Will Running a Marathon Kill You?

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Occasionally I get the question about whether marathon training is damaging to a person’s body.

Maybe a well meaning person has told you that it will ruin your joints, lead to arthritis, or cause sudden death. Often the people spreading these myths about running do so while clutching a big gulp soda in one hand and a cigarette in the other.

So, what does the evidence say? Having the facts can help you answer people who may be concerned that your running a marathon will lead to an untimely death or disability.


First Let’s Talk About Joint Damage

Is running harmful to your joints? A 2006 study in the Journal of the American Osteopathic Association found that “Long distance running does not increase the risk of osteoarthritis of the knees and hips for healthy people… long distance running might even have a protective effect against joint degeneration.”

The article went on to say that running also decreases the risk of cardiovascular disease, diabetes mellitus, and depression, helps with weight control, improves bone density, and decreases mortality.

One of the best studies to prove this point is the 50 Plus Runners Association Study that was started in 1984. When it was launched a control group of subjects age 50 + were chosen and studied at 5 year intervals. It compared runners who averaged 26 miles per week with a non-running group. The most recent report published in 2009 in the Arthritis Research & Therapy Journal found that the runners experienced about 25% less muscloskeletal pain and that women runners benefited the most.

Some possible reasons for these results include: the release of endorphins, fewer muscular injuries, and a higher pain threshold. The study went on to say, “the stronger the muscles and tissues around your joints, the better they will be able to support and protect those joints.” Without continued exercise the joints get stiff and the cartilage is weakened. Obesity is thought to be the major contributor to arthritis and runners are better able to keep the pounds off.

Those at risk of joint damage are runners who log high mileage (120 +) every week for many years and who have a previous history of injury. Women who experience amenorrhea (lack of a monthly menstrual cycle) are also at risk of osteoporosis (low bone density) and joint damage. To prevent these complications make sure that you are not exceeding your personal mileage threshold and that you aren’t consistently overtraining. Eating a healthy diet and using cross training in your routine can also decrease the risk of damage.

Now Let’s Talk About the Risk of Heart Attack

It seems that every year there is at least one news story of a person dying during a marathon. There have been a few cases of runners dying suddenly and it is important to look at some of the potential reasons for this.

For runners 40 years and older a heart attack is usually the result of coronary artery disease (CAD). CAD is caused by cholesterol plaque buildup in the arteries supplying the heart. A blockage in any vessel leading to the heart can lead to a heart attack.

Alberto Salazar, winner of the 1982 Boston Marathon and 94 Comrades Marathon, suffered a heart attack in 2007 at age 48. Salazar had a lot of risk factors: a family history of coronary disease, high blood pressure and high cholesterol, both of which were being controlled with medications. Being male is a risk factor, too. Salazar survived his heart attack, probably due to the fact that he was in such great shape physically.

Dr. Stephen Pribut who specializes in sports medicine talks about the benefits of long distance running. Some of the benefits include:

  • Strengthens the heart – larger stroke volume.
  • Strengthens the leg muscles – endurance is developed.
  • Develops fat burning capacity
  • Increases number and size of mitochondria (powerhouse of the cell).
  • Increases capillary growth into muscle fibers.
  • Increases myoglobin concentration in muscle fibers.
  • Increases aerobic efficiency.
  • Increase in Maximum VO2 (the amount of oxygen that can be utilized during exercise).

For most people the benefits of long distance running outweigh any risks. It is important to remember that running is only one piece of the overall health picture. Even if you run regularly it is still important to eat a healthy diet and know your blood pressure and cholesterol numbers. Things like genetics, a diet high in saturated fat, stress, and certain medications can lead to heart problems.

Be sure you have the clearance of your healthcare professional before undergoing marathon training. Also, make sure that you get a yearly physical so that any potential problems can be noticed and addressed. The advice that we give at MTA is not a substitute for that of your physician. You should never ignore the warning signs of a heart attack: chest or shoulder/arm pain, excessive shortness of breath, abdominal pain (nausea), or dizziness. However, the risks of a runner dying of heart problems is 1/100th that of the normal population. I think I’ll take those odds.



