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How to Run Your Best Boston Marathon (or any race for that matter)


By Mark Cuccuzzella, MD

boston-2016April 17 will be my 23rd running of the Boston Marathon and 17th consecutive.  My only Boston misses since 1989 were for military duties and a foot surgery. I’m not much for streaks, but I run Boston, Marine Corps, and Air Force Marathons every year to get out on the course with friends, fellow Service Members, Vets, and to be part of a large urban party.  At age 50, now it’s fun to look back, and this spring I realized I’ve been running marathons for 30 years without any long breaks.  I had never thought about my running as a “streak” until the number 30 straight years of running sub-3 hours came up. There is actually Guinness Book accounting of the record of consecutive years of sub-3 hours run in the same annual marathon. The world’s lead is 33, held by Chris Finill of the UK at the London Marathon. Runner’s World did an article about Finill’s effort to run 30, and he kept it up for 33 straight years. So, I’ll be out there this year, in Boston, trying to come in under 3-hours, and that will make 30 years of sub-3 hour marathons for me. 

My best time over the last 29 years is 2:24 with an average time of 2:35 during the streak. I won’t be near that mark this year, but I feel healthy, and unless unexpected weather or the gods of marathoning work against me, I feel good about finishing in under 3-hours.   Over these nearly 30 years and close to 100 marathons, my slowest finish is 3:00:00 at Air Force Marathon this year where I ran a large amount of the race barefoot. I have 2 DNFs along the way.  One was my first Boston in 1989 where I ran downhill with rookie ignorance and paid the price.  The other DNF was in 1991 at the New York City Marathon where I started with bad Plantar Fasciitis.

What is the sustainable path? In today’s culture, there is a trend and emphasis on high-intensity training as the path to success.  I agree that for immediate performance this is true, but the jury is out if we are talking about long-term health and balance if one has a busy life. Be careful of who you look to for advice, be cautious if the advice is linked to short term fitness and not to long term health strategy to keep you on the roads.

The late Dr. George Sheehan often wrote, “We are all an experiment of one.” This is true, but I think one must understand the principles of overall health and how to treat your body to keep the experiment going.  Since my foot surgery in 2000, I have not done any training which would be considered “hard” or “anaerobic” by modern extreme fitness zealots. Most proponents of “pain is gain” cannot produce this type of sustainable performance data in themselves or any of their clients or athletes.  I have not missed a Boston or Marine Corps since 2000; and have not had running related injury since then either. Despite some years of extreme weather at these races, my times are all consistent with the gentle physiologic age related decline. The human body does not need technology or fancy stuff as we age.  In 2016 I ran Boston, Air Force, and Marine Corps in 5 Fingers, barefoot, and sandals. I will again be running for research as a minimalist running subject for Dr. Irene Davis of Spaulding National Running Center. 

So, what is the “Secret Sauce” of long-term healthy running?

  • Run for joy.
  • Recover.  Slow jogging is your friend. If you eat and train well, you do not do damage, so there is no real “recovery time” in the modern lexicon of protien shakes , ice baths, rollers, massages, compression, etc.
  • Learn to use fat as fuel. Read about how this works here
  • Do not run too hard. Running is recovery and you should always feel better when you get back then when you went out the door.
  • Keep “fast and agile” with short sprints and drills.
  • Keep mobile, especially in the ankles and hips.
  • Keep your foundation strong–this is your foot.  Wear flat shoes shaped like your foot to stand, walk, run, and play.  Go barefoot as often as you can.
  • Learn the skill of running and keep trying to master this. 
  • Do simple strength training .
  • Be your own body sensor and coach.
  • Don’t sit.
  • Eat real food, and as you age limit the carbs.
  • Do not put your body in pain.
  • And pass it forward…we all continue to learn by teaching and sharing with others.

So now on to the Boston strategy:

As you enter the week prior to the race here are a few strategies to help you set your plan. The best analogy I can think of is this ~ if you have trained your body properly with the right mix of aerobic level training and some up-tempo stuff in recent weeks, you have built your efficient hybrid engine ready to race the marathon. 

