Physiology and Pathophysiology of Marathon Running: A narrative Review
Abstract Background Marathon training and running have many beneficial effects on human health and physical fitness; however, they also pose risks. To date, no comprehensive review regarding both the benefits and risks of marathon running on different organ systems has been published. Main Body The...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-01-01
|
| Series: | Sports Medicine - Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40798-025-00810-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571662533394432 |
|---|---|
| author | Lorin Braschler Pantelis T. Nikolaidis Mabliny Thuany Daniela Chlíbková Thomas Rosemann Katja Weiss Matthias Wilhelm Beat Knechtle |
| author_facet | Lorin Braschler Pantelis T. Nikolaidis Mabliny Thuany Daniela Chlíbková Thomas Rosemann Katja Weiss Matthias Wilhelm Beat Knechtle |
| author_sort | Lorin Braschler |
| collection | DOAJ |
| description | Abstract Background Marathon training and running have many beneficial effects on human health and physical fitness; however, they also pose risks. To date, no comprehensive review regarding both the benefits and risks of marathon running on different organ systems has been published. Main Body The aim of this review was to provide a comprehensive review of the benefits and risks of marathon training and racing on different organ systems. A predefined search strategy including keywords (e.g., marathon, cardiovascular system, etc.) and free text search was used. Articles covering running regardless of sex, age, performance level, and event type (e.g., road races, mountain marathons) were considered, whereas articles examining only cycling, triathlon, stress-tests or other sports were excluded. In total, we found 1021 articles in PubMed, Scopus, and Google Scholar, of which 329 studies were included in this review. Overall, marathon training offers several benefits for different organ systems and reduces all-cause mortality. As such, it improves cardiovascular risk factors, leads to favorable cardiac adaptations, enhances lung function, and improves quality of life in chronic kidney disease patients. It also enhances gastrointestinal mobility and reduces the risk of specific tumors such as colorectal cancer and hepatocellular carcinoma. Marathon training enhances bone health and skeletal muscle metabolism. It further positively affects hematopoiesis and cytotoxic abilities of natural killer cells, and may act neuroprotective on a long-term basis. After a marathon, changes in biomarkers suggesting pathological events in certain organ systems such as cardiovascular, renal, gastrointestinal, liver, hematological, immune, musculoskeletal, central nervous, and endocrine systems can often be observed. Mostly, these changes are limited to 1–3 days post-race and usually normalize within a week. Moreover, marathon running poses the risk of serious adverse events such as sudden cardiac death or acute liver failure. Concerning lung function, a decrease after a marathon race was observed. Acute kidney injury, as well as electrolyte imbalances, are relatively common amongst marathon finishers. Many runners complain of gastrointestinal symptoms during or after long-distance running. Many runners suffer from running-related musculoskeletal injuries often impairing performance. A marathon is often accompanied by an acute inflammatory response with transient immunosuppression, making runners susceptible to infections. Also, hormonal alterations such as increased cortisol levels or decreased testosterone levels immediately after a race are observed. Disturbances in sleep patterns are commonly found in marathon runners leading up to or directly after the race. Conclusion All in all, marathon training is generally safe for human health and individual organ systems. Considering the high popularity of marathon running, these findings supply athletes, coaches, sports scientists, and sports medicine practitioners with practical applications. Further large-scale studies examining long-term effects on the cardiovascular, renal, and other system are needed. |
| format | Article |
| id | doaj-art-7799cfd340374bb29febbb98f75bf937 |
| institution | Kabale University |
| issn | 2198-9761 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Sports Medicine - Open |
