{"id":10399,"date":"2023-02-06T06:00:06","date_gmt":"2023-02-06T05:00:06","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10399"},"modified":"2023-02-06T01:08:26","modified_gmt":"2023-02-06T00:08:26","slug":"a-report-on-marathon-medicine-the-london-marathons-conference-on-the-medicine-and-science-of-endurance-running","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/02\/06\/a-report-on-marathon-medicine-the-london-marathons-conference-on-the-medicine-and-science-of-endurance-running\/","title":{"rendered":"A report on Marathon Medicine, the London Marathon\u2019s conference on the Medicine and Science of Endurance Running"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-10400\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/LDN-marathon-logo-300x110.jpeg\" alt=\"\" width=\"300\" height=\"110\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/LDN-marathon-logo-300x110.jpeg 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/LDN-marathon-logo.jpeg 512w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p><span style=\"font-weight: 400\">Keywords: injury, physiology, health<\/span><\/p>\n<p><span style=\"font-weight: 400\">The <\/span><i><span style=\"font-weight: 400\">Marathon Medicine<\/span><\/i><span style=\"font-weight: 400\"> conference returned to the RIBA London to celebrate its 38<\/span><span style=\"font-weight: 400\">th<\/span><span style=\"font-weight: 400\"> edition on Saturday 1<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> October 2022. The event was organised in partnership with, and supported by, the TCS London Marathon and, had an international panel of experts discussing the medicine and science of endurance running. All talks have been recorded and are available from <a href=\"https:\/\/www.tcslondonmarathon.com\/the-event\/marathon-medicine\"><em>The Marathon Medicine Conference website<\/em><\/a><\/span><span style=\"font-weight: 400\">.\u00a0<\/span><\/p>\n<p><b>What Makes Kipchoge so Good? The Fourth Dimension in the Physiology of Marathon Running<\/b><\/p>\n<p><span style=\"font-weight: 400\">Professor Andy Jones started with a brief summary of the three main physiological characteristics widely accepted to determine marathon performance: maximum oxygen uptake (<\/span><span style=\"font-weight: 400\">V<\/span><span style=\"font-weight: 400\">O<\/span><span style=\"font-weight: 400\">2max<\/span><span style=\"font-weight: 400\">), lactate threshold, and running economy, which may be integrated as the <\/span><a href=\"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/full\/10.14814\/phy2.14098\"><span style=\"font-weight: 400\">critical speed<\/span><\/a><span style=\"font-weight: 400\"> (1)<\/span><span style=\"font-weight: 400\">. Prof. Jones presented data from world-class male distance runners, who were thought to be able to break the mythical barrier of running a marathon in under 2 hours. The <\/span><a href=\"https:\/\/journals.physiology.org\/doi\/full\/10.1152\/japplphysiol.00647.2020\"><span style=\"font-weight: 400\">paper<\/span><\/a><span style=\"font-weight: 400\">, which has attracted over 25,000 downloads, demonstrates that, unsurprisingly, elite endurance runners are very, very fit! They achieved a <\/span><span style=\"font-weight: 400\">V<\/span><span style=\"font-weight: 400\">O<\/span><span style=\"font-weight: 400\">2max<\/span><span style=\"font-weight: 400\"> of ~72 mL\/kg\/min, reaching the lactate threshold at ~94% of their <\/span><span style=\"font-weight: 400\">V<\/span><span style=\"font-weight: 400\">O<\/span><span style=\"font-weight: 400\">2max<\/span><span style=\"font-weight: 400\">, and could run at 2-h marathon pace with an O<\/span><span style=\"font-weight: 400\">2<\/span><span style=\"font-weight: 400\"> cost of only ~190 mL\/min\/kg. However, although 7 athletes were able to reach a steady state at 2-h marathon pace, and thus theoretically being able to break the 2-h marathon barrier, only <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Eliud_Kipchoge\"><span style=\"font-weight: 400\">Eliud Kipchoge<\/span><\/a><span style=\"font-weight: 400\">, arguably the greatest marathon runner of all time, has been able to run the 26.2 miles in less than 2 hours (<\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Ineos_1:59_Challenge\"><span style=\"font-weight: 400\">1:59:40<\/span><\/a><span style=\"font-weight: 400\">). This may be explained by the fact that physiological characteristics are not static, but deteriorate, as demonstrated by the <\/span><a