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Team Marathon Experts

The COVID-19 pandemic has led to the cancellation or deferral of major international marathon races, which have been eagerly anticipated by runners around the world. I believe many runners are enjoying their rest period, which is good for physical and mental health. However, if the rest period is too long, initiation and motivation will drop, together with well-trained physical condition. One of the most obvious example is the drop in maximum oxygen consumption: if training is suspended for 3 weeks, your maximum oxygen consumption will decrease by 7%, which will further drop to 14% for a suspension period of around 8 weeks. VO2 max, %VO2 max at Lactate Threshold (LT) and running economy are important determinants of speed distribution in marathon running. Therefore, in the upcoming few months, runners should focus on enhancing their VO2 max and running economy, and then making a breakthrough on %VO2max at LT.
To enhance running economy, runners can partake in some basic stepping exercise and bouncing drills, which can be practiced at home.
• If outdoor training is not feasible, runners can focus on core training exercises e.g. high-intensity interval training to keep the strength of their abdominal, lower back and hip muscles.
• Make sure that your home is well-ventilated
• Create an appropriate home workout space and be mindful of home safety
• Warm up and stretch adequately before exercise
• Drink water during exercise/workout to prevent dehydration and dry mouth
• Wash hands before and after exercising and be mindful of personal hygiene

Many runners have experienced side stitches; the pain that strikes during exercise often named as exercise-related transient abdominal pain (ETAP). Causes for side stitches are to be found, but most theories focused on four reasons:

    1) Diaphragmatic Ischemia;
    2) Diaphragmatic cramp;
    3) Visceral ligament stress; and
    4) Parietal peritoneum irritation.

The abdomen houses most of the vital organs. They are linked with visceral ligaments, abdominal peritoneum and nerves. Any frequent stimulation would cause irritation. Side stitches during running is common, it may be caused by the upward and downward movements of the diaphragm as you breathe. When beginners start to increase their training intensity, the accelerating pace would lead to greater movements of the diaphragm. If your diaphragm fails to adapt to the increased load, diaphragmatic ischemia or diaphragmatic cramp may occur. For beginners, mastering the breathing techniques is of prior importance. The movements of the diaphragm and the shocks created when your legs strike on the ground would be stressing the visceral ligaments, resulting in stabbing pains. Breathing tempo should be adjusted to lessen the stimulations. The main functions of the parietal peritoneum, in which nerve tissues are widely spread, are to provide lubrication and protection for internal organs. Any actions that increase the friction between the parietal peritoneum and the organs would stimulate the nerves and causing pain. As a result, we recommend a 3-hour grace period between meals and high intensity exercise, avoiding high-sugar beverages before training could also decrease the workload of the digestive system that create frictions between abdominal peritoneum and the organs.

Ways to eliminate side stitches
No matter what reasons caused side stitches during running, ways to relieve pains are similar. The first thing that runners could do is to slow down the running speed or even walk, press on the area with pain and lean forward. Try to have full and deep breathing; adjust the breathing tempo. The pain will be relieved and dismissed. For proper breathing techniques, please refer to: http://www.hkmarathon.com/Training/Training_Tips/Breathing_tempo_s4_p17194.htm

In the long term, sustained training, regular eating habits and having sports drinks are the most efficient ways to prevent side stitches. Increase the strength and speed of training progressively, utilize your deep muscles to control the breathing. This would help runners to maintain posture, lowering the consumption of energy and chances of injury. These are specifically important to runners preparing for the marathon. If you suffer from side stitches recurrently, or the pain sustained or even intensified after stopping training, consult a doctor as soon as possible.

