15th in Boston, MA was 72 degrees and sunny. Great for the Boston Marathon spectators! However, bad for runners.

“72 degrees isn’t that hot though, right? Surely people run in that temperature all the time.”

Yes, but don’t call me Shirley…

Think about the runners’ training cycle. Most of these runners have been training for Boston over the winter. Average temperatures are not terribly high December thru mid-April in most of the country. There have definitely been years when the Boston Marathon is hot (I’m looking at you, 2012: 87 degrees at the finish line!) but most of the time, it’s below 65 degrees. That’s part of the reason why the race starts later in the morning compared to other races.

Here are a few stats from all 29 medical tents from this year’s Boston Marathon: we had 132 people transported via EMS to local hospitals, of whom 48 were admitted to the hospital (34 of which with heat stroke). In the medical tent I was in (St James tent, finish line), we alone had 662 patient encounters with 160 total beds to offer.

We were busy! In fact, busier than usual. This was one of the busiest Marathons we’ve ever had, from a medical encounter perspective. And we’ve seen time and time again that the warmer the weather, the more busy we are. I suppose we were due for a busy year, given the weather the prior few years had been more cooperative.

So what do you do about running in the heat? Whether you’ve trained for it or not, you need adequate hydration not just the day of the run, but the week prior as well. If you’ve had a few weeks to acclimate to the heat, your body is in a more adaptable position to lose heat through evaporative heat loss, but keep in mind that this requires adequate water reserves to actually lose heat. If you stop sweating, you can’t lose heat as easily -> heat stroke.

Here’s your tip: weigh yourself immediately before your run, then do your run and weigh yourself immediately afterwards. Monitor how much weight you’ve lost. If you’ve lost more than 2% of your body weight, especially if combined with darker-than-normal urine color, you’re dehydrated! This puts you at significant risk of heat stroke which can be deadly, as we’ve experienced in Boston countless times. Be sure to check with your physician first to individualize this percentage to your case.

This seems like a fairly simple idea but it’s surprisingly hard to put into consistent practice, and it will undoubtedly require some trial and error. Summer temperatures here in North Carolina are no joke so please take care of yourself and ask us for help, if needed! Hope to see you running around town soon (but not in the medical tent)! Prevention is key. 😊