If you’re one of the 40, 000 runners in the London Marathon, or any of the other marathon’s around the country, you don’t need us to tell you how hard you will have trained for the past months. By now, you’ll likely have spent hundreds of hours pounding the pavements in preparation for the colossal feat of running the 26.2 miles. The amount of work you put in is phenomenal, especially considering so much of it is in aid of raising money for charity.

We want you to have the best possible experience on the day. The following tips will help you be prepared for any eventuality come marathon day.

Correct clothing for the weather:

2018 saw a record high temperature for the day of the marathon and the weather does make a difference. Dress for comfort, temperature and prevention of friction injuries (such as chafing). Make sure you’ve run a long distance in the kit you wear on the day, so that you know it’s comfortable. Reject any clothes with seams that could cause friction burns. Be careful how you pin your number to your chest too.

Remember, although whilst you’re running, you’ll be warm, as soon as you stop, you’ll cool right down. This is where the proffered foil blanket as you cross the finish line becomes necessary.  Ensure someone has warm clothes at the finish line for you and wrap up as soon as you can.

Fancy dress:

Consider very carefully if you are planning to wear fancy dress and ensure you don’t overstress yourself. It may seem like a good idea to run the whole route dressed as a unicorn, a giant toilet or the back half of a pantomime horse – but you may regret it after a few miles.  It can be hot, uncomfortable and after a while, your costume may become a seriously heavy burden.  You could ask someone part way round the route to be prepared to take some of your outfit if it gets to be too much.  Make sure that you have suitable running kit underneath, if you’re considering this though!


Avoid buying new trainers immediately before marathon day – your feet must be comfortable and familiar with the shoes. Also make sure that the socks you choose are comfortable and fit well. If there is rain forecast, ensure your shoes have sufficient grip.

Nipple bleeding and chafing:

If you are prone to chafing apply petroleum jelly or anti chafing talc and it may be helpful to cover your nipples with plasters. If your nipples bleed when training; wash and dry them carefully and then cover with a breathable plaster.  Sometimes, nipple bleeding may be due to more serious problems. If in doubt, consult your doctor.


If you get a blister and the skin is still intact, do not be tempted to pop it.  Cover with a proper blister plaster and ensure there are no wrinkles in socks that are contributing to the rubbing.

If the blister is broken or likely to break; cover with a clean, dry, non-adhesive dressing that extends well beyond the edges of the blister. Alternatively apply a blister plaster.

To avoid blisters, ensure you are wearing shoes that are worn in and comfortable. If you need any plasters or help during the race, stop at one of the many first aid points – they should have plasters available.

What to eat:

Eating high carbohydrate foods like wholegrain bread, rice, pasta, cereal and potatoes the day before will help you to keep going through the marathon day. On the morning of the race, choose another slow-burning food that you have eaten before similar length training runs. Examples are porridge, bagels or toast and peanut butter.

It is important to never try anything new immediately prior to the actual marathon. Stick to what you have already eaten before long runs, as your body will be familiar with processing these foods.

During the race, it’s a good idea to have something sweet at regular intervals. Organisers and the crowd will have plenty to hand you all along the route. If you bring your own, jelly babies are a good option to go for. Plan to have one per mile, or similar.

What to drink:

You need to drink sufficient amounts of fluid to stay hydrated. However, drinking too much or too fast can cause hyponatraemia and make you seriously ill. Initial symptoms of hyponatraemia are similar to dehydration, but this lack of sodium and salt imbalance can cause seizures or a coma. In fact, consuming too much water too fast is one of the most dangerous things a marathon runner can do, especially just before running. Instead, take small amounts of fluid (that will be offered to you) throughout the race.

Sports drinks are thought to be better than pure water for runs longer than an hour, as they help you to maintain your salt balance. Lucozade sport (orange) and water are usually available for runners during the race. Drink small amounts of these regularly during your run, but avoid drinking for 45 minutes prior to the race. Many people advise to drink a gel within the first few miles. If you drink these once you are struggling, it may make you feel sick.


Cramp is a common problem caused by the build-up of lactic acid in the muscles, but this can be avoided by maintaining sufficient levels of salts and fluids and remaining well hydrated. Drink sports drinks during the race and include salt in your normal diet a few days prior to the race.

If you have diabetes:

If you’re diabetic, watch out for excessive sweating, confusion, drowsiness or faintness as these can indicate hypoglycaemia. It is especially important that diabetics consume something sweet at regular intervals to maintain blood sugar levels.

The importance of a warm up/cool down:

Take time to warm up and stretch thoroughly before the race and don’t forget to cool down too, with further stretches when you have finished. You are likely to get cold quickly after the race, so accept the foil blanket offered at the finish line, as this will help you to retain your body heat.

Heat exhaustion:

The weather at this time of year is unpredictable and it could be boiling hot – or snowing!  If it’s a hot day and you begin to feel sick, get a headache or cramps, feel dizzy and sweaty; you may be suffering heat exhaustion.  Heat exhaustion is serious, so it is important that you get help as soon as possible. If you are training, lie down in a shady spot with your legs raised, take regular sips of a sports drink and ideally call someone to come and be with you and get medical advice.

If you are running the marathon and develop the symptoms of heat exhaustion, listen to your body and rest for a while. Get checked out by the medical support who are available all the way along the route and only resume with their say so.

Knee joint injuries:

If you injure your knee; lie down carefully supporting your knee in a relaxed raised position. Do not try to walk on your injured leg or straighten your knee.

Don’t eat or drink anything in case you need an anaesthetic and seek medical attention quickly.

Sprained ankle:

As with knee joint injuries, don’t be tempted to try and continue to weight-bear on an injured ankle. Listen to your body and seek help from the first-aiders there. Rest, apply a wrapped ice pack and let someone assess the injury properly before moving.

The night before

After a carbohydrate focused meal, relax with a film or any other activity that involves putting your feet up. Relax the mind as well as the body, as pre-run nerves could strike. Remind yourself that the marathon should be fun, and that the most important thing throughout is staying safe.

At the finish

In advance of the marathon, designate an area for you to meet your supporters. The finishing area can be overwhelming with 40,000 runners and their supporters attempting to find each other in the crowds.

Make sure you have someone to hand you some extra layers and snacks at the finish line and to help get you home safely. It may be hard for you to navigate the city and transport links alone so it is crucial to have backup. Taxis and ubers are likely to be particularly busy.

There are plenty of first aid points if you think medical help is necessary. Don’t hesitate to ask their advice if you have any concerns.

Staying fit and healthy is the most important thing – but enjoy every moment of this fantastic day and be incredibly proud of yourself.  Well done for putting in so much effort and a huge thank you to all those runners who have raised money for extremely worthwhile causes. Well done to the sacrifices made by the runner’s supporters too.

For an article on London Marathon advice for spectators, click here.

Written by Emma Hammett.

First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a First Aid course to understand what to do in a medical emergency.

Email: emma@firstaidforlife.org.uk or telephone 020 8675 4036 for more information.
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