Marathon may leave some people "very injured"

Huawei lost a great general. It is reported that the 53-year-old Huawei executive died after a 28-kilometer long-distance run. Why does a marathon cause sudden death? How to run long distances scientifically? Let's learn to listen to the voice of the body.

Text/Reporter Ji Jingjing Photo Editor/Ding Lin

New Media Editor/Lv Bingxin

Interview experts:

Huang Guangmin (Chief Physician, Institute of Sports Medicine, State Sports General Administration)

Zhang Li (Associate Researcher, Institute of Sports Science, General Administration of Sports of China)

Ren Gang (Orthopedic surgeon at Beijing United Family Hospital, member of the 2016 Beijing Marathon medical insurance team)

On the last day of the National Day holiday, an unfortunate news came that Ding Yun, Vice Chairman of Huawei's Supervisory Board, President of Carrier BG, and President of Enterprise BG, died of a sudden illness.

On the evening of October 7, Huawei issued an obituary stating, "It is with heavy hearts that we inform you that Ding Yun unfortunately passed away in the early morning of October 7, 2022 due to a sudden illness at the age of 53." Ding Yun joined Huawei in 1996 and has worked at Huawei for 26 years.

There are reports that Ding Yun died of a heart attack after a 28-kilometer run. On the evening of October 6, a Shenzhen netizen said on social networks that he encountered an ambulance in Yangtai Mountain, Shenzhen, where a fallen hiker was being rescued. It was reported from a Huawei source that Ding Yun was keen on long-distance running such as marathons, and "almost all his rest time was spent running."

Yu Weihua, president of the Huayou Association, also posted a mourning message titled "In Memory of Ding Yun" on his WeChat Moments, saying that the cause of his death was a heart attack caused by running 28 kilometers continuously.

Why does marathon running cause sudden death? Who is not suitable for marathon running? Why is marathon running addictive? What sports injuries are likely to be caused by marathon running? How to relieve "runner's knee"? Let's take a look.

01

Marathon may leave some people "very injured"

In recent years, running a marathon has become a fashionable way to keep fit. However, marathon is not a sport suitable for the general public. Almost every year after a marathon, there are always news reports of sudden deaths of runners.

△ The statue of "Marathon Warrior Announces Victory" in the Louvre. The marathon was originally held to commemorate the heroic warrior Pheidippides during the Greco-Persian Wars, who ran back to Athens from Marathon and died of exhaustion after shouting the news of victory.

Huang Guangmin, chief physician of the Institute of Sports Medicine of the General Administration of Sport of China, once provided a group of data on the sudden death rate in marathons to a reporter from Beijing Science and Technology Daily: A report published in the New England Journal of Medicine in 2012 showed that from 2000 to 2010, nearly 11 million people participated in marathons in the United States, and a total of 42 people died suddenly, with an incidence rate of 0.38/100,000; the authoritative magazine Runner's World pointed out that the conclusions of a large number of related studies over the past few decades are very similar, and the mortality rate of marathon participants is about 0.68/100,000; referring to domestic event reports, the mortality rate of marathon participants is 0.44~1.54/100,000. At the same time, statistics show that the probability of sudden death in male marathon runners is more than 5 times that of females.

According to the American magazine Circulation, among the causes of sudden death during exercise, hypertrophic cardiomyopathy is the most common, which is consistent with the statistical results of sudden death during marathons - 90% of sudden death during marathons is due to heart problems. In addition, congenital heart disease, acquired valvular heart disease, ischemic heart disease, exercise stress syndrome, heat stroke, dehydration, etc. are all common causes of sudden death during exercise.

△ Things to note when reducing the risk of sudden death during exercise (Source: CFP)

In addition to causing sudden death, long-distance running is more commonly criticized by doctors and professionals for its high risk of causing sports injuries. In 2014, statistics from the Harvard Journal showed that the injury rate of people who insisted on running every day was as high as 30% to 80%. On March 20, 2016, at the Guangdong Qingyuan Marathon, which was jokingly called the "most injured" event, 12,208 of the 20,000 participants received treatment, including 9,838 muscle spasms, 1,743 sprains, 194 abrasions, 20 fainting, 107 abdominal pain, 306 collapses, etc., 17 people were sent to the hospital for treatment, 5 were critically ill, and 3 were even admitted to the hospital intensive care unit.

Zhang Li, an associate researcher at the Institute of Sports Science of the General Administration of Sport of China, said that injuries caused by horse racing are generally caused by two main reasons: one is the wrong running posture. Long-distance running is a very boring mechanical sport. Even if a very small mistake is repeated 100,000 times, the damage will be magnified 100,000 times, and finally the body will not be able to bear or compensate, resulting in injury; the second is excessive exercise. Excessive exercise here means exceeding one's own tolerance, which can also lead to overtraining injuries. It is generally difficult for non-professionals to control and grasp these two points, so the probability of injury during horse racing is very high. However, even for professional athletes, it is difficult to avoid injuries caused by unreasonable exercise load or incorrect technical movements.

