State 42: Maine (2014 Maine “Half” Marathon)

I awoke on Sunday with a serious, credible issue in my right knee. My IT band was extremely tight and would complain loudly every time I raised it off the ground. It could bear weight, but the minute I sprung forward, it tingled with pain. The hilly and challenging New Hampshire Marathon had pulled something out of alignment and I had hoped against hope that a good night’s rest would somehow nudge all the pieces back to their original positions.

It hadn’t, and I was due to run another marathon in just two hours.

This marked the first time I saw the sun all weekend

This marked the first time I saw the sun all weekend

My friend Javier dropped me off at the start line about an hour before the race was to begin. I made use of that time by walking in circles, hoping to somehow shake off the pain, as if it were a pesky bug that had gotten caught in my leg hairs. As more runners arrived, I felt like I was doing something right. Lifting my leg so that my knee was almost touching my chest, I felt better. I even dashed for a hundred feet and the discomfort felt manageable.  Perhaps I would be able to survive this marathon after all.

It took just one tenth of a mile to crush my optimism like a mallet to an egg.

If I felt any sort of relief, it was gone by the time the smoke from the cannon had faded from the starting line. With hundreds of runners zipping by me, I stopped to walk just a minute into the race. The pain in my right knee was unbearable, sending acidic stings with every step, each one worse than the previous. In that moment, I knew that 26.1 more miles of this would be impossible, if not absolutely excruciating. In my hand I clenched my phone, which I had sealed in a ziploc bag, and every slow, stumbling step I took, I gripped it harder. It was my way out, my lifeline. I could use it to call Javier and this whole thing would be over. I had that power to drop out.  I just worried that I didn’t have the maturity.

Mile 4, by the sea

Mile 4, by the sea

I sent him a text message instead.  “This is not working out.”  It was like mental insurance, an early warning sign of things to come.  But I stopped just shy of using it to call for a rescue.

That first agonizing mile was slow.  Every time I broke into a run, pain would singe into my knee and I would be forced back to a walk.  In that time, the one thing I managed to do very quickly was burn through the five stages of grief.

Denial

This can’t be happening. This is my thing, running is MY thing, and I’ve proven to be pretty good at it. There’s no way that this pain is really such a big deal. I just need to keep running on it so it loosens up my knee.  After that, everything will just click. All pains eventually go away, so it’s just a matter of ignoring this little hiccup, steel yourself, use mind over matter, and pretend it doesn’t exist. Just keep going.

Anger

Ow, ow, ow, this is bullshit and not working. I absolutely killed my training for this without a single issue. There’s no reason why my knee should be hurting this much. It hasn’t ever been this bad. In fact, my right knee has NEVER hurt, so why start now? I didn’t even push myself yesterday and suddenly it’s punking out like it’s never experienced a race before? Unbelievable. Ow, ow, ow …

Bargaining

You know, if I switch my gait to my old, maligned heel-strike, then I can actually pick it up a little. Maybe I can stay with this run/walk business until the end. Can I hobble the full distance?  But then we’d miss our hotel check-out and Javier and his family would end up waiting far too long for me. I wouldn’t be able to shower either – is that such a bad thing though? Is it too much to ask a family of four to wait for five hours and then endure the mephitic odor of an unwashed runner in the car for another two? 

Depression

This sucks. This really sucks. I came all the way here and now I might have to bail. There’s a reason that many runners re-brand DNS from “Did Not Start” to “Did Nothing Stupid” and I’m about to discover just what Stupid is. Man, each step hurts; this is the worst. People are going to give me that smirk and tell me SEE? They KNEW running was bad for your knees, and the proof was in my pudding-like pace. I wish people would stop staring at me.  I know, I’m walking at the first mile, thanks for your concern, but please move along.  And on top of all that, I now have to come back to Maine eventually to re-do this state.