Race day preparation checklist

  • Prepare your running kits the night before - The start time of the Standard Chartered Hong Kong Marathon is quite early, so get organized early.
  • In the morning check your kits a final time and the weather forecast too!
  • Check whether you have pinned your bib and time chip to your running shirt.
  • Have you brought your water, sports drinks and energy supplement packages for marathon?
  • It is suggested that runners apply Vaseline on the surface of body parts that could be rubbed during your run causing blisters or soreness e.g. heels, toes, chest and inside your thighs. Avoid wearing new running shoes and new running kits on race day.
  • Check the inside of your running shoes to see if there are any grains of sand or stones. Choosing running kits is also dependent on weather condition on race day so a different running kits may be needed for certain running conditions. The most commonly used kits are running shirts, shorts, socks and shoes. Shirts made of polyester or synthetic materials are more suitable since they are light, can dry quickly and allow fast heat loss.
  • Make sure you do not choose running shorts that could hinder the movement of your legs.
  • Running socks are an important to avoid the development of blisters on your feet thus they should be light and seamless, fit the shape of your feet, sweat-relieving and shock-absorbing at appropriate spots.
  • Do not wear old socks with bits of yarn or a bur pilling during the race as these old socks may hurt your feet due to intense friction.
  • It is important for runners to keep their body warm before and during the race since muscle flexibility decreases with temperature, otherwise it may affect the running performance and increase the chances of getting hurt.
  • If the weather is cold, runners should prepare extra clothes, hat and gloves to keep warm.
  • If the weather is hot, runners may need a visor or sunglasses. A sunscreen visor can absorb sweat and block UV lights. It should be made out of light and quick-drying material.
  • Sunglasses should also be light and able to block UV lights; polarised lens are more preferable as it will reduce flare.

It is important for runners to begin their preparation for the marathon race with accumulated running mileage so as to build the foundation for long-term, progressive training. However, if you want to perform your best on race day, the key to success is to master your pacing during the competition. Runners should know how to distribute their running strength in different phases of the race, to avoid exhaustion and withdraw at the end stage of marathon. Thus, pace mastering is the first thing that runners need to learn.

Pacing refers to the approximate running speed per kilometer during competition. In the racing day, amateur runners or those who are competing the marathon for the first time might consider to run with a pace which is around 5% slower than their expected racing pace for the first 3 to 5 km of the race. For example, if your expected pacing is 6 min/km, the suggested pacing for the 3 to 5 km should be around 6 minutes 18 seconds. This speed will facilitate the utilization of fat as energy source and retain carbohydrates for energy production at the later stages. If you are comfortable after the first 3 to 5 km, then you can gradually increase the speed to your original or expected pace. The key is to run at a relaxing pace speed for the first 10 to 15 km.

Sylvia obtained her Master of Nutrition and Dietetics qualification from the University Sydney, Australia in 2000. She has been practicing in Hong Kong for 20 years specializing mainly on areas of diabetes, cardiac rehabilitation, weight management and other obesity related conditions and also eating disorders. She often provides nutrition seminars to local and international conferences, corporate companies, school and academic institutions. She is also a reputable spokesperson for the dietetic profession providing accurate and up-to-date nutrition education and information to the general public through newspapers, television and radio programs. Besides, she published more than 10 nutrition cookbooks including topics in sports nutrition, diabetes, heart diseases, weight management, nutrition support for cancer patients, vegetarianism, infant and child nutrition and more.

Sylvia has been the Chairperson of the Hong Kong Dietitians Association from 2007 to 2019, actively promoting Hong Kong’s dietitian profession. Currently she is the External Affair Officer of HKDA. In addition, she was the past Chairperson of the Taskforce of Local Registration for Dietitians and the Convener of the Accredited Register Scheme for Dietitians Working Group. Currently, she is also the Secretary of the Hong Kong Academy of Accredited Dietitians (HKAAD), the country representative of Hong Kong of the International Confederation of Dietetics (ICDA), the President of the Committee to Promote Reduction of Salt and Sugar in Food in 2015, and a council member of the Hong Kong Association of Sports Medicine and Sport Science (HKASMSS).

A balanced vegetarian meal works just as well as a normal meal with meat for long distance runners. Most importantly, balancing different nutrients such as protein, carbohydrates, fat, iron, calcium and B12 is essential. As Marathon running is exceptionally energy demanding, runners would need an extra 30-70% of energy compared to an ordinary person; carbohydrates, proteins and iron are major sources of energy. Since energy density is usually lower for vegetarian meal, athletes should pay attention to the amount of consumption and get enough energy before practice and the race.

Suggested Nutrient Distribution:

Carbohydrates: 60-65% / 7 – 10 grams of carbohydrates per kg body weight

Sources: Rice, pasta, bread, potatoes, sweet potatoes, fruits, breakfast cereals, fruits juices, dried fruits.

