Physiological and performance characteristics in the Spartathlon: A narrative review of scientific findings

The Spartathlon is a 246-km ultra-endurance running race, considered as one of the most iconic and physically demanding ultra-marathons in the world. In this narrative review, we aimed to synthesize the available current evidence on the physiological responses, performance trends, and health implications associated with participation in the Spartathlon. A systematic literature search was conducted to identify high-quality scientific studies on the Spartathlon. The databases Cochrane, EMBASE, PubMed, Scopus, and Web of Science were used to retrieve articles published up to December 2025. We found a total of 33 publications in Web of Science, 25 in Embase, 24 in Scopus, 23 in PubMed, and 1 in Cochrane. After removing duplicates and applying the eligibility criteria, a final selection of studies was included for analysis in this narrative review. The findings on the cardiac system showed reversible changes in echocardiography and cardiac biomarkers. Running the Spartathlon leads to specific effects on the locomotor system, such as an increase in peak pressure in the forefoot area, an increase in biochemical markers of muscle damage and changes in bone metabolism markers. Notably, the use of oral proton pump inhibitors was associated with a lower incidence of gastrointestinal bleeding. The Spartathlon also showed the highest prevalence of exercise-associated hyponatremia (EAH) of up to 65% as reported in the literature on ultra-marathon running. In addition, running Spartathlon leads to an inflammatory response and an increase in oxidative stress. Participation in the Spartathlon leads to several well-documented post-race physiological alterations, particularly affecting the cardiovascular and musculoskeletal systems. Overall, the Spartathlon represents a unique model for studying human physiological resilience and adaptation under extreme conditions.

10 Marathons in 10 Days in Bad Blumau

From June 26 to July 5, 2026, the 9th edition of “10 Marathons in 10 Days” took place in Bad Blumau, Styria, Austria. Participants had to complete a total distance of 422 km in temperatures reaching nearly 40 degrees.

A medal was awarded for each marathon, and at the end, an additional medal was given to those who completed all 10 marathons.

What 50,000 Runners And 76 Studies Teach Us About Racing The NYC Marathon Smarter

A new systematic review¹ of the New York City Marathon reveals what the data says about pacing, injuries, aging, and performance — and what every runner can take from it. The New York City Marathon is a giant endurance laboratory. More than 50,000 runners. Five boroughs. Bridges, wind, crowding, long pre-race logistics, uneven pacing demands, variable weather, and every kind of runner from world-class professionals to first-time marathoners. A new systematic review ‌compiled the scientific literature on the NYC Marathon, including 76 publications reporting findings on participation, performance, aging, nationality, injuries, environment, pacing, medical outcomes, shoes, and other race-specific features.

Kenya’s marathon magic fades after age 40, study finds

Sabastian Sawe’s recent sub-two-hour marathon run was another reminder that Kenya still rules long-distance running. But a major new global study suggests that this picture is incomplete. Kenya’s grip on the marathon appears strongest just in youth, then fades sharply as runners grow older. The Star spoke to researchers who analysed records of more than one million marathon runners over five years. They found that Kenyans and Ethiopians lead the world only between ages 20 and 39. Then the tables turn. After age 40, marathon runners from the United States, Japan, Germany and Switzerland dominate the road.

But it's not worth it at this age?

We report on a runner who, at the age of 87, while being the reigning European champion in the 10 km and half-marathon M85, was denied a revision surgery for foot drop after a failed L5/S1 left isthmectomy due to age and poor prognosis. A revision surgery by another surgeon was successful, and at the age of 91, the runner set a European record in the M90 category for both the half-marathon and marathon distances. At 92, he improved the European record in the half-marathon and became the first European in M90 to run under 3 hours. At 94, he set an IAU world record in the 12-hour run in M90. He passed away at the age of 102. The refusal of revision surgery in older age should be critically reconsidered.

3rd Eastern Switzerland Marathon Days

This year’s 3rd Eastern Switzerland Marathon Days featured 7 marathons in 7 days and, like last year, concluded with the 4-Country Marathon.