Acceptance

… or do I? This slower pace and awkward stride is actually working pretty well. In fact, check it out, I’m at mile 4. I can probably keep this up for another 9 miles, cut my losses, run a half marathon instead and stay on track for all fifty states. It wasn’t my original plan, but if I stop running and go home now, I’ll be very upset at myself. Am I alright with doing “just” a half marathon?  Yeah … yeah I’m okay with that.

(left to right at Sebago): Diego, me, Javier, Erin

(left to right at Sebago): Diego, me, Javier, Erin

I would love to say that a smile burst from my visage from that moment onward and I waltzed happily for the next nine miles. Instead, I was locked in a grimace, a vestigial emotion leftover from the Anger phase. Denial was quickly overcome – there was no getting past the obvious pain. I bargained with my goals and ultimately accepted that I would rather not crawl for five hours, kill my enjoyment of the event and ruin everyone’s plans. But anger would stick around for several thousand strides.

It wouldn’t be until mile 10 that I began to run fast again. I wasn’t in the clear, as my IT band was still pretty tight. But it was no longer feeling like it was getting squeezed. I even sped up to a 6:47 pace toward the end and only then did I let myself smile. Maybe I hadn’t really accepted what I was doing until this point, as if the last two hours had only existed to get my mind off what felt like cheating or giving up.

Lobster Roll at Sebago Brewpub

Lobster Roll at Sebago Brewpub

It took me a while to get over it. I thought of people like Steve, Danielle and Otter, who have gone on to finish long races with terrible, probably worse pains, crossing the timing mats often smiling and with absolutely no regrets. It made me wonder if they know something I don’t, or if their worldview is somehow more mature than mine. Maybe they’re just better actors.  A childish part of me believes that accomplishments are only worthy or important if someone else thinks they’re impressive. I know that’s not true, but I can’t help but think on it from time to time.

I wish I had been able to fully enjoy the friendly volunteers, the flanks of cheerful spectators who assured me that I was “looking good” and encouraged me by name to “keep it up.” I’m sure they had seen my scowl because I had never gotten that much dedicated attention before. It would have been nice to enjoy the picturesque neighborhoods that came alive to witness the stream of people flowing through them. I would have taken more time to breathe in the beautiful seaside vistas and wispy cirrus clouds vanishing into the horizon.  Because the race really was quite scenic and very well organized.

The Maine Marathon gives out enough swag to fill a Doomsday Prepper bunker

The Maine Marathon gives out enough swag to fill a Doomsday Prepper bunker.  And yes, that IS a can of baked beans.

But I did finish smiling. Oddly enough, part of me did have fun at this race, even if the majority of it was spent wincing and facing the possibility of dropping out. If the physical act of running weren’t fun by itself, then I wouldn’t have come all the way here in the first place. Though they were emotionally charged and far from graceful, the miles I ran in Portland were still miles run. And of course, beyond the race itself, there was plenty to enjoy. When I wasn’t running, I was spending a fun weekend with a good friend and his family, happily noshing on local seafood during a gorgeous time of year.

It’s a strange thing, dropping to half the distance.  As the day went on, I quickly forgot about the race, almost as if it had happened weeks ago.  Despite how much those early miles hurt, they didn’t seem to register in my mind.  Maybe my subconscious is already quite aware that I will come back to Maine for the distance I originally wanted to run.  But that comeback will have to wait, and for now, I’m happy with my memories of the Pine Tree State.  Though I will certainly look back on this trip as “the time I dropped to the half,” I will also remember Maine for many other reasons.  There was the lobster, the chance to reconnect with friends and the realization that these events can bring out more than just the strength in your legs and the sweat from your pores.

Onwards.

