They need to give their muscles sufficient time to recover and monitor for any abnormal pain, weakness, or swelling. If one notices the symptoms of rhabdomyolysis during the event, he/she must stop and seek medical help instead of aiming for the finish line. Rachel Apa, a 24-year-old ex-college athlete, collapsed late in the 2026 New York City Marathon. This happened on November 2. She only had two miles left to complete the marathon. Her father, Steve Apa, has come forward with more information about her last phone call with him, in which she told him that she initially felt great but then started experiencing pain. He said she died from rhabdomyolysis, a serious condition involving muscle damage.

What is rhabdomyolysis, and how can marathon runners develop it?

Rhabdomyolysis, aka rhabdo, is an infrequent and dangerous medical condition which marathon runners need to be aware of. The condition arises when there is a rapid breakdown of the muscle cells, resulting in the release of proteins and electrolytes into the bloodstream. This may lead to kidney damage and even have an impact on heart performance.

What are some of the warning signs of rhabdomyolysis?

Some of the common symptoms may include:

• Intense muscular pains or cramps after or during running

• Weak muscles and stiffening

• Swelling of muscles and sensitivity

• Dark brown or red-coloured urine

• Reduced urination

• Dehydration and nausea

What causes this disease among runners?

Acute increases in distance or intensity of the exercise, insufficient recovery period, dehydration, and overheating are key triggers. The lack of preparation for running a marathon is another risk factor. Trauma, crushing injury, burns, electrocution, and prolonged immobility are other factors contributing to rhabdomyolysis.

Other potential causes can be due to medication, especially statin medicines and also antidepressants and antipsychotic medication. Infections and non-steroidal anti-inflammatory medicines (NSAIDS) can also contribute.

How can marathon runners prevent it?

The runners should increase the distance and intensity of training gradually without overstressing the body. They should not overload the body in training sessions since they must have enough time to recover from the workout sessions. If one notices the symptoms of rhabdomyolysis during the event, he/she must stop and seek medical help instead of aiming for the finish line.

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