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AP Photo/Robert Cianflone, POOL
Namibia's Beata Naigambo collapses during the
Commonwealth Games women's marathon, March
19, 2006, in Melbourne, Australia.

Is Marathon Running Dangerous?

October 19, 2009 02:36 PM
by James Sullivan
Three participants in the 2009 Detroit Marathon died within minutes of one another. Though running-related deaths are rare, they cause other runners to ask, “Is marathon running dangerous?”

Marathon Fatalities

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The three runners who died in Detroit, aged 26, 36 and 65, all collapsed within 20 minutes of each other, no further along than just beyond the half-marathon mark. The two younger runners both collapsed for reasons yet unknown. The 65-year-old runner, Rick Brown of Ohio, reportedly hit his head in a fall.

The tragedy in Detroit recalls the 2007 Chicago Marathon, when unseasonably hot weather debilitated hundreds of runners, sending 49 to the hospital. One runner died during the race, though an autopsy revealed a pre-existing heart condition to be the cause of death, not the weather. But unlike Chicago’s 88-degree heat and humidity, the temperature in Detroit was a brisk 28 degrees at the start of the race.

The deadliest running event in recent memory was 2005’s Great North Run in Newcastle, England. On that day, four of the race’s 38,000 participants died. The Daily Mail reported, “Ambulance officials said that the only factor they could put the deaths down to was the ‘warm weather and sunshine.’”


Perhaps the most high-profile marathon death in recent years was that of top American distance runner Ryan Shay, who died in November 2007 while competing in the U.S. Olympic Trials marathon in Central Park. Shay was determined to have suffered a heart attack, resulting from a pre-existing enlarged heart.

In the wake of Ryan Shay’s death, many healthy athletes were left wondering if it could happen to them. His death was particularly shocking because he wasn’t a newcomer, or out-of-shape old-timer who should have seen it coming. He was an athlete at the top of his game. A “Runner’s World” doctor addressed the question of “could it happen to me” by discussing the phenomenon of “sudden cardiac death,” focusing on what healthy people should know about it. He concluded that an annual checkup is useful to learn if any underlying conditions are present before a race. Ultimately, he says, continuing to exercise is better than stopping. He provides a checklist of items you and your physician can look at to cover your bases.

Understanding the Dangers of Marathon Running

At the American College of Cardiology 2009 Scientific Sessions, cardiologist Dr. Kevin Harris and his colleagues presented a study in which they determined competing in triathlons to be more dangerous than running marathons. They found that 1.5 sudden deaths occur for every 100,000 participants in triathlons. “Comparatively, a study by Dr Donald Redelmeier (University of Toronto, ON) of more than three million marathon runners showed the rate of sudden cardiac death to be 0.8/100 000 participants.”

What causes death among marathon runners? Coach Joe English of Portland, Ore., identified four major circumstances, which he discusses in depth on his blog. These are: “heart disease in runners over 35 years; genetic heart defects in runners under 35; hyponatremia or low blood sodium levels; and heat related illnesses, such as heat stroke.”

Elite marathon coach Keith Hanson of the Hansons-Brooks Distance Project told the Detroit Free Press that the rarity of marathon fatalities should be emphasized given the health benefits that so many runners reap through their training and competition.

But earlier in October The Wall Street Journal reported on a trend among marathon participants that conflicts with the long-held impression of runners as the epitome of health and fitness. “Fitness and dietary experts say marathons increasingly are the exercise equivalent of crash diets, with similarly disappointing results. There’s no evidence that running a marathon leads to lasting weight loss, marathon researchers say.” Runners who achieve lasting health benefits are not those who train for five months, run a race, then hang up the shoes and return to the couch; it is those who incorporate running and training into their lives, and create a decades-long program of exercise, that find lasting health.

Reference: Marathon safety

Provided that a runner is prepared and informed, marathons can be a safe activity. Most tips for marathon safety are common sense, but bear repeating.

According to an article on Livestrong.com, people over 40 who attempt a marathon on inadequate training are more likely to experience heart problems than their younger counterparts. The moral here is to train intelligently and sufficiently before participating in the often grueling 26.2-mile run.

Learn to stay properly hydrated. As mentioned earlier, too much water and too little water can both be fatal. Although these are extremes, understanding the foundation of proper hydration is essential to having a strong, healthy performance. Read this article from Runner's World for detailed information about marathon hydration.

If you’re concerned about how much work your heart can handle, talk to your doctor about getting a stress test. During a stress test a patient walks or runs on a treadmill while hooked up to instruments that monitor the heart. The test looks at whether “the blood supply is reduced in the arteries that supply the heart” during exercise. Such a test can be used to diagnose heart-related ailments, and determine an appropriate level of exercise for a patient.
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