Let’s Discuss: “Are marathons bad for your health?”

This isn’t so much a blog post, but more of a musing — one that I hope will generate some interesting discussion in the comments section.  Even before I came down with this hip thing, and actually before I ran Big Sur, I was telling the Gypsy Runner about a friend who was running a marathon despite a bad injury.  He stopped me mid-story and said*, “You know, I used to think that running was healthy, and now with all of these stories you tell me about injured runners, I’m not so sure anymore.”

File this under "Sad but true".

File this under “Sad but true”.

We then had a healthy debate about whether humans were indeed “Born to Run” and if so, were we made for marathon running or shorter distances?  One could argue, as I did, that it’s not so much the running that’s the problem, it’s that 80-90% of our days are spent sitting or lying down, which have weakened our running muscles, making us more prone to injury.  Maybe it’s a biomechanics or form issue.  However, as I’ve been wrestling with my own running injuries of late, I can’t help but look around and notice that all of the injured runners I know also run marathons, whereas those who have NOT run a marathon in the past year are injury-free.  A few caveats: I do know non-injured marathon runners and correlation does not equal causation, BUT it does make me wonder whether marathons are beneficial or detrimental to your health.

In my own experience, I never had any issues until I started training for my first marathon, and even then, they were relatively minor niggles.  I made it through 4 marathons before finally capitulating to a running-related injury, but one that’s unlikely to sideline me for longer than 2 weeks.  So maybe I’m lucky… or perhaps I’m pressing my luck, and it’s only a matter of time before I succumb to something a lot more serious down the road?

Your turn! What do you think?  Do you run marathons or have you in the past?  Did you get injured? Why do you think injury rates seem so high among marathoners?


Howdy! My name is Jen and I live in the San Francisco Bay Area. I like to eat, run, and blog, but not usually at the same time.

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Posted in Injuries, random
32 comments on “Let’s Discuss: “Are marathons bad for your health?”
  1. My story: I’ve been running for 20+ years, and I got my first injury two years ago when I started training for my first marathon. It was hip bursitis and some muscle damage in the gluteus. I took 4 months off running and am back to half-marathon running with no injuries. I took that to mean I may not be cut out for marathon-distance training, although I totally agree it could be a result of how much sitting I (and most people) have to do in our work culture, commuting, etc. THAT SAID, I know that running is mentally and emotionally and socially EXTREMELY healthy for me. I also believe it is extremely healthy for my weight and general fitness. I think injury is a fair risk for those benefits, although I seem to feel my best running 25 miles a week rather than the longer mileage required for marathon training.

    Eager to hear others’ thoughts!

    • Jen says:

      We kind of already discussed this over tweets, but I also seem to feel best around 25 mpw. As with most things in life, running long is a cost-benefit analysis that each person has to figure out for themselves. For me, the benefits of running are (currently) outweighing the costs (both to my body and to my wallet). Thanks for the comment, Jane!

  2. Amy says:

    One of my first thoughts after finishing my first marathon was “humans aren’t designed for this.” Almost 2 years later, I still don’t feel like my body has returned to its pre-marathon state…I took 8 months off of distance training, and within a week, the old niggles were starting to show up again. I’ve also had people who were active runners at my age tell me that they’ve ruined their bodies to the point that they can’t even walk up stairs (I do think science has really come a long way since the 70’s/80’s when most of these people were running though…plus they all seemed to smoke?). AND then there was an acquaintance of Aaron’s, an experienced ultra runner, who died after a long run because she didn’t have enough electrolytes. So…I guess the warning label should say that marathons might cause injury or death?

    BUT, aside from annoying injuries and rare cases of death (which seem to be mostly preventable), I think endurance athletes are far healthier than people who don’t exercise. I also think we tend to be happier, more community driven, better hydrated, and more likely to seek preventative medical care while avoiding the highly processed foods that upset our stomachs (these are all also luxuries that are afforded to financially secure socioeconomic class to which I’ve noticed most marathoners seem to belong…so, it might not be an outcome of people running marathons). I know I make better heath decisions now than I did 3 years ago as a direct result of endurance training.

