Participating in a marathon, such as the TCS New York City Marathon, is a significant accomplishment for many athletes. However, the physical toll of running 26.2 miles can lead to various health issues, from minor discomfort to severe medical complications. Experts warn that potential injuries and conditions can arise not only during the race but also in the training leading up to it.
Research conducted in 2024 involving over 1,000 NYC Marathon runners revealed that nearly 40% sustained injuries while preparing for the event, and about 14% experienced injuries on race day. Dr. Mariam Zakhary, director of running medicine at Mount Sinai’s Department of Rehabilitation and Human Performance, emphasizes that while running a marathon is a remarkable achievement, it imposes unique stresses on the body that can lead to serious issues.
Common Injuries and Conditions
Various injuries and conditions can develop due to the demands of marathon running. Dr. Rock G. Positano, founder of the Non-surgical Foot and Ankle Service, notes that plantar fascia injuries are prevalent among marathon runners. The plantar fascia, which connects the heel to the toes, acts as the body’s main shock absorber. Stress from running can lead to degeneration and even tearing, resulting in sharp pain in the heel or arch.
Stress fractures, often unnoticed until days after the race, are another common issue. These tiny cracks in the bones of the foot and leg, particularly in the metatarsals and tibia, can cause significant pain and swelling when weight is applied. Dr. Adam Bitterman, chair of orthopedic surgery at Huntington Hospital, adds that Achilles tendinopathy, caused by repetitive overload, is prevalent among runners, especially those who increase mileage too quickly.
Additionally, ankle sprains can occur due to uneven terrain or fatigue. These injuries result in pain, swelling, and difficulty walking. Runners may also experience cramping in the calf muscles, particularly during the later miles of the race, attributed to dehydration and muscle fatigue.
Gastrointestinal and Other Health Risks
Beyond musculoskeletal injuries, marathon runners are susceptible to gastrointestinal issues. Dr. Dana Zalkin, a gastroenterologist, explains that during intense physical activity, blood flow is redirected from the stomach and gut to the muscles, potentially causing diarrhea, often referred to as “runner’s trots.” The mechanical jostling of the body during running can also lead to nausea and abdominal cramping.
Moreover, running can exacerbate acid reflux due to the combination of mechanical movement and reduced blood flow to the digestive system. This can result in discomfort during and after the race.
Skin-related issues are also common. Dr. Jacob Beer highlights that friction blisters can develop, especially with poorly fitting shoes or non-moisture-wicking socks. Additionally, conditions like “jogger’s nipple” occur from friction against clothing, affecting both men and women. Fungal infections, such as athlete’s foot, thrive in the warm, moist environment created by sweat and running shoes.
A concerning finding from a 2025 study indicates that marathon running may elevate the risk of colorectal cancer. Among participants aged 35 to 50 who had completed multiple marathons, nearly 50% were found to have precancerous polyps, with around 15% possessing advanced adenomas, significantly higher than the 1-2% rate typically observed in the general population.
Long-Term Considerations
The physical toll of marathon running can have long-lasting effects. Research suggests that the immune system weakens for 3 to 72 hours post-race, increasing the likelihood of infections. Participants may experience cold-like symptoms following the event.
Additionally, marathon training can occasionally lead to acute kidney injuries, although most participants recover without long-term damage. Rhabdomyolysis, a serious condition where muscle tissue breaks down, can also occur, primarily linked to dehydration or preexisting health issues.
Dr. Gina LaRocca, a cardiologist, stresses the importance of health screenings prior to training, as acute coronary events, though rare, have been reported among runners.
The myriad of potential injuries and health risks associated with marathon running highlight the importance of proper training, preparation, and awareness. While the thrill of completing a marathon is undeniable, the physical consequences are a reminder for runners to prioritize their health and well-being throughout their training journey.
