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HEALTH HORIZONS : FITNESS : It’s a Long Way to Run : WHEN YOU ASK PEOPLE WHY THEY RUN MARATHONS, THEY WILL ALMOST ALWAYS SAY THEY WANT TO IMPROVE THEIR HEALTH. BUT THERE IS MORE TO IT THAN THAT.

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<i> Cimons covers federal health policy for The Times from Washington and hopes to run her ninth marathon this fall. </i>

More than a decade ago, the evening before I was to run my first marathon, I went to a runners’ party in a Manhattan restaurant where a mutual friend introduced me to Frank Shorter, the 1972 Olympic marathon gold medalist.

“Frank,” my friend said, “she’s running her first marathon tomorrow. Give her the word.”

Shorter smiled.

“Why?” he asked.

Why, indeed.

Why would anyone deliberately set out to run 26 miles, 385 yards? It is a grueling and humbling event that can take a monumental toll of body and spirit. The very word, in fact, has come to mean any grim endeavor that involves endurance. Anyone familiar with marathons knows the apocryphal story of Pheidippides, the first man to run one. In 490 BC, this Greek soldier ran the distance between Marathon and Athens (about 25 miles) to announce victory over the invading Persians at the Battle of Marathon. “Rejoice, we conquer,” he said. Then he promptly keeled over and died.

The authenticity of that story aside, the race itself is real now. Hundreds of marathons are held each year in cities and small towns all over the world. Tens of thousands of people run in them annually, and there is no evidence that the marathon’s popularity is diminishing.

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Marathoning is one of the few athletic events in which some of the world’s best-conditioned athletes, who are chasing records and lucrative prize money, brush shoulders with middle-of-the-packers such as myself, who seek only to meet a personal challenge.

On average, the world’s marathon elite finish in a bit more than two hours (the men’s world record is 2 hours 6 minutes 49 seconds, set in 1988 by Ethiopian Belayneh Densimo; the women’s mark is 2:21:06, clocked by Norwegian Ingrid Kristiansen in 1985). First-timers are happy to finish at all.

When you ask people why they run marathons, they will almost always say they want to improve their health. But there is more to it than that.

Regular running certainly provides numerous health benefits. It strengthens the heart, lungs and the immune system, lowers blood pressure, thins the blood, elevates the level of the good cholesterol and reduces the bad. It also increases energy, relieves stress and improves the mood. It is a good way to burn calories and fight obesity. Many former smokers say running helped them stop. Also, many people say they are able to solve problems while running.

But all of this can be had with moderate mileage, without the heavy and often time-consuming training logged by the serious marathoner. Further, marathoners who overtrain can also run the risk of injury.

So why do it?

“Most people run marathons for reasons they themselves don’t understand,” says Bob Sevene, who coached Joan Benoit Samuelson to a gold medal in the marathon at the 1984 Los Angeles Olympic Games. “I think the marathon has come to represent the ultimate challenge, the measuring stick of whether you’re an athlete or not.”

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The marathon can mean different things to different people. It can be a race against other athletes. It can also be a contest against the clock, the course and the elements, as well as the distance. And it can also be a confrontation with yourself.

“Life has become tough, with the economy and with all the other stresses we have to deal with in our daily lives,” Sevene says. “It has become very hard for many of us to find something to give us a lift. The marathon gives us something to focus on, a chance to step outside our normal lives and succeed at something. It also gives us a chance to fail.”

Jeff Galloway, an alternate on the 1972 U.S. Olympic marathon team, believes that runners move through different phases after they take up the sport. The marathon represents a high point in the competitive stage--a melding of the competitive drive with the need to achieve a kind of inner strength.

“We turn inward as we get more involved with our running,” Galloway says. “People intuitively move toward the marathon from just running for exercise or from competing in shorter races. They begin to move toward a challenge that involves the mind, body and spirit--and really requires a balance of all three.”

For those who train wisely, marathoning is a safe sport. To be sure, there are occasional stories of runners who have collapsed and died while running marathons. But such tragedies are like airplane crashes: They make news simply because they happen so rarely.

In fact, Dr. Paul D. Thompson, a cardiologist and associate professor of medicine at Brown University, in 1982 collected data on deaths from running during a six-year period and found only one death for every 15,000 healthy runners per year.

