Running a marathon is often celebrated as a significant physical and mental achievement. However, the toll it takes on the body can be severe. As participants gear up for events like the TCS New York City Marathon, it is essential to recognize the potential injuries and health risks associated with such a demanding physical endeavor.
A recent study conducted in 2024 involving over 1,000 runners revealed that nearly 40% reported injuries while training for the marathon, with about 14% sustaining injuries during the race itself. Dr. Mariam Zakhary, director of running medicine at Mount Sinai’s Department of Rehabilitation and Human Performance, emphasized that proper preparation can mitigate many of these injuries.
Common Injuries Faced by Runners
One prevalent injury among marathon runners is related to the feet. Dr. Rock G. Positano, founder and director of the Non-surgical Foot and Ankle Service at Mount Sinai, noted that plantar fascia injuries are common post-marathon. The plantar fascia, which connects the heel to the toes, serves as the body’s primary shock absorber. The stress of running can accelerate its degeneration, leading to partial or complete tears, resulting in significant pain.
Another common issue is stress fractures, which manifest as tiny cracks in the bones of the foot and leg. These injuries may not become evident until days after the marathon, causing swelling and severe pain when weight is applied.
Dr. Adam Bitterman, chair of orthopedic surgery at Huntington Hospital, highlights the risk of Achilles tendinopathy. This condition arises from repetitive strain and is often exacerbated by sudden increases in mileage. It can lead to pain and inflammation in the Achilles tendon, limiting mobility and causing discomfort.
Gastrointestinal and Dermatological Concerns
Gastrointestinal issues are also prevalent among marathon participants. Dr. Dana Zalkin, a gastroenterologist, explained that during a race, blood flow is redirected away from the stomach and intestines to support active muscles, potentially causing symptoms like diarrhea, often referred to as “runner’s trots.” This can be worsened by dehydration.
Skin conditions are another concern. Dr. Jacob Beer, a board-certified dermatologist, pointed out that friction blisters on the feet are common during long-distance runs. Poorly fitting shoes can exacerbate this problem. Additionally, runners may experience jogger’s nipple, a painful condition caused by chafing from clothing against the skin.
Environmental factors can also pose risks. Dr. Jonathan Ungar, medical director for the Waldman Melanoma & Skin Cancer Center at Mount Sinai, noted that long exposure to the sun and heat can lead to skin damage, including sunburn and heat rash.
Long-term Health Implications
Marathon running may lead to more severe health issues as well. Research has indicated that the immune system can weaken for 3 to 72 hours following a marathon, increasing susceptibility to infections. There is also evidence suggesting a temporary reduction in brain myelin, which typically recovers within a couple of months, highlighting the significant demand on the body during such endurance events.
Moreover, a study published in 2025 found a potential link between marathon running and an increased risk of colorectal cancer. Among 100 participants aged 35 to 50 who had completed multiple marathons, nearly half exhibited precancerous polyps, with around 15% showing advanced adenomas. This is a stark contrast to the 1% to 2% rate typically observed in the general population of that age group.
Given these findings, Dr. Gina LaRocca, a cardiologist at Mount Sinai Fuster Heart Hospital, advocates for pre-marathon health screenings. This is crucial as some runners may experience acute coronary events during training, often linked to existing health conditions.
Running a marathon undoubtedly comes with substantial rewards, but the physical toll should not be underestimated. Runners are encouraged to prioritize their health by adequately preparing for the demands of the race and remaining aware of the potential risks involved in this grueling challenge.
