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Top Ten Reasons not to Run Marathons

August 17, 2005 09:23 AM

With my apologies to David Letterman, here are the top ten reasons not to run marathons.

10. Marathon running damages the liver and gall bladder and alters biochemical markers adversely. HDL is lowered, LDL is increased, Red blood cell counts and white blood cell counts fall. The liver is damaged and gall bladder function is decreased. Testosterone decreases.

From Wu, Worl J Gastroenterol. 2004 Sep 15: 10 (18): 2711-4, "RESULTS: Total bilirubin (BIL-T), direct bilirubin (BIL-D), alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) increased statistically significantly (P<0.05) the race. Significant declines (P<0.05) in red blood cell (RBC), hemoglobin (Hb) and hematocrit (Hct) were detected two days and nine days d after the race. 2 d after the race, total protein (TP), concentration of albumin and globulin decreased significantly. While BIL, BIL-D and ALP recovered to their original levels. High-density lipoprotein cholesterol (HDL-C) remained unchanged immediately after the race, but it was significantly decreased on the second and ninth days after the race. CONCLUSION: Ultra-marathon running is associated with a wide range of significant changes in hematological parameters, several of which are injury related. To provide appropriate health care and intervention, the man who receives athletes on high frequent training program high intensity training programs must monitor their liver and gallbladder function."

9. Marathon running causes acute and severe muscle damage. Repetitive injury causes infiltration of collagen (connective tissue) into muscle fibers.

From Warhol et al Am J Pathol. 1985 Feb: 118 (2): 331-9, "Muscle from runners showed post-race ultrastructural changes of focal fiber injury and repair: intra- and extracellular edema with endothelial injury; myofibrillar lysis, dilation and disruption of the T-tubule system, and focal mitochondrial degeneration without inflammatory infiltrate (1-3 days). The mitochondrial and myofibrillar damage showed progressive repair by 3-4 weeks. Late biopsies showed central nuclei and satellite cells characteristic of the regenerative response (8-12 weeks). Muscle from veteran runners showed intercellular collagen deposition suggestive of a fibrotic response to repetitive injury. Control tissue from nonrunners showed none of these findings."

8. Marathon running induces kidney disfunction (renal abnormalities).

From Neyiackas and Bauer, South Med J. 1981 Dec; 74 (12): 1457-60, "All postrace urinalyses were grossly abnormal...We conclude that renal function abnormalities occur in marathon runners and that the severity of the abnormality is temperature-dependent."

7. Marathon running causes acute microthrombosis in the vascular system.

From Fagerhol et al Scan J Clin Invest. 2005; 65 (3): 211-20, "During the marathon, half-marathon, the 30-km run, the ranger-training course and the VO2max exercise, calprotectin levels increased 96.3-fold, 13.3-fold, 20.1-fold, 7.5-fold and 3.4-fold, respectively. These changes may reflect damage to the tissues or vascular endothelium, causing microthrombi with subsequent activation of neutrophils."

6. Marathon running elevates markers of cancer. S100beta is one of these markers. Tumor necrosis factor, TNF-alpha, is another.

From Deichmann et al in Melanoma Res. 2001 June; 11 (3): 291-6. "In metastatic melanoma S100beta as well as melanoma inhibitory activity (MIA) are elevated in the serum in the majority of patients. Elevation has been found to correlate with shorter survival, and changes in these parameters in the serum during therapy were recently reported to predict therapeutic outcome in advanced disease."

From Santos et al Life Sci. 2004 September: 75 (16): 1917:24, "After the test (a 30km run), athletes from the control group presented an increase in plasma CK (4.4-fold), LDH (43%), PGE2 6.6-fold) and TNF-alpha (2.34-fold) concentrations, indicating a high level of cell injury and inflammation."

5. Marathon running damages your brain. The damage resembles acute brain trauma. Marathon runners have elevated S100beta, a marker of brain damage and blood brain barrier disfunction. There is S100beta again, a marker of cancer and of brain damage.

From Marchi, et al Restor Neurol Neurosci, 2003; 21 (3-4): 109-21, "S100beta in serum is an early marker of BBB openings that may precede neuronal damage and may influence therapeutic strategies. Secondary, massive elevations in S100beta are indicators of prior brain damage and bear clinical significance as predictors of poor outcome or diagnostic means to differentiate extensive damage from minor, transient impairment."

Other studies indicate confusion in post-event marathon runners.

4. Marathons damage your heart. From Whyte, et al Med Sci Sports Ecerc, 2001 May, 33 (5) 850-1, "Echocardiographic studies report cardiac dysfunction following ultra-endurance exercise in trained individuals. Ironman and half-Ironman competition resulted in reversible abnormalities in resting left ventricular diastolic and systolic function. Results suggest that myocardial damage may be, in part, responsible for cardiac dysfunction, although the mechanisms responsible for this cardiac damage remain to be fully elucidated."