Protein: 1.3 – 1.8 grams per kg body weight

Sources: Tofu, tofu burger, soy chicken, nuts, soy milk, dried beans, bean curd, hummus(eggs and milk if they are ovo-lacto vegetarian)

Iron: 70-90 mg each day.

Sources: Dark Green vegetables, dried fruits and nuts. The absorption rate for the vegetable iron at 2 to 20% is relatively low. Vitamin C helps facilitate the absorption of iron. Having fruits such as oranges, strawberries, kiwi fruits and guavas after meals are great sources to replenish Vitamin C in your system.

While many runners would usually prepare bananas or energy jelly as supplements, sports drinks, jelly beans, dried cranberries, and raisins can work as well.

Calorie consumption is huge for athletes, so is the demand for nutrients in comparison to ordinary persons. If runners are vegans, it is possible that they could also lack certain nutrients. Therefore when choosing what foods to eat it is important to take extra consideration on your level of calorie intake and nutrient distribution. This could help better prepare your physical condition prior to the Marathon.

Weight gain during Christmas is also a big concern for people, especially for marathon runners. A gain of few pounds or two can greatly affect their performance. A study in UK showed that people usually gain 2 kg over Christmas, so marathon runners have to be extra careful when choosing their foods during this festive season.

Christmas foods always have a bad reputation of being unhealthy as they are often cooked in a lot of sugar, butter, and cream. But when you take a close look at some of the Christmas foods ingredients, they actually provide great health benefits. Besides, healthy cooking methods such as grilling, roasting, poaching, and steaming should be used when making Christmas dishes, so people can still enjoy healthy eating during the festive season.

Potatoes, carrots and pumpkin – A good energy source for runners
Starchy vegetables such as potatoes, carrots and pumpkin are often used as side dishes during Christmas. They are low in fat and loaded with complex carbohydrates, dietary fiber, potassium and vitamin C. Steaming, poaching and roasting are healthy cooking method for starchy vegetables as very little oil is use. Avoid glazing or deep-frying as it would increase sugar and fats intake respectively.

Turkey – the leanest protein of all for runners
Turkey is a good high quality protein source. A palm-size piece of turkey provides only 134 kcal with 25 grams of protein with only 3 grams of fat. It is also a very good source of zinc and selenium. Adequate intake of zinc increases immunity and helps the body to fight infection during winter; while selenium which is a strong antioxidant, can reduce cancer risk. When eating turkey, one should remember to remove the skin and choose more turkey breast as it is lower in fat. Marathon runners can choose turkey as a good protein source during the festive season.

Chocolates – A substitute for power bar
Chocolate or cocoa contains abundant of flavonoid, especially in dark chocolate, which scientific studies show that moderate intake can help reduce “bad cholesterol” and prevent artery blockage. Chocolate could also boost your serotonin level which makes you happy. If you want to take a break from having a power bar at training during Christmas season, now it’s time to indulge in chocolate before training as chocolate is also a low glycemic index foods which is also good for endurance exercise.

Alcohol – drink in moderation
Don’t’ forget that alcoholic beverages are packed with calories which people often overlooked. 150 ml of wine already provides 130 kcal (similar to a can of soft drink). Cocktails with added fruit juices, syrups and coconut milk are even worse. A glass of Pina Colada can go up to 400 kcal per serving. Not only excessive alcohol intake can put a few pounds on you, but also dehydrates the body. If you decide to drink during Christmas, make sure that you should not exceed 1 – 2 drinks per occasion, and drink a lot of water to prevent your body from dehydration.

Other lifestyle tips at Christmas for Marathon Runners:
1. Do not try to save calories by skipping meals. Maintaining a solid meal plan throughout the day will keep you from getting too hungry and eating too much in parties or gatherings.
2. Keep training during your holiday. Don’t’ give yourself any excuses.
3. Keep a food diary to monitor your intake.
4. Weigh yourself every day so to prevent/monitor significant weight gain.
5. Learn to say “No” to foods or drinks if you think you already have too much.
6. Plan ahead and maintain a healthy eating during holiday seasons.