You may have driven in a Prius (or other hybrid car) and watched the subtle shifts between gas and electric on the dashboard.  You do not perceive these shifts. The engine (your muscles) runs on a mixture of gas (sugars) and electric (fats).  Utilizing gas or electric power depends on the effort.  Therefore, slow aerobic training is critical for marathon success, and you build a massive electric (fat burning) engine

Keep this idea in mind:  running on sugar will leave you running on empty while running on fat will make you bonk proof.

Learn how to be a better butter burner:

Imagine you are starting the race with one gallon of gas in the tank- assuming you have eaten a nice meal the night before with a light breakfast to top you off. If you race in all “gas mode,” your engines will run about 1.5 hours at a strong pace; then you are out of gas. If your effort is mostly electric, you can run for hours, but not as swiftly.

With the correct effort you will:  (1) use the proper fuel mix, and you will be efficient for the duration of your event, and (2)  you can even do some topping off along the way.  Running too hard too early will sabotage your race day by not only depleting the gas but also shunting all blood flow to working muscles, thereby not allowing the aid station top-offs to assist you during the race.

Running utilizes about 1kcal/kg/km. So, for a lean marathoner of 80 kg you need about 3,360 kcals (80kg x 42 km) to make it through the race.  The gas is the glucose utilizing pathway. Even fully carbo-loaded, your stored liver glycogen (300-500kcal), muscle glycogen (1000-1500kcal),  and blood glucose (less than 20 kcal) don’t add up. Glucose is easy to access for ready energy but adds up to less than 2,000 kcal.  The fat utilizing pathway is the electric engine.  In marathons, you must be in hybrid mode to make it through the race.  Hybrid is where your energy (ATP) is coming from both fuel sources.  Conserving the gas and using the electric engine early in the race is critical.

Many runners are in great “10k shape” (an all gas event) and train in all gas mode. They start their marathon in the all gas mode….and crash.  Glycogen sparing strategy need not apply in races of less than an hour if you have a good pre-event meal to fill the tank. In marathons and ultras, top-end anaerobic fitness matters little and can only be applied very near the finish.

Glucose gives 36 ATP per molecule with a limited supply, fat 200-400 ATP per molecule and an unlimited supply.  You must tap into the fat burning tank during your marathon. And, now you know how a bird can migrate 7000 miles without an aid station.  It’s all about adaptation in training and pace.

Another key to teaching your body how to burn fat and to maximize aerobic development is to not eat before or during your long runs. If you are reading this for the first time before this year’s race then apply it to your next marathon during your several months of training. Your body adapts to exposures, and if sugar is constantly accessible, it will not learn how to burn fat.  You also want to convert your fast twitch fibers to make them as “red” (oxidative) as possible.  Easy and moderate effort long runs of 2-hours in a fasted state will drain the slow twitch fibers (“red” fibers) of glycogen and force more capillarization of the fast twitch (mix “white”/”red”)  fibers, making them more “red.”

You are doing speed work by running slow with this method, making the powerful fast twitch fibers aerobic.  Distance runners in events from 800 meters to marathons, through generations, have trained this way.  This is part of the Lydiard method and validated by the life work of Dr. Stephen Siler. Only recently have we been convinced by industry that we need lots of sugar before and during long runs.  Race day is different as you are going for performance, not creating adaptations.

So how do you know you are running in your best hybrid mode?

This is difficult, because the body sense at this level (Aerobic Threshold-AeT) is not as profound as Lactate Threshold (or Anaerobic Threshold- AT).  A slight increase from your AeT pace will switch you from hybrid to all gas without you realizing it. The effects are felt miles later. Charging and surging early will tap your gas quickly.  If you want to speed up early….DON’T. Relax and maintain a comfortable effort, not always a specific speed.  You should feel easy in the early stages, it is a marathon.

