It's been a month since I've been out of my boot. I've enjoyed progressing up to a 7 miler this week on trails. It was AWESOME! My foot still has some issues to work out, but I am hoping it is form related and something that I can correct.
I recently read a news article that concerned and frustrated me. At first it just made me angry that the thing I love is now considered "unhealthy". But now I just think it is a piece of information that will transform endurance athleticism and re-create a better and more powerful way to train. I'm hoping the world of crossfit endurance is my calling, but we will see :)
Here's the most recent article I've read on the topic:
Moderation in endurance exercise, as with anything in life, is the key to staying healthy and minimizing risk.
Anyone who’s finished a marathon or Ironman wouldn’t be shocked to
find that the effort caused damage to their body and heart.
Traditionally, though, that damage has been thought to be only
temporary, subsiding after a few weeks.
But, a newly published report in Mayo Clinic Proceedings suggests
that the damage endurance athletes do to their hearts actually adds up
over time. Repeated extreme exercise or long-distance racing can cause a
buildup of scar tissue on the heart, which can lead to the development
of patchy myocardial fibrosis in up to 12% of marathon runners. The
effects of “chronic exercise” can also include premature aging of the
heart, stiffening of the heart muscles, and an increase in arrhythmias
and atrial fibrillation.
“It’s a cumulative thing,” said Dr. James O’Keefe, of the Mid-Atlantic Heart Institute and one of the authors on the study.
“More [exercise] is certainly not better,” said Dr. Chip Lavie, another author on the study and a cardiologist at the Ochsner Medical Center.
In fact, in the release announcing the study, the recent death of ultra-marathoner Micah True–who
frequently ran distances in the range of 50-100 miles–during a training
run is called out as likely being connected to the long-term effects of
excessive endurance exercise. An autopsy of his heart found it enlarged
and scarred and suggested that he died of a lethal arrhythmia, or
But, most of us run far less than Micah True did.
How much less is best is still a question that doctors are trying to
figure out. O’Keefe suggests that aiming to run even three marathons
every year is “not a great goal,” simply because that appears to be
enough to cause long-term damage over the years. “I would advise against
that based on what I know,” he said.
Lavie, who runs 35 to 40 miles a week, says the exactly when heart
damage starts to accumulate is unknown and depends on the person. “We
don’t know enough to draw a line,” he said. The needed studies are
exceptionally challenging and expensive to do. And, Lavie joked, no
one’s going to fund a study to tell people to exercise less.
Certainly, running 10 to 15 marathons a year, or even five marathons a
year for 20 years, is too much, he said. But, that’s not to stop people
from running a marathon or doing an Ironman even if they want to — just
know that it isn’t really going to make you healthier.
The best health outcomes are actually found far below the exercise
levels of even casual endurance athletes. A 15-year observational study
of 52,000 adults found that the highest degree of survival and health
was found from running less than 20 miles per week, in runs of 30 to 45
minutes over three or four days, at about an 8:30 to 10:00 pace. The
benefits decrease at amounts greater than that.
“People who exercise moderate amounts do very, very well,” said Dr.
Jonathan Myers, an exercise physiologist and cardiopulmonary researcher
Myers emphasizes that runners, even extreme endurance athletes, have
better life expectancies on the whole than people who never exercise.
People who exercise generally live longer – something much of the
population still needs to learn.
“Certainly, the biggest problem in the country is not over-exercise,” said O’Keefe.
While the lack of exercise remains a national problem, the dangers of endurance races have been touted before.
In 2010, three high-profile fatalities in marathons sparked concern about sudden cardiac death. But, a study in the New England Journal
found that the rate of deaths in marathons continues to be very low,
between one in every 100,000 and one in every 200,000. With 500,000
people running at least one marathon in 2010, the number of total deaths
were simply higher.
“The majority of people are able to do a marathon and don’t die,” said Lavie.
Finishing just one marathon, though, does cause temporary damage to a runner’s body.
Multiple studies have shown that immediately after a marathon, 30 to
50% of runners show increased levels of enzymes and biomarkers that are
typically released during heart attacks
and associated with heart failure. Originally, it appeared the
race-related damage was less severe in people who trained over 45 miles
per week, but O’Keefe says that doesn’t prove to always be true.
In fact, elite athletes often suffer from an enlarging of the heart
and thickening of the heart muscle known as “athlete’s heart.”
Much of the damage seen immediately after the race goes away within
the month. It is only when the heart is consistently and repeatedly
damaged that the scarring builds up. If you’re going to continuously
compete in long-distance running, cycling or triathlon events, there are
a few precautions you could take, O’Keefe says.
Break up your exercise to give your heart a rest, recommends O’Keefe.
Sitting at your desk, your heat pumps about five liters per minute, but
during exercise it can pump up to 25 liters a minute. “That’s a lot of
cardiac work to do for four hours at a time,” he said.
Vigorous activity, which O’Keefe defines as activity where it’s hard
to carry on conversation, should be shorter than an hour at a time. In
fact, much of the heart damage comes from the combination of intensity
and duration found in a race, according to Lavie. He suspects that going
15 minutes slower in a marathon would drastically decrease the
long-term health effects. But, that’s not something many runners want to
In order to find out if your heart has scarring or damage, athletes
can get an MRI, CT scan or echocardiogram, but the problem is most
insurance plans probably won’t cover it.
Most importantly, though, O’Keefe, Lavie and Myers all note that
people do marathons or Ironmans or cycling races for plenty of reasons
besides optimizing their health. O’Keefe compares running an
ultramarathon to climbing Mt. Everest – a bucket-list item for many, but
not one without its dangers.
“I don’t think anyone climbs Mt. Everest thinking it’ll be good for their health,” said O’Keefe.