A monodisciplinary approach to study running performance: a bibliometric analysis

Background: The toolkits of bibliometrics analysis enable the mapping and identification of trends within a given research area. This study aims to conduct a bibliometric analysis to identify the evolution of the “running performance” research field, focusing on publication characteristics and trends.  Methods: We conducted a search for original articles, using the “advanced search” feature of Web of Science Core Collection (WoSCC). A predefined search strategy was developed using the PICO strategy. Studies were screened by titles and abstracts. The information was used to map authors, organisations, countries, journals, and authors’ keywords. VOSviewer software (version 1.6.18) was used to construct and visualise bibliometric networks. Results: A total of 324 articles were included, with the publication data ranging from 1983 to 2023, with some variation over time. The United States and Canada presented the strongest influence in this research field, followed by European countries such as England, France, Switzerland, and Spain. The leading journals were the International Journal of Sports Medicine, followed by the Journal of Strength and Conditioning Research, and Medicine and Science in Sports and Exercise.  Temporal trends indicated that the earlier studies primarily focused on physiological tests/variables, while more recent studies have shown a growing interest in biomechanics, pacing, and technology (footwear). Conclusion: North America and European countries present a strong influence in this field of study. Earlier investigations primarily focused on physiological tests/variables, while recent research has focused on diverse topics such as technology (footwear). Researchers interested in this research area should consider adopting a multidisciplinary approach in future studies.

Day 1

On May 8, 2026, the 3rd Eastern Switzerland Marathon Days kicked off with the tenth edition of the Arbon Marathon, held in beautiful spring weather.

The Comrades Marathon: A Narrative Review of Physiological Responses and Health Implications in the World's Oldest Ultra-Marathon

Background: The Comrades Marathon is the world’s oldest and largest ultra-marathon, held annually between Durban and Pietermaritzburg, South Africa, since 1921. As a nationally televised event with substantial participation, it provides a unique natural laboratory for studying the physiological demands of prolonged, high-intensity endurance running. This narrative review synthesizes current evidence on physiological responses, performance trends, and health implications associated with participation in the Comrades Marathon. Methods: A systematic search of EBSCO, PubMed, SciELO, and Web of Science identified studies published up to December 2025. Of 116 records retrieved, 42 publications (field studies and case reports) met eligibility criteria and focused specifically on the Comrades Marathon. Results: Women represented 4.2% of finishers, with female participation beginning in 1975. Growth in finishers during the 1970s was driven primarily by men aged 30–59 years. Men were consistently faster than women across all age groups, although the sex performance gap narrowed over time and overall performance improved. Peak performance occurred at ⁓29.9 years in men and ⁓36.0 years in women. Medical encounters occurred at rates up to 20 per 1000 starters. The most affected organ systems were fluid/electrolyte (8.8%; 8.3–9.4), central nervous system (4.0%; 3.7–4.5), and gastrointestinal (2.9%; 2.6–3.2). Dehydration (7.5%; 7.0–8.1) and exercise-associated muscle cramping (3.2%; 2.9–3.6) were the most common diagnoses. Exercise-associated hyponatremia was uncommon (<2%), whereas hypernatremia was substantially more prevalent. Early race editions reported isolated deaths, likely due to ischemic heart disease. Cardiac biomarker elevations and echocardiographic changes observed post-race were transient. The race induced muscle inflammation without major knee MRI abnormalities. In the 1970s, cases of acute kidney injury and renal failure occasionally required dialysis. Faster, well-trained runners showed higher rates of post-race upper respiratory tract infection than slower, less-trained runners. Conclusions: Participation in the Comrades Marathon is associated with well-characterized post-race physiological disturbances. Notably, the event demonstrates an unusually high prevalence of acute kidney injury and hypernatremia compared with other ultra-endurance races, underscoring the substantial renal and fluid–electrolyte stress imposed by prolonged, high-intensity running in challenging environmental conditions. These insights can inform individualized hydration strategies, targeted race preparation, and optimized medical support for ultra-endurance athletes.