Marathon_Map 053 (ME)

State 41: New Hampshire (2014 New Hampshire Marathon)

Autumn in New England, best place and time for a pretty run

Autumn in New England, best place and time for a pretty run

A side-effect and direct consequence of marathon-related selective memory is that you forget how painful and arduous some undertakings are and decide to try them again. One of those is the tricky double-marathon. Last year to the weekend, Otter and I went to the Pacific Northwest to run the Leavenworth and Portland marathons on consecutive days. Though the endeavor did a number on Otter’s knee, I left the region with two new marathon states and a hipster co-op’s worth of confidence.   It wasn’t all perfect, as I didn’t enjoy the otherwise beautiful and impeccably executed Portland Marathon as much as I could have because my brain was too focused on how much my legs were hurting.

Erin ran the point-to-point half marathon on little training like a champ

Erin ran the point-to-point half marathon on little training like a champ

But for some reason (runner’s amnesia), I decided to do it again. In the interim, my West Coast running pal Mike ran two marathons in one weekend and finished each in under 3:45. So, obviously, being the brutish male that I am, I found myself wanting to improve that impressive mark by running both of my marathons in under 3 hours and 40 minutes. And so it was that I found myself in Bristol with my high-school friend Javier and his family for the 22nd running of the New Hampshire Marathon.  I was huddled with Larry Macon and a few hundred runners listening to the Newfound Memorial Middle School band get ready to play the national anthem.  The bassist kept compulsively breaking into the opening notes of “Seven Nation Army” but would repeatedly get hushed down by the conductor.

“This kid just really wants to play that song,” I said to the runner next to me.  “It wants to explode out of him.”
“Teach, I can do it!” he replied, imitating the feverish bassist, “I can rock this bitch, Teach, just gimme a chance!”

It was a foggy, chilly morning

It was a foggy, chilly morning

The famous foliage of New England had started and most trees were shedding their orange leaves and pine straw, preparing for winter. The entire race would be run surrounded by this beautiful change. While the trees were transitioning between forest greens and bright oranges, my feet would soon be in the process of changing from uphill to downhill. It wasn’t long before I realized that I hadn’t done the proper due diligence for this race. Not only did it start with a very long, gradual uphill, but from there it rarely flattened out.  Many of these descents would be pretty steep.

So what does a smart, reasonable person do? He or she would evaluate these new environmental conditions and adjust their time expectations accordingly. Perhaps 3:40 would be a little ambitious given the constant elevation change and the fact that their training grounds afford no hills for practice. It is entirely acceptable to simply dial it back, given that no one below the podium cares about finishing times.

Up, up and away

Up, up and away

But I am not that person. I set out to run under 3:40, come hell or high water. Even worse, I told people about those goals. You can’t just back down after you’ve proclaimed it to the world.

I started with an easy, slow pace and ramped my way up to my target speed.  The course traced a path around central New Hampshire’s Newfound Lake, with many hills lumped along the way. There was a near constant fog hovering above us for the entire race, often descending to the pavement as a light shower. I realize that I boast having never run in rain, and while this race may have proven that long-standing claim untrue, it was quite refreshing and rarely ever felt like a meaningful weather event.  Water wasn’t dripping off me and my shoes hadn’t yet begun to squish against the road.

For virtually the entire race, we ran on the left side of a two-lane road, open to traffic.  The chilly, damp air was being moved briskly by a breeze and as the sun hid from view all day, I was all but ensured to stay chilly for the entire race.  Leaves would rain down from above, along with tine pine needles and the occasional acorn. Boats were moored on the shore by beautiful lake houses, every bit of ground covered in damp leaves. The race claims to be “the most beautiful marathon in New England” and I believed the hype.  Between the tranquil, fog-draped lake and the rich tapestry of autumnal colors, it was indeed the picture of pulchritude.

No more dedicated shoulder, runners are on the edge of the road

No more dedicated shoulder, runners are on the edge of the road

About halfway through my left knee began to feel slightly out of place. I instantly panicked and slowed to a walk. It happened on a downhill, and each stomp moved the knee ever so sightly out of alignment. Dark thoughts raced through my mind and I muttered a soft curse into the autumn air. But once on flat terrain, it seemed to recover and I continued the rest of the race without any serious problems. But the specter of an injury lurked in the back of my mind. After all, many tiny little issues have a way of coming back after the running is over.