02

Who is not suitable for marathon?

Marathon is a long-distance, high-energy, and heavy-load event in track and field sports, and it requires a high level of health. Zhang Li warned: "Don't run a marathon on impulse. As a niche extreme sport, marathon is not suitable for everyone. In particular, patients with some diseases (such as cardiovascular diseases, metabolic diseases, endocrine diseases, neurological diseases, bone and joint diseases, blood diseases, etc.) are not suitable for marathon running. In addition, people whose muscle type is mainly "fast-twitch fibers" are not suitable for marathon running because they are prone to injury during long-distance running due to lack of endurance."

The following people are not suitable for marathons:

People with heart disease: In terms of heart disease, people with rheumatic heart disease and congenital heart disease are not suitable for long-distance running. In addition, people who have had a heart attack recently, people with severe coronary artery disease (angina pectoris), or people who feel chest pain when doing light activities, and people whose faces turn pale or blue during exercise are not suitable for long-distance running. The worst thing is that some heart diseases usually have no symptoms, and even the patients themselves do not know that they have hidden heart diseases. Long-distance running is the most dangerous for such people.

Patients with colds: Viral colds can induce heart failure and myocarditis. Especially fulminant viral myocarditis can cause sudden death. Therefore, if a cold does not heal for two weeks and is accompanied by coughing, chest tightness, palpitations, and shortness of breath, you should pay attention and seek medical attention in time to avoid inducing heart disease.
People with high blood pressure, diabetes or arrhythmia: After running, adrenaline rises, blood pressure and heart rate rise, which can easily lead to a spike in blood pressure and arrhythmia, inducing danger. Diabetics can run long distances, but they must be cautious. If the glycogen reserve is insufficient after intense exercise, it is easy to cause hypoglycemia and cause danger. In addition, diabetes can also cause lesions in small blood vessels and microvessels, bringing vascular risks during running.

Overweight people: Overweight people often have metabolic disorders, and when long-distance running consumes too much energy, it can easily lead to danger.

△ The lower limb joints of heavyweight athletes are subject to greater impact and damage. If you want to lose weight, you can actually choose other types of aerobic exercise such as swimming.

Those who have not received systematic training: People who have no sports foundation, lack training or are in poor physical condition, are prone to dizziness when running long distances, and their bodies cannot bear such a large amount of exercise. It is recommended that people who participate in marathons or long-distance running must have a long-term exercise foundation. It is best to have a comprehensive physical examination before the competition, and only those who are physically qualified can participate in the competition.

Older or younger people and those who are physically unwell: Exercises that are too heavy, too consuming, and too long are not good for the growth and development of young children and will disrupt their growth and development patterns. Older people are not suitable for high-intensity marathons or long-distance running because of aging of their internal organs and tissues and weak physiological functions.

03

"Challenge" does not mean to bear it

People should not only have good exercise habits, but also have a comprehensive physical examination before the competition to ensure that there are no hidden dangers in the body. There are also heart rate monitors and other instruments on the market that can help understand the heart condition during exercise. When preparing for a marathon, you need to pay attention to gradual progress, follow the principle of "from weak to strong, from slow to fast", and gradually increase the distance and speed of long-distance running.

It is worth mentioning that many people think that marathon is a "challenge", so they often endure even if they feel uncomfortable during running, which is an unscientific method. If you are physically tired or your legs are weak, it is okay to overcome it with willpower, but if you feel discomfort in your heart or other organs, you should stop exercising immediately and seek help and medical treatment if necessary.

In response to the multiple sudden deaths and high injury rates in marathon running, domestic marathon races are also consciously addressing the source, such as raising the threshold for marathon running and setting strict registration requirements.

04

Why do so many people like marathons?

In his work What I Talk About When I Talk About Running, Haruki Murakami, a writer who loves marathons, once explained why he recommends long-distance running among many forms of exercise: "Running has several advantages. First, you don't need a partner or opponent, nor do you need special equipment or gear, and you don't have to go to a special place. As long as you have a pair of running shoes and a decent path, you can run as long as you like when you feel like it."

Why can Haruki Murakami "run as long as he likes"? When you run a marathon, your brain produces "endorphins" - this morphine-like biological hormone can be continuously secreted as you continue to exercise, so that you will not feel any or only feel a small amount of pain that occurs in long-distance running. At the same time, endorphins will produce a euphoric feeling in your body called "runner's high".

