The 2014 Boston Marathon runners’ lungs, legs, bodies, and minds were built in the winter.
The weather during yesterday’s Marathon Monday was close to perfect for spectators who donned shorts and shades in the afternoon for the nearly 70-degree weather, but for runners, the end of the day was less than ideal.
The 2014 marathoners trained in an unusually intense winter. The past few weeks of spring were also in the low 40s and 50s, not nearly as warm as Monday’s bright and sunny afternoon, so when the course heated up to 70 degrees, it challenged the final packs of runners who weren’t acclimated to running in those temperatures. This year’s runners experienced a lot of dehydration, cramping, heat illness, as well as low sodium (hyponatremia) from excessive fluid intake that flushes essential vitamins and minerals.
Despite the physical setbacks, these runners were certainly stronger mentally. The B.A.A. announced Tuesday morning that 99 percent of the runners finished the race. Many pushed through physical pain that may have stopped them in previous years, emotionally charged to finish this year’s race. The 26 American Red Cross medical tents along the course saw 1866 runners, the majority of whom continued after resting and receiving treatment.
“The one thing we knew in our medical planning was that these runners were going to do anything they could to push through what they were feeling to get to the finish line,” said Chris Troyanos, who has worked as medical coordinator for the Boston Athletic Association since 1995. “You have to consider the runner’s emotions. They were pushing themselves to get across the finish line, even though they might have previously said they weren’t capable of finishing. The emotions of what happened on April 15 were going to push them through, and that’s exactly what happened.”
From the starting line in Hopkinton to the finish line at Boylston Street yesterday, the B.A.A. reported a total of 3,762 medical tent encounters. But medical tent A at the finish line was certainly hit the hardest with 1,187 runners. Medical tent B treated 645 runners, while Boston Emergency Medical Services treated 54 runners at their medical stations in the Boston Commons.
As of this morning, 192 runners were seen in area hospitals (out of that figure approximately 20 were admitted overnight). Most of those treated were released today, according to Troyanos.
“It’s amazing when you see that 99 percent of the runners finished,” said Troyanos, who rated this year’s medical response as “outstanding.”
The medical tents are staffed according to surge capacity (the surge being primarily the 1 to 3 p.m. slot, when the majority of runners cross the finish line). This year’s marathon medical staff reached 1,900 volunteers, 500 more than last year, not including public safety officials.
“The medical team and volunteers we have, along with public safety partners, it’s a well-oiled machine,” said Troyanos. “These folks have been doing this for a long period of time and doing this in a number of situations. I look at yesterday, the tragic year before that, and even 2012 with high heat, a trilogy of medical events in terms of responses, and I challenge any other medical team in the country to do it the way we do it.”
The medical tents are typically divided into 20 stations, or pods, each with eight cots and a professional medical team including physicians, nurses, physical therapists, and mental health specialists.
Yesterday, I stood outside Medical tent A at Dartmouth Street, watching the flow of volunteers entering and exiting the tent down chutes built out of barricades that maintained clear pathways. The medical staff, wearing white jackets, checked in on runners as they walked through the finish line and pushed runners in wheelchairs into the tents for treatment. Earlier that morning, I could enter the tent and snap a few photos of volunteers packing up medical kits, grabbing their lunches, and the empty cots waiting, lined up neatly along the sides of the tent.
Medical tent A filled the length and width of the block of Dartmouth Street in front of the Boston Public Library at Copley Square. Ambulances pulled up to the back at the intersection with St. James Avenue to carry runners needing additional assistance and treatment to area hospitals.
Dr. Douglas Comeau, a family medicine practitioner who specializes in sports medicine, worked in medical tent B yesterday, where he’s worked for the past three years as a triage volunteer. Medical tent B is after the finish line at the corner of St. James Avenue and Berkeley Street. Dr. Comeau said the tent typically sees runners whose muscles have begun to cramp after walking the finish chute, collecting medals and foil recovery blankets. Their staff doubled this year and still managed to reach 70 percent capacity for the majority of the day.
The Boston Athletic Association coordinated higher staffing numbers, as well as treatment areas, in response to the more than 36,000 runners this year.
Near the family and friends meeting area, runners could receive massages at the Dorothy Quincy Suite inside the John Hancock Building at the corner of Berkeley and Stuart Streets, from deep tissue specialists like Dr. Eric Roseen, who shared proper cool down tips with us last week.
Back at home, Dr. Comeau advises that runners should be staying hydrated, watching out for severe muscle cramping, and continuing to ice any kinds of injuries. “If things aren’t getting better, follow up with your provider, and just make sure your body has time to recover before you go out running again.”Chelsea Rice is a health producer for Boston.com. She can be reached at email@example.com. Follow her on Twitter @ChelseaRice.