Forums » Open clinical » Sport and exercise medicine » Are marathons bad for your health?
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Are marathons bad for your health?
posted at 24/4/2012 12:27 PM BST
on bmj.com
Moved from the General clinical forum
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Posts: 76
First: 16/12/2008 Last: 28/5/2012 |
News of the sudden death of 30 year old Claire Squires at the end of the London Marathon on Sunday has led to widespread shock,sympthay and donations to the Samaritans for whom she was running. Cause of death of this fit, slim 30 year old hairdresser who had already run a marathon before, is still unknown. So should we be advising patients to avoid extreme sports and marathon runnning? There have been 10 deaths during the London marathon since its inception in 1981 (no data on the week or so after). The last death was in 2007 when a 22-year-old fitness instructor died of hyponatraemia,presumably due to overdrinking. Most fatalities are due to undiagnosed underlying heart problems (would that be conduction problems in the young?) Given the numbers running, the fatality rate is reassuringly low. I suppose the question is whether an ecg to check for conduction defect and/ or echo to look for cardiomyopathy are worthwhile before embarking on training for a marathon. The pick up rate's going to be very low but is there any down side (apart from time,money and false reassurance)? Certainly, if there's a family history of sudden death, should we suggest investigations? I've just run my first and last marathon at the age of 52. My dad dropped dead of a heart attack at 48 but I figured that if I didnt get any chest pain while training, I'd probably be ok. And I was. I didn't really consider having any checkups before. What do you think? Foolhardy or rational? http://www.guardian.co.uk/sport/2012/apr/24/claire-squires-donations-london-marathon?newsfeed=true |
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Re: Are marathons bad for your health?
posted at 24/4/2012 1:18 PM BST
on bmj.com
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Posts: 2043
First: 12/3/2010 Last: 21/5/2013 |
Well done Anne! There are still nearly 2000 deaths a year from road accidents, but also still falling.
Should we tell people to stay at home, not drive, cycle or walk anywhere near a road and wear full body armour? I suspect that like Fabrice Muamba and the maraton death you quoted, , most deaths associated with sport are due to occult dysrythmias, not ischaemia, or to the excessive heat and dyhydration demands on endurance athletes. The resources required to detect the first would also be excessive, while the care and observation to prevnt the second might be, and I am sure have been, instituted in marathons. John |
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Re: Are marathons bad for your health?
posted at 24/4/2012 1:22 PM BST
on bmj.com
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Posts: 318
First: 27/10/2011 Last: 20/5/2013 |
Hi Ann, Firstly, congratulations on your first marathon. It is a gargantuan effort and I'm sure positions you well to understand the duress the body is placed under before, during and after such trials. There are a few intersting points here. Of course, the marvellous case of Fabrice Muamba highlights the stark contrast in possible outcomes. Tragic or miraculous, these are sensational stories for the media that distort the reality of the risks involved - expert, politically unmotivated and media-free opinion can be the only guide here... But does knowing actually help? Are we able to predict those at risk accurately enough to avoid the psychologically and physically detrimental effects of knowing that if you push it too hard, you could die? When I was at school, there was a boy in my house called Richard van Rossum who knew he had a deadly cardiac arrhythmia. He had an internal defibrillator/pacing device. He was a marvellous guy, full of spirit, and very active. He played many sports and did so well. And with all that, he collapsed and died running to a History lesson. It was a huge shock, especially considering the circumstances, but something he and his family understood could happen. His father, an Olympic hurdler, continued to coach at the school for a few years after his death, which was such a typically selfless gesture of the family and was hugely appreciated. What can you do? |
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Re: Are marathons bad for your health?
posted at 24/4/2012 1:25 PM BST
on bmj.com
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Posts: 1177
First: 19/4/2010 Last: 16/5/2013 |
Good response, JohnD, as ever. I'm training for IronMan triathlon. An extreme event, for sure. Anyone who is even considering long distance triathlon racing needs to know the risks of poor hydration/overhydration, poor nutrition, etc, and also how to train and race at the right intensities to reduce risk. But no amount of planning can prevent an occult dysrhythmia. Who's to say that she wouldn't have had had the fatal arrhythmia whilst walking around TESCO?
