About 16,000 runners are set to take part in the full Philadelphia Marathon on Sunday; nearly 15,000 more will join the half marathon or 8K races this weekend.

Race medical director Steven Cohen says his team will be on alert, hoping to see all that all runners have a healthy race.

 

Bottom line, though: Runners beware. Ultimately, participants assume responsibility for their own health.

"There's no way to screen 30,000 runners prior to an event," said Cohen, an orthopedic surgeon at The Rothman Institute. "They are encouraged to see a physician to make sure they are healthy to run the event. Obviously, they sign a waiver."

A staff of nearly 100 emergency-response workers, volunteers or medical staffers will monitor the race. Spokesman Randy Giancaterino said many will be stationed near the end of the course.

Experts aren't entirely sure why, but they have noticed a pattern among those suffering serious injury and deadly heart problems. When they strike runners, it often happens in the final miles of a long-distance race.

Last year two men died at the Philadelphia event.  A 40-year-old marathoner collapsed with just a quarter mile to go. And a 21-year-old University of Pennsylvania student fell after completing the half-marathon.

A race spokesman says medical help arrived quickly, but personnel weren't able to revive the men, who were both conditioned athletes.

Each year, Cohen says, many less experienced athletes attempt the 26.2-mile trek. They may be motivated by the desire to say they did "something big."

"I think it is certainly grand," Cohen said. "But I see the toll that most of the bodies sustain by running in this, and I will tell you that most people who run in a marathon are not meant to do that."

Before 2011, there hadn't been a death linked to the Philadelphia race since 1995, Giancaterino said.

Do get the proper gear; don't sprint to the finish

Race-day fatalities are unusual, but bursitis, stress fractures and other overuse injuries are common.

Physical therapist John Feely cares for elite runners and novices at Moss Rehab.

"Often they have done too much, too soon, too quick," Feely said.

His advice includes hints to avoid some of the more mundane, but vexing, problems, such as skin chaffing and toe blisters.

Feely says petroleum jelly soothes sensitive areas and Band-Aids can prevent friction from clothes. He also recommends synthetic socks over cotton footwear, which hold onto moisture.

Other experts tell runners to resist end-of-race adrenaline and the urge to sprint to the finish line. For some vulnerable racers, trying to find that extra gear can be deadly after a grueling race.

And finally, the finish line isn't the end.

"A lot of times people have the urge to sit down right away," Feely said. "And they really should move around for 10 or 15 minutes to make sure that blood is not pooling in the legs."