Dr. Louie Hung-tak obtained his doctorate degree in physical education from Springfield College, U.S.A. and is the Associate Professor in the Department of Sport and Physical Education, Hong Kong Baptist University. He also serves as the Associate Director of the Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University. Dr. Louie is a Fellow and the current President of the Hong Kong Association of Sports Medicine and Sports Science.

A scientific training programme is essential for marathon runners to achieve their goal. Full marathon runners need six to nine months of systematic training, while half marathon runners and 10KM runner need about 6 months and at least three months of training respectively. As outdoor training is not feasible now under COVID-19, runners are recommended to conduct some cardiovascular or high-intensity interval training at home. Home exercises such as squat, strength training and core muscles workout can be done to maintain the muscular strength of lower limbs for running. In terms of the impact of prolonged suspension of training to runners, a less than 4 weeks suspension can be considered as a short-term physiological adaptation with relatively minor impact; while an over 8 weeks suspension is a long-term physiological change with greater impact, such as a decrease in cardiovascular function by up to 20%, losing physiological benefits from previous training.

Dr. Gary Y.K. Mak is currently the Director of the Pro-Care heart Clinic and Pro-Cardio Heart Disease and Stroke Prevention Center. He is also the Consultant cardiologist of Sir Run Run Shaw Heart & Diagnostic Center, St. Teresa’s Hospital, Consultant Cardiologist & former Director of Cardiac Catheterization Lab. in Hong Kong Baptist Hospital.

Dr. Mak is the Consultant Cardiologist of the Hong Kong Sports Institute for over 20 years taking care of elite athletes as well as visiting lecturer for the cardiology and sports medicine related programmes of the Chinese University of Hong Kong and the Hong Kong Polytechnic University. He is also the Past President of the Hong Kong Association of Sports Medicine & Sports Science.

Graduated in University of Hong Kong in 1982, Dr Mak received his medical training in the Department of Medicine, Chinese University of Hong Kong and completed his Interventional and Nuclear Cardiology training in the University of Toronto.

After the long Christmas and New Year holidays, runners should increase their exercise, diet and sleeping pattern discipline in order to prepare for the race in 1 month’s time.

Adjustment in Training

At this stage, full marathon runners can have a 32km or above long distance training and run with full capacity racing speed. While training volume should be reduced in the following 2-3 weeks to allow the body to be prepared for the challenge on race day. Runners should continue their ongoing running schedule as planned and add in interval cross training to maintain the cardiopulmonary function while avoiding excessive training to the muscles used for running.

Diet and Sleeping Pattern

It is time for runners to adjust their biological clock in a progressive manner and adapt to the time of the race. On the Standard Chartered Marathon race day, the first batch of runners set off at 5:30am. Runners who usually practice at night, should adjust their bedtimes starting from weekends or holidays and switch to morning practices.

It is important to maintain a healthy and balanced diet; runners should be careful with the intake of carbohydrates, protein and fat proportions. Stimulants like excessive alcohol and cigarette smoking should be avoided.

For more training related diet tips, please refer to the recommendations of Miss Sylvia Lam, our Team Marathon Expert.

Personal Assessment before Race

Marathon race is a high intensity competitive sports that demands a high level of cardiovascular fitness. You should therefore know your body before you participate.

In the past few years, the number of amateur participants increased. Many of these amateur runners were over 40 years of age and have significant cardiovascular risk factors such as smoking, high blood pressure, diabetes, high cholesterol, history of heart disease or stroke. The recommended self-assessment questionnaire and the 4 steps medical evaluation by doctors are especially helpful in these high risk individuals.

While soft heart murmur are common in athletes, prominent murmur demand further medical assessment with echocardiogram.

Performing high intensity exercise during viral infections (such as “flu” or diarrhea) might prompt them to develop acute myocarditis which can lead to very serious consequences. One should therefore skip training and not to race when they are not feeling well, especially if they are having a fever.

To avoid excessive stress related to the element of competing, leisure marathon runners should keep a constant pace and enjoy the run rather than focusing on the finishing time and position.

