Sports injuries
Introduction
Playing sport and doing regular exercise is good for your health, but sometimes you can injure yourself.
Sports injuries can be caused by:
- not warming up properly before exercising
- using inadequate equipment
- pushing yourself too hard
- an accident
Types of sports injury
Some common types of sports injuries include:
- blisters
- bruises
- cuts
- minor head injuries
- sprains and strains
- swelling of a tendon (the medical term for this is tendonitis)
Less common but more serious types of sports injuries include:
For a more comprehensive list of sports injuries, including symptoms, see Symptoms of sports injuries.
Your doctor may refer to sports injuries as:
- a sudden injury – where damage happens as a result of a sudden impact or an awkward movement
- an overuse injury – where an injury occurs over time due to overusing certain parts of the body
Children are most at risk of developing an overuse injury. This is because their bodies are still growing, which can make their bones, muscles and joints unstable and more vulnerable to damage.
To find out which injuries are common to particular sports, see Causes of sports injuries.
What to do if you have an injury
Stop exercising if you feel pain, regardless of whether your sports injury happened suddenly or you’ve had the pain for a while.
If a particular movement or activity hurts, stop doing it and get medical help. Continuing to exercise while you're injured may cause further damage and slow your recovery time.
If you get a severe injury while doing a sporting activity, such as a deep cut or concussion from a blow to the head, go to your nearest accident and emergency (A&E) department.
If the injury does not require immediate medical attention but causes severe pain, swelling or numbness, or if you cannot place any weight on the affected area, go to your GP or local NHS walk-in centre.
Treating sports injuries
Most minor sports injuries can be treated using self-care techniques, such as:
- resting the affected body part
- using over-the-counter painkillers, such as ibuprofen, to relieve symptoms of pain and swelling
More serious sports injuries, such as a broken bone or severely damaged cartilage, may require surgery to help repair the injury.
Find out more about treating sports injuries.
Preventing sports injuries
Not all sports injuries can be prevented, but you can reduce your risk of getting injured by:
- warming up properly before you exercise
- not pushing your body beyond your current fitness level
- using recommended safety equipment for specific sports, such as shin guards for football or a gum shield for rugby
If you start doing a new sport or activity, get advice and training from a qualified healthcare professional or sports coach. See fitness and training tips for more advice.
Symptoms of sports injuries
Which parts of the body do sports injuries affect?
Most sports injuries affect the parts of your body that are involved in physical activity. These include:
- muscles
- bones
- ligaments – thick bands of tissue that connect one bone to another
- joints – the points at which two or more bones make contact (the hips, elbows, ankles and knees are some of the most important joints)
- cartilage – tough, flexible tissue that covers the surface of joints and allows bones to slide over one another
- tendons – tough, rubbery cords that link muscles to bones
Minor injuries
Sprains and strains
A sprain is where one or more of your ligaments is stretched, twisted or torn. Sprains often occur in the ligaments around the joints of the ankle or knee. The joint is not dislocated or fractured.
The symptoms of a sprain include:
- pain
- swelling and redness
- bruising
- restricted movement in the affected area
The most common places for a sprain to occur are:
- the knee – which can be sprained if you turn quickly during sports or other physical activities
- the ankle – which can be sprained when walking or running on an uneven surface
- the wrist – which can be sprained if you fall onto your hand
- the thumb – which can be sprained during intense and repetitive activity, such as playing a racquet sport
A muscle strain is where muscle tissues or fibres are stretched or torn. It is sometimes referred to as "pulling a muscle". Strains occur when a muscle is either overstretched or pulled in too much.
Symptoms of a strain include:
- pain
- muscle spasm
- a loss of strength in the muscle
Strains commonly occur in many sports, particularly those that involve running, jumping or rapid changes of direction, such as football. The most common types of strains are:
- hamstring strains – the hamstrings muscles run down the back of the leg and are connected to the hip and knee joints
- calf strains – the calf muscles are at the back of the lower leg
- quadriceps strains – the quadriceps are three large muscles at the front of the thigh
- lumbar strains – the lumbar muscles are in the lower back
Find out more about sprains and strains.
Cuts
Cuts are usually minor injuries which heal quickly on their own and do not need treatment.
Treatment for a cut is usually only required if the cut is deep or has damaged body parts beneath the skin, such as nerves, blood vessels or tendons.