    In conclusion: my IT band might never be the same, and I might not be as mobile at 65 as I could have been, but I know that I’m improving my quality of life, so, I’m hoping that it’s an ok trade-off. (Literally writing this as I’m falling asleep, so sorry if it makes no sense!).

    • Jen says:

      Good points, Amy. Running has brought a lot peripheral benefits to my life too, like more health conscious eating, less drinking, and making sure I get plenty of sleep.

      Take care of yourself — I really hope your mobility doesn’t suffer at 65 due to marathon training!

  3. Yang says:

    I’ve only been running for 2 months so far so no marathon or related experience but I do find it utterly ridiculous that injury-free runners seem to be an anomaly. I began running because it seemed fun and I want to lose weight and be healthy in the most general sense, and I can’t figure out why so many avid runners are injured in one way or another. I don’t think it’s running the marathon that’s the problem. If not given a time limit (like the Honolulu marathon) any one can do it, even if you walk the entire way it only takes about 8 hours. I think those who suffer the most are those who seriously train for a goal time. I know it’s hard to not push to exceed your previous self, but I truly think that sometimes people are so obsessed with whatever goal they are striving for they sacrifice their bodies to achieve it.

    • Jen says:

      Thanks for the perspective, Yang. I definitely agree that it’s not the marathon itself that’s dangerous, it’s how runners push themselves to (and sometimes, beyond) the edge that’s the problem. Unfortunately, testing one’s limits is one of the main draws of running too. I guess the key is for each person to be aware of what that limit is and how to balance drive with safety.

  4. Cathryn says:

    Oooh, great question.

    In principle, I don’t think they ARE bad for your health (assuming a runner trains thoroughly and carefully). Having said that, they do put an enormous strain on your body. My own decision to not run marathons stems from a statistic that runners with heart conditions are 4 times more likely to die of a cardiac episode in a marathon than a half-marathon. Clearly there’s a lot to discuss there, but the statistic implies that the strain on your body is significant.

    I think the GR makes a good point though…that what is probably a healthy hobby can become unhealthy if we obsess over it enough. Have you seen this youtube clip? (Some swearing). It’s hilarious, but I get what it’s saying about how we lose sight of what’s sensible because of our determination to race/run.

    • Jen says:

      Hahahaha. That video is so on point. Thanks for sharing. I totally agree that most endurance athletes are an obsessive bunch and it’s so easy to get caught up in training and forget about the big picture.

      Thanks also for the statistic re: the strain on your heart from marathons vs. half marathons. No wonder you don’t run marathons anymore! Do you know what the difference is for those without heart conditions?

      • Cathryn says:

        Apparently the chance of dying in a half marathon is 40% that of a marathon. Both stats (this one and the heart one) are probably as skewed and unreliable as any statistic, but it keeps things in perspective for me!

  5. outside time says:

    Just at the personal anecdote level, I know I am much healthier thanks to running. Beyond the physical stuff (low heart rate etc.) I use running to help cope with stressful situations, and making goals around my running has really fueled a sense of general life ambition. I know running involves some trade-offs (including health ones — injuries ain’t fun) but at my age they’re well worth it.

    • Jen says:

      The mental and emotional benefits of running outweigh the risk of injuries for me as well. Just wondering – at what point would you say that it’s not worth it?

  6. Like everything else, I feel like distance running is going to produce different results in different people. Some people can run long distances frequently and experience no ill effects (thinking of my friend Sarah here, who has run over 50 fulls, and a handful of ultras, and from what I can think back and remember, has not really missed any time for training due to injury). WHEN I TRAIN PROPERLY, the full distance hasn’t given me any issues. #1 can run 50 mile weeks, at a fairly high level, and hasn’t been injured yet (knock on wood).

    I don’t think everyone is “built to be a runner”. Just like not everyone is built to swim, or paint, or sing. Some people just can’t handle the distance, their bodies just don’t like it. That’s not inherently the fault of running. It’s just natural, not everyone can do everything.