The COVID pandemic and social distancing measures have affected runners in the following areas:

1. Psychological status
Recent reports indicated that about 70% HK people has mood disorder, such as anxiety, depression or post-traumatic stress syndrome during this COVID pandemic. Runners should keep positive. Regular moderate intensity aerobic exercise is helpful to improve the mood hormones, serotonin and endorphin.

2. Detraining
To maintain physical fitness, regular cross training in form of moderate intensity aerobic exercise and resistant training for muscle tone, are important to avoid rapid loss of cardio-pulmonary function and muscle mass. Home exercises like rope jumping, intervals and circuit training, and resistance exercise are recommended.

3. Retraining
Runners should keep up with regular running practice in order to avoid taking 2-3 times extra effort on regaining the lost fitness. Running with a mask is hard if it would decrease the oxygen intake. One should monitor their heart rate, scale down the intensity and target for long distance. One should start retraining at least 2-3 months before the next marathon.

4. Cautions
Marathon running is a high intensity competitive sports and medical assessment before participation is essential. Those with confirmed Coronavirus infection, many have heart and lung damage without symptoms, they should undergo detail heart and lung assessment before participation to avoid potential lethal complications.

Dr Michael Tse is the Director of the Centre for Sports and Exercise at HKU. He has played a major role in raising the awareness of exercise and wellness at HKU, striving to make it a more active and exercise-friendly campus. In 2008 he stablished the Active Health Clinic (AHC), which today, with the dedication of a team of exercise physiologists/specialists, has grown into a very successful and unique exercise clinic that incorporates “exercise medicine” as a prime intervention tool to enhance well-being and help combat chronic inactivity related diseases.

The AHC has worked closely with various collaborators in HKU and other institutions to investigate the evidence-based role exercise plays in various health and diseased populations including those suffering from cancer and diabetes, as well as elderly and other special needs patients/clients. The AHC team has also been instrumental in bringing Exercise is Medicine® to HKU campus in an effort to make HKU a healthier and more physically active campus. Dr. Tse was also a former head performance coach at the Hong Kong Sports Institute in the area of strength and conditioning and worked with many successful Olympians and World Champions.

Runners should keep up resilience and strengthening the immune system. Eating well, reducing stress, sleeping enough and also maintaining a base level of fitness should be fine. At home there are many exercises that can be done to improve both the muscular and cardiovascular systems, such as squats, pushups, getting a TRX and doing some strength for your back and core. Additionally, the cardiovascular system can even be maintained and improved with general calisthenics, such as jumping jacks, running in place, or even traditional skip rope exercise.

I do not recommend that they take a long break. There are so many different kinds of exercises and cross training types of movements to do. For whatever reason someone needs to take a long break, then coming back again would require a buildup of weekly mileage from shorter runs to longer runs in a progressive manner. Jumping right back into the training level someone was doing before after a long break would increase the chances of injury.

There is diet for health and diet for performance. At this stage people should be focusing on diet to maintain good health, which can also strengthen the body and make it more resilient. Diet and nutrition for performance can be addressed at a later stage prior to the final build up months to the marathon event.

Dr. Jonathan Wai has great proficiency and extensive experiences in coordinating and providing medical first-aids support for various sports games and major sports events in Hong Kong. He had been assigned as the Medical coordinator to the Hong Kong Standard Chartered Marathon. Dr. Wai also worked as team physician for the Hong Kong Team in many national games outside Hong Kong. He is devoted to community education on health promotion, sports participation and sports injuries prevention through his lectures and books. As a leader of the Hong Kong Auxiliary Medical Service, Dr. Wai was involved in organizing and teaching the sports injuries first-aids for the members of the Service every year. Athletes would receive the suitable care and medical supports during their exercise.

Continuous training is of utmost important to marathon runners. They should be advised to continue their training with usual exercise schedule. This allows them to maintain their physical fitness and prepare themselves for the event. Mid-intensity outdoor running is advisable but social distancing must be ensured. In addition, indoor resistance workouts are also recommended to keep up with the training progress. This can be done at home but runners must aware of the surrounding safety. Runners may experience “De-training effect” due to a sudden cessation of high-intensity training in pandemic. This may result in substantial decline in muscular strength, endurance or cardiovascular fitness. Therefore, it is important to maintain continuous training. However, high-intensity training is not advised under current pandemic as it may weaken the body immunity to fight against general bacterial and virus infections. Runners are also recommended to have a healthy diet and good sleep, while avoiding visiting high-risk areas such as wet markets or crowded places for the prevention of infections.

