Disclaimer: This is for the purpose of education only. Don’t try to self supplement or self medicate.

Like most things in life, you should by now be able to anticipate that a good physician would recommend that the extreme version of anything is incorrect.


Extreme running is bad for many things. It destroys your skin, muscles, bones, joints, brain, viscera, and solid organs. And, in that it is risky, it dodges the main principle of all healthcare which is to minimize risk.

There is in fact a cool pneumonic (you knew that was coming) that helps you remember the 3 things that extreme running and marathon races in general produce for you in terms of bad health.

“C’s” of marathon races and extreme running: Cecal volvulus, Compartment syndrome (incl. felons), Cerebral edema.

Yes, the cecum, a part of the large bowel, can rotate on itself in runners (cecum? Latin for blind pouch? “Seek”? Blind? Whatever). This can strangulate tissue there and lead to an acute abdomen, and death. It’s easy to imagine the scenario. So, an intense runner just pushed their body to the severe extremes of dehydration, AND they get a cecal volvulus to boot. So they’ve got this acute abdomen and they’re already severely dehydrated and compromised at that moment. Dying is a regular event in this setting.

Compartment syndrome. This is a swelling of a limb distally like around the ankles, so, the legs of a runner, one or the other, but regularly both, that is so extreme, that blood continues to pump into the distal limb, but blood can’t get out of it because of the swelling trapping it in there. It becomes a vicious cycle. They can lose a foot. So now we’re at loss of life, loss of limb. What’s next…

Cerebral edema. That’s right. A lot of these runners push water so aggressively, so excessively, that it swells every tissue in their body. Most tissues have give. But the brain tissue, not so. It is trapped by the calvarium, a very non-forgiving, non-expanding box that blocks their brain from swelling as much is it wants to. So their brain herniates down through the middle fossa, producing brain death, if not death. So even if it’s questionable whether or not extreme running isn’t bad for your heart per se, the water these athletes push before the marathon during the marathon and after the marathon above and beyond the thirst they have for water is definitely harmful.

How about the heart specifically? There isn’t an an expert I know that won’t say extreme running can’t contribute to a buildup of scar tissue on heart muscle, heart valves, and the pericardium. All of these things lead to myocardial fibrosis. That will limit your heart’s function. That will lead to congestive heart failure, a condition where blood and fluid backs up behind the heart because the heart can’t pump it through. Congestive heart failure folks. Not a good outcome, either. Certainly not the outcome you want from your chronic exercise routine.

I know runners that say they’ve not had a correct extreme running work-out until the nausea and the vomiting it produces occurs in a manner that they cannot contain it for at least 30 minutes. That’s the DESIRED outcome!

That’s just wrong. Nausea and vomiting of that nature can produce esophageal tears known as Mallory-Weiss tears. The esophagus is very vascular. If you tear it from excessive retching, including especially excessive retching over time, months of training, months of running, you are likely to bleed out and die. If you are on blood thinners, this is almost a guarantee. So how can I be excited about any sport that drives you to vomiting for 30 minutes in order to be doing it correctly? I strongly advise against it.

But even in general, “more“ of anything it’s not always the correct thing to do. Once you have hit a good exercise routine that is keeping you healthy or generating weight loss if you are obese at the rate of 2 to 4 pounds per month, then you have hit the ideal work-out. If at that point you do more to speed things up or to “become extreme,” it’s “extremely” likely that more exercise will stimulate more appetite and lead to more weight gain. More is not always better.


Turns out, and I was frankly surprised, that bodybuilding by lifting weights is the healthiest form of exercise for your heart.

Nicely, that is also the healthiest form of exercise for your joints and bones. There’s no impact involved. So, no damage or tissue injury can follow if done correctly. Or at least adverse these things happen a lot less. Damage and tissue injury including the heart, brain, and limbs is almost a guarantee if you try to use extreme running for heart conditioning.

Lift weights! Now am I talking power lifting with steroids? Absolutely not. Start with low weights, increased reps before advancing on weight, advance slowly. No steroids. No testosterone without an expert physician’s involvement.