On His Way To A PR, A Marathoner Collapsed At Mile 26

They blamed it on minorities or "illegals"

I agree.

The reason you haven't heard of rhabdomyolysis "applied" to marathoning, is because it isn't usually fatal in that circumstance and therefore doesn't get a headline. Mild rhabdo gets better when you orally hydrate after a race and you'll have no symptoms other than brutally sore legs and temporarily dark urine. Severe rhabdo, also usually gets better with IV hydration in a hospital. At worst, it may damage your kidneys. This could happen to 100 marathon runners and you'd never hear about it.

One thing that can go along with rhabdomyolysis, is an elevated potassium level. Again, that usually resolve with hydration, by dilution. However, a severely enough potassium elevation can stop one's heart. That's probably how this guy was feeling fine one minute, then flatlined the next. It's a rare combination of events. But it can happen.

Surprised no one has linked this.

kevinbeck.substack.com

Images only (#114)

Kevin Beck

Well, we* gave it an extended shot

Open link

My wife got rhabdo after collapsing at the finish line of a marathon. Thanks to her hospitalization she survived. Like you described, she had weak and sore legs for months afterwards. The condition could have easily been fatal had she not received immediate medical attention.

Tragic story. As a physician I highly recommend everyone who runs even at the recreational level to have a baseline EKG and for it to be read by a physician. Especially if youre doing a lot of zone 5 training. Any chest pain, or fluttering sensation while doing speedwork is of paramount concern. I will say I have detected some arrythmias and ventricular abormalities in runners who are also my friends and patients.

Do not take the topic lightly. It can save a life!

It is sad when open discussion of the mechanism that might have led to this poor guy's condition is being censored by mods. The "fix" is in.

BTW I am not "anti-vax". I had a tetanus booster a few months ago. I am anti-censorship and coercion of an experimental injection, especially for low-risk groups. Our bodies, our choices.

This is a really sad story. I hope the guy recovers at least some awareness (though it seems likely he'll never run again).

That said, I think there should be a discussion about qualifying times for big races and how the system of taking the lowest times, so you need to have a five minute buffer to enter the race, causes people who are good (but not pro or elite) runners to ride the line of absolute maximum effort. For elite and even sub elite runners (who trained in college and never stopped running and who have pro coaching) this is absolutely fair. They train hard and know the line. (i.e. do Nascimento making a beeline to the toilet then dropping at mile 20 instead of pushing on, probably was Rhabdomyolysis). In this case the qualifying time was 2:55, and that guy had that in the bag by mile 22. But because you need to be under 2:55 to actually get guaranteed entry to New York, he targets 2:48, which was probably his absolute limit, hits it and goes into shock a quarter mile before the finish line. Story might have had a different outcome if he had run say 4 minutes slower over last four miles. Maybe he doesn't go into shock. Maybe the shock hits at the finish line (where medical equipment...defibrillators...is more readily available and spends less time without oxygen to the brain).

I remember less of this happening 20-30 years ago when a BQ for somebody in his late 30s or early 40s was 3:15-3:20. Now it's 3:00-3:10. Age is age. And you make it so people at an advanced age have to push that hard to hit a time and inevitably some are going to have breakdowns. Most aren't fatal but some are. Granted super shoes (and doping, yes there are people who dope to hit BQ times, but doping carries its own risks and can make something awful happening more likely, don't dope) have made times faster. But this brings more and more people close to their absolute limit (which is dangerous in any race, but particularly dangerous in a marathon where there may be long gaps between emergency personnel).

I don't know how we solve it. Maybe one solution is to limit out of area registrations for Boston and New York to once every 3-5 years and slow qualifying times. Maybe the solution is slowing the times & hitting the qualifying times gives you an entry into a lottery and hitting the qualifying time two or three years in a row gets automatic entry if you don't win the lottery. Maybe the answer is reducing charity entries, increasing entry fees and raising $ directly from participants. But the current system of having people run a 2:50 to hit a 3:00 qualifying standards and actually get the entry they want is nuts. A 2:48 is good enough to win some medium sized marathons. And for us hobby joggers, it's probably too fast and has a high likelihood of inducing (hopefully not fatal or chronic) injury.

I took the tetanus booster as well a few years back.

Don't know why and will not do again.

Any chance the jab is the cause of any of these?

I’m sure the guy was vaxxed. Even cardiologists are in denial. See the quack above recommending EKGs for everyone now.

Don’t recall them ever pushing for EKGs without any symptoms. Could not possibly be vax related, yeah? An autopsy would probably find one giant clot. They stop doing autopsies on cases where “doctors are baffled”?

Amazing this is getting down voted, do people here actually want to have people risk their lives for a race entry? If so, how far our sport has fallen...

Down voting the possibility!

Yikes

Also going to point out that the runner here has a previous personal best of 3:05. So 2:48 was a 17 minute improvement, or 9.1% faster. Would he really have been that aggressive if the entry he was chasing meant he'd get in at 2:59? Would the shock have happened if he had run 11 minutes slower? I think the answers to that is probably not. Big races (and for that matter running shoe store training programs) shouldn't create incentives for people to push past their limits...

SO?
The guy in question ran a 2:06:38 (6:20) pace for a 20 mile race a month before CIM 2022. (in sacramento no less). I think anyone would think that indicates fitness for the pace he ran.

Maybe it is downvoted because it simply not a good point. You calling 37 an "advanced age" is silly and not relevant. Do you know that your 5 minutes will magically save lives? Seems weird to claim that.

People will always push to reach a number and sometimes, that number is too much.