Graduated from the Hong Kong University in 1991, Dr Wong is now a specialist in Cardiology. He has been practiced in several public hospitals including Queen Mary Hospital, Grantham Hospital and Ruttonjee Hospital. He started his own private clinic in 2003. In addition to focusing on his work in clinic and hospitals, Dr Wong is also the council member of Hong Kong Doctors Union, council member of Hong Kong Medical Association (HKMA) and chief editor of the HKMA Continuous Medical Education Bulletin. He is particularly interested in -medical education, writing and sports, and successfully completed a number of Standard Chartered Marathon races, ranging from 10KM, half marathon to full marathon.

It is common that every year in the Standard Chartered Hong Kong Marathon, there are runners who want to compete with others, or challenge their personal best. Actively keeping track of your heart rate is the indicator of setting the intensity of a runner’s training. Runners should first calculate their maximum heart rate (i.e.220 – your age). It is suggested that beginners should keep the intensity of training at a level which your heart rate equals to 70-80% of their maximum heart rate during training, and gradually increase the intensity at a later phase. For amateur runners who train three to four days a week, it would be very good for their bodies if their heart rates reach 65-80% of the maximum. This could lower the chance of having heart diseases and strokes by 20-30% and the chance of having cancer by 40-50% respectively.

Rest and Recovery Run

Although rest is essential to training, runners should not sit down and rest immediately after finishing a long distance run or speed training. Leg and core muscles still remain in an intense state which could lead to the accumulation of lactic acid. Runners can do some stretching or even have a slow-walk of about 1-2km to warm down. This will also help to remove the toxic waste in your muscles, and regulate your heart rate from a high level (80% of our maximum heart rate or above) to an aerobic level (65%), until it further drops to the resting heart rate.

The best time to go for a recovery run would be one to two days after your long distance run; the ideal distance being less than 10km. While on a recovery run, jog at a speed that you feel comfortable with. The aim of the recovery run is to remove the lactic acid accumulated in your body and restore the normal mechanisms of your muscles.

Recovery of Your Achilles Tendon

Runners who have joined the full marathon race could likely accumulate a total mileage of up to 80km of training per week. It is normal that muscle pain could appear as a post-training symptom. As a result, runners should not ignore the warning signals from their ligaments and leg muscles. After running, ligaments and muscles could be mildly torn or wounded to a certain extent after each long distance run. Therefore the speed of recovery for the wounded ligament takes approximately one week, if collaborated with the appropriate stretching and recovery training. Once used to the intensity, runners can gradually adapt to higher intensity training and manage to deal with a longer distance at a faster speed. If you still feel difficulty walking and the pain becomes unbearable it also could be a sign of muscle strain. In this case, you should consult a doctor as soon as possible for medical treatment.

Many long-distance runners have experienced in the midst of a race sudden diarrhea, i.e. IBS - Irritable bowel syndrome. Using the toilet during the race, will not only affect the runner’s pace and finishing time but may force runners to quit and thus wasting the training effort endured over the past few months. To prevent this from happening, runners should firstly understand the two major causes of mid-race diarrhea.

Psychological Factors:

Since our digestive system is controlled by autonomic nerves, the muscles of our stomach will become tense once the feeling of nervousness is felt which triggers the feeling of having diarrhea. If runners can adjust their mood and mentality in a race to keep calm, the chances of having diarrhea will be greatly lowered. Try to enjoy the scenery along the race course or even run with friends to reduce the psychological stress. These tips can effectively help prevent having IBS.

Physiological Effects:

Runners who have a sensitive stomach should reduce the amount of fiber-rich foods in their diet before the race. Fibers stimulate peristalsis of the intestines and accelerate defecation, causing the occurrence of diarrhea. Thus runners should be extra careful when selecting their food before the race. Avoid irritating food; for example food which is too cold, too hot, over-seasoned or even drinking coffee and tea which contains caffeine that stimulates bowel movements.

