Fewer medical incidents reported at L.A. Marathon

One hundred and eleven runners were treated for medical maladies. Thirty were taken to hospitals. One went into full cardiac arrest.

This qualified as “a very good day” for the Los Angeles Marathon.

Given the record field of 26,054 on Sunday, Greg Gibson, an L.A. Fire Department battalion chief, said he expected 40 or more runners to require hospital visits.

“The transports were down, which was great,” Gibson, who has overseen medical treatment for most of the last 10 L.A. Marathons, said Monday. “It was a very good day.”

In what sporting event other than a marathon — besides, perhaps, the running of the bulls in Pamplona, Spain — can so many medical incidents trigger so little alarm?

It could be because marathon deaths are rare. Dr. Maureen Strohm, co-medical director for the L.A. Marathon, said sudden death in endurance events such as marathons ranges from 1 in 50,000 to 1 in 100,000, depending on race conditions.

“Marathons are generally pretty safe, even though they’re kind of the ultimate stress test,” said Dr. Mark Morocco, associate clinical professor of emergency medicine at Ronald Reagan UCLA Medical Center. “For people who are properly trained, the risks are low.”

Gibson credited ideal conditions Sunday for the low number of medical issues compared with the circumstances six years ago, when temperatures along the route reached 93 degrees and 600 runners required treatment and 60 were taken to hospitals.

Temperatures during this year’s race ranged from 53 degrees at the starting line at Dodger Stadium to 63 degrees when men’s winner Wesley Korir crossed the finish line in Santa Monica.

A 21-year-old male went into cardiac arrest during the 18th mile and was taken to UCLA Medical Center, where he remained Monday. Hospital officials declined to comment on his status, citing privacy laws.

Marathoners have been dying, at least according to legend, since 490 BC, when the Greek messenger Pheidippides ran about 26.2 miles from the battlefield of Marathon to Athens to announce that the Persians had been defeated, then almost immediately dropped dead.

Three runners have died in the 25-year history of the L.A. Marathon. In 2006, a 53-year-old L.A. police detective and a 60-year-old retired sheriff’s deputy perished from heart-related problems. In 1990, a 59-year-old man under a doctor’s care for hypertension suffered a fatal heart attack.

Morocco, who has run three marathons, said the most common causes of death in long-distance races are genetic heart disorders, underlying heart disease and low blood sodium caused by a shortage of electrolyte-enhanced fluids.

Although the L.A. Marathon does not require a physical for entry, Morocco said pre-race doctor’s visits are “something each runner should require for themselves.”

Training is also important. The L.A. Roadrunners, led by four-time Olympian Rod Dixon, conduct a preparedness program that lasts 27 weeks and includes lectures from medical and nutrition experts.

“This is not just a walk in the park,” Dixon said of running a marathon. “This is not something where you go out and buy a pair of shoes on Friday and run on Sunday. This is hard.”

On race day, Gibson oversees 10 medical aid stations along the course that are staffed by paramedics, emergency medical technicians, doctors and nurses. Gibson said runners’ most common complaints include chest pains, pains in the side, heat-related illnesses and stomach problems. Severely ill runners are taken to hospitals.

“Typically, you don’t have anything serious,” Gibson said. “But it always can happen.”

ben.bolch@latimes.com