All runners are not created equal. There are those who think running a marathon might be fun, maybe something to check off their bucket lists. They train once or twice a week, and as the race gets closer they kick it up a notch in the hopes of making it to the finish line. Then there are the ones who train daily. To these people, a marathon is just a walk in the park.

However, every runner in the field of participants at the 2019 VCU Health Richmond Marathon on Nov. 16 has one thing in common: They all will be met at the finish line by Mary Caldwell, D.O., assistant professor for VCU Physical Medicine and Rehabilitation and Sports Medicine.

Caldwell wants to ensure that every runner finishes the race in good health.

“I just want the runner to be happy, [to] help runners of all different ages, of all different abilities, get you where you want to go so you can enjoy the day,” Caldwell said.

As a former Division I NCAA collegiate middle distance runner for Lafayette College, Caldwell understands the runner mentality. Suffering from multiple stress fractures throughout her track career, she wanted to make sure it did not happen to other women. It became a driving factor in her choice to become a sports medicine professional. 

But Caldwell’s greatest challenge came in 2017 when she contracted Guillain-Barre Syndrome, a virus that causes loss of sensation and muscle weakness. After two years of intense therapy and rehab, she is finally able to continue her work and go back to the running she enjoys in her spare time.

She also has worked with multiple professional teams, including the Washington Wizards, Washington Mystics and the Washington Spirit, as well as the Joffrey Ballet. In addition to covering the Richmond Marathon, she has served on the health teams of several other marathons, including the Chicago Marathon and the Baltimore Running Festival. 

According to Caldwell, those in the beginning stages of training have significantly different needs than seasoned runners. For new runners, she places an emphasis on maintaining a proper diet for the calories burned while training and paying attention to anything causing pain that does not go away as training progresses. Caldwell points out that it is critically important not to ignore the warning signs behind pain. 

She has treated the many muscular and bony injuries prior to and after the marathon, but the injuries for a runner that concern her the most are heart and heat-related injuries that can occur during the marathon.  

Symptoms of heat-related injuries include cool, moist skin with goosebumps when in the heat, heavy sweating, faintness, dizziness, fatigue and weak, rapid pulse. This occurs most often in persons who have not trained appropriately for the marathon.

“I have seen cardiac arrest at the finish line two or three times,” Caldwell said. “I have seen a heat injury. [The runner] was seizing. We had to cool him. Reacting in those kinds of situations is what changes and saves a life.” 

To prevent injury, no matter what caliber runner, Caldwell offers some tips to remember while training or racing. Paying attention to things such as feeling tired when exercising, getting chest pains or palpitations, feeling overworked, and understanding any family history of cardiac problems or heat-related injuries are key to staying safe.

Why does Caldwell love the Richmond Marathon?

“I love our runners,” she said. “I think they are some of the most motivated group of runners — everyone is super positive.” 

Another aspect of the race that Caldwell enjoys is working with the medical team ready to treat any injuries that may happen during the day. 

“I love the team commitment between us and the emergency room students,” she said. “We work really closely with Dr. Jeff Ferguson [associate professor of emergency medicine] and his team to make sure that we are prepared for emergency situations.”

This year is the 42nd running of the Richmond Marathon. In addition to the 26.2-mile run, other races include the Allianz Partners 8K and the Markel Richmond Half Marathon. For more information on the 2019 VCU Health Richmond Marathon, visit https://www.richmondmarathon.org/.