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Marathon Runners Face Health Challenges

marathon runners

Marathon runners typically endure a lot of training, discomfort, and pain so they can run 26.1 miles. Two new studies report that marathon runners face a number of health challenges, including potential problems from use of pain killers and, for a significant number of female runners, a condition called mastalgia.

Marathon runners should beware of painkillers

For non-runners, the thought of running 26.1 miles may seem daunting, but for millions of people young and old, there is great satisfaction and joy in this accomplishment. But this sport often involves pain, which many marathon runners try to prevent or relieve with over-the-counter painkillers.

German researchers explored the impact of use of painkillers during and/or after the race among runners who participated in the 2010 Bonn Marathon/Half-Marathon. A total of 3,913 runners (out of 7,048) completed the questionnaires, and this is what the researchers found.

  • 20% of runners who took painkillers before the race also did so during training to avoid pain
  • 10% of runners said they had pain before the race compared with 1% who did not use painkillers
  • 54% of the painkillers were OTC and included aspirin, ibuprofen, and diclofenac (most commonly used, by 47%)
  • The number of runners who withdrew because of gastrointestinal problems or muscle cramps was significantly greater among those who took painkillers than among those who did not take medication
  • Runners who took painkillers were five times as likely to experience symptoms as their peers who did not the drugs
  • 93% of the runners said they were not aware there were any risks associated with taking painkillers for endurance sports
  • 9 runners who took painkillers were admitted to hospital within 3 days of the event for temporary kidney failure (4 runners, ibuprofen), bleeding ulcers (4, aspirin), and heart attack (2, aspirin)

The authors noted that painkillers block enzymes (cyclooxygenases), which regulate prostaglandin production. Since prostaglandins protect the body in stressful situations, such as marathon running, taking these painkillers may be harmful rather than helpful, as suggested by this study.

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Breast pain in marathon runners
When women marathon runners line up at the starting post, one in three can expect to experience breast pain (mastalgia) during the race. That was one of the findings of a new study published online in the British Journal of Sports Medicine.

Researchers based their report on the responses from 1,285 women runners who competed in the 2012 London Marathon and who completed the questionnaires. Overall, the investigators gathered the following information from the female marathon runners:

  • 32% of women experienced breast pain, and the proportion increased as cup size increased
  • Childless women were significantly more likely to have breast pain than women who had given birth
  • Half the women said their menstrual cycle was responsible for their breast pain, although 30% said this was only true sometimes
  • 8% said their breast pain was distressing or excruciating, and 17% said mastalgia affected their ability to exercise
  • To help relieve mastalgia, 20% of respondents wore a sports bra, about 16% used painkillers or held their breasts while running, but 44% just endured the pain and did nothing to alleviate it

The authors concluded that given “the number of participants who took no measures to relieve their mastalgia, or resorted to pain medication, highlights the importance and significance of research into exercise-related mastalgia.”

These two studies are among numerous reports relating the risks and benefits experienced by marathon runners. Anyone who engages in marathon running or other endurance sports should be aware of the health challenges, as well as the benefits, of their chosen sport.

Brown N et al. The experience of breast pain (mastalgia) in remale runners of the London Marathon and its effect on exercise behavior. British Journal of Sports Medicine 2013; 0:1-6
Kuster M et al. Consumption of analgesics before a marathon and the incidence of cardiovascular, gastrointestinal and renal problems: a cohort study. BMJ Open 2013; 3(4): e002090

Image: Morguefile