(Photo: Getty Images)There are three types of people: those who run marathons, those who think marathon runners are insane, and those who don't run marathons but secretly harbor the desire to run one-and think they would become a better person if they did.
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The physical indignities of marathon day are graphic and humiliating but add to the mystique of the courageous runner: blisters, black toenails, chafing in weird places, and the aptly named "trots" are badges of honor. You may hit a wall, you may publicly throw up, you may fall in an ugly heap across the finish line, but still, wrapped in your cape-like silver space blanket, you will be a superhero.
This year's ING New York City Marathon, which has exploded to 45,000 plus participants from the original 245, is a supermodel smackdown starring Christie Turlington vs. Veronica Webb. Sean Combs ran a marathon after only 12 weeks of training, Katie Holmes did it to "get rid of her baby weight." And who can forget Oprah? A quick Internet search yields thousands of training programs that will supposedly get you race-ready in a few months. The prevailing message is of marathon boosters is: anyone can do it.
The bad news is, not everyone can or should. "The real victory is in keeping fit over the long haul, keeping weight off, and minimizing behaviors that increase cardiovascular risk," says Leslie A. Saxon, MD, Chief of the Division of Cardiovascular Medicine at UCLA. She continues, "I know people who do it and train incessantly. They have very little in cardiovascular and immunological reserve. They get sick a lot and faint easily."
Chris Osgood, a former National Team cross-country skier who holds an advanced degree in kinesiology points out that, "26.2 miles doesn't make physiological sense and is based on an arbitrary benchmark. The body only has about 2000 calories available for use--that's why runners hit 'the wall' at 20 miles. A saner distance is a half-marathon." He reminds us that the runner in Greek myth who ran 26 miles to tell the Athenians of their victory over Persia dropped dead of exhaustion.
Reasons not to run a marathon include:
Heart damage. A 2010 study co-hosted by the Canadian Cardiovascular Society and the Heart and Stroke Foundation found that more than half of the segments in the heart's main pumping chamber decreased functioning during and after the race. This condition was worse in novice runners and took up to three months to reverse. A 2006 study on otherwise healthy male endurance runners aged 50-72 found that frequent marathon running may correlate with increased heart damage.
Hypotremia. A study by the New England Journal of Medicine found that hypotremia, or over-hydration, is "an important cause of death and life threatening illness among marathon runners." The study pointed out that non-elite runners and marathon walkers are particularly at risk because they take in more fluid over a greater length of time during the race.
Sudden cardiac arrest. Every year, a handful of runners, often young and physically fit, die during marathons from sudden cardiac arrest. Part of the problem is that participants aren't required to have physical exams before race day-which might expose underlying conditions. Saxon recommends, "Anyone thinking of doing it should get a cardiovascular assessment that includes a history, a physical exam, and an ECG."
Overuse injuries. Both training for and running a marathon can cause overuse injuries such as tendonitis, stress fractures, and shin splints. A 2005 survey of male participants in the Rotterdam marathon found that more then 15% suffered a leg or foot injury in the month proceeding the marathon and more than 18% were injured during the race.
Time commitment. In an article published by the Hospital for Special Surgery in New York City, Rebecca Demorest, M.D., recommends that runners, both elite and recreational, will need at least 14-24 weeks of training four-six days a week to prepare for a marathon. She goes on to say, "Overuse injuries such as shin splints, IT band syndrome and patellofemoral stress syndrome can plague runners, especially during long distance runs, so proper training and cross training is essential. Acute injuries such as ankle sprains, falls and dehydration can unfortunately not always be avoided."
No one doubts the health benefits of running, but moderation is a safe route for the average person. Dr. Paul Thompson, a former marathon runner and head of cardiology at Hartford Hospital in Connecticut, put it this way in an interview with CBS news, "I don't recommend that people run marathons. I want all my patients to walk a minimum of 30 minutes every single day." Maybe its time to delete "run a marathon" from your bucket list and be content to sit back and watch others experience "the thrill of victory"-and the agony of the feet.
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