[ggm]

Maybe the question is: should you run the Boston Marathon

  In 2016, a systematic medical review found that the risk of sudden cardiac death during or immediately after a marathon was between 0.6 and 1.9 deaths per 100,000 participants, varying across the specific studies and the methods used, and not controlling for age or gender. This translates to a few published marathon deaths worldwide in a typical year, although the authors lamented the lack of a central registry for the information.

That said, the Boston Marathon has a lower presence in the marathon-death-tables, the bombing aside: That's really not relevant to this. So, if you want to take the aggregate risk (which is between the risk of fatal insect sting, and lightning) of all the Marathons to chose to run, Boston is one of the better ones.

[jerlam]

The Boston Marathon is not open to the general public - you cannot simply "choose" to run it like you can other marathons.

It's likely that more people suffer health issues from overexertion by trying to qualify for the Boston Marathon, because it's a difficult goal. Once you're already running in the Boston Marathon there is less drive to push yourself over the limit.

[khuey]

That's a far better death rate than the original marathon.

(1 death per 1 participant according to the tale of Pheidippides.)

[philipwhiuk]

Yes yes, discount the fact he'd just finished a battle and ran over 100 miles to get there in the first place.

> He ran about 240 km (150 mi) in two days, and then ran back. He then ran the 40 km (25 mi) to the battlefield near Marathon and back to Athens to announce the Greek victory over Persia in the Battle of Marathon (490 BC) with the word νικῶμεν (nikomen[8] "We win!"), as stated by Lucian chairete, nikomen ("hail, we are the winners")[9] and then collapsed and died.

But sure, it's the last 25 (50 given both ways) that really killed him, not the other 150 miles.

[jimbob45]

Are those numbers even possible with the resources he’d have had at his disposal? How could he have fueled properly for that effort?

[InitialLastName]

> How could he have fueled properly for that effort?

Clearly, he didn't.

It's hard to get specifics, but that doesn't seem impossible for a pre-industrial, highly trained runner (several hunter-gatherer tribes seem to be capable of those sorts of distances over multiple days, and he was as close to a professional distance runner as existed at the time). Remember also that he isn't running through uninhabited territory; there would likely have been multiple opportunities (pre-established supply depots? well-known locals?) where an official representative of a major local power would have been able to acquire food.

[ggm]

Yea, I think Cochrane decided that wasn't an adequate sample to include.

[philipwhiuk]

And what's the sudden cardiac risk for any other given activity. "Cardiac Risk in the Young" is a legitimate problem regardless of running a marathon.

And what's the cardiac risk for no exercise at all?

You're not controlling for the fact you have to exist.

[ggm]

I'm not here to argue for not doing marathons. It's safer than walking out with a risk of thunder, its a bit less safe than walking by a bee hive.

I do note that every marathon runner I know (thats about 5) carries some burdens afterward above and beyond simple post-race injury: there is an effect on your health, it's multi-dimensional, and it goes on a while. They enjoyed the run so I guess it's a fair exchange. Knowing when to stop is part of the process I guess.

[philipwhiuk]

> I do note that every marathon runner I know (thats about 5) carries some burdens afterward above and beyond simple post-race injury: there is an effect on your health, it's multi-dimensional, and it goes on a while. They enjoyed the run so I guess it's a fair exchange. Knowing when to stop is part of the process I guess.

People bucket-list it. They don't prepare properly, they train through injury because they want to do the race they spent money on, or they just think they can wing it (not helped by TV shows and celebrity comments). And they get injured as a result.

It's not hard to run a marathon and not get injured. It's just lots of people think they can shortcut hard work.

I've done 9 marathons. The only long lasting sports injury I have is from skiing.

I'm tired of anecodotal data being unacceptable in any field except running, where old wives tales and crappy studies replace actual data, which is that, if you train properly, running is beneficial for your health and there's no actual contraindictions.

Why is it we A-B test button colours on a marketing website but we accept folksy knowledge for serious topics.

[mbreese]

Just to concur (and I’ve run a similar number) - what I tell people that ask about my training schedule is that just running a marathon isn’t the hard part. With some training and mental effort, it can be done… but that will only get you so far.

For me, the real reason for training is so that when you’re done, you can still walk normally the next day… that you have a good experience… and that your body feels better for the effort. The training takes (a lot of) time and is hard work, but if you follow a solid training plan, your body can be well prepared for it. If you don’t train enough, you will not have a good experience. I’m about 8 weeks out from my next one and this is when the grind really starts for me. But I know that if I follow the plan, I’ll have a good experience on the day of the race (and after).

Oh, and for the record, I’m nowhere near a BQ time. :)

[mikestew]

They don't prepare properly…

I’ve seen so many people who do half their weekly mileage in one day: their Sunday long run. That alone is a recipe for injury and, come race day, a good way to find that “wall” everyone talks about. Top that off with weekly mileage that hovers around 30 miles/week at best, and yeah, folks are going to get injured and/or be barely able to walk the next day.

Running marathons isn’t bad for you, but running marathons when poorly trained is.