Comrades runners urged to listen to their bodies as race day approaches
The race starts in Durban and finishes in Pietermaritzburg, includes an elevation gain of about 1.8km and must be completed within 12 hours.
With thousands of runners preparing to tackle the 2026 Comrades Marathon on Sunday, medical experts are urging participants to prioritise their health, stay hydrated and pay attention to warning signs during the gruelling 85.777km Up Run from Durban to Pietermaritzburg.
The race, which starts in Durban and finishes in Pietermaritzburg, includes an elevation gain of about 1.8km and must be completed within 12 hours.
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For the past 48 years, Comrades Marathon Association race doctor Dr Jeremy Boulter has overseen the extensive medical, emergency, first aid and physiotherapy support network that assists runners along the route.
“Medically speaking, we expect this year to place similar physical demands on runners as previous Up Runs,” said Boulter.
Even seasoned Comrades runners tend to find the race starting in Durban more challenging, and much depends on the weather conditions on the day.
“At this stage, the forecast looks favourable with dry, cool to mild conditions expected, although we prepare for any eventuality.”
“Runners must keep their fluids up, whatever the weather, and bear in mind that temperatures often drop steeply after 4 pm.”
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Netcare general manager for emergency and trauma, transplant and corporate social investment, Mande Toubkin, said months of planning go into ensuring runners have access to medical care throughout the race.
“For a quarter of a century, Netcare and Netcare 911 have provided emergency medical support for Comrades Marathon runners under the guidance of Dr Boulter,” said Toubkin.
This year, Netcare will deploy 90 paramedics, 73 nurses, 10 doctors, 16 advanced life support ambulances and an ICU-configured emergency medical helicopter, among other resources.
Digital technology will also help keep families informed if runners require medical treatment.
“When Netcare 911 picks up any runners requiring assistance, the Joint Operations Centre (JOC) is informed, and the runner’s selected contact receives a message to let them know where the person is receiving care,” explained Boulter.
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Doctor’s advice for runners
Boulter urged runners to ensure they are properly prepared before taking on the race.
His recommendations include:
- Only attempt the race if you have trained adequately.
- Do not run if you are ill, taking medication or have had influenza within the past two weeks.
- Replace fluids and electrolytes throughout the race.
- Eat lightly and regularly to maintain energy levels.
- Avoid painkillers and anti-inflammatory medication during the event.
Netcare 911 operations director Shalen Ramduth said runners should not ignore symptoms that may indicate a medical emergency.
“The Comrades Marathon is a test of endurance that carries certain medical risks,” he said.
Ahead of the race, we are urging runners to listen to their bodies and approach us for medical support, whether for minor scrapes or any concerning symptoms.
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Warning signs not to ignore
Runners are advised to stop immediately and seek medical assistance if they experience:
- Dizziness
- Confusion
- Nausea
- Muscle cramps
- Disorientation
- Chest pain
- Sudden chills
“Listen to your body and never ignore warning signs such as these,” Ramduth advised.
Supporters urged to stay safe
Medical teams have also issued advice to the thousands of spectators expected to line the route.
Supporters are encouraged to stay hydrated, avoid excessive alcohol and caffeine consumption, wear sunscreen and comfortable shoes, and keep emergency access routes clear.
Officials also warned against leaving children, vulnerable people or pets in parked vehicles, even for short periods.
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Race organisers and medical teams say preparation, awareness and early intervention remain key to ensuring a safe and successful Comrades Marathon for both runners and supporters.