Another hormone secreted by the body during marathon running is adrenaline, which can also make the body excited. These two hormones will only increase after reaching a certain amount of exercise, so you may sometimes feel pain from exercise in the early stages of running. In the second half of the run, as the hormones continue to be produced, they will be replaced by a feeling of euphoria, comfort, excitement and excitement. Many runners insist on long-distance running just to pursue this euphoria brought by the brain every time they run.

△However, being overly immersed in this euphoria may cause runners to ignore or underestimate some of the body's warnings due to injuries during the race.

In theory, sticking to long-distance running can promote the body's metabolism and improve endurance. When you are running, the heart's stroke volume and the elasticity of the blood vessel wall are significantly enhanced, the blood and lymphatic circulation will begin to accelerate, the breathing frequency and depth will increase significantly, the vital capacity will increase significantly, and the lung's ventilation and ventilation functions can also be significantly improved. The upper respiratory tract's adaptability to changes in air temperature during long-distance running will gradually increase with the frequency of exercise. With the improvement of the body's cellular immunity and humoral immunity, the body's disease resistance, especially the upper respiratory tract's anti-infection ability, will be significantly enhanced. In addition, rhythmic limb movements during running can also enhance the body's coordination. Especially after jogging in a natural environment with a high oxygen content, you will feel comfortable and clear-headed, and your mental stress will be relieved to a certain extent.

"For me, running is not only a beneficial physical exercise, but also an effective metaphor. I have surpassed myself yesterday, even if it is just a little bit, which is more important. In long-distance running, if there is an opponent that must be defeated, it is my past self." Haruki Murakami made this conclusion for his long-distance running career that he has persisted in for many years. However, among the many effects of long-distance running on the body, in addition to the benefits, there are also sports injuries that cannot be easily avoided.

05

Common running injuries

Why can some people jump up and down and take selfies after running a marathon, while others collapse to the ground? This ultimately depends on whether the runner manages his or her physical condition scientifically and prepares for training rationally. Understanding the most common sports injuries in marathon sports may help effectively prevent them and conduct targeted professional recovery.

(Map by Qin Tong)

Lower limb injuries are common in marathon clinics. The situation of "meniscus worn out" is actually rare, but the knee is indeed the most worrying part for most runners. If you can always maintain a scientific and reasonable long-term exercise, running will help improve the wear resistance of the knee joint. At the same time, if the core strength is properly trained and the quadriceps in the front of the thigh and the inner side of the knee patella are strong, it can also help protect the knee during long-distance running and avoid knee pain. If you don't exercise properly, knee pain caused by running will be very difficult.

The most common prepatellar pain, also known as "runner's knee", is manifested as pain caused by soft wear between the patella and femur, and you can hear the sound of friction. If you suffer from "runner's knee", in addition to seeking medical treatment, the recommended recovery method is to use the wall squat method to exercise the quadriceps of the thigh: lean your back against the wall, keep your knees below your toes, squat 30 degrees, and persist for at least 5 minutes. You can feel the muscles on the inner front of the thigh bulge and it will work.

Knee problems can also be seen in iliotibial band syndrome, which is a symptom that is more "concerning" for female runners. The iliotibial band is a deep fascia on the outside of the thigh. If you imagine the iliotibial band as a bunch of strings, it is this bunch of "strings" that connects the thigh and calf as an important structure to fix the knee joint. When you are running, this bunch of strings will rub against your knee joint. When the friction is excessive, the sliding of the iliotibial band is hindered, and when the hip joint moves, the two rub against each other and make a snapping sound, and you will feel pain. The recovery method recommends using a foam roller. Use a foam roller for traction and stretching after running, which can have a good effect on deep tissue massage, tissue traction, pain relief, and anti-inflammatory.

In addition, lower limb injuries caused by marathon running also include Achilles tendonitis, medial tibial stress syndrome and plantar fasciitis. The male-female ratio of Achilles tendonitis is 10:1, and it is more common in male and elderly runners. Medial tibial stress syndrome "favors" female runners, and is also common in some people who have no running experience, or who are heavy, have calcaneal valgus, low arches and a tendency to flat feet. Corresponding to "runner's knee", plantar fasciitis is also often called "runner's foot" by many people. According to statistics, 10% of long-distance runners or people who have the habit of long-distance running suffer from this disease. Plantar fasciitis is manifested as pain near the heel when walking, and the pain is aggravated when jumping and running; there is obvious tenderness at the proximal attachment of the plantar fascia (heel tuberosity); and pain is also produced when the metatarsophalangeal joint is passively stretched. It can be relieved by repeatedly practicing pulling the big toe upward and dorsally.

△Schematic diagram of Achilles tendon and plantar fascia

According to Ren Gang, the above lower limb injuries cover more than 85% of the problems of orthopedic outpatients. In addition, he also reminded runners that improper marathon running can even lead to fractures. This type of stress fracture is also called marching fracture. It can occur in the tibia, navicular bone, calcaneus, tibia and fibula, pubic bone, and femoral neck, and is generally diagnosed through MRI scans.