    With the increase in sheer numbers over the last several years, of course there will be an increase in the number of running injuries. How many of those are from people doing too much, too soon? Not training properly? Not training with the right plan for their body?

    I don’t think it’s reasonable to think that runners would never get injured – isn’t it just a matter of probability that if you run enough, eventually you’ll have a thing? The more miles you run (marathoner vs 5ker), the higher probability that you’ll get injured?

    Anecdotally, I had multiple injuries training for a half, but have had no real injuries (nothing that has come close to preventing me from running) since training for fulls. I might be slow, but I seem to be able to run long, ha ha.

    • Jen says:

      Lots of good points, Heather. I definitely think that the recent rise in popularity of running, especially marathons, has made injuries more commonplace in recent years. There are a lot of people (myself included) who jumped into marathons without a significant base and are then more prone to injury. I think that ramping up speed and/or mileage too fast is a big part of running injuries. Did you do more speedwork while training for the half marathons where you got injured?

  7. Kate says:

    I think everyone’s body handles the stress of a long distance differently, and I also think pace/effort plays a big role. For myself, I find that I get injuries/aggravations less if I do about half of my training on trails, instead of all on the roads. I went from being a very good couch potato to being a runner, so I definitely had more aches & pains when I started running, since I was building up tendons, ligaments and muscles that had never been used. I also think that strength training makes a huge difference in the amount of pounding that a body can withstand. Saying marathons are healthy or unhealthy is an oversimplification. The marathon is what it is; how a runner trains for it and recovers from it with a conscious, active recovery will have the greatest impact on how their individual body responds.

    • Jen says:

      Well said, Kate. Strength training is a big missing link for a lot of runners, myself included. I hope to correct that soon!

  8. Dominick S. says:

    I haven’t had an injury from running in either one of my training programs related to the marathon distance. Sure some aches but nothing in comparison to my first year of “real” running. I remember doing 4 miles one morning when training for a 10k and getting into the shower and just sitting down because my legs hurt so bad. Like someone else said above, I think it is more about your approach to running and your goals. I had no idea how to train or rest, every run was the same speed and usually the same distance. Then when I started training for a marathon I actually learned to have variations in my training in regards to mileage and tempo.

    My running injuries have always come from ramping up mileage too quick or not being prepared for something like hills (up or down) but everything else has been just fine. It’s all a process and I try to learn about everything from form, stride, diet, recovery and effort. I also like to do most of my runs on trails (like someone else said) versus road because there are so many more variables that it allows me to build different muscles. Cross training like Yoga, Pilates have also done me well since they strengthen breathing, hips, core and increase flexibility. I need to get in the pool or on a bike but that is the next step to a healthier lifestyle that will definitely have running at the center. Anyway, its a science and I think people need to respect the process…which most don’t…everyone wants to get from A-Z as quickly as possible.

    Anyway…I have lost 20+ pounds over the last 3 years, my legs are twisted steel and I feel fantastic. If someone wants to say that marathons aren’t healthy then by all means…thats a solid excuse. I’m kidding Jen…I told you not to run more than one…dufus.

    • Jen says:

      Haha, I should’ve listened to you, Dominick!

      I completely agree about varying terrain and throwing in core and strength work being important in avoiding injury. Not ramping up too fast is key too. That’s definitely been my issue with speedwork in the past.

  9. Angela says:

    I think that marathons just take more of a toll on your body, so they require a higher level of biomechanical efficiency, functional strength, etc. I think many of us get suckered into thinking we’re all good in that department because we can run shorter distances often & well with no problem, and then maybe we try to freaking DOUBLE that without paying additional attention to what kind of shape our biomechanics & functional strength is in. (I’m pretty sure this was the case for me, a mistake I am trying desperately not to repeat.)

    • Jen says:

      Yeah, I never really think about how far a marathon is until the days before the race. Then I’m like, “I have to run 26.2 miles?! Am I crazy??” It is a LONG way to go with poor/less than perfect mechanics and any muscle imbalances will surely make themselves known!

      I’m really interested in seeing how this training cycle goes for you! Keeping my fingers crossed that your proactive steps will reap great rewards in August!

