Long-distance runners won't be stopped by health warnings
Doctors' warnings that ultramarathons and extreme endurance racing could be dangerous are being treated as just another bump in the road by Butler County long-distance runners.
The cautions follow the death in March of ultra-marathoner Micah True, 58, who ran as many as 100 miles a day. True died of a heart attack during a 12-mile run.
Writing in Mayo Clinic Proceedings, Dr. James O'Keefe of St Luke's Hospital in Kansas City, Mo., and colleagues said True may have died of cardiomyopathy, a thickening of the heart muscle that caused it to beat irregularly, a condition that could have been brought on by excessive exercise.
O'Keefe's study suggests extreme training can induce temporary changes in the heart. But for some runners, if the training is continued, it can result in permanent thickening of the heart tissue.
In the study of marathon runners, 12 percent showed evidence of scarring of the heart, and there was a “significantly higher” rate of heart disease “events” among them during the subsequent two years.
But several local long-distance runners said the greater danger would be using the report as an excuse not to exercise.
Jeff Lynn, an associate professor of exercise and rehabilitative sciences at Slippery Rock University and an ultra-marathoner for the past seven years, said, “This research is looking at a small percentage of people who are training for hours and doing endurance events.”
“For the 99 percent of the Butler Eagle readers who are exercising an hour a day on the elliptical, it's extremely unlikely there is any danger.”
“I am familiar with that research,” said Sandy Ihlenfeld, senior physical director at the Butler YMCA and a long-distance runner. “In exercise, there is a dose response, meaning the more exercise, the more benefits up to a certain point. And that certain point is variable with the individual.”
Ihlenfeld isn't too worried about the purported dangers of overexercising.“It's a small population group, not a lot of people are consistently exercising or exercising at all,” she said.Ihlenfeld said she is not worried about her personal health nor are any of the runners that she knows.“There are more joint concerns than heart concerns,” she said.Tammy McGaughey of Chicora has been running for 15 years and doing long-distance trail running for five.“I do believe in high-mileage running,” McGaughey said. “The body can handle it. I do believe if you give the body rest it will come back stronger.”“Of course, that varies from individual to individual. I see that a lot in my trail work. Everybody trains at a different pace,” said McGaughey.Dr. Dean Wolz, an interventional cardiologist with the Butler Health System's cardiovascular consultancy, has background in cardiovascular sports medicine and has worked as an independent contractor for the Pittsburgh Steelers and Penguins.Because of this and because he is the father of four children involved in sports, Wolz said the Mayo Clinic article was very interesting to him. “It was well done, very thoughtful and got good reviews,” he said.The subject certainly merits further study, Wolz said.“The first person who ran a marathon, Pheidippides, finished, declared victory and dropped dead,” Wolz said. “Since that time, we've wondered if there could be a link between extreme sports and sudden cardiac death and cardiac disease.”In the cases of cardiomyopathy, Wolz asked, are they being caused by the excessive exercise or is it something the victims were born with?“What's truly new and different about this article is it goes into the history, the symptoms, the MRI data,” Wolz said.“A small minority might be predisposed to patchy fibrosis or scarring of primarily the right side of the heart,” he said. “This can lead to arrhythmia and functional problems of the heart.”“I almost liken it to traumatic brain injuries. Some people can get 20, 30 concussions and never have a problem, other people have one and have to learn to read again,” Wolz said.
Dr. Wolz said the study suggests at the very least it should lead to further study.Probably the smartest thing to do is follow the words of another famous doctor, Hawkeye Pierce of MASH, Wolz said, “Everything in moderation, including excess.”“All we can say is, we don't know who has the propensity, who's at risk. We don't know. There is no test, no marker,” Wolz said.“The key is conventional wisdom suggests 30 to 60 minutes of moderate exercise three times a week can lower blood pressure, cut cholesterol and cut the risk of heart attack or stroke,” he said.Lynn agreed, saying small doses of exercise are better than not doing anything.“It's like brushing your teeth. You know never brushing is bad. If you just brush once in a while, well a little is better than nothing. If you are brushing every half hour, not so good,” he said.
“The more you do, the greater the benefit up to what appears to be about an hour,” said Lynn.“From a scientific perspective, every time you exercise you do damage to your body, that's just the way the body is built,” said Lynn. “But if you rest, during rest after exercise, the body repairs the damage and rebuilds.”Beyond one hour a day or six days a week, Ihlenfeld said, exercise can have effects that are not beneficial like joint stress or a body that does not recover, she said. “So you can get into excessive exercise and you can/will develop injuries over time.”“Too much of anything is not good,” she said. “But having said that, exercise is fun. Exercise is used as a mood lifter and in social interaction. Endorphin drugs are involved. That's what they seek.”“Everybody's routine varies,” said McGaughey. “You just have to listen to your body. It's a learning process: Certain things work, certain things don't.”“What I'm doing I know is working for me, so I'm rolling with it,” she said.
