Hidden dangers of marathon running

I sit down to write this Dispatch on what is observed as Patriot’s Day in Massachusetts. Patriot’s Day commemorates the Battles of Lexington and Concord, the opening conflicts of the Revolutionary War. Of course, it’s also the title of the new movie with Mark Wahlberg, Kevin Bacon (who seems to have his best roles playing a Boston cop ever since Mystic River), and John Goodman, which offers a cinematic account of the 2013 Boston Marathon bombing.

As a child growing up in the Boston area, we got the day off school each year for the Boston Marathon. You couldn’t get through the closed streets anyway. Boston streets — originally the old cow paths through town — have enough traffic when they’re not closed.

I remember going up to the top of the Prudential Tower to watch the runners going by on the street far below.

Of course, four years ago, what started as a beautiful day was marred by the Boston Marathon bombing. Security has been increased since then, but there remains another, hidden danger to marathon runners everywhere: kidney damage.

Researchers investigate hidden danger of marathon running

The year before the bombing, scientists from William Beaumont Hospital in Michigan published a study about marathon runners. (The hospital is named for a 19th century Army surgeon who made ground-breaking observations of the GI tract by observing an open, unhealed abdominal wound in a solider.)

Beaumont researchers found that about 40 percent of runners suffer kidney injuries following marathons.

A kidney specialist and professor of medicine at Yale, Dr. Chirag Parikh wasn’t sure what to make of Beaumont’s findings at the time. So — he set about trying to understand them.

His lab just published a new study in the American Journal of Kidney Diseases. They found that nearly 75 percent of marathon runners suffer kidney damage.

Once they looked for it, the evidence was not hard to miss. They found that marathon runners suffer a degree of inflammation and injury comparable to patients coming out of heart surgery in the Intensive Care Unit (ICU). At least in the ICU, doctors know what to look for, so they monitor the patients accordingly. In the cases of marathon runners, most of them run around (literally) with serious kidney damage and don’t even know it.

Plus, according to Dr. Parikh — the world is in the midst of “an epidemic of marathon running.”

Prior studies on marathon runners measured the build-up of creatinine and urea in the blood. Normally, the kidneys filter these metabolic byproducts. But when the kidney is damaged, these byproducts build up in the blood. Creatinine also builds up when there is muscle damage, as occurs when you over-exercise. Creatinine build-up can also result from dehydration, over-heating, stress, or the combination thereof.

Dr. Parikh wanted to determine which of these factors were at work in marathon runners. He measured all the different factors in the blood and urine during a marathon, making sure runners stayed well-hydrated, making them all stop to drink from numerous hydration stands along the way. Still, the physical stress on the kidneys measured five- to 10 times higher than normal baseline levels.

Long-term effects of marathon running unknown

Of course, his study only measured the short-term effects of running a single marathon. The cumulative effects of repeated kidney injuries — after repeatedly running marathons — are not known.

Doctors often encourage their older patients and patients with Type II diabetes and high blood pressure to exercise regularly. But it seems — just as importantly — they should also warn their patients about extreme running and over-exercising.

Despite these obvious dangers, some doctors try to argue that the kidney damage may somehow benefit the runners.

They, of course, claim they need to do more research. And, after all, that kidney damage must be good for business.

We don’t need “more research” — we need to pay attention to the results

Dr. Parikh’s study was funded by the National Institutes of Health (NIH). And the doctors took the opportunity in their report to complain about the proposed NIH funding cuts under President Trump’s budget proposal.

But if doctors continue to ignore what their data tells them, in favor of politically correct interpretations that run counter to common sense, then maybe President Trump has a point. (And in essence, that appears to be Trump’s point.)

About 20 years ago, during an NIH reauthorization hearing for ever more funding, I personally heard former Congressman Earnest Istook of Oklahoma refer to this whole medical research business as, and I quote, “welfare queens in lab coats.”

So, the kidney specialists conclude you can keep on running as long as you stay well dehydrated, don’t get physically stressed, and don’t increase your body temperature. But how do you that when over-exercising itself forces you to ignore your body’s signals — not to mention your common sense?

In other words, they advise you can keep running, as long as you don’t keep running!

Everything we need to know about marathons, we learned 2,500 years ago

As I’ve reported many times, research shows excessive running and over-exercising causes joint damage and heart muscle damage.

Indeed, the name of this 26-mile course comes from the ancient Battle of Marathon, waged on the plains of Attica in 490 B.C. In a single afternoon, the citizen soldiers (hilots) from Athens defeated the Persians (of modern-day Iran) in their first attempt to invade Greece. Historians traditionally represent this battle as a crucial victory for western civilization over oriental despotism. (Yet, the larger conflict does not appear to be over yet.)

A runner called Pheidippides ran the 26 miles from Marathon to Athens to inform the citizens of their historic victory. As soon as he delivered the message, he promptly dropped dead of exhaustion.

Perhaps we already learned all we really needed to know some 2,500 years ago, even without more NIH research funding.

As far as healthy exercise is concerned, I urge you to forget running in city streets on hard pavement altogether.

I think swimming in the ocean, lake, pond, or pool is the best way to support your heart while supporting your joints. The buoyancy of water (especially salt water) prevents excessive stress and damage on joints and the rest of your body. Plus, overheating (which is a big problem for your kidneys) doesn’t usually happen while swimming. And the resistance of movement through water makes it a healthy and effective exercise for all your muscles.

If chlorine bothers you, find a facility that uses non-chlorine salts and/or minerals filtration system. Or simply take a nice walk outdoors in Nature…it has all of the same benefits.



“Marathons Injure Kidneys,” The Atlantic (www.theatlantic.com) 3/28/2017