by on June 7, 2016

in Monthly

Almost one year ago at the San Francisco marathon start I had the opportunity to briefly visit with a fellow runner who was going to run his first marathon. He was 15 years old and his proud father was going to run the hilly 42.2 kilometers with his son.

A few years prior to that, after completing the Houston marathon, I was exhausted and seated at the recovery area next to a 13 year old runner who finished his race long before I did. His name was Josh and he and his dad assured me that Josh will be representing the USA in the marathon at the 2020 Olympics.

Most marathons in North America require the participants to be over 18 years old. Some exceptions are Houston (they allow 12 years and older runners), The Marine Corps Marathon (14 years and older) and Chicago (16 years and older)

Long distance running carries definite risks and for that reason the International Marathon Medical Directors released a report concluding that the marathon (42.2 kms) should be an activity only for runners 18 years of age and older.

Dr. Lyle Micheli from the Sports Medicine Division at Boston Children’s Hospital feels strongly that establishing 18 years as the minimum age for marathons, while not perfect, minimizes the chances of long-term damage in younger runners.

Other internationally-respected sports medicine doctors, such as Dr. Tim Noakes, the author of the Lore of Running, have a different view. Noakes feels that if a child under 18 years enjoys running, increases the weekly distances gradually, and follows the advice of a knowledgeable coach that there is no reason to be alarmed.

In African countries like Kenya, it is not uncommon for younger school children to run to and from school every day. Bengt Saltin, a Scandinavian researcher, found that in 1995 the average running distances covered by Kenyan school children varied between 50 to 80 kilometers a week. One elusive factor is the role of genetics. Could it be that Kenyan children are genetically wired to run more efficiently and thus reduce their risks of injury?

One of the major concerns in distance running is overuse injuries related to the constant pounding. A recent article in the Journal of Athletic Training revealed that children don’t absorb the impact of running as well as adults. The younger the runner, the shorter the strides and with that the number of strikes over 42, 200 meters increase dramatically. (Among adult runners the annual injury rate can be as high as 70 percent)

Other than overuse injuries, young distance runners are at risk for epiphyseal plate injuries, stress fractures, patellofemoral syndrome and chronic tendonitis. Iron depletion is also more common. It takes children longer to acclimatize to heat or cold—thus putting them at risk for hypothermia and heat stroke. Over-training is often associated with endocrine concerns and may impact menstruation.

But all these concerns are not always true. One of more exceptional and also disturbing stories is that of a four year old marathon runner from India, named Budhia Singh. Budhia had a trainer who coached him through 48 marathons in one year. A movie, Marathon Boy, was made of this story and screened at the Toronto International Film Festival in 2011.

From my own experiences, after completing 99 marathons, I am concluding that our bodies are too diverse to have blanket statements and that scientists are simply not capable of coming up with definitive answers.
It makes sense to err on the side of caution though. My suggestion to families about marathon running under age 18 is to postpone it if possible. Perhaps cross country running may be a more conservative and enjoyable approach. A key question to consider is whether the idea of training for a marathon belongs to the child or parent and if the child is still enjoying the activity when the distances get longer and longer.

Training gradually, running on soft, flat surfaces, staying well hydrated, using the correct shoes, and having recovery days are all key precautions to take. Some experts point out that children who play in a number of soccer games in one weekend during tournaments also run rather long distances and do not get injured from running. My guess is that it has to do with taking breaks ever so often—as opposed to relentless pounding on a hard surface.

Since distance running increases free radicals caused by oxidative stress I encourage all endurance athletes not to take anti-oxidant vitamins, but rather to take in triple the amount of the daily recommended fruits and vegetables.

Universal recommendations thus far are contradictory and for that reason the middle way may be the wise path to take. A half-marathon at age 16 would seem reasonable as long as the precautions mentioned are followed. It is not a matter of just doing it, but rather doing it wisely and primarily for health reasons.

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