Bruises
Bruises are bluish or purple-coloured patches that appear on the skin when tiny blood vessels, called capillaries, break or burst underneath it.
Bruises can be very painful at first, but they are not usually a serious threat to your health.
For more information, see What is a bruise?
Blisters
Blisters are small, fluid-filled swellings that form in the upper layers of skin. Fluid collects under the damaged layer of skin, cushioning the tissue underneath and protecting it from further damage.
Blisters are a common type of minor injury caused by friction on soft skin. They're common in long-distance runners and rowers.
Minor head injuries
A minor head injury often causes a bump or bruise on the head. Other symptoms may include:
- feeling sick
- mild headache
- tender bruising or mild swelling of the scalp
- mild dizziness
Mild knocks to the head don’t usually need to be treated. However, go to your nearest accident and emergency (A&E) department if you have concussion.
Symptoms of concussion include:
- brief loss of consciousness
- memory loss
- vision disturbances, such as "seeing stars"
- confusion
Most people with concussion make a full recovery.
Heel pain
Heel pain can happen when the thick band of tissue that runs under the sole of the foot becomes damaged.
The medical name for this type of injury is plantar fasciitis. It can cause a sharp and often severe pain when you place weight on your heel. In most cases, only one heel is affected, although it is thought that up to a third of people have pain in both heels.
Heel pain is common in runners and joggers.
Tennis elbow
Tennis elbow is a painful condition that affects the outside of the elbow. It is caused by strenuous overuse of the muscles and tendons of the forearm and around the elbow joint.
The symptoms of tennis elbow include:
- swelling around the outer edge of the elbow (due to the tendon being inflamed)
- tenderness around the elbow
- pain when moving the elbow
Tennis elbow is caused by repetitive movement of the muscles in the lower arm. Despite its name, tennis elbow also affects people who take part in sports other than tennis, such as cricket and swimming.
Golfer’s elbow
Golfer’s elbow has similar symptoms to tennis elbow. However, due to the difference in arm movement in golf, the swelling occurs on the inside of the elbow rather than on the outside.
Tendonitis
Tendonitis is inflammation of a tendon. Symptoms of tendonitis include:
- swelling, redness and pain in the injured area
- restricted movement of the affected area
- sometimes a change in appearance of the affected area, such as a lump or a visible change in the position of a limb
Tendonitis is a fairly common injury that can be caused by a strain or tear in tendons around the:
- shoulder
- elbow
- wrist
- finger
- thigh
- knee
- back of the heel
Older people who start exercising after being inactive for a long time are particularly at risk of tendonitis. This is because their tendons cannot cope with the sudden extra pressure that's placed on them.
Sore shins
Sore shins, sometimes known as shin splints, cause pain along the shin bone. The shin bone runs down the front of the lower leg between your knee and ankle.
Sore shins are caused by swelling and tiny fractures in the surface of the bone. The main symptoms of sore shins are aching, throbbing or tenderness along the inside of the shin, which sometimes travels to the outside of the shin.
Sore shins are common in any sport that involves running and are often caused by doing too much training too soon. They can also be caused by running on hard surfaces or by running in shoes that do not give enough foot and ankle support.
Knee pain (runner’s knee)
Runner’s knee is one of the most common types of knee injury. It develops when the cartilage underneath the kneecap softens or wears away, causing swelling at the back of the kneecap.
If you have runner’s knee, you will have soreness and discomfort beneath or to one side of your kneecap. It can also cause a grating sensation in your knee. Runner’s knee is caused by the repeated impact of running on hard surfaces.
Stress fractures
Stress fractures are tiny cracks that develop in a bone as a result of repeated stresses and strains. The two most common symptoms of a stress fracture are pain and swelling in the affected body part. Most stress fractures will heal on their, as long as you rest the affected body part.
Bursitis
Bursitis is inflammation of a bursa, which is a small fluid-filled sac underneath the skin, usually found over the joints and between tendons and bones.
Symptoms of bursitis include:
- pain – often a dull ache in the affected body part that is made worse by movement or pressure
- tenderness in the affected body part
- swelling of the affected body part
- loss of movement in the affected body part
The areas where bursitis most commonly occurs are the:
- shoulder
- elbow
- ankle
- knee
- hip
- thigh
Cartilage damage
The symptoms of articular cartilage damage include:
- swelling
- joint pain
- stiffness
- a decreased range of movement in the affected joint
If the damage is particularly severe, a piece of cartilage can break off and become loose. If this happens, the loose piece of cartilage may affect the movement of your joint. This can cause a feeling of the joint locking or catching. Sometimes, the joint may also give way.