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The greatest danger from marathoning is overdoing it. There are overzealous people who are driven to running dozens of marathons every year. “I think people who go out and run them every weekend, as some do, are a little bit touched,” says Amby Burfoot, who won the Boston Marathon in 1968 and is now executive editor of Runner’s World magazine. “They have agendas other than their own health when they do that. For most of us, the act of training sensibly for marathons and running one or two a year is part of a lifelong fitness regimen.”

Cardiologist Thompson agrees: “I liken it to buying stock. Exercise long term has a benefit. I don’t care whether someone ran a marathon two weeks ago. I care that he’s running 20 years from now.”

High mileage accumulated slowly over a reasonable period enables the body to adjust. Those who increase their mileage rapidly will be prone to muscular/skeletal problems, says Dr. David Brody, a Norwalk, Conn., orthopedic surgeon and medical consultant to Washington’s Marine Corps Marathon.

Stress fractures are the most common result of injudicious training or of running too many marathons. These small breaks in the bone are caused by cumulative stress and often require six to eight weeks to heal. Other problems include the usual array of minor muscle strains and sprains, blisters and cramping. Women whose high-mileage training has resulted in extremely low body fat--which is believed to be tied to estrogen production--can also experience the temporary loss of menstrual periods.

Brody says there has never been evidence that marathons or marathon training produce arthritis. However, “individuals with pre-existing conditions, such as early arthritis in the knee or the hip or a disc problem in the back, may aggravate them through training,” he says.

And while moderate running appears to strengthen the immune system, there is some evidence that running marathons may temporarily weaken it.

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David C. Nieman, associate professor in the department of health, leisure and exercise science at Appalachian State University in North Carolina, studied 2,300 runners who competed in the 1987 Los Angeles Marathon. He found that 13% became sick with a cold or the flu during the week after the race, compared to 2% of those who trained for the marathon but didn’t run it.

Nieman, a researcher at Loma Linda University at the time, then collected blood samples from 10 seasoned marathoners before, during and after a simulated marathon run in which they ran their fastest pace for three hours on a treadmill. He found that, after the run, their levels of the hormone cortisol increased nearly 60% above pre-run levels. This caused a weakening in activity of the immune system’s natural “killer” cells, which play an important role in the body’s first-line defense against foreign invaders. The activity of these cells remained weak for six hours after the race, he says.

As a result, he believes that marathoners are more vulnerable to bacterial or viral attacks during those six post-race hours.

I happen to know this is true. In the fall of 1990, when I ran the Marine Corps Marathon, I felt drained and couldn’t understand why. I had trained well. I was rested. But the morning after the race, I woke up with one of the worst colds I have ever had. Apparently, I had been fighting an infection in the days before the event. By running the marathon, I’d given the virus the advantage.

That marathon was my first since 1985; in previous years, I had finished six. I had been running regularly, but the demands of work and new motherhood had forced me to put my marathon training on hold. During the summer of 1990, I decided that it was now or never: If I didn’t run another marathon soon, I might never run one again.

Secretly, I was hoping to run a personal best--anything faster than 3:44. But I told people I wanted only to break 3:55, a time that would qualify me to run in the Boston Marathon, a longtime dream.

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But race day turned out to be warm and sunny--in the ‘70s--terrible for a marathon. The aforementioned cold was brewing. And if all that wasn’t enough, I developed blood blisters on both feet after only six miles. The weather had already eliminated the possibility of a personal best. By the time I reached the 16th mile, with both feet screaming, I knew that Boston was also out of the question. I would be lucky to finish.

I have never dropped out of a marathon. And I swore that I would not on this day either.

I crossed the finish line in a rather disappointing 4:14, having walked much of the last 10 kilometers. Not a performance to boast about.

I tried again last fall. This time the weather was perfect--sunny and in the mid-40’s at the start--and I was healthy. And I was well-trained, or so I thought.

But the one predictable thing that can be said about marathons is that they are unpredictable. I clocked exactly what I had the year before: 4:14. I don’t know what went wrong. I might have over-trained and been too tired going in. I might have been dehydrated--always a danger--since I felt thirsty from start to finish. Or maybe I have to work harder on my mental training: in past marathons I have never stopped to walk during those final miles as I did during the last two. Maybe I’m getting flabby inside my head. But I don’t intend to give up.

Despite two discouraging performances, the overwhelming feeling that washed over me as I crossed the finish line each time was not disappointment--but elation. I had finished another marathon; I was back in marathoning again.

Bob Sevene is right. The marathon does give you the opportunity to fail.

But it also gives you the opportunity to change your definition of success.

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