Is Endurance Exercise Safe? the Myth of Pheidippides

Christine Rutlen, David L. Rutlen

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


With the increase in participation in endurance events in the general population, patient concern may arise as to whether endurance exercise is safe. Acute but not chronic increases in blood urea nitrogen, creatinine, and urine albumin occur in endurance exercise. Iron-deficiency anemia may be observed in female athletes. Upper respiratory illness is increased in elite athletes but decreased in intense recreational athletes. No convincing evidence of developing osteoarthritis exists. Common gastrointestinal symptoms occur and isolated reports of gastrointestinal bleeding exist. Nevi are increased and the minimal erythematous dose is decreased. Exercising in the presence of air pollution has negative pulmonary effects, but overall, benefit exists. Numerous reports pertain to the cardiovascular system. The risk of cardiac arrest increases during exercise, troponin is elevated after exercise, and a predisposition for atrial fibrillation exists. Ventricular myocardial scar formation as assessed by gadolinium enhancement on magnetic resonance imaging is inconsistently observed, and increased coronary plaque of a more stable variety is reported. Left ventricular compliance is chronically increased and no decrease in longevity is found. Although some concerns exist, endurance exercise is safe.

Original languageEnglish (US)
Pages (from-to)210-214
Number of pages5
JournalSouthern medical journal
Issue number4
StatePublished - Apr 1 2019
Externally publishedYes


  • UV exposure
  • atrial fibrillation
  • endurance exercise
  • iron-deficiency anemia
  • longevity

ASJC Scopus subject areas

  • Medicine(all)


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