New Telegraph

Running a Marathon; the days after

The scene
OMG has been participating in a Marathon over the last 5 years. It is an annual ‘’ritual’’ she looks forward to, but events following his last participation made her to have a rethink. About 4 weeks after the race, she developed a serious form of sneezing, runny nose and cough which was unresolved over 6 weeks despite usage of prescribed medications.

Background information
History has it that Pheidippides ran to Athens with the news of the great victory his people had over the Persians at Marathon. It was 490 BC, and the distance he ran was about 26 miles (or, around 40 kilometers). After he delivered his message – “Nenikikamen” (which means, “Rejoice we conquer” or, put differently, “We have won”) – Pheidippides died.

The main issues
1. Injuries
Most marathon runners experience minor discomforts ranging from muscle soresness to painful feet, shin splints and stress fracture. Blisters and black toenails are common among marathoners, and are caused by the rubbing and banging of the feet against the shoes.

2. Reduced immunity
After completing the marathon, your immune system may be compromised for several months after running a marathon and leave you susceptible to colds and infections. After running, your immune system is concerned with your recovery and diverts white blood cells to repair muscle damage. As a result, you are left with weak spots in your immunity, leaving you more susceptible to infection.
3. Impaired heart function
In some runners, heart function may become impaired for a time after completing the marathon. These changes in heart function tend to occur in recreational runners more often than in trained athletes. While running marathons may give you a better chance at surviving a heart attack, it’s not going to prevent one, and it may actually increase your risk of having one. In a study conducted on healthy volunteers using ultrasounds of the heart (echocardiographies), MRI and CT scans, and blood tests. It was discovered that straight after completing a 26.2 mile marathon, the top runners aged 50+ years had temporary elevation in blood markers and temporary weakness and swelling of the right side of the heart. These abnormalities returned to normal within 1 week of completing the race. In essence, it is expected that any heart function impairment should normalize in one week post marathon! This does not eliminate the fact that permanent scarring of the heart muscles may occur; repeated, extreme exercise or long-distance racing can cause a buildup of scar tissue on the heart, which can lead to the development of patchy dead heart muscle in up to 12 per cent of marathon runners. The effects of “chronic (long term) exercise” can also include premature aging of the heart, stiffening of the heart muscles.
4. Impaired Kidney function
Blood flow to your kidneys will decrease during the marathon and may impair kidney function for up to two weeks. Damage to the kidneys will be compounded by dehydration and a rise in core body temperature. Some marathoners have also been unnerved by what appears to be bloody urine following the race. However, you needn’t worry about internal organ damage — tea-colored urine is actually a byproduct of muscles breaking down. When our muscles are pushed far past their normal stress levels, they release a chemical called myoglobin, which helps to carry oxygen. Myoglobin is filtered out of the bloodstream by our kidneys and passed to the bladder to be removed from the body, tinting pee dark brown. While the presence of myoglobin isn’t necessarily cause for worry, too much of it can lead to kidney damage.
5. Another major effect that extreme exercise (as marathon) has on our bodies is an immediate increase in cortisol, the hormone that is released when the body is under stress. Heavy-resistance exercises are found to stimulate markedly acute cortisol responses, similar to those responses found in marathon running. In the long term, high levels of cortisol can increase your risk for a variety of health issues, such as sleep disturbances, digestive issues, depression, weight gain, and memory impairment. Also in the long term, excess cortisol encourages fat gain, particularly around the abdomen.
6. Impaired thyroid function
Overtraining (such as a marathon) has been shown to affect blood levels of important neurotransmitters (such as glutamine, dopamine, and 5-HTP) which can lead to feelings of depression and chronic fatigue. The stress caused by intense, excessive exercise can negatively affect the hypothalamic-pituitary axis, possibly causing conditions such as hypothyroidism (a condition in which the thyroid gland is not able to produce enough thyroid hormone-a hormone which runs the body’s metabolism). Hypothyroidism is known to cause depression, weight gain, and digestive dysfunction along with a variety of other symptoms.
7. Hormonal imbalance
When a female athlete overtrains, her estrogen levels drop. This has a very strong effect on bone health. Fortunately, there is a warning signal: Such women have irregular periods or even stop menstruating.
But no matter how you look at it, running a marathon is a huge accomplishment. Crossing the finish line is a surreal feeling that very few ever get to experience. The aches and pains that you experience during and after the race quickly subside and you will be left with a wonderful sense of fulfilment. Thousands of people run marathons every year, with no long-term ill effects. The benefits of running are well-known, and in all likelihood, you’ll end up healthier after a marathon. The real danger is taking on too much too soon, which is why most training regimens emphasize a long, slow build-up to serious workouts. Our bodies are wonderfully adaptable to extreme situations, as long as we give them a little time to get used to it.

Take Home
A pre-race thorough Medical check should be done before embarking on the laudable initiative of running a marathon.

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