href=\"https:\/\/journals.lww.com\/acsm-msse\/Fulltext\/2018\/08000\/Effects_of_Two_Hours_of_Heavy_Intensity_Exercise.15.aspx\"><span style=\"font-weight: 400\">reduction in critical speed<\/span><\/a><span style=\"font-weight: 400\"> during prolonged exercise (2). Indeed, the concept of <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40279-021-01459-0\"><span style=\"font-weight: 400\">durability<\/span><\/a><span style=\"font-weight: 400\">, or resilience, has been recently suggested to account for the ability of runners to resist such changes and preserve their physiological characteristics, which indeed appears to contribute to explain <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40279-022-01680-5\"><span style=\"font-weight: 400\">marathon performance<\/span><\/a><span style=\"font-weight: 400\"> (3, 4)<\/span><span style=\"font-weight: 400\">. In addition to <\/span><span style=\"font-weight: 400\">V<\/span><span style=\"font-weight: 400\">O<\/span><span style=\"font-weight: 400\">2max<\/span><span style=\"font-weight: 400\">, lactate threshold, and running economy, the concept of durability (or resilience), may be considered as the fourth parameter of endurance performance.\u00a0<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10401\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-300x188.png\" alt=\"\" width=\"596\" height=\"373\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-300x188.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-768x480.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-1536x960.png 1536w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-2048x1280.png 2048w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-1-640x400.png 640w\" sizes=\"auto, (max-width: 596px) 100vw, 596px\" \/><\/p>\n<p><b>The aetiology of bone stress fractures in female athletes<\/b><\/p>\n<p><span style=\"font-weight: 400\">The second talk of the day was delivered by Professor Julie Greeves OBE, on the aetiology of bone stress injuries in female athletes. The talk explored the <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4767832\/\"><span style=\"font-weight: 400\">first reports of stress fractures<\/span><\/a><span style=\"font-weight: 400\"> in Prussian soldiers by Breithaupt in 1855, who termed these injuries as march fractures (5).\u00a0 We now know, however, that bone stress injuries (BSI) happen in a continuum, from stress reaction to complete fracture, and that female runners have a higher risk of BSI than their male counterparts. There are a myriad of factors to explain the higher risk of BSI in females, which may be related to the <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24620037\/\"><span style=\"font-weight: 400\">Relative Energy Deficiency in Sport<\/span><\/a><span style=\"font-weight: 400\"> (RED-S) (6). The concept of RED-S, describing a total energy expenditure in excess of energy intake, is broader than that of the Female Athlete Triad. It encompasses a wide range of health outcomes, including physical and cognitive performance, as well as wider populations, including non-athletes and men. One such population is <\/span><a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2020.00142\/full\"><span style=\"font-weight: 400\">military personnel<\/span><\/a><span style=\"font-weight: 400\"> (7)<\/span><span style=\"font-weight: 400\">, who may drop into energy deficiency during periods of intense training or combat, and as a result experience impaired bone health, which ultimately can result in an increased risk of BSI. Prof Greeves discussed <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s11914-021-00671-1\"><span style=\"font-weight: 400\">practical strategies<\/span><\/a><span style=\"font-weight: 400\"> (8) that may improve bone health, and reduce the risk of BSI. Such strategies may include managing training load, nutritional strategies, and better screening, but also would need to consider cultural barriers.\u00a0<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10404\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-300x188.png\" alt=\"\" width=\"614\" height=\"385\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-300x188.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-768x480.