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Image: Runners cross the Verrazano-Narrows Bridge during the New York Marathon
Lucas Jackson  /  Reuters
Runners cross the Verrazano-Narrows Bridge during the New York Marathon November 7, 2010.
TODAY contributor
updated 11/4/2011 9:04:16 AM ET 2011-11-04T13:04:16

In 1996, Uta Pippig became the first woman to win the Boston Marathon three times in a row. This historic accomplishment seems even more remarkable when you consider that she reportedly crossed the finish line with menstrual blood and diarrhea dripping down her legs — and live television cameras rolling.

As Pippig recalls, "I started having stomach cramps about 5 miles into the race, and shortly after I had diarrhea. I was self-conscious [about it] not only for me — but in a caring way for our sport."

She considered dropping out 7 or 8 miles in and even walked a little. Although uncomfortable, her focus shifted from winning the race to staying in it and running as well as she could in this situation.

Later in the marathon, she admits "I was frightened when I felt blood flowing down my legs." That red trickle was widely attributed to menstrual problems, which Pippig says was a misconception. After winning the race, she was diagnosed with "ischemic colitis," or inflammatory bowel disease.

While Pippig's bodily woes that day became famous, she admits that "any time this would happen today, even most likely in a leading position, I would stop running." She realizes that her body was talking to her. "It was a signal, and now it's clear I was ill."

As more than 47,000 runners toe the line for this Sunday's ING New York City Marathon — and push themselves through a challenging 26.2 mile test of their physical endurance and mental muscle — a few strange things could happen to their bodies along the way.

The most common injuries seen are blisters and muscle strains and pulls from overuse, says Lewis Maharam, MD, a sports medicine specialist who was the medical director for the New York City Marathon for 15 years. While he wouldn't call the following health woes "weird" or "strange," he prefers to think of many of them as specific to running and less common than in other sports.

Runner's trots. During or after a long run, your GI system may also get the runs. It can start as stomach cramps or gassiness, and progress to a desperate need to poo. It's likely caused by eating improperly, says Maharam, and not due to race-day excitement.
The fix? Avoid high-fat foods before a race, advises Maharam, and eat the same way as you trained. "Go to the bathroom twice at the start to clean yourself out," he suggests.

Hyponatremia. Some marathoners worry about drinking too little water during a race, but drinking too much of it during a time when you're sweating a lot may cause a dangerously low concentration of sodium in the blood. Ironically, hyponatremia has some similar symptoms to dehydration, such as dizziness and nausea. Slower runners and women because of their smaller body size are at greater risk.
The fix? Simple: Drink only when thirsty, suggests Maharam, the author of the "Running Doc's Guide to Healthy Running."

Chafing and bloody nipples. Sweat, movement and clothing seams can rub your skin raw in some odd places. It can irritate the armpits, inner thighs, ankles, and in women, along the lines of a sports bra. Men's nipples may chafe and bleed.
The fix? Lubricate these tender areas with vaseline or Bodyglide. Men can use NipGuards, duct tape, or waterproof band-aids to protect their nipples. "Avoid wearing new clothing on race day," Maharam recommends.

Blackened toenails. Snug running shoes can make your toenail hit the end or top of the shoe, causing blood to pool underneath the nail. Sometimes painful, the nail will eventually grow out or fall off.
The fix?Properly fitting shoes, suggests Maharam. "You need a thumbnail distance between the longest toe and the end of the shoe."

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Hitting the wall. When your body runs out of carbs, marathoners run out of gas. "Bonking" happens when your body turns to its fat stores for energy, a less efficient fuel.  Your legs feel like lead, you're completely wiped out, and you're forced to slow down.
The fix?"There's no reason to hit the wall," says Maharam, if you include plenty of carbs in your diet while training.

Despite these quirky health hazards, Maharam says that running a marathon is good for body and mind. And that's one reason runners keep striding toward the finish line — exhausted but exhilarated about completing the race.

Pippig, the 1993 New York City Marathon women's champion, offers participants this piece of advice: "Whenever you feel any discomfort besides the usual fatigue connected with marathon running, please stop running and take care of yourself. Keep the race in perspective; your health is most important."

Runners: Tell us your tried-and-true tips to avoid these health complaints over on our Facebook page.

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