Health risks associated with ultramarathons

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If you ever visit the finish line of any ultramarathon, you can easily conclude that such races are unhealthy. Weary runners, sore feet, and crowded medical tents are not uncommon.

We know that regular physical activity has a range of benefitsFrom reducing disease risk to improving brain health. But ultramarathons don’t have to be “regular physical activity,” and recent research suggests they can actually have long-term risks. These negative health outcomes can seem alarming. However, according to experts and current evidence, most people can safely participate in sprints with smart training and racing habits.

Heart concerns

According to Nick Teller, MD, a researcher and researcher at Harbor-UCLA Medical Center, the biggest area of ​​concern about potential long-term risks of ultrarunning is cardio. This is because the cardiovascular system can be easily altered by activity and is essential to health.

Recently, Teller co-authored A reconsidering A possible long-term effect of ultra-endurance racing. First of all interests? Maladaptation of the heart.

Competing in the ultramarathon requires a great deal of training that forces the body to adapt. Changes – like Increased capillary density Which allows more blood to be delivered to the muscles, or Increased blood delivery With each heartbeat you allow for more efficiency – improving your running ability.

“All of these things are favorable, but the downside is, because your cardiovascular system is so flexible, you can have adverse reactions as well,” Teller says. These negative responses are well documented. Lifelong runners have an increased risk of developing it predictive factors To treat heart disease and death, such as atrial fibrillation (a heart rhythm disorder) and myocardial fibrosis (scarring of the heart). Likewise, runners can evolve Right ventricular weakness (the right ventricle of the heart loses its efficiency) and coronary artery calcium buildup (calcium-rich plaques in the arteries).

Related: How Common Are Heart Problems in Athletes, Really?

These adaptations are found in a large portion of endurance athletes. The prevalence of atrial fibrillation was among endurance runners and professional cyclists have found to be five times larger than the other groups. Search Published in the journal Rotation It has been found that more than 50 percent of endurance athletes display right ventricular hypertrophy. else studies Elevated levels of plaque were found in nearly 50 percent of the participants who exercised vigorously.

If all of this sounds alarming, there is good news. According to Tiller, there is some evidence to suggest that higher levels of aerobic fitness and higher training volumes do not actually put you at increased risk of death. In fact, one study concluded that higher training loads and associated increased coronary artery calcium (CAC) did not appear to increase the risk of death or heart disease. another more recent study It found that although people who trained with higher volumes had higher levels of CAC, they did not experience more adverse effects than those who exercised less.

“I want to be very clear that running is healthy, more so than being a sprinter,” says Dr. Mark Hurst, MD, a University of Washington sports medicine physician and medical director of the Seattle Marathon. He has published research on optimal levels of exercise for cardiovascular health. “We just don’t know what the limit is [of healthy exercise] he. But with the limited evidence we have, it appears there may not be a definite limit. It may not be better to do more, but it may not be worse either.

High levels of training definitely cause changes in the heart. Some of these changes may be associated with negative outcomes, but the important question is whether they actually lead to health problems and increased mortality. Hurst says there isn’t enough data to give a definitive answer, but mounting evidence suggests there’s no clear point where the potential risks outweigh the benefits of running.

Takeaway? If you’re healthy, it’s probably safe Keep training.

Kidney damage

The heart is not the only part of the body affected by ultrasound. Racing stress affects multiple body systems. One of the most common health risks on race day is acute kidney injury (AKI), which is an episode of kidney failure. During exercise, blood flow to the kidneys decreases, and as a result, kidney function decreases. Often, acute renal insufficiency is exacerbated by high temperatures, dehydration, and anti-inflammatory ingestion; It is commonly observed among both marathoners and ultramarathoners.

These infections are short-term ailments, and often resolve within a few days. However, it is repeated AKI It has been linked to an increased chance of developing chronic kidney disease. How strong this link is, and how vulnerable ultra-runners are, is unknown.

During a race, the most common advice to mitigate the risk of acute renal impairment is to follow current guidelines for fluid intake and salt replacement. “After the race, there are a lot of things to worry about, including acute kidney injury becoming more of a chronic kidney injury,” Hurst says. “You need to recover before you start pounding the pavement or start pushing too much.”

Bone and muscle damage

Many runners worry about joint damage, and with good reason. Musculoskeletal injuries Mutual among endurance athletes. These can range from stress fractures to muscle tears to tendinitis. Nearly 90 percent of injuries suffered by ultra-endurance athletes are related to overuse, according to study Posted in Sports medicine. This makes sense, given the high training volumes needed to complete these events. While low to moderate levels of running have been linked to increased bone strength, high volumes can have the opposite effect.

Related: 10 Tips to Avoid Injury and Run Healthy

There are some Evidence Something similar happens with the development of runners’ arthritis. “When you’re not running at all, you have a higher level of arthritis. If you’re a light to moderate runner, your chance is lower. These levels of running are actually effective for preventing arthritis,” Hurst says. However, with larger runners, the data isn’t clear, but it “suggests that there is more arthritis in this population.” He asserts that most people should not avoid running for fear of developing arthritis.

For runners concerned about developing osteoporosis, Hurst recommends an individual approach, as some factors can make a person more likely to develop osteoporosis. These include previous knee injuries and family history. Runners can consult a physician or physical therapist to develop strength training programs designed to help prevent the development of arthritis, and they should be careful with increasing their training and recovery volume.

Youth participation

Most experts agree that the ultramarathon is not for teenage athletes. “We know that young athletes, under the age of 16, shouldn’t participate,” Teller says. Young athletes who participate in ultras tend to get injured more often than their peers, and are more likely to get injured in adulthood, and Often it does not last To participate in ultra endurance events.

Hurst agrees. It is recommended that “for long distances such as the marathon and above, wait until late in high school, if not later.” He stresses that any participation must be youth-driven, and higher training volumes must not be the result of parental pressure or guidance. The stress on the body is excessive, the levels of training needed to perform well are likely to be too high, and the risk of burnout increases. And so, many experts recommend Discouraging young people from specializing in one sport until after puberty.

risk mitigation

The stress of racing is evident throughout the body after the race. “You get a huge change in the body. You get a significant decrease in lung function, a significant decrease in heart function, and a significant increase in inflammation,” Teller says. Most of these changes resolve within a few weeks. For the most part, on intermittent doses, Not to worry. But Teller, who recently turned 40, is concerned about the long-term effects of repeated exposure to these stresses, and has changed his racing habits accordingly.

“Knowing the manners as well as I do, I’m much more conservative now with my running. I used to race between three and five ultras a year, but these days I’m more selective, especially as I get older,” he says. The time between races allows the body to recover.

The time it takes between races varies for different individuals. Teller suggests at least a few months between ultramarathons, but this will vary depending on distance, effort, and other similar factors.

Likewise, here’s Harrast’s biggest tip for would-be ultrarunners: “Respect the distance and make rest part of your training regimen,” he says. He stresses that recovery is essential both in training and after the races. “Really, it just means paying attention to your body. Don’t go through injury and pain. Don’t try to push when you’re not ready for it.”

Hurst says runners should try to get good sleep, nutrition, and take care of any ailments of the musculoskeletal system. Whether it’s through massage and myofascial work or cross training and rest days, recovery is essential to maximizing health and longevity in sports. Likewise, by following an individualized training plan tailored to you, you can improve your race results while enhancing recovery and mitigating the risk of overtraining.

So, is ultramarathon safe? For the most part, yes. By making informed decisions about what races to run, how often to race, and how well you recover, most people can participate in ultramarathons without negative results. Running is good for your health and ultramarathons can be a fun way to challenge yourself and compete with like-minded people.

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