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-1536x960.png 1536w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-2048x1280.png 2048w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-4-640x400.png 640w\" sizes=\"auto, (max-width: 614px) 100vw, 614px\" \/><\/p>\n<p><b>The postpartum runner: A unique opportunity to prepare for injury<\/b><\/p>\n<p><span style=\"font-weight: 400\">The third speaker of the morning was Dr Isabel Moore. This talk reminded us, as a community of sports medicine and sport and exercise science specialists, we need to focus more on female research. Whilst there is a wealth of research on the male sex, there are only <\/span><a href=\"https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/17461391.2014.911354?journalCode=tejs20&amp;\"><span style=\"font-weight: 400\">35% to 37% female participants per article<\/span><\/a><span style=\"font-weight: 400\"> across sport and exercise journals (9). The shortage of female-specific data is <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40279-021-01435-8\"><span style=\"font-weight: 400\">likely the result of the inability<\/span><\/a><span style=\"font-weight: 400\">, or lack of willingness, to effectively adapt experimental designs to incorporate female-specific considerations, such as the menstrual cycle, hormonal contraceptive use, pregnancy, and the menopause. This affects the lack of female-specific perspective studies, addressing issues that affect specifically the female sex, such as pregnancy. Dr Moore discussed novel approaches to record and report injuries and illnesses, with a novel framework that may be implemented during pregnancy, in preparation for their postpartum rehabilitation and eventual return to work. The <\/span><a href=\"https:\/\/bjsm.bmj.com\/content\/56\/5\/244\"><span style=\"font-weight: 400\">6 Rs framework<\/span><\/a><span style=\"font-weight: 400\"> is one such approach, which aims to get athletes <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">eady for the anticipated changes associated with pregnancy and partum, <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">eview and evaluate the postpartum athlete, <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">estore physical and psychological well-being, <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">econdition in order to be able to cope with the physical and psychological demands of the sport or activity so that athletes can, eventually, <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">eturn to sport, and strategies can be <\/span><i><span style=\"font-weight: 400\">R<\/span><\/i><span style=\"font-weight: 400\">efined, if needed (10).\u00a0<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10402\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-300x188.png\" alt=\"\" width=\"625\" height=\"391\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-300x188.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-768x480.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-1536x960.png 1536w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-2048x1280.png 2048w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-2-640x400.png 640w\" sizes=\"auto, (max-width: 625px) 100vw, 625px\" \/><\/p>\n<p><b>Strategies to Improve Durability of the Masters Runners<\/b><\/p>\n<p><span style=\"font-weight: 400\">After a comfort break, Dr Richard Willy delivered a talk on the fastest growing segment of marathon runners, the <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Masters_athletics\"><span style=\"font-weight: 400\">master athlete<\/span><\/a><span style=\"font-weight: 400\">, now representing over 50% of all marathon finishers. Ageing is characterised by a myriad of changes, affecting multiple physiological systems. Even if a decline in aerobic function and muscle strength seems inevitable with ageing, running can slow down the process. However, endurance running may not be enough, and a decline in running performance still happens as we age due to <\/span><a href=\"https:\/\/journals.lww.com\/sportsmedarthro\/Abstract\/2019\/03000\/The_Physiology_and_Biomechanics_of_the_Master.4.aspx\"><span style=\"font-weight: 400\">multiple reasons<\/span><\/a><span style=\"font-weight: 400\">; declining cardiovascular function, reduced muscular capacity, altered biomechanics (11). As a result, master athletes tend to have greater susceptibility to running injuries, primarily, from soft-tissue injuries to the lower leg and foot.\u00a0 This includes Achilles tendinopathy, the most common running-related injury experienced by master runners, as well as calf strains and plantar fasciopathy. Simple, yet effective, interventions addressing soft tissue injuries were discussed during the talk (such as heavy slow seated calf raises to optimise soleus strength), which may be used to reduce the risk of injury in the master athlete.