Mercifully, the biggest climbs were all in the first half of the race. I would dedicate the majority of my energy in the latter half to maintaining an even pace and keeping my feet even on the ground. When you’re running on roads that bank upwards on hills, you’re essentially running on the sides of your feet, lop-sided. This isn’t much of an issue if it’s temporary, but it happened for most of the race and I was worried about how it would affect my knees.

Approaching halfway, the road has narrowed

Approaching halfway, the road has narrowed

Aid stations came and went, staffed by two volunteers each. I might have guessed that about 800 people were running the marathon, so there wasn’t much need for large, industrial aid stations. But despite the slow trickle of runners, each volunteer was nothing but assiduous in making sure we were hydrated.  There were several aid stations through which I walked, but even my slower pace didn’t dampen the volunteers’ dedicated energy.  They would walk right up to me with two cups and hold them right at my chest level, as if offering me the elixir of life.

As the race drew to a close, I couldn’t help but wonder how my legs were going to wake up the next day. I wasn’t tired, but the near constant mix of ups and downs had pummeled my quads more than any 20-miler in recent memory. It wasn’t too late to slow down and give them a rest, but my troglodyte mind had been made up days ago; I was here to run a certain time and no amount of sound logic would get me to stop. I had built up a lot of momentum scaling these hills and I wasn’t about to let that meaningless 3:40 threshold pass me.

Miles 20-22 were right on the shores of Newfound Lake

Miles 20-22 were right on the shores of Newfound Lake

Three hours and thirty-eight minutes later, I was crossing the finish mats at Newfound Memorial Middle School. I happily downed a bottle of water, some orange wedges and a few cups of Gatorade before heading to the school locker rooms for a much needed shower. It took a long time to change out of my running clothes, rinse them and put on new ones. Though I strode confidently over the finish line in a time that would have been a PR two years ago, I was aching. The adrenaline had receded from my muscles and without my body’s mechanical, forward chug, I found myself hurting.

Mile 25 runs along the Newfound River

Mile 25 runs along the Newfound River

And this time, the pain was coming from that hitherto impervious joint, that steely bastion of endurance that had almost never complained in all my years of running: my right knee.  The usual culprit was always my left side.  For some strange reason, which a detailed gait analysis might disinter, most of my running pains emerge on the left.  Historically, it’s my left metatarsals that get aggravated; my left knee was to blame for my first ever DNF; even my left elbow was struck with bursitis three years ago.  But my right side had always kept it together until the afternoon after the New Hampshire Marathon.

You wouldn’t have guessed it on my face. I left the locker to find Javier and his family, actively disguising my clumsy limp, trying to look confident for the next day’s event. I did mention that I had overdone it, but said it with such sangfroid you’d think I was talking about putting too much barbecue sauce on a McRib. I had no idea how tomorrow would unfold, but knew without a doubt that I wasn’t going to laugh through it. After almost seven months of near invincibility, something had gone wrong, and I had yet another 26.2 miles to face down the next day.

Marathon_Map 052 (NH)

Paces High (2014 Air Force Marathon)

We walked between floodlights and domed hangars under the night sky, following the crowd to the start line. My wife Steph was running her first (and likely only) half marathon along with her sister, mom and uncle. An hour before they were due to start, I would begin the marathon with my father-in-law Steve as his pacer.  This race was particularly significant for Steve, because not only was he in the Air Force for six years, it would be his first marathon since 2008.  Both of these reasons imbued him with omnipotent Dad Power, which meant he made t-shirts and signed up the entire family for the event.

left to right: Steve, Janine, Jan, Steph, me

left to right: Steve, Janine, Jan, Steph, me (with head wings!)

