Enough of the Aerobic and Endurance Bashing Fostered by “New Research” and Personal Agendas

shoe coffin

Will you end up in a coffin like this from training too hard? It’s minimalist.

It’s back, and it’s getting old. Actually it never went away. I’m referring to the current round of news reports, websites, and “research” that have once again concluded that so-called aerobic and endurance training will, to some extent, harm your health if not outright kill you. I was going to let it go since these news reports state nothing new, but after many questions and concerns I’ve decided to address it again. Hopefully I can help you make sense of such reports, not just from a personal viewpoint in health care and as an athlete, but also looking at the scientific research, facts, and common sense.

Peter Griffin Running

Endurance and Mortality Research

This past June, The New York Times cited a huge research study which found that running more than 20 miles per week may have more risks to your health than if you ran less. Running procrastinators and couch potatoes celebrated this victory. As I discussed at that time in my article, “Make up Your Mind: Will Running Kill You or Make Your Stronger?”, the study was poorly interpreted, to say the least. There’s no reason to revisit old material and say the exact same thing and call it new, but clearly the Wall Street Journal does not feel the same way. Just this past week the WSJ discussed the exact same research study in their article, “One Running Shoe in the Grave“. It’s a catchy title, but there is absolutely nothing new here that hasn’t been said before other than some cardiologists bantering about agendas. I can just about guarantee you that you’ll see another similar article or research study next month, and month after that, and month after that.

Runner, PhD physicist, and science writer over at Runners World, Alex Hutchinson, also notes the absurdity of this re-circulating study as the researchers “used statistical methods to effectively “equalize” everyone’s weight, blood pressure, cholesterol, and so on.” I, like Alex, am all for research, but research that is unbiased, statistically accurate and complete, and the findings are consistent within a reported population. In other words, don’t include non-runners or overweight alcoholic smokers in an endurance study.

Alex also makes reference of another study published in the Lancet in Oct 2011 which, via a questionnaire to over 416,000 participants, concluded that greater than one hour of endurance activity provides no further benefit than less than one hour.  Actually in truth, as Alex notes, the researchers were not able to identify an upper limit of exercise where the risks outweighed the benefits. But the researchers simply left this part out of the published report.

Greek Runner

Way too buff to be an endurance athlete.

Cardiologists Know the Heart, But They Don’t Know How to Train It

News and studies like this spread quickly across the media-driven world we live in, even to so-called “experts” like the research cardiologist on TEDx claiming that we humans are meant to walk, not run. O’Keefe’s video begins as if he’s the narrator of a play, and although his accent and accolades may impress you as much as the lantern and calming white couch backdrop, he too is citing “research” that is again misinterpreted and cherry-picked to make his point.

He begins by mentioning how even way back in 490 B.C. there was that guy we all know of as Pheidippides who collapsed and died after his marathon into Athens. The doctor doesn’t realize this story is just a myth, taken from various accounts including that of Herodotus, “the father of history”, who wrote that Pheidippides ran between 140 and 153 miles from Marathon to Sparta in just two days, and then back again, with no mention of him dying. Though some say that story is false too, either way the one fact here is that the doctor starts his anti-running campaign with a myth, and then continues from there on. He includes the same study which The Times and WSJ reference, (completely bogus and O’Keefe’s colleague was one of the researchers of the study), notes his cardiologist friend John who runs 12 miles a day now riddled with dangerous artery calcification, (classic chronic cardio – so of course nobody should run conclusion), and mentions a “physician in the mid-70s who became famous by claiming that if you can complete a marathon you were immune to a heart attack”, (he’s referring to Jim Fixx – his statement is accurate but it’s a scare tactic if you know about Fixx as I discuss here). Although there’s so much more wrong with his presentation I’ll stop here. Nothing personal, but I’ll pass on taking health and fitness advice from a cardiologist, just as I currently do with Dr. Oz. It’s the same reason I’d never take any health or rehabilitation advice from a orthopedist; I’ll hold off on their expertise unless I need surgery. We live in a society that when someone hurts themselves or is susceptible to such injury, we tell them not to do the given activity again rather than teach them proper technique. These doctors do not know how to recognize or achieve health, let alone teach it.