\u00a0\u00a0\u00a0<\/span><\/p>\n<p><b>Cardiovascular effects of endurance exercise: Mainly good but some concerns\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400\">Professor Sanjay Sharma closed this year\u2019s conference with a talk addressing the cardiovascular effects of endurance exercise. Prof. Sharma started the talk with a brief summary of the indisputable benefits that regular endurance exercise has on the cardiovascular system. Prof. Sharma reminded the audience that the recommended guidelines for physical activity, <\/span><a href=\"https:\/\/www.nhs.uk\/live-well\/exercise\/exercise-guidelines\/\"><span style=\"font-weight: 400\">150 min of moderate exercise per week<\/span><\/a><span style=\"font-weight: 400\">, should be the bare minimum we aim for! Indeed, those who manage to accumulate 3-5 times this amount of endurance exercise per week experience greater benefits to health. However, the talk revolved around those who significantly exceed these recommendations (up to 10-15 times the recommended guidelines, or 25 hours per week), namely endurance athletes. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25839670\/\"><span style=\"font-weight: 400\">Emerging data<\/span><\/a><span style=\"font-weight: 400\"> indicates that long-standing vigorous exercise may be associated with adverse electrical and structural remodelling in otherwise normal hearts (12). The significance of these data remains to be fully elucidated. However, the scarring within the heart and <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33748860\/\"><span style=\"font-weight: 400\">increased calcification<\/span><\/a><span style=\"font-weight: 400\"> within the coronary artery may pose a higher risk of atrial fibrillation, particularly in middle-aged, older male endurance runners (13). In summary, endurance exercise is undoubtedly beneficial to the cardiovascular system, yet some concerns may exist, particularly to those in the upper limit of the endurance exercise continuum.\u00a0<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10403\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-300x188.png\" alt=\"\" width=\"640\" height=\"401\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-300x188.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-768x480.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-1536x960.png 1536w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-2048x1280.png 2048w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/01\/Marathon-med-3-640x400.png 640w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400\">The <\/span><a href=\"https:\/\/twitter.com\/marathonmed\"><span style=\"font-weight: 400\">39th Marathon Medicine Conference<\/span><\/a><span style=\"font-weight: 400\"> will take place on 22nd April 2023.\u00a0\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400\">By Dr Daniel Muniz, University of Hertfordshire<\/span><\/p>\n<p><span style=\"font-weight: 400\">No competing interests<\/span><\/p>\n<p><span style=\"font-weight: 400\">d.muniz@herts.ac.uk<\/span><\/p>\n<p><span style=\"font-weight: 400\">Twitter: @Daniel_Muniz_<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400\">References<\/span><\/p>\n<ol>\n<li><b>Jones AM, Burnley M, Black MI, Poole DC, and Vanhatalo A<\/b><span style=\"font-weight: 400\">. The maximal metabolic steady state: redefining the \u2018gold standard\u2019. <\/span><i><span style=\"font-weight: 400\">Physiological Reports <\/span><\/i><span style=\"font-weight: 400\">7: e14098, 2019.<\/span><\/li>\n<li><b>CLARK IE, VANHATALO A, BAILEY SJ, WYLIE LJ, KIRBY BS, WILKINS BW, and JONES AM<\/b><span style=\"font-weight: 400\">. Effects of Two Hours of Heavy-Intensity Exercise on the Power\u2013Duration Relationship. <\/span><i><span style=\"font-weight: 400\">Medicine &amp; Science in Sports &amp; Exercise <\/span><\/i><span style=\"font-weight: 400\">50: 1658-1668, 2018.<\/span><\/li>\n<li><b>Maunder E, Seiler S, Mildenhall MJ, Kilding AE, and Plews DJ<\/b><span style=\"font-weight: 400\">. The Importance of \u2018Durability\u2019 in the Physiological Profiling of Endurance Athletes. <\/span><i><span style=\"font-weight: 400\">Sports Medicine <\/span><\/i><span style=\"font-weight: 400\">51: 1619-1628, 2021.<\/span><\/li>\n<li><b>Smyth B, Maunder E, Meyler S, Hunter B, and Muniz-Pumares D<\/b><span style=\"font-weight: 400\">. Decoupling of Internal and External Workload During a Marathon: An Analysis of Durability in 82,303 Recreational Runners. <\/span><i><span style=\"font-weight: 400\">Sports Medicine <\/span><\/i><span style=\"font-weight: 400\">52: 2283-2295, 2022.