3. Endurance athletes have more spine degeneration.

From Schmitt et al Int J Sports Med. 2005 Jul; 26 (6): 457-63, "The aim of this study was to assess bone mineral density (BMD) and degenerative changes in the lumbar spine in male former elite athletes participating in different track and field disciplines and to determine the influence of body composition and degenerative changes on BMD. One hundred and fifty-nine former male elite athletes (40 throwers, 97 jumpers, 22 endurance athletes) were studied. ...Throwers had a higher body mass index than jumpers and endurance athletes. Throwers and jumpers had higher BMD (T-LWS) than endurance athletes. Bivariate analysis revealed a negative correlation of BMD (T-score) with age and a positive correlation with BMD and Kellgren score (p < 0.05). Even after multiple adjustment for confounders lumbar spine BMD is significantly higher in throwers, pole vaulters, and long- and triple jumpers than in marathon athletes."

The number two reason not to run marathons,

2. At least four particiants of the Boston Marathon have died of brain cancer in the past 10 years. Purely anecdotal, but consistent with the elevated S100beta counts and TKN-alpha measures. Perhaps also connected to the microthrombi of the endothelium found in marathoners.

And now ladies and gentlemen the number one reason not to run marathons,

1. The first marathon runner, Phidippides, collapsed and died at the finish of his race. [ Jaworski, Curr Sports Med Rep. 1005 June; 4 (3), 137-43.]

Now there is a recommendation for a healthy activity. The original participant died in the event. But, this is not quite so unusual; many of the running and nutritional gurus of the past decade or two died rather young. Pritikin, Sheehy, Fixx, and Atkins, among many other originators of "healthy" practices died at comparatively young ages. Jack LaLanne, the only well-known guru to advocate body building, will outlive us all.

· Endurance Training: Death, Injury, and Risk ~ · Evolutionary Fitness ~ · Sports

Comments

I'm curious how four cases of terminal brain cancer out of a field of 150,000+ is indicative of anything at all, let alone an indictment of the marathon they all ran at some point in the last 10 years. Anecdotal? More like meaningless. I'm sure there are that many and more from the same group who have died in car crashes.

As for the rest of it, it seems like cherrypicking, and not very good cherrypicking at that. Fixx, Atkins? I don't doubt the veracity of some of the data, but it's all too easy to find several counterpoints enumerating the benefits to marathoning for every one listed here saying the opposite.

What it boils down to is that marathoning is not for everyone, but that on the whole, well-trained marathoners tend to be a pretty healthy lot. I'll take my chances in a marathon or ultramarathon before something really unhealthy, like...say, motorcycling.

Posted by: LightInAugust [TypeKey Profile Page] at October 18, 2005 1:30 PM

Better late, blah blah...

Dr. Atkins died at the age of 72, certainly not young, albeit untimely.

Dr. Atkins died when he slipped and fell on an icy sidewalk on his way to work. He cracked his head, went into a coma, and never came out of it. When he was admitted to the hospital, he was 6'0", 195 lbs., a solid weight for a 70 year-old man.

- Josh

Posted by: Wild Pegasus [TypeKey Profile Page] at October 18, 2005 7:06 AM

...these purported health gurus aren't more than a single data point and you only see what they want you to see. That they did not live long is evidence that one should not take these examples as proof of anything

One of those data points, Jim Fixx, doesn't support the point of your post, given that he lived nine years longer than his father, has a terrible diet, and had smoked and was obese into his 30's.

Living longer

Jim Fixx may have done just that, given the fact that his father died of a heart attack at age 43, and he survived nine years longer to age 52. He might have lived longer had he listened to Dr. Cooper, who urged him to take a stress test during one visit to the Cooper Clinic in Dallas. Despite having cholesterol levels above 250, Fixx demurred for reasons we can only guess at. In the several months before his death, Fixx ignored what hindsight reveals were the warning signs of advanced coronary artery disease. An autopsy revealed blockage in Fixx's three main arteries of 95 percent, 85 percent and 50 percent.

Source: http://www.halhigdon.com/Articles/Fixx.htm

These two writers explain that for a long time researchers didn't really know why Fixx had died. They essentially assumed his coronary attack just stemmed from a genetic condition. But about a decade later, friends of Jim began to admit that his lifestyle actually was anything but healthy.

"Ultra-marathoner Stan Cottrell said he and Fixx appeared together at a
conference," they write. "Just before Fixx went in to speak, he 'stuffed himself with four donuts and said, "I didn't have time for breakfast."'"