The knee joint is the most common location for cartilage damage to occur. In some cases of knee joint damage, bleeding can occur inside the knee joint.
Most cases of cartilage damage are not particularly serious. However, it can be frustrating to live with because it often takes quite a long time for the cartilage to regain its normal functions.
More serious injuries
Broken bones
Symptoms of a broken bone include:
- pain and swelling
- bruising or discoloured skin around the bone or joint
- the limb or affected part of the body being bent at an unusual angle
- inability to move or put weight on the injured limb or body part
The pain that is associated with a broken bone can often be severe and can make you feel faint, dizzy and sick.
Severe head injuries
A severe head injury can cause a wide range of symptoms such as:
- unconsciousness, either very briefly or for a longer period of time
- difficulty staying awake or still being sleepy several hours after the injury
- a seizure or fit, when your body suddenly moves uncontrollably
- difficulty speaking, such as slurred speech
- vision problems or double vision
- difficulty understanding what people say
If you think someone has a severe head injury, take them immediately to the accident and emergency (A&E) department of your nearest hospital, or call 999 and ask for an ambulance.
Ligament damage
The most common type of ligament damage is a torn anterior cruciate ligament (ACL). The ACL is one of four ligaments in your knee. It can be torn if you suddenly stop or change direction, or if you land incorrectly from a jump. If you tear your ACL, you may hear a pop or crack at the time of your injury.
An ACL tear is a fairly common sports injury, and around 20% of all sports-related knee injuries involve the ACL. The symptoms of a torn ACL include:
- severe pain in your knee
- instability in your knee, which means you cannot put much weight on it
- swelling in your knee
- not having the full range of movement in your knee and, in particular, not being able to straighten your leg
Depending on the severity of your ACL tear, you may need to have reconstructive surgery to repair it.
Causes of sports injuries
Most sports injuries are avoidable and are often the result of:
- not warming up properly
- poor technique
- not using equipment correctly
- not taking the proper safety precautions for your sport
- overestimating your levels of fitness, strength and endurance
Sudden sports injuries, including cuts and sprains, are usually caused by accidents, such as a sudden impact or an awkward movement. These types of spontaneous injury can be difficult to avoid. However, you can minimise the damage that a sudden injury can cause by wearing appropriate safety equipment, such as a helmet while skiing or snowboarding or shin pads while playing football.
Competitive athletes, such as sprinters, long-distance runners and rugby players, have a high risk of overuse injuries due to the intense nature of their training and the overuse of specific muscle groups.
Children are also at risk of overuse injuries because they are still developing physically. For example, the female shape changes significantly during puberty (usually between 10 and 16 years of age). As the hips widen, exercise can put pressure on different areas of the legs and feet, which can sometimes lead to injury.
Sport-specific injuries
The repetitive and aggressive movements used in many sports can cause several types of injury to different parts of the body. Below are injuries that are specific to some common sports.
Cricket
All cricketers are vulnerable to straining their hamstrings. This is because during a match a player often stands still for a long time before suddenly sprinting.
Bowlers are also vulnerable to straining their ankles, and fast bowlers have a particularly high risk of developing tendonitis in their shoulders. Wicketkeepers and fielders can sometimes develop back pain.
Batsmen should wear cricket helmets to reduce the risk of a severe head injury from being hit on the head with a ball.
Cycling
Common injuries that can affect cyclists include:
- runner’s knee
- cuts and bruises, which can be caused by a fall
- blisters
- heel pain
- sprains and strains
- numbness in the fingers, due to holding the handlebars for long periods
Severe head injuries are less common and more serious, and can occur if a person falls or is knocked off their bike and lands on their head.
Most leading medical and safety organisations, such as the Royal Society for the Prevention of Accidents (RoSPA) and the World Health Organisation (WHO), recommend that cyclists wear cycling helmets to protect against head injury.
Field athletics
The sudden movement and intense power required by throwers, such as shot putters and discus throwers, can cause upper-body injuries. The upper limbs, usually the shoulders, elbows and wrists, are particularly susceptible to injury.
