Friday Rant: Running, Marathons, Sudden Death — Lessons For Minimizing Risk For the Heart/Racing

It's been a hot and debate-filled few weeks in the Busch/Reisman household regarding the participation of yours truly in various running races. Before getting into the details -- and some of the lessons of the outcomes, including those we might apply to corporate procurement and supply chain functions -- it's worth sharing some context, overall and then on a more personal level. Chicago's local running scene was turned upside down this past weekend following the death of William Caviness in the Chicago Marathon. Caviness was in exceptional shape, judging from his 10K split of 43:25 (sub seven minute pace) and 1:31 half marathon pace. If I may opine, it's downright scary that someone in such wickedly good conditioning could simply die in a race. But more on this (and perhaps why he died, like others before him) in a minute.

After Caviness death, my wife and I sat down to talk (I won't go into the lecture I received about my running habits). My sister ran in the same race last weekend, as did a good friend (I sat out this year, but was planning, before this tragedy, to certainly race in 2012 and go for a personal best time). This year, it was relatively hot out, and that undoubtedly contributed to Caviness' slowing in the later sections and ultimate collapse at the end of the race. Yet there's more to it than that. When runners die in races, they almost always suffer the same malady (heart attack, hyponatremia, etc.) in the second half of the race, and in a significant number of cases, at the very, very end or after the finish line.

I've not done a regression analysis of the factors of different deaths in recent years (though I plan to), but anecdotally, I've been able to make a number of general observations (including the timing issue). Those who die:

  • Tend to die late in races rather than earlier -- often at the very end

  • Are often in extremely good shape even compared to others in the race -- these are not the just "Mt. Everest Tourists" looking for a Sherpa to guide them to a safe finish. Rather, many of the runners are in the top 10% of all marathon (and half-marathon) in terms of time, have raced many times before, are going for a personal best time
  • Do not necessarily present symptoms even before a race even in a clinical, test setting (e.g., heart stress test)

Now, the other side of the morbidity aspect of marathon and endurance running is that the great majority of athletes do not die (the typical ratio, during races not counting those who die in training, varies, but is somewhere in the neighborhood of 1 death per 75,000 participants historically) and those who live are much less likely to simply keel over outside of a race. In other words, running -- and fitness in general -- is great for you, if you don't die doing it, and is likely to improve and prolong your life otherwise (and the chance of dying, statistically, to be specific). Some studies I've seen peg the reduced chance of death from those who distance run at over a 10x reduction overall. Yet given the benefits, you've got to admit that 1-75,000 odds of sudden death during a race are optional odds, mind you. And they aren't that great. But what can you do if you want to race and you want to minimize risk? The answers are actually pretty straightforward if you sit back and digest the data.

  1. Compete in races, but don't race in races; in other words, the key is to keep your cool in a race environment and never push to 100% to it over longer distances (e.g., half-, full-marathon).

  2. Any distance over a 10K in a race environment can prove dangerous. Don't assume a "half-marathon" is half the stress on the body if you run it hard.
  3. Don't race if you can't reverse split the race (i.e., run a bit faster in the second half than first, picking up the pace or maintaining it versus slowing down -- Caviness and others often present great times initially but then slow toward the end, perhaps suggesting they over-stressed their bodies too early on).
  4. Cross the finish line with something left and purposely slow down toward the very end (even if your body can take more).
  5. If you race, and want to race even moderately hard, put in the requisite training up front if you must compete. I have read in numerous places that those with greater weekly mileages (e.g., over 40 miles per week, ideally over 45) are less likely to die competing than those who put in 25 miles or less per week.
  6. Don't race in heat. Statistically, it increases the chance of distance-related issues. Bag it or take it easy if the mercury is forecast to climb.

Now, on a more personal level, there's that topic of my own racing next year, having introspectively looked at my own love of running as well as my familial responsibilities and issues (now with three kids). After weighing the odds, it seems silly to even compete at the half and full distance in a race setting. Better to truly take it easy if you're going that far. Yet, I probably will keep running in races because I'm stubborn and enjoy it, but I won't "race in the race" so to speak. I'll plan to dial it back a notch, especially in longer events. What do I have left to prove at my age, after all? I've finished a marathon already and most important, have a family that I adore and that needs me.

Having said this, I'm not bowing out. I also intend to increase my mileage and decrease my intensity in longer efforts when training for specific events. I'll make the time to do it or won't do it at all. Now as to ever doing a full marathon again, I'm sure why wife will have something to say in that regard, although I plan to hire an intern in December when I have some time to really pour through all the numbers and do a statistically analysis that goes beyond my small sample size. Indeed, I do believe with the right data behind such a look and modified behavior as a result, that it will be possible to reduce the odds even more of tragedy in distance running.

Next week, I'll share what I view are some of the procurement and supply chain lessons we can take from all of this. There are some good ones!

- Jason Busch

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