Source: http://www.vop.com/previous_broadcasts/2001/april/01183.html


I've never done a marathon. I managed two halfs last year and will tacking my third at the Detroit International this weekend.

Posted by: Michigander [TypeKey Profile Page] at October 18, 2005 5:23 AM

Art,

Great summary & I agree with you 100% on marathoning and beyond. I tried a 1/2 once and swore never again! For those who try & succeed...Lance Armstrong, Johnny Kelly, et al...all the more power to them. But like any extreme, you're going to have repercussions.

A friend at a gym I'd trained at was also an ortho and his studies showed powerlifters, for example, had a higher rate of spinal degeneration/compression than those of us who did leg presses or alternated our leg work. Like you mentioned in your post on the football player, the human body isn't designed for extremes.

Any information on those who pursue the shorter distances, eg the 800 - 10k distances?

Again, excellent job!

Parker

Posted by: Parker [TypeKey Profile Page] at August 22, 2005 6:40 PM

Mike:

I relied on the source I gave on Phidippides. I have seen other cites to the same effect, but I understand there may be disagreement on these historical facts. I do wonder about Wikipedia sometimes as an authority.

But, it was partly in jest and used to make the larger point that using exemplars from any field can lead to bad decisions.

Then again, perhaps a more irresponsible thing to do is to encourage indiduals to do marathons or endurance running without pointing out the downside that I show on my post. And, even more important, without checking the condition of their hearts. It seems that, overwhelmingly, sudden deaths among distance runners, and youthful sports participants too, is some sort of heart-vascular problem that could be spotted before.

So, it is not just preparation, which can help, but it does have its downside too. The problem being there is no preparation for a preexisting heart condition, so training is just more exposure, and prepared athletes tend to go at it harder. Training improves their other systems, which may have limited their ability to stress their heart. Consequently, a better conditioned athlete may actually increase the stress on their heart.

Anyway, poor Phidippides, true marathoner or not, may he rest in peace. I would not run a marathon for any thing.

Posted by: Art [TypeKey Profile Page] at August 22, 2005 1:21 PM

Art,

Great article as usual, but I'm a bit disappointed in your #1 reason for two reasons of my own:

Reason #1:

1a: Phidippides doesn't appear to have actually run from Marathon to Athens. (from Wikipedia: http://en.wikipedia.org/wiki/Pheidippides)

1b: He doesn't appear to have died after his run at all. (ibid) I think calling it a "race" may also be a stretch, but that's just semantics.

Reason 2:

Assuming that he did make the run in question: there's no reason to think that Phidippides was a trained marathoner, so comparing a guy who essentially forced himself to run that distance without proper training and an athlete who spends months if not years working towards that goal is at best irresponsible and at worst disengenous.

Of course, it's entirely possible that the #1 entry was facetious and I completely missed it. If that's the case, I apologize.

I do plan on sending a link to this post to a friend who is planning to run the NYC marathon though.

Not the same Mike that posted above.

Posted by: Mike [TypeKey Profile Page] at August 22, 2005 12:35 PM

I red both, Matt's bodyweight book and Brook's one as well :o) and yes, those trainings are completely different.

Posted by: pruzicka [TypeKey Profile Page] at August 18, 2005 8:27 AM

Perhaps you are correct. I do recall having a book and video by Matt titled Dinosauer Training. He is now a big proponent of bodyweight training and has a book out directed towards that. Interesting stuff and quite effective.

Posted by: bluesman [TypeKey Profile Page] at August 18, 2005 8:27 AM

Bluesman,


Actually, Matt Furey is all about bodyweight conditioning and I believe it was Brooks Kubik who coined the term "Dinosaur Training". He also wrote a book of the same title but they are two completely different training methodolgies.


Mike

Posted by: Mike [TypeKey Profile Page] at August 18, 2005 8:09 AM

"Hard" days are typically 25-30 min, with very little rest. Perhaps 1 min. between sets. I like the sandbag deal. I was using large bags of rock salt till it broke on me. The kettlebells are tremendous tools and will leave you pleasantly whipped. They build great core and funtional strength too. I play in an annual "Turkey Bowl" football game where the young studs come home for the holidays and take on us old timers. I was playing D-End and had the local youngster puking on the sideline trying to stay up with me. Perhaps his hangover contributed, he he. Check out Matt Furey, he coined the "dinosauer" training which involves unusual old time strength training.