  10. BT says:

    What I’ve observed is that recreational runners are more likely to push through the pain than other adults who exercise. I’ve been essentially injury free (knock-on-wood) for 9 years of running including 39 halfs and 9 fulls (plus 1 full DNF). BUT, one big difference I’ve noticed about myself vs. many other runners is that I decrease pace, walk, and/or cut mileage whenever something doesn’t feel right. I’m more likely to err on the side of being too easy on myself than pushing it too hard when it comes to running (which is very strange, as it’s probably one of the only areas in my life where I do this). I can’t tell you the number of times I’ve discussed running-related pain with runners who chose to push through their scheduled run without any alteration. If you are prone to this type of event, it is more likely to happen on a higher volume training plan or longer race — I don’t think this is the entire explanation, but I do think it’s part of it.

    • Jen says:

      You’re a very smart woman AND a smart runner, BT. I think that marathon runners are a rare breed of slightly OCD, driven people who feel like they have to check off the box on the training plan, regardless of how they’re actually feeling. Like Cathryn said above, it’s easy to get caught up in the training and lose sight of the big picture — which, for me, is long-term health.

      • BT says:

        Interesting point re: the *type* of people who run marathons. Perhaps the event itself tends to attract folks who are more likely to either make decisions that may harm themselves in their training, or perhaps just ignore symptoms in pursuance of their goals. I attributed this to all runners and just figured that if you’re training for a marathon your volume is higher and the race distance is longer, so the odds of pushing through something that could hurt you is higher. But, I don’t actually know that many runners who haven’t done at least one marathon, so perhaps there are more non-marathon runners with a different “type”.

        • Jen says:

          I have a friend that never races and, as far as I know, has never pushed through a run (or runs) while injured. So maybe it’s the general psyche of “training”?

  11. I do think we were born to run. But, we weren’t born to run on pavement. And maybe not in one solid stretch like that. And, we weren’t born to sit and work at desks like most of us do. So, I think some adjustments/injuries are just kinda part of the game!

    • Jen says:

      Yes to all of your points, Jan. Even the primitive people who engaged in endurance running while stalking prey (elk, deer, antelope, etc.) did so in spurts, and in the woods and grasslands.

  12. I could go on and on about the topic of injuries.

    I think I’m wired a bit differently from most runners. When I have an injury, or when I’m hurting, that’s when I push myself the hardest. To me, I’d rather push myself past the breaking point and risk further injury, or even risk never running again, than to give up. I actually still think this way, years later. Running to me is not recreational, and I don’t do it for health benefits or to be outdoors. I do it for the challenge. If it doesn’t hurt, then I’m not running hard enough.

    The two marathons I’m most proud of were Silicon Valley Marathon in 2006 when I had all sorts of IT band issues and I could not take a step without pain in my hip AND knee. The smart thing would’ve been to DNF, but the pain actually made me even more determined to finish. The second was the Disney Goofy Challenge in 2010. I was already developing anterior fibial tendinitis (started at CIM a month before), but it became full blown intense pain by the middle of the half-marathon on Saturday. Again, the smart thing would’ve been to skip the marathon on Sunday, but a part of me saw this as an obstacle to overcome. I couldn’t even stand without searing pain (imagine knocking your shin hard against a table… and imagine that momentary pain being permanent). But I gutted it out, crying at points, even hobbling on one foot to finish the darn thing (and under 4hrs. Woo!) I was in a brace the next day and for the next two months. Was I smart to have run? Hell no. Would I have done anything differently in hindsight? No. Why? Because even despite the ridiculous pain, and the weeks of physical therapy that followed, I had never experienced as big a runner’s high as after that Disney marathon. And I’ve run 20 marathons since then.

