Marathons, triathlons, biathlons, mega marathons, and other super intense races and challenges seem to be becoming more popular these days. In fact, in the past year, registrations for marathons has increased by two million!  Interestingly, we are beginning to see a significant divide between those that take workout to the extreme and couch potatoes or chair pears. Concern is arising that marathon running may not be safe for the heart. Specifically,  the Canadian Cardiovascular Congress states that moderate exercise will reduce your risk factor for heart disease by two to three fold, but marathon running can actually increase your risk for heart problems by seven times! Other studies in the Journal of Applied Physiology and Circulation have noted that the hearts of marathon athletes are scarred in comparison to those who do not run. While these concerns are legitimate, they are only pieces of the puzzle of the safety of marathon running.

In January 2012, the New England Journal of Medicine release an article titled “Cardiac Arrest during Long-Distance Running Races.” After an analysis of 11 million marathon runners, they concluded that there is a low overall risk of cardiac death or sudden death associated with half-marathon or marathon running.

However, men should be careful…

The study noted that there is an increase in the number of older men participating in marathon running over the last few years. Unfortunately, many of these men have pre-existing enlarged hearts or heart disease that places them at an increased risk of having a heart problem during a race. The same holds true for women with known heart disease. Therefore, approval from your cardiologist is an absolute must before taking on a marathon. Please don’t overlook this important fact.

To address the “scarred hearts” noted in other studies- scarred heart muscle tissue in endurance athletes has no direct implication at this point. Sure, a scarred heart may be “a bad thing,” but chances are the changes seen are positive adaptations to exercise. We know that when a muscle is worked, fibers tear and the muscle becomes stronger. The same is true for the heart. When you exercise or run, the heart remodels itself to become more efficient at pumping blood. It may be that the scarring is evidence of the remodeling process and a positive adaptation to exercise. But neither side can be confirmed to date.

So, is marathon running safe?

1 in 184,000 runners [are at risk] for developing cardiac arrest during or just after a run. The risk of sudden death was 1 in 259,000, which the researchers characterized as “a low overall risk.”

Here are a few points to consider:

  1. Most importantly, check with your doctor… Always… Even if you are young or a woman.
  2. Interval training and 20 minute workouts should be your “bread and butter.” Much research has shown that shorter, more intense workouts are better for you overall.
  3. Listen to your body. If you get chest pain, become excessively short of breath, note dizziness or experience any other concerning signs or symptoms, you should not ignore them! Go get checked out! It could be the difference between life and death…
  4. The key is moderation. Space out your marathon running. Compete in shorter 5K or 10K runs and make your goal the fastest time, instead of the longest race.

Be smart, keep your doctor on board, and enjoy being the marathon running athlete you are!

What kinds of aerobic or cardiovascular activities do you participate in? Share your comments below!