Long Distance Running Can KILL You

In 490 BC, after the Battle of Marathon, Pheidippides ran 25 miles to Athens to announce the Greek victory over the Persians.  When he arrived in Athens he said, “We have won!” and then he collapsed and died.  Thus, the Marathon was born.  Rather than make a correlation between Pheidippides death and running a distance of 25 miles immediately prior to his death, runners have decided to celebrate this event by attempting the same feat without suffering the same fate.  Long Distance running can kill you by inducing arrhythmia, increasing coronary plaque, and causing scar tissue to be formed in and around the heart.

The first Marathon did not end well.


Well known distance runners in good shape who died at a young age:

490BC – Pheidippides, a messenger by trade, runs 25 miles from Marathon to Athens to deliver news of a Greek victory.  After delivering the message, he collapses and dies at the age of 40.

7/20/84 – Jim Fixx, author of “The Complete Book of Running”, drops dead of a heart attack at the age of 52.  Dr. Eleanor N. McQuillen, Vermont’s chief medical examiner who performed an autopsy on Mr. Fixx, said in an interview that all three of his coronary arteries were damaged by arteriosclerosis, the underlying cause of heart attacks.

3/19/04 – Brian Leigh Maxwell, an avid marathoner and founder of PowerBar dies of a heart attack at 51 years old. 

12/19/04 – Greg Marr, Editor of Silent Sports magazine and an avid runner, dies unexpectedly while skiing at Iola Winter Sports Center in Iola, Wisconsin. While skiing, Marr collapsed as the result of a heart attack. He was only 52 years old and in excellent physical condition.

Those are just a few of the many examples and those don’t include individuals who had heart attacks but did not die.  All of the aforementioned cases were of individuals in peak physical condition, with no genetic abnormality (e.g. enlarged heart) and were avid distance runners and marathoners.  None of these cases involved an out of shape individual who ran all out on a whim and suffered a heart attack.  How do seemingly “fit” individuals drop dead at a relatively young age?  The activity they thought was increasing their life span ultimately cut it short. 

Long Distance running can induce arrhythmia
 An arrhythmia is also known as an irregular heartbeat.  When a heart beats irregularly, it can either beat too slow (bradyarrhythmia – less than 50 beats per minute) or too fast (tachyarrhythmia – faster than 100 beats per minute).(1)  “Athletes with no discernible danger can be susceptible to arrhythmias, especially during runs of 15 miles or more. On long runs you can become significantly dehydrated, leading to changes in the blood’s levels of potassium, magnesium, and calcium.  These chemicals play a vital role in starting and conducting electrical impulses in the heart.”(2) An arrhythmia can lead to cardiac arrest and ultimately death.  Notice the key statement above (15 miles or more), we aren’t talking about a jog around the block.

Long distance running INCREASES coronary plaque buildup
Based on the multitude of treadmills at the average gym, the idea of jogging endlessly gives the impression that you are “getting in some cardio” and that “your heart will thank you”.  Two recent studies show that is NOT the case.  One study, administered at the West-German Heart Center Essen, focused on male marathoners age 50 and up.  Among the study’s findings, while the runners had lower than average cholesterol levels and better blood pressure, they had more measurable coronary calcium buildup or plaque than the general population.  In the study, German scientists scanned the hearts of 108 experienced, male distance runners in their 50s, 60s and 70s.  The runners had completed a minimum of 5 marathons in the previous 3 years.  When the researchers studied the runners’ scan results, they found that more than a third of the men showed evidence of significant calcification or plaque build-up in their heart arteries.  Several also had scarring of some of the tissue in their hearts.  The researchers stated, “In our study regular marathon running seems not to protect runners (from coronary artery disease).  In fact, we even cannot exclude the possibility that exercise to this degree has deleterious effects on coronary arteries.”(3)

A second study of 25 middle-aged male runners, each of whom had completed the Twin Cities Marathon annually for the past 25 consecutive years, demonstrated they had significantly greater mean volumes of coronary calcified plaque than did age-matched sedentary controls.  The lead researcher, Dr. Jonathan Schwartz said, “The bottom line here is just because you run a lot of marathons and you’re very active doesn’t mean you’re protected from coronary artery calcification.  Benefits to long-term, high-volume endurance training for overall health include favorable body mass index, heart rate, and lipid panel, but these may be counterbalanced by metabolic and mechanical factors that enhance coronary plaque growth.”(4)  Coronary plaque reduces blood flow which can result in a heart attack and if a piece breaks off, one may suffer a stroke.  Heart attacks and strokes usually result in various forms of irreparable damage and often result in death.

