Is running a marathon a risk to your health?

We live in a world of digital addiction, bad diet and even worse posture.

So is it over-ambitious for many of us to go out and attempt to run 26 miles – a marathon? Would our bodies resist or would our hearts fail under the strain?

Each year in the UK, more than 2 million people applying to run the 200 plus organised marathons annually but according to the sport science experts, tragedies are mercifully few and far between - less than 1 in 150,000.

“Exercise is good for the heart,” asserts David Oxborough, professor of echocardiography and cardiovascular physiology at Liverpool John Moores University, world-leading sport science school.

“We know that regular moderate-intensity exercise improves your cardiovascular risk, it reduces mortality and it has real positive benefits.”

Ultimate physical test

For any human, fit or not-so-fit, the marathon is about as intense a physical feat as is possible, so it is vital that runners both in training and the race itself take precautions to keep themselves safe.

You're going to hurt during and after, and sports scientists say your physiological markers are going to be all over the place.

Markers of muscle damage and heart damage are elevated, at least for a little while. But Professor Oxborough, who has studied these markers, says that they come back down swiftly and don’t seem to be linked to long-term damage.

Having studied heart risk in exercise for more than two decades and run a pre-screening programme which has saved hundreds of lives, David stressed than those that do succumb in a marathon are not random.

Two groups at risk

People who die during endurance running events tend to fall into two categories, often identified after the fact: either younger people who have undiagnosed genetic heart problems, or middle-aged men who have heart disease without any symptoms.  

“If you've got underlying disease, then there is a risk of sudden cardiac death. If you're under the age of 35, that is usually caused by an inherited disease, such as cardiomyopathy. As you go over 35, the main cause is more acquired disease, like coronary artery disease,” he says.

If you're over 35 or 40, go speak to your GP. Get an ECG done.

Professor David Oxborough, School of Sport and Exercise Sciences, LJMU

So should you find out if your heart is healthy enough for a marathon?

“You should, absolutely,” says Professsor Oxborough. “We do pre-participation cardiac screening for young people in competitive sport. This is a simple 12-lead ECG and a questionnaire to young people.” 

That’s enough to start the process of figuring out whether people might have an inherited disease, the experts say. If they do, it doesn’t mean they have to stop training. It just might shape how they decide to train and manage their risk.

What about older people?

The problem with coronary artery disease is that many people have no symptoms in the early stages. 

If you’re thinking of running a marathon and you’re over 35 or 40, here’s what Professor Oxborough recommends: “Go speak to your GP. Have a 12-lead ECG done. Have your blood done. Make sure your cholesterol levels are normal. Have your blood pressure taken and, if any of them show any sign that they may be a higher risk, then we recommend an exercise stress test. And if you're very lucky, if you're able to access it, a CT coronary angiogram,” he says. These are tests that will help establish your baseline and what is likely to be happening in your arteries before you really ramp up training.