As accomplished and legendary a U.S. marathoner as has ever competed, Frank Shorter (Olympic marathon gold medalist in 1972) never won Boston. In fact, he never even cracked the top three. On the other hand, the equally legendary Bill Rodgers won the Boston and New York City marathons four times but finished a disappointing 40th in the 1976 Montreal Olympic marathon. And since 2002, either a Kenyan or Ethiopian has won Boston—with Kenyan Geoffrey Mutai setting the course record of 2:03:02 in 2011.
Some people make the grade in Boston—literally; others don’t.
“Bill Rodgers was made to run Boston because he’s a downhill runner,” says Shorter, 66. “And what Mutai has shown is that he, biomechanically, moves in a way that allows him to run downhill really well.”
Biomechanically, downhilling involves greater ground reaction forces and therefore induces more stress on the tissues of the leg; it also requires less metabolic energy. Meaning, “the energy required to support any speed is substantially reduced when running downhill,” says Peter Weyand, associate professor at Southern Methodist University’s Department of Applied Physiology and Wellness. Basically, figuring out a downhill pace that feels best for you is the best way to avoid wear and tear, and hence, fatigue.
Physiologically, the bigger you are, the harder you hit the ground. “Since the force at any running speed and incline is set by the body’s weight, gaining or losing weight will increase or decrease the forces on the ground and therefore also experienced by the tissues of the feet, joints and legs,” explains Weyand. “So, if all other factors are equal, being lighter would tend to lessen the pounding a runner sustains at any downhill running speed.”
One of the Boston’s biggest challenges is that its downhill sections come late in the race (the net drop from its start in Hopkinton to the finish is 400 feet), when the legs are more susceptible to stress-induced damage from all the prior miles. Weyand therefore hypothesizes that “the better downhill runners are more willing or able to absorb the pounding—or both.”
More willing and able because they train that way. “My training is very up and down all the time,” says Mutai, who feels it helps to have strong upper legs but whose training probably isn’t all that different from his Kenyan and Ethiopian peers. “So running on hills is normal for me.”
As it was for Rodgers, whose high school coach told him to lean forward and use his momentum when going downhill. “It’s also a time many runners assume is a recovery period—after an uphill—so strategically it can be a decisive move many runners do not want to follow,” says Rodgers, 66, who has always viewed racing as psychological as much as physical. “Breaking way is the name of the game if you’re competing, and in road racing, hills play a crucial role.”
Still, it’s not all psychological. As Weyand says, “The physics cannot be fooled—the ground forces involved are set by a runner’s body weight and speed. The faster one runs, the great the ground forces. The steeper the downhill, the greater the forces are at any speed.”
Which is why Boston is so physically taxing. “Boston left my legs more sore than any other marathon course,” says Rodgers, who doesn’t see any particular body type as being better suited to hills than any other.
“There are so many grades and hills, but I saw them as key opportunities,” says Mutai, who won’t be running Boston this year. “Think of them in a positive light. As a chance to shift gears, and a time to run away from your competition.”
There are plenty of reasons to fear ticks—Lyme disease, Rocky Mountain Spotted Fever, general aversion to blood suckers. Here's another one to add to the list: severe and sudden allergies to red meat.
In September, Norman was camping with her husband in Falls Creek Falls Tennessee. At 3 a.m., she woke up with hives. She and her husband drove five miles to get cell service, and the 911 operator they called told them to stay put. "By the time the ambulance got there my throat was pretty closed up, and I had hives completely," Norman says. "They told me I would not have made it if we had driven."
The cause of the reaction? A tick that had bitten her six weeks earlier and a steak she'd eaten for dinner that night.
Across the American Southeast, and in parts of Europe and Australia, doctors are treating patients with sudden, potentially fatal allergies to red meat that researchers believe are caused by bites from specific types of ticks. In the U.S., it's the Lone Star Tick.
"These bites are really common, especially in places where there are tons of these ticks, in the Southeast particularly," says Dr. Robert Valet, an assistant professor of medicine at Vanderbilt University. "The vast majority of people don't get this. But it is on the list of things that can come from tick bites."