You must rehearse in training.  I focus on relaxation and belly breathing.  If I’m breathing one cycle to 5 steps, then I’m hybrid.  If I’m breathing faster, I’m using mostly sugar as fuel.  Belly breathe by allowing the lower belly to blow up like a beach ball on inhalation as your powerful diaphragm contracts.  You will fill the lower lung areas where oxygen exchange occurs. Notice the breathing efforts of those around you. Many are rapid breathing. They will suffer somewhere past half way.  Practice nasal breathing, it forces belly breathing and prevents you from running in too high of a gear.  Nasal breathing also allows CO2 to rise naturally to assist in offloading the oxygen to the tissues.  Blowing off CO2 binds the oxygen to the hemoglobin, inhibiting offload to the tissues.

In a marathon, the last 3-4 miles you will be using mostly gas to maintain the same speed as fatigue sets in and your heart rate rises.  The breathing is usually on 3 to 4 steps per breath cycle, and that is OK.  Still stay relaxed and use the cues that you have rehearsed to keep your form.

Find a nice rhythm. Races are filled with excitement and distractions.  Try not to get distracted and find peace in the moment.  The art of a marathon is to relax and to be in the moment. Smile and enjoy the route.  Land softly, especially on the early downhills.  Focus on good form. Land soft and springy with good “impact moderating behavior” harnessing elastic recoil. Gently landing on and rolling from the heel can work as can mid-foot/forefoot.  Mix it up. Do not over-stride with fully extended leg. Focus on posture and hip extension. Your trunk will lean forward slightly.  Think “face forward” and look ahead. Run over the ground not into the ground

Remember, your brain is the captain of the ship and will always try to protect you.  Even at “all on” we are only really using 50-60% of our capacity.  The brain likes homeostasis and running 26.2 miles is counter to this.  Assuming you are medically healthy, you can play some tricks to outwit your brain, which is constantly telling you to slow down or stop.  Work around the bad patches with your mind and find a better mental place.  You are not “done.”  Shift your stride, take something at the aid station, run mile to mile, sing a song, relax and slow the breathing.  You want to be “parasympathetic” (rest and digest).  This is happy land.  If your brain tells you the body is in peril, “sympathetic” (fight or flight) stress kicks in.  This is good for running from a wild animal (a sprint), but not for persistence hunting (a marathon).

Have a course specific plan for your race. My best learning experiences were when the men and women started together, and I had the privilege of running alongside and witnessing the patient approach and incredibly efficient running of the top ladies.

In 2001, I witnessed multiple world champion and Boston winner Catherine Ndereba employ a relaxed strategy.  Her light springy stride and complete relaxation of effort contrasted with the other ladies in the pack whose body language and breathing displayed that they were putting out more energy than Katherine.  As a group, we hit the half marathon in 1:14. Catherine kept relaxed down the long downhill at mile 16, then tightened the screws with a huge acceleration over the Newton hills, running 50 minutes the last 10 miles for a 2:24.  Catherine helped my day.  By cueing off her pacing and relaxation, I ran an even race and finished in 2:29.

The other runner who taught me to have fun out there was the legendary 3-time Boston winner Uta Pippig of Germany.  In 2002, I ran with her until she dropped me at Cleveland Circle (mile 22).  The crowds loved Uta, and the noise escalated as she approached.  She smiled the whole way.  Maybe this was her cue to relax, feed off the crowd’s energy, and have fun in the moment. In marathoning, you must be present in the moment; not thinking about how far you have to go; what you may feel like later; wondering if you are going to slow down; fearing the wall is coming.  Uta ran a strong fourth place that day in 2:28 and I finished a few strides back in 2:29. She is an example of how our brains govern our effort. When we are positive it flows.

These ladies made sure to get their fluid and nutrition at all stops. The few extra seconds used here paid dividends down the road.  They ran over the road not into the road, especially on the downhill. Their posture was tall and their arms always relaxed.  But most vital was their overall efficient energy conservation and utilization strategy.

