Are You Running Yourself to Death?

Running a marathon puts severe and sometimes dangerous stress on your body. Why do so many still want to do it

Most health professionals will agree that gentle running is good for you (see post “Want to live longer? Run slower!“).  However, cardiac arrest is not uncommon during marathons (see: Why Do Healthy People Die Running Marathons?). Having said that, given the number of participants, it is statistically much more dangerous crossing the street. However, the article below may give you pause for thought… particularly if a marathon is on your bucket list (it could end up being the last entry!)

On the first Monday of November 1994, if you happened to be in Ardmore, Pennsylvania—actually, anywhere near 7 East Athens Avenue—at about 8:30 in the morning, you would have heard the following sound coming from an aging red-brick apartment building.

Thud. Arghh. Thud. Arghh…
Ax murder? Not exactly. No, this was the sad, solitary sound of me, walking down three flights of steps the morning after running the New York City Marathon. As my feet landed on each step, pain spiked into my race-fatigued thighs. By the time I reached the bottom, 48 steps later, I was so exhausted that all I wanted to do was go back to bed. But that would have required climbing back up three flights of steps. I drove to work and slept at my desk instead.

New York ’94 was my third and last marathon. Since then I’ve downgraded my running efforts to more manageable distances like the half marathon and 10-K. Secretly, I’ve come to wonder if I didn’t do damage to myself in each of the marathons I ran. I don’t have any scars or permanent injuries (that I know of), but where pain and exhaustion typically fade from memory, my postmarathon distress is as vivid to me now as it was on that horrific morning after.

Which is why it’s kind of strange, you’ll have to agree, that lately I’ve found myself wanting to run another one.

Over the course of a generation, the marathon has undergone a startling change in status. What was once a loopy stunt attempted by only a few weirdos is now a rite of passage for many men, the coolest test out there of fitness and health.

My buddy McDade actually put running a marathon on his list of Things a Man Must Do in His Lifetime, right there alongside reading War and Peace and seeing the Grateful Dead. (This was before Jerry Garcia croaked.) McDade is hardly alone. Last year, nearly 400,000 runners finished marathons in the United States, up from 300,000 in 2000 and a mere 25,000 in 1976.

On one level, you can file our current marathon mania under “extremely good news,” since there’s little doubt that training for the race is one of the best ways to improve your health and fitness. Over the years, studies have shown that regular exercise decreases everything from high LDL cholesterol to high blood pressure.

Check out “101 Ways To Lower Blood Pressure Naturally

The problem? Lately, evidence has begun to mount that running the raceis, as I’ve feared, anything but good for your health. Not only did two high-profile marathon deaths occur in fall 2007 (one in Chicago, the other at the Olympic trials in New York), but recent studies have shown that pushing your body to run 26.2 miles can cause at least minor injury to your heart.

“We didn’t find any gross injuries, such as blocked arteries or blood leakage. But we did find some enzymes leaking through the heart membrane, which is consistent with significant stress on the heart,” says Malissa Wood, M.D., the lead author of a 2006 study in the journal Circulation.

Now, hardly anyone is suggesting it’s time to pull the plug on America’s marathon obsession. A handful of deaths versus hundreds of thousands of happy survivors every year aren’t horrible odds. (And a new study found that closing roads for marathons prevents more traffic deaths than the running causes.) Even Dr. Wood remains an active marathoner. But if you’re one of those men with “run a marathon” on a current to-do list (or, like me, on a “maybe-do-again” list), the latest news should definitely give you pause. Could the race you’re running as a demonstration of your health and fitness actually make you unhealthy? Or, to put a finer point on it: Could this stunt you’re attempting in order to give meaning to your life end your life?The Chicago marathon and Olympic Trials in 2007 weren’t the only races marred by casualties in the past couple of years. There have been several others, including the Little Rock Marathon in March 2008, the London Marathon in 2007, and the Tucson, Twin Cities, and Marine Corps Marathons in 2006. (Also in 2006, two runners died at the Los Angeles Marathon.) And that’s not counting the races during which runners suffered cardiac arrest but managed to survive.

Any historian of running will tell you there’s nothing new about death and the marathon. Legend has it, remember, that the original marathoner, Pheidippides — the Greek courier who ran 25 miles to deliver news of victory at the Battle of Marathon — dropped dead immediately after his job was done. At the inaugural Boston Marathon in 1897, authorities were so concerned about fatalities that they had two attendants on bicycles trailing closely behind each of the runners — all 15 of them.

It’s a risk that has persisted through the decades. “There was actually a cardiac arrest at one of the first Boston Marathons I ran, in the 1970s,” says Arthur Siegel, M.D., director of internal medicine at Harvard’s McLean Hospital in Belmont, Massachusetts. In addition to running the Boston race some 20 times, Dr. Siegel has published many studies on the health consequences of marathons. It’s late on a Tuesday afternoon, and I’ve come to visit him. He’s an engaging man in his late 60s with white hair and a round belly, for one simple reason: to understand what exactly happens to a man’s body when he forces it to run 26.2 miles.

Researchers have identified a number of physical effects of running a marathon, including changes in immune system and kidney function. But Dr. Siegel says the brunt of the damage falls exactly where you’d expect: on your muscles. As the miles pass, skeletal muscles stiffen and leak injury-signaling enzymes into the blood.

Now, a certain inability to (ahem) walk down steps the next day notwithstanding, this may not seem like such a big deal, particularly given that the damage is self-inflicted. But your body’s internal balance is deeply affected. As Dr. Siegel puts it, “Your body doesn’t know whether you’ve run a marathon…or been hit by a truck.” This is why, as you go deeper into the race, your body reacts to injury by mounting an emergency-repair response. Your adrenal glands and brain produce the stress hormones cortisol and vasopressin; your damaged muscles churn out proteins called cytokines, which trigger your liver to start producing C-reactive protein. The result is what Dr. Siegel calls “an inflammatory storm” throughout your body, one that sets the stage for some potentially adverse consequences. Early on, marathon researchers weren’t sure if theheart was among the muscles being stressed, but in recent years they’ve confirmed that it most definitely is. In a 2001 study published in the American Journal of Cardiology, Dr. Siegel and his colleagues analyzed the blood of marathoners less than 24 hours after a race and found high levels of inflammatory and coagulation markers that are also associated with heart attacks.

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