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Re: Are marathons bad for your health?
posted at 24/4/2012 5:14 PM BST
on bmj.com
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Posts: 578
First: 8/6/2011 Last: 19/5/2013 |
One important point of the clinical examination is to examine and take ecg from both parents. I was a runner of long distances , But say the truth i never took place in a competition. Anyway i was trainning or very early in the morning ( around 5-7 a.m) .or in the night (after 9 OO pm) . Becouse the wether was more pleasent for me at these times ) And as i was prefer to train in lonly places , now i am thinking that if i would have colapsed somewhere they would had find me after many-many hours or even days... |
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Re: Are marathons bad for your health?
posted at 25/4/2012 10:46 AM BST
on bmj.com
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Posts: 15
First: 24/6/2009 Last: 9/5/2013 |
In Response to Re: Are marathons bad for your health?: Corection : weather . ( propably there are other mistakes also , but i hope that you will tolerate me until i perfect my english ) Posted by ikaros Great to see the discussion. This is a topic we grapple with at the BMJ. Clearly the benefits of physical activity greatly outweigh the slightly increased risk of sudden death while exercising. In older people the most common causes of sudden death are ischaemic heart disease in contrast to those in younger people. In Italy, sports club members need to be screened. In France, you need to provide a note/certificate to say you are fit to exercise (How a doctor decides is another issue!). In the UK, you just turn up. Should people be screened? See some of the stuff in the BMJ: Clinical ReviewPreparticipation screening for cardiovascular abnormalities in young competitive athletesMichael Papadakis, Greg Whyte, Sanjay Sharma BMJ 2008;337:a1596 (Published 29 September 2008) ResearchCardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional studyFrancesco Sofi, Andrea Capalbo, Nicola Pucci, Jacopo Giuliattini, Francesca Condino, Flavio Alessandri, Rosanna Abbate, Gian Franco Gensini, Sergio Califano BMJ 2008;337:a346 (Published 03 July 2008) ...of such cardiovascular screening on reducing sudden death...participants with a positive screening result are not available...some potentially fatal cardiac diseases such as coronary...Cardiovascular pre-participation screening of young competitive... Head to HeadCan electrocardiographic screening prevent sudden death in athletes? YesAntonio Pelliccia, Domenico Corrado BMJ 2010;341:c4923 (Published 14 September 2010) ...electrocardiographic screening prevent sudden death...2 Department of Cardiac, Thoracic and Vascular...electrocardiographic screening of athletes would...evidence suggests that screening with electrocardiography...the risk of sudden cardiac death in young athletes EditorialSudden cardiac death in young athletesJonathan A Drezner, Karim Khan BMJ 2008;337:a309 (Published 03 July 2008) ...supports a systematic screening programme before...risk for sudden cardiac death is a highly...pre-participation screening programme for all...examination, and screening electrocardiography...Board for the Sudden Cardiac Arrest Association... |
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Re: Are marathons bad for your health?
posted at 25/4/2012 3:23 PM BST
on bmj.com
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Posts: 1264
First: 13/4/2010 Last: 20/5/2013 |
I do have problems with the concept of road running per se (as opposed to running on fields, beaches or forestry tracks) bcause I think, even with the best training shoes, you are doing repeated damage to you ankles, knees, hips and lumbar spine which will come back to haunt you. I know it from first hand experience. I spent my youth playing football, tennis, squash, volleyball, basket ball, etc. on an almost daily basis but almost always on hard surface such as clay. Now in my late 40s my knees and hips hurt :-( I don't run myself (my sore knees and hips now prefer yoga and non-weighbearing activities like swimming) but I am led to believe by friends who do run seriously that you should change your running shoes every 8 weeks if you are a serious runner otherwise all their support has gone. But in reality how many folks do that? Certainly none of my running friends do! |
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Re: Are marathons bad for your health?
posted at 25/4/2012 9:26 PM BST
on bmj.com
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Posts: 3
First: 25/4/2012 Last: 5/11/2012 |
Here is an answer to the question about what the causes are of Sudden Cardiac Death in the Young (it's from BJSM (Br J Sports Med) http://tiny.cc/e97bdw |
Forums » Open clinical » Sport and exercise medicine » Are marathons bad for your health?