<\/span><\/li>\n<li><b>Astur DC, Zanatta F, Arliani GG, Moraes ER, Pochini AdC, and Ejnisman B<\/b><span style=\"font-weight: 400\">. Stress fractures: definition, diagnosis and treatment. <\/span><i><span style=\"font-weight: 400\">Rev Bras Ortop <\/span><\/i><span style=\"font-weight: 400\">51: 3-10, 2015.<\/span><\/li>\n<li><b>Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, and Ljungqvist A<\/b><span style=\"font-weight: 400\">. The IOC consensus statement: beyond the Female Athlete Triad&#8211;Relative Energy Deficiency in Sport (RED-S). <\/span><i><span style=\"font-weight: 400\">Br J Sports Med <\/span><\/i><span style=\"font-weight: 400\">48: 491-497, 2014.<\/span><\/li>\n<li><b>O&#8217;Leary TJ, Wardle SL, and Greeves JP<\/b><span style=\"font-weight: 400\">. Energy Deficiency in Soldiers: The Risk of the Athlete Triad and Relative Energy Deficiency in Sport Syndromes in the Military. <\/span><i><span style=\"font-weight: 400\">Frontiers in Nutrition <\/span><\/i><span style=\"font-weight: 400\">7: 2020.<\/span><\/li>\n<li><b>O\u2019Leary TJ, Rice HM, and Greeves JP<\/b><span style=\"font-weight: 400\">. Biomechanical Basis of Predicting and Preventing Lower Limb Stress Fractures During Arduous Training. <\/span><i><span style=\"font-weight: 400\">Current Osteoporosis Reports <\/span><\/i><span style=\"font-weight: 400\">19: 308-317, 2021.<\/span><\/li>\n<li><b>Costello JT, Bieuzen F, and Bleakley CM<\/b><span style=\"font-weight: 400\">. Where are all the female participants in Sports and Exercise Medicine research? <\/span><i><span style=\"font-weight: 400\">European Journal of Sport Science <\/span><\/i><span style=\"font-weight: 400\">14: 847-851, 2014.<\/span><\/li>\n<li><b>Donnelly GM, Moore IS, Brockwell E, Rankin A, and Cooke R<\/b><span style=\"font-weight: 400\">. Reframing return-to-sport postpartum: the 6 Rs framework. <\/span><i><span style=\"font-weight: 400\">British Journal of Sports Medicine <\/span><\/i><span style=\"font-weight: 400\">56: 244-245, 2022.<\/span><\/li>\n<li><b>Willy RW, and Paquette MR<\/b><span style=\"font-weight: 400\">. The Physiology and Biomechanics of the Master Runner. <\/span><i><span style=\"font-weight: 400\">Sports Medicine and Arthroscopy Review <\/span><\/i><span style=\"font-weight: 400\">27: 15-21, 2019.<\/span><\/li>\n<li><b>Sharma S, Merghani A, and Mont L<\/b><span style=\"font-weight: 400\">. Exercise and the heart: the good, the bad, and the ugly. <\/span><i><span style=\"font-weight: 400\">Eur Heart J <\/span><\/i><span style=\"font-weight: 400\">36: 1445-1453, 2015.<\/span><\/li>\n<li><b>Parry-Williams G, Gati S, and Sharma S<\/b><span style=\"font-weight: 400\">. The heart of the ageing endurance athlete: the role of chronic coronary stress. <\/span><i><span style=\"font-weight: 400\">Eur Heart J <\/span><\/i><span style=\"font-weight: 400\">42: 2737-2744, 2021.<\/span><\/li>\n<\/ol>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Keywords: injury, physiology, health The Marathon Medicine conference returned to the RIBA London to celebrate its 38th edition on Saturday 1st October 2022. The event was organised in partnership with, and supported by, the TCS London Marathon and, had an international panel of experts discussing the medicine and science of endurance running. All talks have [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2023\/02\/06\/a-report-on-marathon-medicine-the-london-marathons-conference-on-the-medicine-and-science-of-endurance-running\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":463,"featured_media":10402,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068],"class_list":["post-10399","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-featured"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A report on Marathon Medicine, the London Marathon\u2019s conference on the Medicine and Science of Endurance Running - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/?p=10399\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A report on Marathon Medicine, the London Marathon\u2019s conference on the Medicine and Science of Endurance Running - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"Keywords: injury, physiology, health The Marathon Medicine conference returned to the RIBA London to celebrate its 38th edition on Saturday 1st October 2022. The event was organised in partnership with, and supported by, the TCS London Marathon and, had an international panel of experts discussing the medicine and science of endurance running. 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