Jumping events, such as the long jump and triple jump, can cause stress fractures to the lower limbs and spine. Competitive athletes who participate in jumping events are at risk of developing overuse injuries, such as tendonitis and torn ligaments.
Football
People who play football at all levels have an increased risk of minor sports injuries, such as cuts, bruises, minor head injuries and sore shins.
Semi-professional and professional players are more likely to get more severe sports injuries because the physical demands of the game are more intense at advanced levels.
Injuries that are known to affect semi-professional and professional footballers include:
- hamstring injuries – which in the most serious of cases can result in a torn hamstring (older players are most at risk because the hamstring becomes less flexible over time)
- torn anterior cruciate ligaments – which can occur when a player suddenly loses balance and twists their knee into an awkward position
- broken bones – particularly in the feet and legs
A less common but more serious football-related injury is a severe head injury, which can occur when two players jump to head the ball at the same time and their heads clash together.
Golf
The most commonly reported injuries among golfers are:
- back pain
- golfer's elbow
- shoulder pain
- carpal tunnel syndrome – a condition that causes pain, numbness and a burning or tingling sensation in the hand and fingers, and is often associated with overusing the wrist
Gymnastics
Researchers in Canada found that most children who do gymnastics would be expected to have a mild to moderate painful injury for every six hours that they practice gymnastics. Most of these injuries are caused by falling or landing badly onto the floor, and they only cause short-term pain that rarely last more than a minute.
More serious injuries, such as spinal injuries, are usually only a major risk for elite gymnasts who compete at a high level.
Racquet sports
Racquet sports include badminton, tennis and squash. Injuries are often caused by players falling onto hard surfaces and include cuts, bruises and fractures.
Eye injuries are a particular risk during racquet sports such as squash, where the ball travels at high speeds. Many squash players wear protective goggles to reduce the risk of eye damage. There is also a risk of lower- and upper-body muscle strains, particularly in competitive players.
Rugby
Due to the physical and aggressive nature of rugby (both rugby league and rugby union), injuries are often more common than in other sports, although they are usually only mild to moderate.
The most commonly reported injuries in rugby players are:
- severe bruising, which can cause a collection of blood to pool in the surrounding tissues (a haematoma)
- muscle strains
- joint strains
Less common and more serious injuries include:
- broken bones
- concussion
- damage to the discs that make up the spine
Running and jogging
Common injuries that affect people who regularly run or jog include:
- heel pain
- tendonitis – particularly the Achilles tendon, which is the large tendon at the back of the ankle
- stress fractures
- sore shins
- hamstring strains
- knee pain
- bursitis
Swimming
Swimming has a relatively low risk of causing injury compared with other sports. Shoulder pain is the most commonly reported injury in swimmers. It can be caused by either poor technique or overuse of muscles, joints and bones.
Diagnosing sports injuries
Your GP will probably ask you about how your injury happened, what kind of sport caused it and the level at which you were playing.
Physical examination
Your GP will examine the affected body part and ask you to move it in all directions so that they can assess your range of movement. If your GP thinks you may have a broken bone, you'll be referred for an X-ray.
If you have significant swelling around a joint, your GP may remove some of the fluid from inside the joint to see if it is blood stained. If it is, it could indicate that you have a torn tendon or cartilage.
Arthroscopy
Sometimes a device called an arthroscope is used to look inside a joint to check for damage. This is a small, flexible tube about the size of a drinking straw. It contains fibre optics which transmit and receive light signals.
The fibre optics can act as both a light source and a camera. This allows surgeons to illuminate the joint while at the same time sending images to a video screen or an eyepiece.
This procedure is known as an arthroscopy.
An MRI scan may be recommended if your GP suspects damage to your tendons, cartilage or ligaments.
Treating sports injuries
Minor sports injuries
If your injury does not require medical treatment – for example, a mild sprain or other minor muscle or ligament damage – you can treat it at home using RICE therapy.
RICE stands for:
- Rest – avoid regular exercise and reduce your daily physical activity. Using crutches or a walking stick may help if you cannot put weight on your ankle or knee.
- Ice – apply an ice pack to the affected area for 10–30 minutes. A bag of frozen peas, or similar, will work well. Wrap the ice pack in a towel to avoid it directly touching your skin and causing ice burn.
