The Evolution of Endurance Sports Turns Deadly

My career in physical therapy has paralleled the endurance sport boom in America. In the late 1970s, while I was at the State University of New York at Stony Brook studying physical therapy, the running movement was literally hitting full stride. Millions of Americans laced up and hit the roads in search of the optimum health that was promised in the new research on the benefits of aerobic exercise. It soon became apparent that, while running had improved their lives, danger was lurking in the repetitive nature of their new sport: overuse injuries. Their enthusiasm and the lack of good science at the time lead them down the primrose path of running every day. In my new book, Healthy Running, Step by Step, I describe my experience as a young physical therapist, treating runners and starting my own practice in Santa Monica:

"Runners defended their fanatical dedication to running by citing literature that promised near immortality from the cardiovascular benefits of aerobic exercise. Hard-core runners, caught up in their addictive over-training, seemed to believe that one missed day of running would clog their arteries overnight, such that they would then die of heart disease.

It was therefore inevitable that the only thing that would stop obsessed runners, who did not yet know the dangers of too much of a good thing, would be injury. By the mid-'80s, too many runners landed in my physical therapy office in Santa Monica with severe and debilitating injuries. Why? Because they ran too much, too often, and too far. In an attempt to manage the fanatical allegiance to their sport, many doctors were reluctant to tell runners to stop running. It was the ignorant leading the obsessed: soon, shin splints turned into stress fractures, heel bones grew bone spurs, and running through injuries caused irreversibly damaged tendons."

In the latter part of the 80s, when multi-sport endeavors like triathlon and adventure racing became more popular in America, it was a relief for me and my clients. Now, as they used their bodies in different movement patterns, the stress of continuous movement was spread out among more joints, muscles, and tendons, and they saw fewer injuries as a result. Swimming, biking, trekking, mountaineering, and paddling gave my endurance junkies their endorphin fix, while their joints and I got a break, too.

Unfortunately, human nature is such that we take things at first to extremes, before fanatical enthusiasm gives way to better understanding. The same was true with adventure racing, which sent athletes on seven to 10 day expedition races that spanned 400 miles of the most rugged and dangerous places all over the world. In 1995, I had the chance to support a team at the Eco-Challenge race in Utah, and the punishing daytime heat, nighttime cold, and the nearly impossible-to-traverse terrain -- along with the competitive nature of athletes -- once again left me disturbed. I had spent the last 15 years working with athletes to preserve health and function, and now they found a way to turn a good thing into a dangerous and damaging endeavor. The lead teams looked great, unbelievably fresh and unscathed. Everyone else was battered, torn, and damaged. Frostbite, fractures, swollen and exhausted joints, and rhabdomyolysis (a sometimes fatal massive breakdown of muscle tissue that overtaxes the kidneys to a degree that they malfunction) ended the race for many athletes, and sent too many others to the hospital.

This week's feature article by my client and friend, Rebecca Rush, is a well-written and poignant description of an overzealous adventure race gone horribly wrong. Rebecca is a world-renowned endurance athlete who has won many national and world championships and has written a new book, Rusch to Glory. Check it out.