The Science of Endurance
While standing at Mile 24 during the New York City Marathon, Michele Monaco, DSc., associate professor of Exercise Science at Immaculata University, was experiencing “endurance medicine” up-close and personal.
Within six months, Monaco had volunteered for four marathons–not to participate as an athlete, but to help the athletes during the marathon. Last October, a friend asked Monaco to volunteer with the finish line medical team at the Chicago Marathon. Soon thereafter, she found herself at the New York City Marathon and the Philadelphia Marathon, accompanied by three athletic training students from Immaculata University. Then came the nation’s oldest and most prestigious marathon in Boston. Monaco witnessed history when the first woman who tried to run in the Boston Marathon 50 years earlier (when women were not allowed), ran the marathon again at age 70.
“Endurance athletes are unique beasts,” Monaco explains with a grin. Having run half and full marathons herself, Monaco understands the tenacity required for endurance athletes. “I know the mental status of these athletes: first-timers tend to push through anything and everything.” But she asks, how much can you put your body through?
With a headset connected to Central Command during the Chicago Marathon, Monaco and the medical staff were alerted when a runner was flagged. While running a marathon, athletes typically encounter acute injuries such as dehydration, blisters, or hurt knees. However, there are also times when a runner needs treatment at the ICU. Although the average person would not suspect such an immense operation, the volunteers were capable of servicing anything from every-day scrapes and podiatry issues to people with cardiac problems or chest pain. In Boston, three medical tents provided support, including the Heat Illness Deck, utilized specifically for heat exhaustion and heat stroke.
As a professional who treats athletes on sports teams, helping people of all ranges and abilities cross the finish line was extremely satisfying, both personally and professionally for Monaco. In addition, she is gaining familiarity with an exclusive component of her profession, and she is working with some of the best medical directors in the country.
Another thing that Monaco has gained from her marathon experiences is the ability to remain calm even when exposed to intense injuries. “During her career, she has treated a variety of sports injuries, including cervical and spine injuries but, she admits, she has never had to deal with such extensive, potential life-threatening injuries in one day.
Monaco recalls the woman that she treated at Mile 24 in New York. “You’re two miles from the finish line so you don’t necessarily want to pull them [from the race].…you want to encourage them.” However, it was Monaco’s duty to evaluate. It was at Mile 24 in Central Park where she encountered a woman with high-core body temperature, which is life-threatening as it could become heat stroke. This woman also had collapsed veins, so putting in an IV to get fluids into the patient was very challenging—and she spoke French! With the onset of heatstroke, the woman was cognitively disoriented so Monaco found it difficult to garner her medical history. To make matters worse, the only emergency contact information was a French number. By staying calm and attending to the needs of the patient, Monaco was able to help.
Less than a month later, Monaco found herself alongside Immaculata students, Kenny Anderson ’17, Annemarie Bartow ’18 and Joe Sullivan ’17, at the Philadelphia Marathon where no athletic training students had ever volunteered. The students were with Monaco at the finish line and through her instruction, helped the runners to continue past the finish line so their bodies had time to transition from a running motion. With the food tent closer to the finish line than the medical tent, Monaco and the students discovered that many athletes had bypassed the medical tent to grab food first and then began to cramp up inside the food tent. Monaco requested medical assistance there instead.
For the size and scope of the Philadelphia Marathon, Monaco noticed that there was not a large medical staff. Operating her own athletic training consulting services, serving as secretary of the Eastern Athletic Trainers’ Association, and with the experience she gleaned from the NY and Chicago marathons, Monaco felt she might be able to enhance the Philadelphia event. She sent the officials from the Philadelphia Parks and Recreation [who run the Marathon] a proposal to oversee the education of the Philadelphia Marathon medical team. After attending the extensive mandatory medical training for the Chicago, New York and Boston marathons that included physical training and a session with Homeland Security, she envisioned a more structured training policy for Philadelphia. She also offered to provide training and credentialing for volunteers and to create an organizational chart for the volunteers. Also included in the proposal was how to utilize students and conduct triage. Monaco is waiting to hear back from representatives from the Parks and Recreations regarding her proposal.
In the meantime, she has taken on an expanded role within the Chicago Marathon and will oversee a medical group next time. She is also considering volunteering for the Iron Man competition in Arizona and is continuing her research on sports-related concussions while teaching full-time and raising teenagers.
Realizing there is a term for endurance athlete, there must certainly be a term for endurance professors.