Are Ultra Marathons Bad for You?

If you've been running for some time or if you're just getting into the sport, you probably see people do these things called ultras. And you go, Hey, that's cool, I want to do that. I want to take on this big challenge.
Are Ultra Marathons Bad for You?


If you've been running for some time or if you're just getting into the sport, you probably see people do these things called ultras. And you go, Hey, that's cool, I want to do that. I want to take on this big challenge. But one thing you might need to ask yourself is, are ultramarathons bad for you?

Now, if you haven't been on the channel before, I'm Jesse Funk, this is a show I call runner's high. But you might also not know you should subscribe and all that good stuff, but the reason you should subscribe besides this show is I also talked to really cool people every Friday on another show I do called the Smart Athlete Podcast.

This is where I talk to athletes that are from amateurs to pros to Olympians that also have something going on in their lives. That is not athletics, which makes them very, very interesting people. Now I've talked to I really don't know how many ultra marathoners now, so I have a pretty broad cross-section of people that do this. It's not my particular bend, so I can't talk to you from experience.

But when I talk to these people, I can give you a little bit of insight into what they suggest and how they approach it now. Recently, I talked to none other than the author of the trail runner's companion guide, Sarah Lavender Smith, and we talked about getting into ultras. She mentioned how she had been running for at least a decade, maybe 15 years before she got into ultras, and we generally agreed.

It takes some time to get into it because if you want to have longevity in the sport, you can't just jump from couch to ultra and expect to make it. Is there going to be a rare case of somebody who can do it? Yes, probably. Is it a good guideline for most people? No, absolutely not.

And it has to do with distance running in general. It's also the reason why the best endurance athletes on the planet, typically mid 30s to 40s even. It just takes so much freaking time for your body to adjust in all these years and sometimes decades to get ready to do it.

Now let's look into what actually happens with these ultra hours and should they be doing it at all?

One of the problems with studies that I talk about in general is that there's not a really large sample size, and that is again the issue here with ultra runners, in particular because the ultrarunning community is not that big at all. Runners, there's hundreds of thousands of runners that participate in races in the U.S. any given year, but that number is much, much smaller when we get to the ultra scene.

So there's not as many pieces of data to look at when we can look at what are the risks to ultra runners. Generally speaking, the risk is are going to be relatively low. It's going to be overuse injuries. Duh. You could have seen that one coming right and then stress fractures, which is also going to be an overuse injury, but of a different sort and typically a stress fracture is going to be from a lack of nutrition or because it could be several things.

But one possible reason is lack of calcium in your diet and then your body begins leaching that out of your bones to try to make up for that deficit. That can lead to stress fractures, but in general, if you're not feeding yourself enough nutrients that can lead to the weaknesses in bones. Stress fractures you get to heal all the kind of thing.

In either case, overuse injuries are pretty much going to be the majority of it. You know what the issue is with ultra runners? Now, that doesn't mean that there aren't other things. There are ultra runners that die, and the leading cause of death in ultra runners is one thing and something you can probably predict; which is heart failure.

Something like forty three percent of deaths in ultra marathoners are from heart failure. Now, before you go, Oh, my heart is going to explode if I run an ultra. No, that's really not the case in the vast majority of these cases that people that died from heart conditions or heart failure had a preexisting heart condition. This is also why if you never played in college sports, you don't know this, but to participate in college sports as a freshman, when you come in, you have to undergo an echocardiogram.

You have to have your heart examined because colleges don't want your heart failing on you. When you're participating in their school sports.

You see stories about this, and it's especially devastating when you see, like high school runners, die from a preexisting condition from their heart, you know? My friends and I at that age, it hits you because this is such a passion and it's something that you're so into and we we almost in, I guess I'll apologize to my parents for having such a weird outlook at the time, but we'd say, you know, well, if I if I'm going to die, I'd rather die running.

Part of that's the just the naivety of youth and in that kind of feeling of immortality. And, you know, nothing can happen to me a little bit. And some of it's just like being dumb, I guess, you know, maybe there's something deeper there. Maybe it's just a dedication to your passion at the time, but you see these stories and they hit you hard. But the thing to know is that they are typically not directly related because of the sport. The sport didn't cause it, so to speak. The sport revealed it, albeit in a very devastating way.

So if you're going to undertake ultras, figure out how to get an echo some way, get your heart checked out and make sure you don't have any underlying conditions. That's just easy preventive care. I can tell you from experience that had an echo when I went to college, it wasn't an issue.

But I've also had like random pains in my chest, which I've spoken to doctors about, and they go, Oh, that's fine. My now wife is concerned about this, and I wanted to get an echo. At the time, I was late 20s and it was just about impossible to get me referred anywhere to get an echo. So I know that if you're going this route, it may be difficult to get this exam done. My suggestion, and if I was going to go this route again, it would be this go to a sports specific place because they're going to prioritize this kind of thing. Now they may also say, Hmm, you probably don't need it. And truthfully, you probably don't. The vast majority of people don't have underlying heart conditions. But is it worth the risk? That's something you have to decide.

Personally, I would suggest pushing a little bit to get this exam probably worth your time, but only you could decide what risks you want to live with. All that being said, and knowing that ultras really are probably fine for you, I have to admit that it comes with one big caveat, and that is selection bias. So if you're not familiar with selection bias, it's basically when a study or an observation involves a group that's not representative of the whole. So what are we talking about in this case? In this case, I'm talking about how ultra marathoners are basically self-selected, right? We don't just pick people off the street and say, Well, you're an ultra marathoner now.

They decide themselves. This is what I want to do. So likely they already have the background, the physical capability, the willingness to do it and the willingness to spend time and energy to take care of themselves. So when you have this self-selected group that isn't really representative of saying are ultramarathon healthy for everyone, are they healthy for everyone? We don't know. We don't have a study that just says, OK, Joe, blow, like, we're going to pick you off the street and now you're running ultras, and we don't know the implications of what happens there.

We can guess at them and say, that's probably going to be a bad time. It's probably going to be a bad situation if we just take anybody off the street and make them run ultras. So selection bias is important to take into account when you're thinking about, you know, is this thing healthy? Is this thing bad? So that brings me to our final conclusion here, which is if you're already running, you've been running for a number of years, you have no problem tolerating higher mileages.

You're probably fine. Again, I'd suggest getting that echo just in case, but you're probably within that self selection criteria that says, I have the fitness, I have the background, I have the willingness, I have the means. I have the time, I have the energy. Let's do it. If you're somebody who's never done, you know anything, you just hanging out on a couch like I do when I'm talking to you here.

Maybe try 5k out first, and I don't mean that disparagingly. I love 5ks, 5k 10k. That's my bread and butter. Those are the events I like to do. There's nothing wrong with them. But if you want to get to an ultra, you probably need to spend some time. And as both I and Sarah Lavender Smith would suggest, spend some time building mileage, being in the sport, working on the longevity of it and enjoying the process of it, rather than trying to dive into the deep end. And beyond that, if I torture the metaphor, it's like diving into the deep end and trying to scuba dive into an underwater cave without ever having gone swimming, which would be crazy. So don't do that.

But have you been running for a while? You're thinking about it? I'd say, go for it. I don't see any evidence that it's going to be that much more risky than anything else you might take on as long as you take the proper precautions. Get plenty of rest and set up your training schedule for success. So what questions do you have for me about running, about training, about the guests I see on this podcast on Fridays here on this channel? Again, subscribe. Leave them down in the comments below, and I'll see you next time on the next episode of Runner's High.

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