Running a marathon beyond the word health?

"Running the Marathon: More Benefit Than Penalty, But It Must Understand the Body Right."

(Summary from Sports Medicine Research 2025)

When we see people finish the marathon, many people think that nature can make people run 42 kilometers. But if you look at the heart doctor, the long run is a stress test on every single day. Heart, kidney, immunity, muscle and respiratory system work near the limit simultaneously for 3-6 hours.

A 2025 study confirmed that the benefits of training and marathons are "clearly greater than the risks," but the risks are real. If not prepared, the body may show warning signs that many people do not know.

The heart is the most used system. During the race, the heart has to pump 4-6 times more blood than usual, the pressure rises by an hour, and the right heart can become temporarily exhausted after the end, causing the value of troponin to rise, so that many people are shocked to mistake it for ischemia, which is actually "temporary fatigue of the heart muscle," which is common and can heal in healthy people.

Kidneys are another system that requires hard work, dehydration, high heat bills, inadequate eating of NSAIDs or rehearsals can cause kidney fatigue or acute kidney injury. This condition is more common than it seems, but most heal within days. Another risk is low sodium from drinking too much water, causing headaches, fatigue, or seizures.

Muscles and ligaments support tens of thousands more shocks than usual, risk cumulative pain, such as knee, shin pain, or plantar fascia, bruising secondary, especially if running too fast or sparring inadequately.

The immune system weakens 24-72 hours after the race, making it easier to get sick because the body is drawn to the discomfort of the "fall."

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But all of this does not make marathons dangerous. On the contrary, if you train correctly, run slowly enough, run fast enough, recover properly, the average person has achieved huge benefits, including VO2 max, higher pressure, better weight, better mood, and 2-3 years of longevity, according to many countries.

Despite the benefits of marathons, overracing increases the risk to the body in many systems. 2025 research indicates that the body needs two to six weeks to fully recover, especially heart, muscle, and immunity.

The key is "marathons are safe for well-prepared people, but they are risky for unprepared people." If there are already health problems such as high pressure, diabetes, high fat, fainting at exertion or over the age of 40, I recommend cardiac tests and fitness tests such as CPET to determine the proper running zone before starting a training program.

Answering the right marathon practice is healthy in the big picture, but race day is not done for health, is stress test body whole system, is done for success, challenge and self-proof.

Finally, marathon is the journey of the whole body and mind. It is important to run self-understanding, systematic training, and always respect the body's signs. If possible, the long-term benefits outweigh the risks.

Cr.: Air Doctor, Heart and Sports Doctor