Be sure to save energy for the later stages of the race; this is where things can get tough.  Remember, if you feel really good in the early stages, and feel like you want to speed up, DON’T.  It is a marathon, and you should feel good in the early miles.  Don’t take the bait. Charge when you can “smell the barn,.” This occurs when you see the Citgo sign (comes into view at Mile 23).

Now a few extra ways to get from start to finish quicker on the same gallon:

  • Do not sabotage your event by having a large carbohydrate heavy breakfast the morning of the race.  This will increase your insulin levels and lock out the ability to burn fat.  Fill your glycogen stores by eating adequate amounts of healthy carbohydrates the 3 days prior and not running those three days before the event. 
  • Make sure to get fat and protein, too. Do not “overload,” you can only store a specific amount.  A light breakfast of a mix of carb/fat/protein is a good thing, as well as your morning coffee if you are a coffee drinker. Personally, I am insulin resistant with age so I do not carbo-load and prefer the slow release super starch UCAN the morning of events and on courses where I can leave a bottle or two.  I have adapted to using primarily fat as fuel and want to do this during the race.
  • If you can add a little gas along the way this helps both glucose and fat burning.  Adding just a little is best.  If running too fast or if is temperatures are high, you shunt blood to working muscles and to the skin to cool, and the blood diverts from the gut, so nothing digests.  Plus, you are burning quickly through the glucose/gas.  If you are in hybrid mode in the early going of the race, you can continually add some fuel. The key is not only the correct fuel, but the right pace. Just a little sugar every 30-minutes is easy to digest and can help keep you fat burning till the final miles. Drink mostly water instead of the energy drinks, which are often less predictable on the run and can spike your insulin and sugar excessively.
  • The early downhills are fun, but if run too hard, they can drain your gas quickly and damage your quads.  Go smooth and easy down them. Allow gravity to assist you down. Do not overstride with hard heel hit on the down hills.
  • Maintain effort on uphills.  Your pace will slow, and you can easily use all your gas here if your effort increases.  Shorten your stride, relax, and use your arms.  Relax and recover on the downhills.  Save something for this section of the race!
  • If you are having a “bad patch,” try to refocus on relaxing, fuel a bit (sometimes a blood glucose drop triggers the sense of doom), and have faith in your training and race plan.  Another nice trick is when you hit mile 21 it is not 5 miles to go, it is 4 and change. Mile 22 is 3 and change to go.  Just run to the next mile marker and count them down one by one. Smile and enjoy the crowds.
  • If it is windy get behind a group.  This can save lots of physical and mental energy.
  • Do not over drink water. This can lead to the dangerous condition called hyponatremia.
  • A final tip comes from 4-time Olympic Trials qualifier Josh Cox, who spoke with me before the Air Force Marathon a few years ago.  The night before the race make “the invisible man.”  Get everything you are going to wear/use the next day set up and ready to put on in the morning.  Scrambling to find your number, socks, favorite hat, gels or other item adds stress.  Get the outfit laid out on the floor, ready to wear. Then get some sleep.

The fun of the marathon is that we are always learning and enjoying the adventure of it.  I’ve done over 100 marathons and Ultras over the last 29 years.  We learn from experience, taking chances, and occasional failures.   Train to race efficiently and economically in the marathon, but know there are still uncertainties every time you line up.  I learn something new every time. So, relax, taper, and seize the day.

Good luck to all of you, and see you at the start and the finish!

This article first appeared March 26 on Natural Running Center.

Mark's principles of sustainable running and nutrition are explored more in the recent podcast.  Listen to it now.

Dr. Mark Cucuzella is a Family Physician at Harpers Ferry Family Medicine and Associate Professor at West Virginia University School of Medicine. As a Lieutenant Colonel in the Air Force Reserves, he is coach and captain of their marathon team and designing programs to reduce running injuries in military personnel. He is the chief medical consultant for the Air Force Marathon ( His passion for health extends beyond the walls of the clinic into the medical home’s “backyard”- the trails and open space that create the arena for optimum wellness.

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