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The elite women in Greenwich during the 2022 TCS London Marathon

Marathon Medicine 2022

Lectures from the London Marathon Medical conference

On Saturday 1 October – the day before the 2022 TCS London Marathon – the 38th annual London Marathon Medicine conference was held at the RIBA headquarters in central London.

Featuring a panel of sports scientists and medics with extensive experience in the science and medicine of endurance running, the 2022 conference focused on the medicine and science of marathon running.

Watch the videos below to catch up on the research presented on the day and read the report on the conference here.

What makes Kipchoge so good?

The physiological determinants of distance running performance are widely accepted to be maximal oxygen uptake (VO2 max), lactate threshold (LT) and running economy (RE). Although this is well-known, it is rarely acknowledged that VO2 max, LT and RE are not static but rather are dynamic variables that change with time as fatigue develops during endurance exercise. 

In this lecture, Professor Andy Jones explores the notion of the ‘fourth dimension' in the physiology of marathon running – namely, fatigue resistance or resilience – and considers whether the all-time greats of marathon running can thank their success, at least in part, to superior resilience.

Maintaining durability in the masters runner

Masters runners – typically aged 40 years or over – together form the fastest growing segment of marathoners since 2010 and respresent, in fact, over 50 per cent of marathon finishers since 2016. However, while the masters athlete is considered the ideal model for successful ageing, it is clear that chronic endurance running is insufficient when it comes to maintaining muscle mass and function as we age.

In this lecture, Dr Richard Willy considers age-related changes in running biomechanics, tissue qualities and injury risks, and presents clinic-ready strategies to address soft tissue injuries in the masters runner.

The postpartum runner: A unique opportunity to prepare for 'injury'

Here, Dr Izzy Moore presents the case that women are under-researched in sport and exercise medicine, and that it is time to apply a female-perspective to research so sport and exercise practitioners can provide more evidence-based support to female runners.

Dr Moore considers explores how we can record and report on female injuries and illnesses in light of the menstrual cycle and pelvic health – which affect only, or pose unique challenges to, the female sex – with a focused look at the postpartum runner.

Endurance exercise: Mostly good but a few concerns!

The cardiovascular benefits of regular, moderate exercise, says Professor Sanjay Sharma, are clear and incontestable. In fact, exercising as much as four times the current physical activity recommendation set out by the World Health Organisation has been associated with improved cardiovascular health and the reduced risk of several malignancies.

Endurance athletes exercise as much as 10 to 15 times the current physical activity recommendations, with the vast majority of these individuals remaining ostensibly healthy and living longer than the general population. However – while the significance of these findings is still unclear – it is now recognised that the risk of certain heart ailments is increased amongst middle-aged and older male endurance athletes. This talk by Professor Sharma provides an overview of the physiological effects of lifelong endurance exercise.

Bone stress injuries in female runners

Bone stress injuries (BSI) are a common training injury in runners that result from the failure of bone to withstand repetitive, submaximal loading. Bone stress injuries are a particular concern for athletes as they occur frequently, are painful, can take a long time to heal and tend to recur.

Female runners are more prone to BSI than men, with key risk factors including poor bone health, menstrual disturbances and inadequate energy intake – a complex interrelationship termed the female athlete triad. In this presentation, Professor Julie Greeves discusses practical strategies to improve bone health and prevent BSI risk in female runners.