Here's how researchers believe it works: When a Lone Star tick bites a person, it introduces something called alpha-gal sugar into the bite. Some bitten patients become allergic to the sugar, which is also found in red meat. For those patients, eating alpha-gal can cause hives, lip or tongue swelling, or anaphylaxis, a potentially deadly allergic reaction that can cause the throat to close or blood pressure to drop.
Symptoms tend to appear four to six hours after eating red meat, and sometimes even dairy, and reactions tend to occur weeks or even months after a patient was bitten.
"Within the Southeast…it's up there with peanut allergies and shellfish allergies," Valet says. About one percent of the patients who visit the Vanderbilt Asthma, Sinus and Allergy Clinic are coming in with the allergy. Dr. Platts-Mills, who lead the UVA study and has the allergy himself, told NPR that this particular tick is "very aggressive. Its larval forms will bite humans, whereas none of the other American tick larvae will do that."
If you're wondering why you've never heard of it, researchers at the University of Virginia published the first study linking ticks to the allergy in 2009. "We've really only been testing for it in the last couple of years," Valet says.
It's also fairly rare in comparison to other tick-borne disease like Lyme disease, which reports about 25,000 new cases a year; so far, UVA has recorded only about 1000 cases of the tick-related allergy.
But that doesn't mean there's no reason to be careful, particularly if you live or hike in areas of Tennessee, Virginia, or North Carolina, though Lone Star Ticks can be found as far north as Maine and as far West as Nebraska—and bit-related allergies have been reported in states like New York and .
There's also no cure. Beyond carrying an Epipen and trying to avoid ticks to begin with, there's not a lot you can do. Though some allergies do go away on their own, it's a safe bet that most people who get it won't be eating red meat again, and some like Norman—about 30 percent of those with the allergy—are also allergic to dairy. In severe cases, it can also cause an allergy to gelatin.
But this isn't the kind of disease you need to get tested for. "It's kind of one of those things that will happen and it will be obvious," Valet says.
Researchers have thrown tons of time and money into studying whether exercise has an effect on depression, but far less research has gone into how exercise might affect antidepressants. If serious athletes are upping their training, it could change how the drugs are metabolized in the body, and how much medication they should take at a given time, an interaction scientists are only now beginning to investigate.
For now, the research is thin. Though drug companies are required to submit data about the effects of drugs on pregnancy and other factors, they're not required to provide any data about physical exertion. "We know nothing about the majority of the drugs and their interaction with exercise," says Dr. Ira Jacobs, a professor and dean of the faculty of Kinesiology and Physical Education at the University of Toronto. With one in ten Americans taking antidepressants, and a constant effort to encourage patients to be more active, it's an important area of study—though only a handful of people are actively researching how they interact.
Jacobs spent 25 years of his career working for the Canadian Department of Defence researching topics like the effects of performance-enhancing drugs on special operations units. Anecdotally, he found that after troops deployed, they reported side effects from various medications that they had never experienced pre-deployment. It made him wonder how acute bouts of exercise might affect medication generally.
"People who are exerting themselves acutely all of a sudden are diverting blood flow to their muscles," he says. "Where it's coming from, among other organs, is the liver, one of primary organs where we metabolize drugs."
It's possible that as we exercise and move blood away from the liver, we metabolize our medication more slowly, meaning we may need less of it.
Last year, Ethan Ruderman, a then a graduate student under Jacobs' supervision, conducted a pilot study looking at the effects of one acute bout of cycling on sertraline, also known as Zoloft. He found that the drug was removed from the body slightly more slowly during exercise.
The study is very preliminary, and Ruderman cautions against making any conclusions based on the data—particularly for people who have a constant amount of daily exercise, as opposed to a single, intense bout—but it "does help to lay the groundwork for future studies in this area."
Though doctors still don't know a lot about how exercise affects antidepressants, Ruderman and Jacobs agree it's still worth discussing with your doctor. "If an athlete is getting an improper dose of anxiety/depression medication, this may impact their mood, ability and effort to train and practice, which will certainly impact their performance on game day," Ruderman says.