Meeting the Medical Needs of Houston Runners
TIRR Physician Compaq Houston Marathon Medical Director

Should they have needed the medical attention, the nearly 10,000 participants of the recent Compaq Houston Marathon were in good hands.

For the past five years, Dr. John Cianca, medical director of The Institute of Rehabilitation and Research’s Human Performance Center, been medical director of the marathon.

Dr. Cianca has been running for 27 years – since the age of 14. He competed in both track and cross-country events in high school and college, and in 1983, completed his first marathon.

While attending Albany Medical College, where he graduated in 1988, he maintained an interest in running. In 1992, Dr. Cianca finished his postgraduate medical training with a musculoskeletal fellowship through Baylor College of Medicine, where he is now an assistant professor of physical medicine and rehabilitation.

Dr. Cianca says it was because of the combination of his athletic interest and the care of athletic injuries throughout his training that a sports medicine specialty appealed to him. However, this type of practice was not common while he was undergoing medical training. Through persistence he has developed such a practice in Houston.

"I enjoy treating athletes of all ages and abilities," he says.

But he is best known for treating runners – from the highest level triathletes and marathoners, to the recreational runner. His background as an athlete, running coach and personal trainer have given him first-hand knowledge of the medical problems that runners and recreational athletes may face, and have increased his credibility with patients.

Dr. Cianca says he still aspires to return to competitive running, however his practice prevents him from training as intensely as needed in order to race as well as he would like. In his running "career," his best track events were the 800 meter, with his fastest time recorded at 2 minutes, 5 seconds, and the 1,600 meter, with his fastest time at 4 minutes, 50 seconds.

Upon being asked to coordinate the medical team for the Houston Marathon, Dr. Cianca says the project was intimidating.

"At first I was nervous about it," he says. "But my predecessor, Dr. Ken Dennis, and the huge group of longtime volunteers, particularly those on the medical committee, have made my job much less anxiety provoking."

Each year, Dr. Cianca coordinates care for the throngs of Houston Marathon runners. The needs of the race-day marathoner are much different than those he sees in his office. Heat illness, hyponatremia, dehydration and cardiovascular emergencies are all serious repercussions than can happen to a marathon runner.

The logistics of planning, coordinating and overseeing the care of such a large event take tremendous amounts of time and organization. There are 300 to 400 volunteers on the medical committee alone. Planning for the races begins a year in advance, and gets especially busy in the six months prior to the race. Dr. Cianca utilizes three "lieutenants" – Dr. Joe Chorley, Dr. Jon Divine, and Dr. Tami Hew – who help deliver care and conduct marathon research. In addition, 11 "captains" are responsible for nine specific medical committee areas. Along the race route, 15 first aid stations are manned, and 20 to 30 emergency medical technicians and paramedics patrol the route on bicycles and in ambulances. There is also a finish line team of paramedics, a triage team, and areas for massage, podiatric care, and major and minor medical care. Research services, central supply and computer support round out the venues in the medical area.

Dr. Cianca reports to race director David Hannah, to let him know the medical status throughout the race.

"I present good news or bad, and suggest changes that should be made for the future."

In recognition for his time and talent spent with the Compaq Houston Marathon, Dr. Cianca was recently elected to the event’s board of directors.

In addition to his normal patient load, for two years Dr. Cianca has also served as medical director of the Houston leg of the Susan G. Komen Foundation’s "Race of the Cure," and does community outreach for a local group called RunSport. Since 1994, he has held free clinics once a month, where runners can come and ask questions about such things as injuries and running shoes. Dr. Cianca and his colleagues, Drs. Chorley, Divine and Hew, also see runners every Saturday from July through January in conjunction with USA/Houston Fit, the largest marathon training program in Houston. They assemble a "medical tree," and runners gather there to ask advice about injuries.

"I believe these types of services will help runners avoid problems, and keep them from becoming seriously injured while they train for marathons," he says.

Dr. Cianca wants to help people find a more efficient way to enjoy the sport of running. Ultimately, he tries to teach people to move better, so they are safer and perform better.

Dr. Cianca cautions runners to not become greedy once they achieve some success. He says he finds it all too common that runners get carried away with the "thrill of victory," and fail to allow their bodies time to prepare properly and recover sufficiently to continue running injury free.

"I hope to continue to develop my practice and the TIRR Human Performance Center in order to initiate programs in Houston to help people achieve their goals of being active and healthy in sports and exercise," he says.

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