    That is not to say I don’t actively try to prevent injury. I actually do a lot of proactive stretching / icing at the first hint of pain. And I do a lot of exercises for the oft-neglected muscles, like hip flexors and adductors. But I won’t stop if I start hurting more. In fact, a part of me wishes for it. I’m never as focused as when I’m hurting. Yes, I am masochistic. (Friend the other day said that since I love pain so much, he could just kick me in the balls, but I clarified that I like *self-inflicted* pain)

    Also, I’ve found that some (who shall remain nameless) need to reevaluate what pain actually is. Just from the way they describe their hurts, it often sounds like they’re not used to any discomfort whatsoever. I’m talking pain that I’d rate at a 1 or 2 out of 10. Now, it could be reasonably argued that pain is pain, no matter how serious it is, and everyone is different in terms of how much pain they actually feel, and you should be cautious. At the same time, you can’t expect not go through some pain, even if it’s just sore muscles.

    Like I said, I could go on, but I think I’ve already typed your eyes out (as opposed to talked your ears out) (=

    • Jen says:

      What an interesting and unique perspective – thanks for sharing, Dennis! I wish I had some of your chutzpah when it comes to pushing past the pain. Like you said, though, it depends on why you’re running. I’d like to still be active when I’m older, so I guess I’m a bit more conservative when it comes to nipping potential lifelong injuries in the bud.

      I definitely agree about the variance in each individual’s perception of pain. When I first went to the sports chiro, I was filling out my chart and, despite this chronic ache in my left hip, and even though it was enough for me to seek treatment, I still only rated it a 2 or 3 because it is nowhere even CLOSE to the worst pain I’ve ever experience. (Now, when I got on to the table and he started doing ART… that was pain — probably closer to a 7 or 8.) I work in legal consulting and deal with a lot of personal injury claims — you would not believe the way some people complain about their pain from a 5 mph rear end collision!

      • When I was 12, I developed a cyst under my right armpit and had to have it removed. My parents distrusted full anesthesia, so they asked the doctor to give me only local numbing. They didn’t know then that I have a resistance to numbing agents (my dentist knows to give me double dose of Novocaine, and even then, my mouth doesn’t go completely numb). So I pretty much felt the whole thing, of the doc cutting into me and digging the cyst out. (Incidentally, decades later, I still have phantom pains there.)

        I bring the story up to make the point that I have a pretty good gauge of what a 8.5-9.0 / 10 pain feels like. I’d rate running with tendinitis at about an 8 / 10. So often, I think to myself, “Does it hurt as much as that time I had tendinitis? No? Then suck it up, buttercup.”

        But again, I think I am a bit of an outlier. In fact, I often recommend to others to rest or take it easy. It’s not that I don’t think they’re as tough as me, but I want them to do the smart thing, whereas I willingly throw myself into doing the exact opposite (I always tell people, “Do as I say, not as I act.” Heh.) And I know they have different goals than me (run healthy, run strong, run forever, etc). Also, I’m glad you got your hip checked out. Hopefully, ART will do wonders!

        BTW, I will say, I am a complete wuss when I have someone working on me. I had some ART done a couple years ago, and, I’ll tell you what, I was crying on the inside the entire time. Or did I cry on the outside as well? I don’t remember. (I shall deny that I ever said this).

  13. […] since Jen asked if we thought marathons were healthy last week, I’ve been considering what a lot of the […]

  14. I don’t think marathon is bad fir the health it is actually the opposite. Running is one of the best exercise that you can do because it affects your entire body. Although there’s a lot of marathoners getting injured there are more marathoners that hasn’t been injured ever and has been living their life in tip top shape. Being injured would usually make someone quit what caused that injury but if it is something like sports or exercise I don’t think you shold do so. I think that exercise makes a person healthy and the healthier you are the faster you recover from injuries so that you can continue to do activities you love like running.

    Olivia Clark

  15. My take on it is this… I don’t think we’re designed to run huge distances or exercise to excess. I think we should all do a good amount of exercise but running for 26 miles is probably not ideal, especially on hard surfaces (or in traffic fumes for that matter).

    I don’t run at all but I know very many long-distance hillwalkers, of which I am one. Absolutely every one of us has got to middle age (around 50) and joints have started to wear out, mostly hip joints but some knees as well. Some are even younger than their 50s – sometimes they’re only in their 30s. People who are just doing moderate exercise don’t seem to be having the same problems.

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4/28/19: London Marathon

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