| spelling | doaj-art-7799cfd340374bb29febbb98f75bf9372025-02-02T12:25:54ZengSpringerOpenSports Medicine - Open2198-97612025-01-0111116710.1186/s40798-025-00810-3Physiology and Pathophysiology of Marathon Running: A narrative ReviewLorin Braschler0Pantelis T. Nikolaidis1Mabliny Thuany2Daniela Chlíbková3Thomas Rosemann4Katja Weiss5Matthias Wilhelm6Beat Knechtle7Centre for Rehabilitation and Sports Medicine, Inselspital, University Hospital of Bern, University of BernSchool of Health and Caring Sciences, University of West AtticaDepartment of Physical Education, State University of ParaBrno University of Technology, Centre of Sport ActivitiesInstitute of Primary Care, University of ZurichInstitute of Primary Care, University of ZurichCentre for Rehabilitation and Sports Medicine, Inselspital, University Hospital of Bern, University of BernInstitute of Primary Care, University of ZurichAbstract Background Marathon training and running have many beneficial effects on human health and physical fitness; however, they also pose risks. To date, no comprehensive review regarding both the benefits and risks of marathon running on different organ systems has been published. Main Body The aim of this review was to provide a comprehensive review of the benefits and risks of marathon training and racing on different organ systems. A predefined search strategy including keywords (e.g., marathon, cardiovascular system, etc.) and free text search was used. Articles covering running regardless of sex, age, performance level, and event type (e.g., road races, mountain marathons) were considered, whereas articles examining only cycling, triathlon, stress-tests or other sports were excluded. In total, we found 1021 articles in PubMed, Scopus, and Google Scholar, of which 329 studies were included in this review. Overall, marathon training offers several benefits for different organ systems and reduces all-cause mortality. As such, it improves cardiovascular risk factors, leads to favorable cardiac adaptations, enhances lung function, and improves quality of life in chronic kidney disease patients. It also enhances gastrointestinal mobility and reduces the risk of specific tumors such as colorectal cancer and hepatocellular carcinoma. Marathon training enhances bone health and skeletal muscle metabolism. It further positively affects hematopoiesis and cytotoxic abilities of natural killer cells, and may act neuroprotective on a long-term basis. After a marathon, changes in biomarkers suggesting pathological events in certain organ systems such as cardiovascular, renal, gastrointestinal, liver, hematological, immune, musculoskeletal, central nervous, and endocrine systems can often be observed. Mostly, these changes are limited to 1–3 days post-race and usually normalize within a week. Moreover, marathon running poses the risk of serious adverse events such as sudden cardiac death or acute liver failure. Concerning lung function, a decrease after a marathon race was observed. Acute kidney injury, as well as electrolyte imbalances, are relatively common amongst marathon finishers. Many runners complain of gastrointestinal symptoms during or after long-distance running. Many runners suffer from running-related musculoskeletal injuries often impairing performance. A marathon is often accompanied by an acute inflammatory response with transient immunosuppression, making runners susceptible to infections. Also, hormonal alterations such as increased cortisol levels or decreased testosterone levels immediately after a race are observed. Disturbances in sleep patterns are commonly found in marathon runners leading up to or directly after the race. Conclusion All in all, marathon training is generally safe for human health and individual organ systems. Considering the high popularity of marathon running, these findings supply athletes, coaches, sports scientists, and sports medicine practitioners with practical applications. Further large-scale studies examining long-term effects on the cardiovascular, renal, and other system are needed.https://doi.org/10.1186/s40798-025-00810-3Endurance trainingsports performanceSex differencesAthletic injuryExercise overtraining |
| spellingShingle | Lorin Braschler Pantelis T. Nikolaidis Mabliny Thuany Daniela Chlíbková Thomas Rosemann Katja Weiss Matthias Wilhelm Beat Knechtle Physiology and Pathophysiology of Marathon Running: A narrative Review Sports Medicine - Open Endurance training sports performance Sex differences Athletic injury Exercise overtraining |
| title | Physiology and Pathophysiology of Marathon Running: A narrative Review |
| title_full | Physiology and Pathophysiology of Marathon Running: A narrative Review |
| title_fullStr | Physiology and Pathophysiology of Marathon Running: A narrative Review |
| title_full_unstemmed | Physiology and Pathophysiology of Marathon Running: A narrative Review |
| title_short | Physiology and Pathophysiology of Marathon Running: A narrative Review |
| title_sort | physiology and pathophysiology of marathon running a narrative review |
| topic | Endurance training sports performance Sex differences Athletic injury Exercise overtraining |
| url | https://doi.org/10.1186/s40798-025-00810-3 |
| work_keys_str_mv | AT lorinbraschler physiologyandpathophysiologyofmarathonrunninganarrativereview AT pantelistnikolaidis physiologyandpathophysiologyofmarathonrunninganarrativereview AT mablinythuany physiologyandpathophysiologyofmarathonrunninganarrativereview AT danielachlibkova physiologyandpathophysiologyofmarathonrunninganarrativereview AT thomasrosemann physiologyandpathophysiologyofmarathonrunninganarrativereview AT katjaweiss physiologyandpathophysiologyofmarathonrunninganarrativereview AT matthiaswilhelm physiologyandpathophysiologyofmarathonrunninganarrativereview AT beatknechtle physiologyandpathophysiologyofmarathonrunninganarrativereview |