Long distance running increases the buildup of scar tissue in and around the heart
A recent study published in the Journal of Applied Physiology(5) examined the incidence of myocardial fibrosis (scar tissue in and around the heart) in veteran lifelong endurance athletes.  The study involved 12 veteran athletes ages 50-67, 20 age-matched controls (non-athletes) ages 52-69 and 17 younger endurance athletes ages 26-40.  50% of the veteran endurance athletes had scar tissue in and around their heart versus ZERO in the younger athletes and the non-athletes who were the same age.  As stated in the study, “The affected men were, in each case, those who’d trained the longest and hardest.  Spending more years exercising strenuously or completing more marathon or ultramarathon (>50 miles) races was, in this study, associated with a greater likelihood of heart damage.”(5)  Scar tissue is rigid and can cause the heart to beat irregularly and ultimately lead to heart failure.  A recent study in laboratory rats(6), showed a link between certain kinds of prolonged exercise and heart damage.  For the study, published in the journal Circulation, scientists had young, healthy male rats run at an intense pace, day after day, for three months (10 years in human terms).  The training was designed to mimic many years of serious marathon training in humans.  The rats had begun the study with perfectly normal hearts.  At the end of the 3 months, heart scans showed that most of the rats had developed scarring and some structural changes, similar to the changes seen in the human endurance athletes.  A control group of unexercised rats had developed no such changes to their hearts.

I know what some of you are saying, “I am not running marathons for a living, I just want to do one!” OR “I have ran a marathon a few times, what’s the big deal?”  Did you know that the stress placed on your body after just one marathon can produce inflammation and negative effects that last for up to 3 months!!!  Dr. Eric Larose told the 2010 Canadian Cardiovascular Congress, “…marathon running can damage your heart.  Fortunately the exercise-induced injury is reversible over time, but it could take up to three months to completely recover.”(7)

Marathoner vs Sprinter: which would you rather look like?

The fact of the matter is that our bodies were not meant to run long distances for long periods of time.  At the end of the day, we are animals.  Have you ever watched the Discovery Channel or observed animals before?  If you have then, you would notice that the vast majority of the time they are resting.  Whether it is your dog, your cat or the lion hanging out in the Serengeti in Africa, the vast majority of the time, they are relaxing.  When they do move to catch pray or avoid a predator, they sprint.  This activity does not happen often or for prolonged periods, it is only when necessary.  Their “exercise” involves short intense bursts not long slow movements such as jogging.

You don’t see him jogging for hours on end

The intent of this article is not to justify being lazy or sitting and doing nothing.  Most folks in America don’t have the problem of too much exercise, but rather too little.  What I don’t want to see is you wasting your time doing distance running when you can get better results in less time, all without damaging your heart.  The best part is that you can gain muscle AND burn fat rather than look like a skinny weakling!!!  Tune in next time to find out the cardio that you SHOULD be doing.




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1) Robert J Bryg, MD. “Heart Disease and Abnormal Heart Rhythm (Arrhythmia)”, Published on 3/7/09, Accessed on 3/25/11. http://www.webmd.com/heart-disease/guide/heart-disease-abnormal-heart-rhythm

2) Jennifer Pirtle. “The Heart of a Runner”, Runner’s World magazine. August 2004.

3) Breuckmann F, Möhlenkamp S, Nassenstein K, Lehmann N, Ladd S, Schmermund A, et al. “Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners”, Radiology. April 2009 251:50-57.

4) Schwartz JG, Merkel-Kraus S, Duval S, et al. “Does elite athleticism enhance or inhibit coronary artery plaque formation”. American College of Cardiology 2010 Scientific Sessions; March 16, 2010; Atlanta, GA.