I was a little nervous. It wasn’t the marathon distance that intimidated me, but the task of being Steve’s pacer. Before I had even run two miles in my life, he had already earned several marathon and triathlon finishes. I went to watch him run the 2006 and 2007 Chicago Marathons, years known respectively for being very cold and dangerously hot, and felt completely humbled (and intimidated) by what I had just witnessed. Today, I hoped that I would be able to guide him through the race without feeling impertinent – after all, this was the guy who taught me how to run six years ago.

Mile 0: The Start

Mile 0: The Start

By 7:30 in the morning, as darkness gave way to a pristine morning at Wright-Patterson Air Force Base in Dayton, Ohio, it was time to start. The race began with the unexpected, full-bodied boom of a cannon, instantly sending my heart crawling up my throat. We started our watches, shook off the nerves and took off with one helluva roar.

The race website, literature and even satellite maps gave me the impression that we were going to run purely within the base. If you close your eyes and imagine a typical airport, I’m certain that your mental image will not include trees or shade. And for a large part of this race, that’s how we ran, climbing high into the sun. The first 5k had most of the hills, rolling over the Air Force Institute of Technology’s campus and by the Wright Brothers Memorial.  We cruised past the Wright State University Nutter Center, where we had picked up our race materials the day before, and then the course ushered us to the McClerron Memorial Skyway for longer than I would have wanted.  Eventually we reached the Wright-Patterson Golf Course at 10k and happily welcomed the cover of trees.

Mile 5: McClerron Memorial Skyway

Mile 5: McClerron Memorial Skyway

This was a delightful change of scenery. Though most of the surrounding area for the entire race was green, the actual trees themselves were always too far away to provide any shade. But we felt instantly cooler once the course narrowed on the golf course. Steve and I had started walking a minute for every ten minutes of running, though still keeping an even pace.

For the next 10k we would run through Fairborn, a small town just northeast of the base. We wouldn’t see this many spectators until the finish line, but our attention was focused elsewhere. It seemed like this part of town was looking forward to Halloween like a kid going to sleep at 3 PM on Christmas Eve. Every other store was displaying spooky wares and one family had erected a professional-grade ghost ship on their front yard. There was even a house with a “ghoul train” on its lawn and a two-story tall Grim Reaper fastened to its façade. It was easy to forget that we’re still five weeks away from All Hallows’ Eve, but they all made for excellent distractions as we crossed mile 10.

Mile 7: The course narrows a bit by the golf course

Mile 7: The course narrows a bit by the golf course

As we made our way out of Fairborn, I kept noticing that Steve was steadily pulling away from me. I didn’t want to temper his enthusiasm too much, but we were out here to run a smart pace. “Let’s reel it in a bit,” I would say, keep the wings level and true, and he’d dial it back. Once again, I felt a tiny twinge of impertinence because I felt like I was putting a stopper on the pent-up energy he had stored over the years, waiting to burst out.

Once out of Fairborn, it was time to run around the perimeter of Wright-Patterson Air Force Base. As you might imagine, it’s an enormous sprawl of land with few trees to provide any shade. As we wrapped around the base, Steve began talking to a fellow Team Red White & Blue member. He soon learned that his new friend was stationed at Malmstrom Air Force Base, where Steve spent six years as a missile security officer. They talked for about a mile about who did what, what happened when, what is and what isn’t. Making quick friends has always been one of his core competencies and had we not reached an aid station, I don’t know when the conversation would have stopped. Part of me wanted to pull him away and get him to re-focus on the race.  But that would have been cold; he was having so much fun.

After all, we had just run a half marathon just shy of his all-time PR and had plenty of energy to keep up an animated conversation. This wasn’t always the case.

Mile 10: Fairborn decked out in Halloween decorations

Mile 10: Fairborn decked out in Halloween decorations

Sometime in late 2008, Steve’s body rebelled against him. The well of energy that had always provided him with enough kick to participate in long-distance races, work a difficult and challenging job and be the best family man this side of Hobbiton had suddenly and inexplicably run dry. By 2009, he was walking half marathons because he couldn’t quite pick up the pace. In 2010, when my own running exploits were gaining traction, he had to drop out just shy of the second mile of the Indy 500 Festival Mini-Marathon because he didn’t have it in him.

