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

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Ultra-endurance running (UER) may pose long-term health risks across multiple organ systems. This review highlights potential maladaptations and calls for further research, especially concerning female athletes and specific health concerns.

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Area of Science:

  • Sports Medicine
  • Exercise Physiology
  • Public Health

Background:

  • Physical activity is known to reduce mortality and prolong life.
  • Ultra-endurance running (UER), races exceeding marathon distance or spanning multiple days, is increasingly popular.
  • While acute adverse events are rare, UER may lead to long-term health problems.

Purpose of the Study:

  • To review the current knowledge on potential long-term health problems from UER.
  • To identify maladaptations in cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems.
  • To consider specific risks for youth, masters, and female athletes.

Main Methods:

  • Literature review of existing research on UER and long-term health.
  • Analysis of potential pathophysiological mechanisms.
  • Focus on organ system-specific effects and susceptible populations.

Main Results:

  • UER can affect multiple organ systems, with notable cardiovascular impacts like right ventricular dysfunction, arrhythmias, and hypertension.
  • Acute kidney injury in UER may progress to chronic kidney disease.
  • Limited data exist for female athletes, who may face increased risks due to hormonal and energy availability interactions.

Conclusions:

  • UER presents potential long-term health risks requiring further investigation.
  • Understanding sex differences is crucial for female athlete health and longevity in UER.
  • This review aims to inform risk stratification and guide future UER health research.