- Compression – use elastic compression bandages to limit swelling.
- Elevation – keep the injured leg, knee, arm, elbow or wrist raised above the level of the heart. This may also help to reduce swelling.
After 48 hours of RICE therapy, stop compression and try moving the injured area. If, after this time, your symptoms are worse, seek advice from your GP.
RICE therapy can be useful for any sports injury, but some injuries may require additional treatment.
Pain relief
Painkillers, such as paracetamol, can be used along with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help ease the pain caused by sprains and fractures and help reduce any swelling.
Aspirin should not be given to children under 16 years of age because it can trigger a condition called Reye’s syndrome, which can cause brain and liver damage.
Immobilisation
Immobilisation is a treatment that helps prevent further damage by reducing movement. It also reduces pain, muscle swelling and muscle spasm, and speeds up the healing process by encouraging blood to flow directly to the injured area.
A sling can be used to immobilise an arm or shoulder. A splint or cast made of plastic or fibreglass will protect injured bones and soft tissue.
After a knee injury or knee surgery, a leg immobiliser, made from foam rubber, may be used to keep the knee in a fixed position and prevent it from bending.
Corticosteroid injection
If you have severe or persistent inflammation, a corticosteroid injection may be recommended. As well as reducing inflammation, it will help prevent long-term muscle and ligament damage.
During a corticosteroid injection, a fine needle will be used to inject the steroid cortisone into the tender area. It will usually be combined with an anaesthetic so that it is not painful.
Most people who have a corticosteroid injection find that their pain improves significantly or disappears completely within four weeks of treatment. For some people, pain relief is temporary and the pain returns after a few weeks. In such cases, two or three corticosteroid injections may be needed over a few weeks.
The risk of side effects after a corticosteroid injection is small, although you may have some increased discomfort at the site of the injection for up to 48 hours.
Physiotherapy
Physiotherapy involves using massage, manipulation and special exercises to improve the range of motion and return the function of injured areas to normal.
For example, people who are recovering from a long-term injury may benefit from a programme of walking and swimming to help strengthen the muscles in the affected body part.
Massage
Some sports therapists and coaches believe that massage may be an effective method of speeding up the recovery process. Supporters of massage argue that it helps in two main ways:
- It encourages the flow of blood into the affected body part and the nutrients in blood can help repair any damaged tissue.
- It increases flexibility in the affected body part.
Massage is not recommended if you have a serious soft-tissue injury, such as a torn ligament, as it could make the injury worse.
Despite being a very popular treatment, there is little hard evidence that massage is effective in aiding recovery. However, it can reduce stress levels and make you feel more relaxed, which may be important benefits themselves.
Heat treatment and ultrasound therapy
Some sport therapists argue that using heat therapy (heat pads or lamps) and ultrasound therapy (high-energy sound waves) may work in a similar way to massage by stimulating blood flow to the affected body part. However, as with massage, the evidence for the effectiveness of both these treatments is not conclusive.
There is evidence that ultrasound can help improve flexibility in damaged joints, but this may not necessarily always be a good thing. If a damaged joint is moved too far before it has fully healed, it could lead to further damage.
Ultrasound also seems to speed up the healing process of fractured bones. However, there is little evidence that it speeds up the healing process in other types of sports injury.
Heat treatment seems to help relieve pain, but there is little evidence that it can speed up the healing process.
Surgery
Most sports injuries do not require surgery. However, very severe injuries, such as a torn ligament or badly broken bones, may require corrective surgery.
Rehabilitation
Rehabilitation is an important part of treating sports injuries. A rehabilitation programme aims to return the injured body part to normal function by gradually introducing it to movement and exercise.
With most sports injuries, it helps to move the injured part as soon as possible to help speed up the healing process. Gentle exercises should help improve the area’s range of motion. As movement becomes easier and the pain decreases, stretching and strengthening exercises can be introduced.
During the rehabilitation process, you should not attempt to do too much too quickly. Start by doing frequent repetitions of a few simple exercises before gradually increasing the amount that you do. Avoid painful activities and do not return to your sport until you have no pain, and full strength and flexibility have returned to the injured area.
A healthcare professional, such as a physiotherapist or sports injury specialist, can help you design a suitable rehabilitation programme and advise you about which exercises you should do and the number of repetitions.