Mile 12: Alien-themed aid station provides Steve a Close Encounter of the Thirst Kind

Mile 12: Alien-themed aid station provides Steve a Close Encounter of the Thirst Kind

He got blood work done, changed his diet, got tested for allergies and saw doctors of every ilk, but the mystery went unsolved. He gained weight and felt increasingly imprisoned by this inescapable lassitude, sometimes spending dark days in the basement alone with his thoughts. Oddly, this decline coincided with a surge in running by those around him. By then I was literally running wild with the sport and not long after, his brother men, Greg and Jim learned to fly, becoming marathoners themselves. His brothers-in-law Scott and Dan soon followed while Steve could only watch from the sidelines.

I remember asking him once if he would prefer that I keep my running stories to myself, because I began feeling a little obnoxious talking about my most recent PRs.  It felt like happily feasting in front of someone who hadn’t eaten in days. He said no.  Not only did he take pride in knowing he had set me on the running path, but these stories were exactly the kind of motivation he needed.

Mile 17: Wide open, sunny stretches were frequent

Mile 17: Wide open, sunny stretches were frequent.  Under warmer conditions, this race could have been much tougher.

During this time, he became an avid scuba diver, dedicating himself to the activity and joining several charities aimed at helping veterans assimilate back into civilian life through scuba missions. His passion for the underwater world mirrored his diehard pursuit of endurance sports, but part of him was always itching to get fully back into the running game. You could hear it in his voice when he’d give tips or lend gear, that telltale enthusiasm that lets you know he hadn’t forgotten anything.

But he managed to turn things around. With help from his family (most notably his wife Jan), he changed his diet, refused to stay down and began to slowly climb out of the basement. Whatever was ailing him was never truly discovered or even named, but that didn’t stop him from putting in the time and sweat.

His training went into overdrive during an emotional trip to New Jersey in the summer of 2013.

It was a warm, muggy day on the eastern coast. I wore shorts and a salmon colored Polo, hoping it would unite the conflicting goals of staying cool and looking somewhat respectable. But the heat of Leonardo was oppressive and after walking for a minute dragging scuba gear through the sand, I could feel the sweat dripping down my arms. My in-laws were gathered along the beach, unsure if the occasion warranted a dose of their natural charisma or a helping of sober reflection. Because all of them, uncles, cousins and those who cleverly used marriage to sneak in, were there to remember and pay tribute to the family matriarch, who had passed away the previous summer.

Mile 19: A shaded service road comes to the rescue.

Mile 19: A shaded service road comes to the rescue.

While most of the family stayed on the sand, Steve and his brothers walked into the frigid waters of Sandy Hook Bay to bring Gram back to the shores of her childhood home. They released her ashes into the icy waters and left a stone with her name engraved on it, a memento for the remarkable woman who raised the wonderful, supportive family that so eagerly embraced me. Speeches were given and more than one fond memory recalled before a ponderous, and rare, moment of silence. Not long after, there was a lunch at a nearby restaurant, where it seemed like all sorrow and solemnity had been washed away by the zany extended family that we seldom get to see. It was easy to think at the time that Gram would have wanted it this way.

Mile 25.6: Beast mode

Mile 25.6: Beast mode

“I told myself while I was in the water,” Steve said, around mile 23, “I gotta turn this around.”

By that point, he had already started the comeback.   He had been training regularly and had run the Hoover Dam Half Marathon with us, preparing for Moab and later Miami. It was then that he dropped the megaton hammer on us by revealing that he had signed up for Ironman Cozumel. There it was, the massive 140.6-mile carrot that would dangle before him, the bright beacon on the horizon pushing him to train harder than ever.

The Air Force Marathon was part of that plan, and there we were, cruising past 40k.

