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Sports Medicine
Published in: Sports Medicine 4/2022

01-04-2022 | Review Article

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Authors: Volker Scheer, Nicholas B. Tiller, Stéphane Doutreleau, Morteza Khodaee, Beat Knechtle, Andrew Pasternak, Daniel Rojas-Valverde

Published in: Sports Medicine | Issue 4/2022

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Abstract

It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.
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Metadata
Title
Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review
Authors
Volker Scheer
Nicholas B. Tiller
Stéphane Doutreleau
Morteza Khodaee
Beat Knechtle
Andrew Pasternak
Daniel Rojas-Valverde
Publication date
01-04-2022
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 4/2022
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-021-01561-3

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