Posted by: bluesman [TypeKey Profile Page] at August 18, 2005 7:19 AM

to Bluesman: how long your 'hard' day session lasts ? When I do work out with heavy sand bag, I'm always *wasted* after 5x5 clean&press... I sure have no more energy to sprints :o(

Posted by: pruzicka [TypeKey Profile Page] at August 18, 2005 5:33 AM

http://www.bhf.org.uk/events/index.asp?secID=12&secondlevel=91&thirdlevel=908&artID=4143

Thought this was interesting. Last year (? I think) these two guys ran 7 marathons in 7 days on 7 continents. One of them had already had a heart attack. Any way read what it did to them:

".....With its unbearable humidity the Singapore stage induced muscle stiffness, severe cramps and blisters, prompting the pair to question whether they were going to make the final three.

Subsequent blood tests revealed that the enzyme commonly known as CK, was 50x over its normal level in Sir Ranulph's bloodstream and 500x over in Dr. Stroud's.

As a result, the enzyme was eating away at their muscles causing agonising muscle cramps and in Dr. Stroud's case, making him urinate blood whilst his muscles were literally wasting away....."

Posted by: Chris H [TypeKey Profile Page] at August 18, 2005 4:03 AM

What about 1 reason not to play 5 a side football (soccer).

Even though my ball skills are terrible, I thought it would be great for the whole evolutionary fitness approach - lots of sprinting up and down the pitch, changes of direction etc mixed up with a turn in goal and a bit of walking around. Intermittency, intensity and fun..

Fine until I pulled a muscle in my thigh early on in the match and ended up limping round for most of it.

That is something that hasn't come up much in the blog - injuries....strains.....muscle tears.

Every now and again I get a bad back spasm, but I think that is usually due to stress in some area of my life. (don't know where that pyschological approach would fit in with the ev Fit ideas?).

But what about other injuries: are they to be expected as inevitable or are should they be an exception, perhaps due to bad form? Did the huntergatherer warmup? Surely not....


Chris

Posted by: Chris H [TypeKey Profile Page] at August 17, 2005 4:05 PM

David:

Its ok to be grouchy. I am only reporting the facts on these guys and it supports your point. Namely, these purported health gurus aren't more than a single data point and you only see what they want you to see. That they did not live long is evidence that one should not take these examples as proof of anything. Me either.

As to the theory and evidence, it is all there in the references in the post to be followed up by skeptics. And the samples are rather large, particularly when the number of studies is taken into account.

Posted by: Art [TypeKey Profile Page] at August 17, 2005 2:23 PM

I know this was intended to be kind of humorous,
but some parts of Art's posting typify extracting
too much significance from individuals/individual
events. I'm very ready to accept there're problems
with Atkins/.... programmes, but given the wide variety of people, genetics, etc, out there I don't take the fact that they died young as particularly strong evidence for it. Likewise, I don't take Art individually as any real evidence for his beliefs because there's no way to decide for a single individual just how much of his physiology that amazes even his doctors is do his ev-fit lifestyle, his genetics and pure random factors. I'm much more convinced by the theoretical arguments and references to statistical studies that back them up.

I just point this out as reader feedback because each time a "look at individual A: from him we know X is BAD" or "look at individual B: from him we know X is GOOD" point is made it makes me LESS likely to be convinced by what's being argued, even when there's valid argument preceding it, because it looks like grabbing at straws, even though it probably isn't. (Incidentally, who're the biggest users of "appeal to individual examples"? cosmetics companies who have super-model X proclaiming the effects of a company's products on their skin/hair/....)

Sorry to sound like a grouch.

Posted by: david tweed [TypeKey Profile Page] at August 17, 2005 2:05 PM

I used to be an avid distance runner, since I recently turned 45 that has changed. I have molded my workouts in part to what i have read on this website. Basically, I have adopted a 4 day-2 easy, 2 hard program. Hard days typically start with bodyweight exercises(hindu squats & pushups). Then a kettlebell circuit that goes: skip rope, heavy bag work, kettlebell exercise. I continue this for 4-5 circuits. Finish is with a sprint medley-15-20 yards. Medley is straight sprint, backward sprint, side shuffle and bounding. Then toss a log and sprint to it for 20 yards.
Easy days typically would be rowing, biking or hill runs, 1.5 mile, first 1/2 all uphill. Mornings tend to start with Yoga and or Qi Gong. Diet too has changed to largely, veggies, salad, fish and chicken. Occasional red meat , beans, some pastas. Snacks basically, popcorn, almonds, maybe yogurt. Mornings include a vitamin shake(Natures Way Energy)., and some fruit. I will indulge 1-2 a month in some shrimp, scallops etc. I now rest more and 3-4 times per year will take 5-7 days off.
Comments welcome.

Posted by: bluesman [TypeKey Profile Page] at August 17, 2005 1:24 PM

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