Also Mentioned in this Episode
St. Louis Rock and Roll Marathon October 23 -Trevor and I are signed up for this race. This will be Trevor’s first marathon! We would love to see you there.

Guest Blog Post Series by Andy Richardson – Andy is a fellow blogger who will be using my ebook to train for his first marathon this November. He will be sharing his insights with us here on the MTA blog.


Thanks for reading this blog post. Talk to you again soon!

11 Responses to Will Running a Marathon Kill You?

  1. Trevor May 12, 2011 at 1:23 pm #

    Has anyone else had a non-runner tell you that running is harmful?

    • Andrea July 14, 2011 at 10:25 am #

      My husband was presented with this opinion/argument when he told his (non-running) family members of his hopes to run his first marathon this year. Understandably, their urging him not to run a marathon were a result of their lack of knowledge combined with concern for his well-being. The irony: the conversation occurred in a bar while some of the skeptics had cigarettes in hand. *True story* Thank you for setting the record straight and covering most of the common argumets against marathon running in your podcast. Keep the great podcasts coming Trevor and Angie!

      • Angie July 15, 2011 at 9:29 pm #

        Hi Andrea. That’s a crazy story! I’m glad that your husband didn’t let well-meaning skeptics stop him from marathon success!

  2. Michael May 12, 2011 at 4:12 pm #

    Since I started running and training for a Marathon. I have talked to two doctors. Both have said the benefits far, far, far outweigh the drawbacks.

    I have had some folks caution me to the point of discouragement. I finally asked them to stop warning me. I was aware of the risks, but I was going forth anyway. I thanked them for their concern and let them know that I had sought medical advice and was given a green light.

    • Angie May 12, 2011 at 8:45 pm #

      You’re definitely taking the right approach Michael. Stick with the expert advice and thank everyone else for their concern 🙂 Happy running!

  3. ben May 18, 2011 at 4:12 pm #

    yeah I’ve had people tell me stuff like, “you always hear about people who are marathon runners who suddenly drop dead one day”… but obviously you hear about it BECAUSE these were such healthy people. if they reported every time a lazy overeater dropped dead, there would be no time for the rest of the news.

    • Angie May 18, 2011 at 9:27 pm #

      Good point Ben. I guess it’s human nature to focus on the anomalies in life. Personally I’d rather wear out than rust out 🙂

    • Paul June 30, 2011 at 9:11 am #

      If they were HEALTHY people, they would not drop dead. The latest study I read was than long time marathon runners who trained “a lot” for many years had more plaque and occlusion in their arteries than sedentary people. AT first glance this may seem contradictory, but if you think about it, it’s not…training and running marathons is very stressful on your body (if it weren’t, everyone would run marathons). It can be very destructive, cause chronic inflammation (maybe this is what causes the plaque), and the only PHYSICAL (not mental) positive may be that you can run for a greater length of time if a mugger (or a handicapped lion) is chasing you. I used to run, but when I saw that I became a bag of bones, always achy, I decided that this just can’t be good for me in the long run. I took up weightlfting, gained 40 pounds (mostly muscle-my waist size did NOT increase), and look younger now (10 yrs later) than I did when I was running. But if you weightlift everday,for too long, you will encounter the same problem as training for marathons daily…too much stress on the body, and you shrink-not grow- and possibly occlude your arteries as well…just my opinion.

      • Angie June 30, 2011 at 9:53 am #

        Thanks for sharing your perspective Paul. I definitely don’t think that overtraining is good for anyone. You’re right that people can overdo it with running and weight lifting (and many other sports). The key is to find a balance between being cardiovascularly fit as well as maintaining strength, balance, endurance, flexibility, and taking recovery time. Getting that yearly physical can also help you know your risk for heart disease.

  4. Paula May 18, 2011 at 10:08 pm #

    My nutritionist tried to get me to stop distance running but I told her absolutely not! So she got me on some supplements to boost my energy. 50-something females sometimes need help with vitamin B and thyroid. Great podcast as usual!

    • Angie May 24, 2011 at 6:10 pm #

      Thanks Paula. I hope those nutritional supplements are working well for you. It’s important to look at the whole health picture before cutting out distance running! Keep up the great work.

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