At the same time, marathon running also brings other health risks. For example, when running on a track in the city, you are more likely to be exposed to air pollution - outdoor exercise in smog weather may cause irreversible damage; in addition, long-term outdoor exercise will cause the skin to be exposed to more direct sunlight. According to a 2006 study in the journal Dermatology, the incidence of skin cancer in marathon runners is higher than the average level.

Long-distance runners who challenge the distance of a marathon are likely to experience a unique experience that other long-distance runners will not have. That is, when the running distance reaches a certain value (about 30 kilometers for most people), you will "run into" an invisible transparent "wall".

"My brain was working hard, but my hands and feet were out of control. My abdominal muscles were cramping and uncomfortable, as if the energy in my stomach had been drained. I felt desperate and didn't want to keep running..." This "hitting the wall" phenomenon is also called the "extreme phenomenon". It is a short-term phenomenon caused by the inability of the body's nervous, cardiovascular and energy metabolism systems to activate fast enough to keep up with the intensity of exercise. Slowing down the pace, replenishing energy and maintaining rhythmic breathing can help you get through this so-called "hitting the wall period".

Running regularly or using some special training methods, such as running at variable speeds, can reduce or delay the occurrence of the "extreme phenomenon". When you run a marathon, if you don't want to experience this special experience at all, the only way is to let your body "have the final say" and control the running speed to a level that your body can adapt to more easily.

06

If you must run a marathon, please make a reasonable plan

Huang Guangmin suggested that all runners preparing for a marathon should first undergo a comprehensive physical examination, such as testing their cardiopulmonary endurance, predicting oxygen consumption, etc., to comprehensively and objectively evaluate their health and physical condition, and then carefully choose a marathon schedule based on their own situation. Before the race, runners also need to scientifically set performance goals that suit them, make a good plan for physical strength allocation, and feel and adjust during pre-race training. Ren Gang also suggested that when setting a marathon goal, the weekly increase in exercise should not exceed 10%. If it exceeds 15%, it is easy to get injured.

Huang Guangmin also emphasized the dietary preparation before marathon. In addition to balanced nutrition and proper quantity of three meals, he also said that special attention should be paid to replenishing muscle glycogen reserves. Huang Guangmin said that sugar is the only heat energy substance that can enter the blood-brain barrier, which directly affects the maintenance and enhancement of athletic ability. Marathon has higher requirements for the quantity, quality, combination and time of sugar replenishment. In addition, it is also very important to replenish water in time during exercise. Sports drinks containing appropriate electrolytes and light salt water containing sugar are better choices.

During the competition, you should try your best to get rid of the wrong running posture, avoid inward rotation of the knees and landing on the heels, and try to land on the toes and midfoot for "elastic running" to reduce the impact on the knees.

△The correct running posture can save energy and reduce the chance of injury.

If you are a long-distance running enthusiast, you may not have the same medical supervision as a professional athlete, but you can use some sports equipment to observe your heart rate to understand your body's response to exercise in a timely manner, so as to adjust and control the intensity of exercise and the rationality of exercise intervals in a timely manner.

Although everyone's heart rate is different, generally speaking, the pulse of an adult in a calm state should be stable at 60 to 75 beats per minute, and moderate exercise will make the heart rate reach 120 to 160 beats per minute; and after exercise, the average adult can return to the initial heart rate within 10 to 30 minutes. If after long-term observation, it is found that the heart rate changes abnormally during exercise, the cause should be found from the amount of exercise, exercise intensity and exercise intervals, and reasonable corresponding adjustments should be made.

07

Don't run when you shouldn't

Mastering the correct "posture" for marathon running also includes having a correct mentality. As an ordinary runner, there is no need to pursue "faster, higher, stronger" like Olympic athletes. When challenging extreme sports such as marathon running, you must always "listen" to your body. Whether to run or not is determined by your body. The most important thing is always to grasp your own sense of rhythm.

In addition to physical reasons, try not to run when there is air pollution. Smog is very harmful to the lung and heart functions of the human body. Even if you wear a mask, pollutants will enter the respiratory tract. It is recommended to do some targeted strength exercises or core training indoors on smoggy days.

Huang Guangmin, Zhang Li and Ren Gang, three experts, all suggested that people who are not suitable for marathon running do not need to force themselves to run. The benefits of long-distance running, such as improving endurance and cardiopulmonary capacity, are also available in other sports. Ren Gang recommends that novice runners or older runners can use brisk walking instead of running as a transition when they are preparing to choose marathon running. Not only can they achieve the same fitness effects of training endurance and strengthening the heart and lungs, but they generally do not cause too much damage.

△Running is written into human genes, but distances like marathon are not.