5) Wilson MG, O’Hanlon R, Prasad S, Deighan A, Macmillan P, Oxborough D, et al.  “Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes”, Journal of Applied Physiology. Published online 2/17/11. http://www.ncbi.nlm.nih.gov/pubmed/21330616

6) Begoña Benito, MD; Gemma Gay-Jordi, PhD; Anna Serrano-Mollar, PhD; Eduard Guasch, MD; Yanfen Shi, MD; Jean-Claude Tardif, MD, et al. “Cardiac Arrhythmogenic Remodeling in a Rat Model of Long-Term Intensive Exercise Training”, Circulation. 2011;123:13-22. Published online before print December 20, 2010.

7) Dr. Eric Larose. “Marathons damage the hearts of less fit runners for up to 3 months”, Canadian Cardiovascular Congress 2010; October 25, 2010; Montreal, Quebec.

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12 Responses to “Long Distance Running Can KILL You”

  • Neil:

    Great article! looking forward to the follow up of the cardio we should be doing.

    • Ken:

      Thanks Neil, I’m glad you enjoyed it! The cardio you should be doing will be coming shortly; better results in less time, can’t beat that!

  • Very good….this must be a topic of major concern in so many ways. Outside of the accurate data you presented on basic human physiology the cost of repetitive injuries like those with runners is through the roof. Pick up some weights and interval train….high intensity low duration = less stress on joints, ligamnets, disc and cartilage.

  • Jacob:

    Great article.

    As a runner myself, I need to point out a few observations.

    The “Marathon versus Sprinter” photo implies that if you want to look like one over the other, then you should exercise like one over the other. The two photos however, are of elites in their respective field. They are elites, due to auto-selection of the particular sport they are training in, not the other way around. It makes just as much sense to say, if you want to be a young black man, then do sprints, but if you want to be an old bald white man, do marathons. See my point?

    I would like to see the results of similar studies done on sprinters or HIT folks to see what their heart examinations reveal. I’ve heard too many anecdotal cases of power lifters and bodybuilders that fall dead in the gym from a heart attack. Only with such a study can you draw the conclusion that that HIT is better for your heart than low intensity long duration running.

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  • Jordan:

    This article is completely WRONG. Humans were made to run long distances. Our bodies are more fit than any other creature to run long distances. Obviously the author has never done a long run in their life. A long run may hurt, but your perspective on the world changes. Long distance runners are some of the greatest athletes there are and most do not look like that picture. The author will never know the joy of distance running because, like many people, he is not willing to go through the pain.

    • Ken:

      The research bears out. Long distance is a relative term. Steady state running for many hours is not what our bodies were built for, hence the stress response from our endocrine system (i.e. cortisol) and the associated stress on our tendons and ligaments. Were we made to move? Absolutely. Were we made to run long distances in a steady fashion for hours on end? Absolutely not.

  • [...] runners should not have plaque buildup.. Most of the studies I have seen dont bear this out. http://www.unstoppablestrength.com/l…-can-kill-you/ [...]

  • John:

    Distance runners don’t have to look like skinny weaklings, as you so put it. My girlfriend (and many women, to be honest) is more attracted to a lean, tone, distance runner body than bulky, abnormal, overly muscular looking body. Also, your comparison for who would you rather look like features a black man in what looks like his mid 20s against a guy who looks at least double that. Also, not every DR is that skinny. Being in shape isn’t defined by your body type.

  • Bill Wheatley-Heckman:

    I am a 59 year old runner who has completed 24 marathons in the past 23 years. I qualified for Boston in April of 2014 but was just tested with a calcium score of 926 with 767 of that being in the LAD artery. My dual isotope stress test was OK. I am considering to run or not to run. Your opinion……????? This article looks like it is about me…..higher calcium and plaque….older runner….many marathons, etc…..???? Is it unsafe to run one last marathon?

    • Ken:

      The research repeatedly shows that long distance running is bad for your joints and your cardiovascular system, contrary to popular belief. You sound like another case of someone who has suffered as a result of thinking they were doing the right thing in running marathons. I would recommend sticking to high intensity interval training rather than long distance steady state cardio. It’s your call whether to run another marathon, is it worth it? That’s for you to decide

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