Mile 26: Cleared for landing

Mile 26: Cleared for landing

“I look to you guys, to my brothers and you, and it inspires me.” In the moment, I could do little else but keep running, though I felt moved by what he said. The guy who was stationed at an Air Force base near Great Falls, Montana during most of his 20s, raised a five-star family and was staring down an Ironman with determination and grit, was somehow inspired by me. I thought his cables might have gotten crossed in the last 10k, but then I remembered what he told me five years ago. Every time he heard about race stories, from me or anyone else close to him, he got a little closer to his homecoming.  “Without you guys running together,” he said, pausing.  “I don’t know.”

“Alright, there’s mile 25,” I said as we approached the entrance to the base. “Time to give it all you got.”
“This is all I got.”

0920_airforcemarathon 40The final U-shaped stretch was lined with American flags followed by a fleet of intimidating military planes, all facing us as if ready to fly into the wild blue yonder. As we made that final turn, the chutes closed in on us, the finish line a bull’s eye just ahead. Enormous black and green wings passed above us like the arms of a slow-moving fan, with crowds cheering underneath. We passed a Lockheed C-141 Starlifter, then an AC-130, and finally a giant Boeing C-17 Globemaster before reaching the blue finish banner. There were 26 miles of running behind me, but so many more behind Steve. The last six years had been a frustrating series of races that ended too soon or stretched on for too long. But here he was, running what was quite possibly his fastest ever marathon.

“Hey,” I said, nudging him on the shoulder, “welcome back!”

Finishers!

Finishers!

We passed every plane and crossed the finish line, making our way through a large, white tent to meet up with the rest of the family. Everyone was smiling, if not a little achy, and ready to head back to the hotel for a shower. The rest of the weekend was spent eating, napping, watching movies and visiting the Museum of the US Air Force. Even if nobody had finished the race, or if we had all been carted off the course in a medical van, what mattered most was that we spent a fun weekend with family, learning about Steve’s time in Montana with the US Air Force.

But if I too live to be a grey-haired wonder, I hope to still be knocking out races like this.

Marathon_Map 051 (OH)

Marathoners, Get an EKG

Disclaimer: I am not a medical professional and do not have the credentials to provide medical treatment or advice.  This post is only my personal opinion based on my own experiences with medical tests and running.  It is not meant to be used as a guide for your own health decisions.  If you think you need an EKG or a similar procedure, please consult your personal care provider.

Getting into marathon shape is not easy, regardless of your weight, height or athletic history. Even once you make it to the finish line, you feel like your muscles are full of battery acid, ready to eat through your skin. You limp for days and wonder how you’ll ever manage to take another airborne step again. But one thing is certain: you’re likely to be in pretty good shape.

The buildup of mileage, the rush of oxygen and tearing up of muscle over the last four to six months have made you stronger. Your legs can carry you forward for hours, your resting heart beat has dropped a few beats per minute, and your body has become more energy efficient. There’s always one sign at every marathon emblazoned with some variation of the oft-quoted (but statistically unreliable) factoid that only 0.1% of the population has finished a marathon. We take that to heart, pun intended, because despite the noise and talk, we really are a minority.

The problem is that after many years of this, long-distance runners can fall into the trap of thinking they’re invincible. While the country (and increasingly the world) experiences public health and obesity crises, we stand somewhat apart, logging weekly miles and trying to eat right. Our reasons are diverse. We might have started training to lose weight, to challenge ourselves, or to carve out daily time to clear our minds. Whatever the cause, running between five and ten miles in one sitting is rarely a big deal to us.

But every so often the specter of doom rears its ugly head. I’m not talking about injuries – those happen to all of us and often enough that we know how to deal with most of them. I’m referring to the sobering fact that every so often, we are flooded with emails from friends and relatives all reminding us that someone died mid-race.

Long distance running is a unique sport. Few other sports allow thousands of amateur athletes to compete alongside the cream of the crop. Few other sports allow spectators to witness such incredible variance in performance over such a long period of time. We watch professional athletes on TV perform amazing feats, as they drop to the ground, heaving and sweating, but we never think they’re in any real danger. They are, after all, professionals. But that moment of security last a few minutes in a marathon as the elites and top 1% zip by. After that, it’s the throng of every-people, who run for fun or a sense of accomplishment.