Treating specific injuries
Click on the links below for more information about treatment for specific sports injuries:
Preventing sports injuries
Competitive athletes may have difficulty avoiding sports injuries due to the intensity and frequency of their training. However, most people can prevent sports injuries by following the advice below.
Warm up
It's very important to warm up properly before you start to exercise more vigorously.
A proper warm-up routine should last for a minimum of 10 minutes. Start with a few minutes of gentle exercise, such as walking or jogging, to get the blood flowing to your muscles. Gradually increase the pace until you are running briskly.
Once your muscles are warm, do some gentle stretching exercises, paying particular attention to the muscle groups that you will be using – for example, legs for running and arms and shoulders for racquet sports. Only begin more vigorous activity after you have warmed up thoroughly.
Don't overdo it
If you start a new exercise programme, it's very important not to do too much too soon. If you have not exercised for a long time, strenuous activity could do more harm than good.
Be realistic about what you can achieve with your current level of fitness. Once your fitness improves, you can increase your level of activity.
Most sports coaches support what is sometimes known as the 10% rule. This states that you should increase your level of physical activity by no more than 10% every week. For example, if you ran 20 miles one week, don't try to run more than 22 miles the following week.
If you have not exercised for many years, you could benefit from our Couch to 5k running plan. The plan is a series of podcasts that you download to your MP3 player. It's designed to gradually get you running 5 kilometres (3.1 miles) or for half an hour in just nine weeks.
Avoid dehydration
Always drink plenty of water when you exercise to prevent dehydration. If you become dehydrated, your physical and mental fitness will be impaired.
Aim to drink one glass of water for every 20 minutes of exercise. This should be in addition to drinking the recommended six to eight glasses (1.2 litres) of water a day. If you exercise in warm weather, or participate in endurance sports, you will need to drink more.
Do not drink large amounts of water in a short time because that could lead to a serious condition called hyponatremia, which can cause unpleasant symptoms such as:
- extreme tiredness
- convulsions (involuntary muscle contractions)
- headache
- weak muscles or muscle spasms
For endurance sports events, such as a marathon, sports drinks containing electrolytes (salt and sugar) are the best way of avoiding hyponatremia.
Use the right technique
Using the proper technique for your sport can help reduce the risk of overuse injuries, such as tendonitis and stress fractures.
If you are unsure about the correct technique, a qualified sports coach can give you advice. If you exercise in a gym or a leisure centre, ask a fitness instructor or member of gym staff for help.
Use the proper equipment
Head guards and helmets are particularly important for sports where the head is vulnerable to injury, such as rugby, boxing, cricket, cycling, skiing, snowboarding and motorsports. Helmets protect the skull and brain from injuries caused by impacts to the head. This greatly reduces the risk of serious head injuries.
For some sports, particularly those that involve person-to-person contact, protective equipment is essential. For boxing and rugby, gum shields and protective head gear are particularly useful for avoiding injury. When playing cricket, helmets, boxes (to prevent groin injuries), shin pads and gloves will help prevent injury.
For sports that involve running, well-fitting, cushioned and supportive footwear is essential to prevent injuries to muscles, joints and tendons. Everyone runs differently, so it is very important that your running shoes are appropriate to your build and running style. If you're not sure which footwear is right for you, go to a specialist running shop for advice.
Cool down
When you have finished exercising, cool down properly with 5–10 minutes of light aerobic activity, such as easy running, jogging or walking.
A gentle cool down will help remove the waste products that have built up in your muscles, leaving you with less muscle stiffness and soreness afterwards. Some gentle stretching, focusing on the muscle groups you have used during exercise, may also help.
Further information
For more information and advice about exercise, fitness and sport, see:
Hyponatremia
Hyponatremia is a potentially fatal brain condition caused by drinking too much water. The excess water decreases the amount of essential sodium (salt) in the body’s cells, causing the brain to swell. Hyponatremia causes the following symptoms:
- extreme tiredness
- convulsions (involuntary muscle contractions)
- headache
- weak muscles or muscle spasms
- nausea and vomiting
- restlessness
- confusion
- loss of consciousness
Hyponatremia requires immediate medical attention. Treatment includes a saline (salt solution) drip and sodium tablets.
For endurance sports events, such as a marathon, sports drinks containing electrolytes (salt and sugar) are the best way of avoiding hyponatremia.
