ReviewSports medicine (Auckland, N.Z.)2022
Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review.
Review in Sports medicine (Auckland, N.Z.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 6 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Psychological traits associated with mental and performance resilience in long-distance and ultra-endurance runners: a systematic review.Frontiers in psychology · 2026Pooled it
- Acute Kidney Injury Biomarkers in Marathon Runners: Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- The effects of high-intensity interval training versus moderate-intensity continuous training on athletes' aerobic endurance performance parameters.European journal of applied physiology · 2024Pooled it
- Mental Health in Ultra-Endurance Runners: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2023Pooled it
- Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review.Sports medicine - open · 2023Pooled it
- Acute Kidney Injury and Hyponatremia in Ultra-Trail Racing: A Systematic Review.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Epidemiology, mechanisms and clinical implications of heat-related kidney disease.Nature reviews. Nephrology · 2026Review
- Running-Related Musculoskeletal Injuries in Saudi Arabia: Epidemiology, Biomechanical Determinants, and Global Comparative Insights.Healthcare (Basel, Switzerland) · 2026Review
- Review
- Risk of Menstrual Dysfunction, Low Energy Availability, Eating Disorders and Injury in the First All-Female UK Military Team Rowing 3000 Miles Across the Atlantic.Sports (Basel, Switzerland) · 2026Article
- Exercise-specific epigenetic effects on cardiovascular health.Clinical epigenetics · 2026Review
- Musculoskeletal Ultrasound and Protein-Based Hydrogels: Novel Approaches for the Diagnosis and Treatment of Sports Injuries.Polymers · 2026Review
- Hematological and Biochemical Responses During and After a 12-h Track Ultra-Marathon Race.Journal of functional morphology and kinesiology · 2026Article
- Oxy-Inflammatory Profile of Finishers and No-Finishers in an Extreme Ultra-Endurance Trail Race: The 866 km Transpyrénéa.International journal of molecular sciences · 2026Article
- Physiology of lived experience: Cruising among the Swiss peaks.Experimental physiology · 2026Article
- 24-Hour Ultra-Marathon Running: A Narrative Review of Performance Factors and Physiological Impacts.Sports medicine - open · 2026Review
- Understanding the Behavioural Determinants of Nutrition Practices in Ultra-Endurance Runners in Ireland.Sports (Basel, Switzerland) · 2026Article
- Risk of Rhabdomyolysis and Kidney Injury after Intensive Exercise. Potential of Novel Biomarkers of Kidney Injury: A Narrative Review.Journal of human kinetics · 2026Review
- Agreement and Reliability Between Urine Reagent Strips and Refractometry for Field Assessment of Hydration in Ultra-Trail Runners.Nutrients · 2026Article
- Assessment of depression and suicidal thoughts among female trail runners.Frontiers in psychology · 2026Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.