The farther down the course you traverse, the more ragged everyone looks. The enthusiastic smiles of the first 10k become contorted in rictus grimaces, ebullient cheers are now hissed through gnashed teeth. As you watch people struggle to stay strong over such an unforgiving distance, it’s only natural to wonder whether the sport is good for them. And every so often, it seems like that question is given a dark answer.

First, the good news is that the numbers are on our side. If marathon running were truly bad for us, then we’d be seeing a lot more deaths. A recent Forbes article pins the likelihood of death from a marathon at 0.5 to 2 deaths for every 100,000 participants. While that is absolutely no comfort to the friends and family of the rare death, it does put the activity in perspective. For example, you are more likely to die while swimming, biking, playing football or even playing tennis and far more likely if you drive a car. Even with the boom that the sport is experiencing, deaths are very rare. A study published in the American Journal of Sports Medicine showed that despite the increase in participants from 2000 to 2009, the low incidence remains the same.

But the fact that they still happen sends a shiver down our spines, regardless of our PR ambitions. This year alone there have been deaths at the New York City Half Marathon, the London Marathon, the Shamrock Marathon in Virginia Beach and the Rock ‘n Roll Raleigh Half Marathon.  The fact that three of those examples were half marathons shows that the phenomenon is not limited to runners journeying 26.2 miles.

So why is it that some runners never cross the finish line? Dr. Peter McCullough from Dallas’ Baylor University Medical Center says that whenever a young, relatively fit person collapses mid-race, it’s most likely due to hypertrophic obstructive cardiomyopathy (HCM). This is a condition where the heart muscle or myocardium is thickened and thus restricts blood flow. The biggest issue with this condition is that it is asymptomatic, or difficult to detect until you’re having a cardiac episode.

But there is a way to detect if you have any abnormalities in the heart, including HCM, and that’s by getting screened. This is done via electrocardiogram (ECG or EKG), a device that measures the electrical activity of the heart. I went through the procedure in early May and it was completely painless. In addition to the EKG, I also underwent an ultrasound and a stress test, where I walked on an inclined treadmill with several electrodes attached to my chest. Every two minutes or so, the speed and incline increased until I was sweating bullets. During the ultrasound, I could see my heart expanding and contracting and each individual valve flapping effortlessly.

Most of the screening was, to be completely honest, a fun ego stroke. The majority of the patients that walk into the doctor’s practice were there because they had a problem and not for some peace of mind. Since HCM is a largely unfelt heart condition, I wanted to make sure I wasn’t that one unfortunate runner among the masses. After all, the most common fatalities occur in men in their 30s, albeit those with pre-existing, undiagnosed heart abnormalities.

It would seem somewhat reasonable to suggest then, that you too should get screened. If you are a serial marathoner, an ultrarunner or someone who routinely logs over 30 miles a week in the sport, it wouldn’t be unwise to take a look at your heart, especially if you experience any sort of chest pain or pressure during a run or if you have a family history of HCM.  Some might even say that routine checkups should be compulsory.  However, the American Heart Association has oddly not recommended mass screening. Their reasons have to do with resource allocation and logistics – there are simply many more health issues to tackle that take more lives and there are far too many active, athletic people in the United States to warrant that many EKGs (it’s also suggested that it would cut into cardiologists’ profit margins if widespread EKGs achieved economies of scale).

“The cardiac community is divided on this,” says Dr. McCullough. “But I fall in the camp where I think that everyone involved in serious athletics should have a echocardiogram, just like every woman who gets pregnant has two or three ultrasounds.”  Source

I agree completely. If you have the incentive (you are a serial marathoner or an ultrarunner) and the opportunity (you have decent health insurance), then by all means, get screened and run calm.

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