How to Deal with IBS during a Race:

If you suddenly feel like having a stomachache in the middle of the race, first of all, relax and try to maintain a good mood. Divert your attention from the pain of having diarrhea, do not worry, most runners can still continue the race after going to the toilet. However, if you have to stop at each mobile toilet along the course you should consider giving up the race. Since having diarrhea and keeping up consistently high amounts of exercise at the same time could lead to dehydration. If diarrhea persists, you should seek medical assistance as soon as possible.

Subsequently IBS can be controlled through medication nowadays. Runners are advised to conduct a pre-race self-assessment. If you often have syndromes of stomachache or diarrhea due to nervousness, you should consult a doctor before the race.

5 marathon training tips for runners to keep fit and stay healthy, getting ready in their best shapes for the next marathon season!

1. No Smoking and less alcohol
- Remember to avoid adopting bad habits like smoking and drinking in excess during the lockdown period.

2. Maintain a healthy diet
- To stay fit – Less salt and oil intake, avoid excessive consumption of carbohydrates, maintain suitable amount of protein intake and eat more vegetables and fruits.

3. Daily regular high-intensity training for 45 minutes to 1 hour
- Core muscle training
- Stretching to improve flexibility of ligaments, tendons, joints and muscles
- Cardiovascular exercise
- Nerve reflex training

4. Stay happy, positive and optimistic
- Avoid excessive consumption of neuro-simulating food stuff, e.g. tea and coffee
- Adequate rest and sleep, wake up early
- Be helpful and useful to others
- Spending less time on smart phones, computers and television
- Keep learning new things every day, better with no relation with your usual work or hobbies

5. Maintain good relationship with family doctors
- Regular annual body check
- Regular vaccination
- Seek medical attention at the early stage of illness

Dr Ella Yeung is the Practice Principal of Aurora Physiotherapy and Fitness Centre. She was Professor in Physiotherapy at the Department of Rehabilitation Sciences of the Hong Kong Polytechnic University. She now serves as Adjunct Professor at the Hong Kong Polytechnic University, where she contributes to teaching and research.

Ella's area of expertise is in the field of orthopaedics and sports physiotherapy. For many years Ella has served in different national sports teams and has worked with elite athletes. Ella was the Team Physiotherapist to the China Women’s Hockey Team at the Beijing 2008 Summer Olympics, and was also appointed Sports Medicine Specialist of the China Olympic Team for London 2012 and Rio 2016 Summer Olympics. Ella has been the physiotherapy coordinator for Standard Chartered Hong Kong Marathon since 2008.

Prof. Yung Shu-Hang Patrick, is now a world recognized prominent international leader in the field of Orthopaedic Sports Medicine, being the Chairman/President of several influential local & international organizations on Orthopaedics, Sport Medicine & Arthroscopy surgery. He is now the Chairman of the Department of Orthopaedics and Traumatology of the Faculty of Medicine of CUHK. He is also the Directors of different prominent health science centers in HK, such as the Hong Kong Centre of Sports Medicine and Sports Science, and also The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre. He is now also the President of the Asian Federation of Sports Medicine (AFSM), as well as the Past President of The Hong Kong Association of Sports Medicine & Sports Science (HKASMSS) and the Hong Kong College of Orthopaedic Surgeons (HKCOS).

Training of keen runners is inevitably affected by COVID-19 epidemics and runners are recommended to focus on doing more cross-training & other regions which are seldom being exercised, such as the muscle strength and flexibility. Balanced and adequate muscle strength, with good flexibility, can definitely improve runners’ performance as well as lowering injury risk. Exercising of core muscle groups including abdominals, back and buttocks can help muscle development for preventing injuries and improving performance. In addition, runners should maintain regular cross-training for a more rapid pick-up of performance when training is resumed. Recently, much have been discussed about wearing a mask while running. Some people have a wrong perception that wearing a mask & run can simulate altitude training, which is indeed not true. Runners should monitor their physical condition carefully and increase the intensity gradually when running with a mask, it is recommended to begin with brisk walking or cycling, and then progress to slow running based on individuals fitness and physical ability.

© Standard Chartered Hong Kong Marathon 2021

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