Marathon Health & Injuries

There is a common assumption that runners, and marathon runners in particular, will lead healthy lives and not be beset by illness. But marathon health and injuries has a dark side and this article will outline some of the hazards and health threats that runners can face, along with some of the measures you can take to avoid them.


The most famous victim of marathon running is the author and marathon aficionado, Jim Fixx, who died while training near his home in Vermont. Fixx had taken up running at the age of 35, when he was 240lbs (110kg) and smoking two packets of cigarettes a day. By the age of 60 he had lost 27kgs, was smoke-free and had become a marathon expert, writing a best-selling book called The Complete Book of Running.

Unfortunately, cases like Fixx, and US Olympic marathon hopeful Ryan Shay, who died at the age of 28 from an irregular hear-beat, are used by non-runners to justify their reluctance to take up the activity. These cases are rare and only make the headlines for that very reason. But that does not mean that people who push their bodies to extremes do not have to be careful and look after their well-being.

When you run long distances your heart does undergo some changes to cope with the pressure. The muscle walls strengthen to cope with the increased flow of blood and on some, rare, occasions this can result in arrhythmia. The jury is still out on whether this is caused by exercise or whether it is a hereditary condition that gets exacerbated.

Runners are always advised to go to the doctors for a check up before embarking on a training program. And certainly, if you feel anything unusual during or straight after you exercise, you must go to the doctors. This includes excessive breathlessness, extreme fatigue, dizziness or a general lethargy.

Another potentially fatal problem that runners may face is water toxication, or hyponatremia. This occurs when you drink too much water, and as runners are always being told to stay hydrated, this is a condition to be wary of. Hyponatremia occurs when an excessive intake of water dilutes sodium levels in the blood to an extent that causes a chemical imbalance. This results in electrical transmissions to the muscles becoming uncoordinated, which can lead to a sudden cardiac arrest.

It must be stressed that these are rare cases and there are many millions of runners around the world who will never experience such problems, but is also emphasises the need to get regular health checks.

More common marathon health and injuries problems involve the lower limbs. Over-use injuries are annoying and can become long-term if they are not dealt with quickly. Sprains and pulls to ligaments and tendons, also known as tendonitis and strains and tears to muscles are equally common and can become problematic if left untended.

The golden rule in these cases is to stop running, get ice and heat treatment to the affected area and, if possible, get some physiotherapy. Minor sprains and tears should repair quickly, and so a week of active recovery (swimming or cycling) will soon see you back on your feet.

Some injuries are more stubborn and can take a few weeks to recover. Bursitis or shin splints are classic cases of injuries that seem fairly innocuous but keep stubbornly returning just when you thought you had recovered. There is not much you can do besides following the ice, heat and rest (from running) protocol and get treatment to help speed the process.

Running can be a good gauge of your general health. If you struggle to complete a run that you normally breeze through, or if you feel nauseous during a run that is not excessively hard work, then you could be sickening for something. At this point, prevention is better than pushing on with your training program and you should just take a few days off to allow your body to recover.

Marathon health and injuries tend to get accentuated because you are pushing your body harder than average humans. Someone who sprains their ankle on the way to work would probably find it mildly irritating, whereas for a runner that is a major blow to their training program. Likewise with a cough or a cold. A sedentary person would take a cold remedy and carry on as normal; a runner would anxiously assess whether they could still do a run despite a streaming nose. In this situation a rule of thumb is that, if the symptoms are above the neck then you can carry on, anything below the throat should be treated with caution (rest).

The biggest enemy of the committed runner is over-training. You have your goal, you want to get there quickly; you overdo it and have to take an enforced break from training. Remember to take small steps towards your goal; you will get there quicker in the end.