Running Is Harmful to Your Health (?)

Weird Al Running With Scissors

In some cases you should always walk.

Marathons will kill you. If that sounds familiar it’s because I’ve said it before – right here in Part V of the Sock Doc Training Principles. I also believe it was such overtraining that killed the real-life legend Micah True. But that doesn’t mean we stop running any more than you should stop lifting a weight if a study comes out saying that those who lift weights are more susceptible to hip injuries and that causes more falls leading to death.

None of these endurance focused studies ever discuss heart rate, which is a key factor when it comes to training intensity. This leaves the study participants or analysts to determine intensity by using words such as easy, moderate, vigorous, etc. That’s pretty crazy when you think about it. A study participant who smokes, is overweight, and “runs” a few times a week, even if that mile takes him 20 minutes, will likely be in anaerobic excess, yet the run may be called “easy”. Another participant who exercises ten hours a week and is healthy might be training at a very low easy intensity but the mileage is “vigorous”. Yet, this is how these questionnaire studies eventually lead to wild conclusions when they hit the wire. Many only read the headline, the writer’s point of view, or abstract at best and then draw even further conclusions on their own.


“Who Do You Want To Look Like?” Part of your answer may depend on the color of your skin.

Sprinter Vs. Jogger

Now, to add fuel to this endurance-will-kill-you fire, enter the bloggers, coaches, trainers, gym owners, and people who just switched from soy milk back again to rice because of the soy article they just read in Cosmo. And before some of you who are in that category get all steamed up, I’m probably not talking about you. Well, probably not. I’ll get right to my point and say it as directly as possible: Please stop posting this fucking stupid photo of the sprinter vs. marathoner with a caption such as, “Who would you rather look like?”. Enough – it’s like you’re a pear saying all apples suck and you found a rotten apple to be your poster fruit. You might as well say, “Vanity is all that matters. Your health, fitness, and overall well-being come second to your ripped abs and pecs.”

Sure, probably not too many people want to have significant muscle loss at the expense of increased fitness, and the photo clearly depicts a somewhat emaciated distance runner. Of course all distance runners look like this guy in the eyes of the one-mile challenged. But guess what? A lot of people also don’t want to look like the sprinter, who for all we know, may be on performance enhancing drugs. I’m not making an uncalled accusation here, (I tried to find out who the sprinter is, but was unsuccessful), but history tells us that many elite sprinters are on drugs. Even if he is clean, and I hope he is, the majority of people will never look like him, even if they wanted to and spent countless hours training. *Edit* See comments: UK sprinter is Dwain Chambers – busted for performance enhancing drugs. The marathoner is Finnish 2002 European champion Janne Holmen.

Genetics and Body Type

Our genetics make up our muscle fibers, though these fibers can be changed and of course developed through training, to some degree. Most people have about half of Type I (aerobic) fibers and half of Type II (various degrees of anaerobic) fibers. An elite sprinter may have well over 75% of his muscle fibers as Type II (white, fast-twitch) whereas an elite marathoner is going to have 75% as Type I (red, slow-twitch, aerobic). Though you can change these somewhat and become more efficient with what you’ve got, you’re never going to get an elite distance athlete to look like an elite sprinter or vice-versa.

Kip Kemei

Kip Kemei – a relatively muscular Kenyan marathoner.

However, this doesn’t mean that the majority of us, the non-elite ninety-nine percent, have to suffer the consequences of poor health, poor fitness, or even perhaps the wasted-away physique of some endurance athlete as the numerous proponents of this photo want you to believe. There are plenty of sprinters who are lacking strength – I know because I see them in my office. Some are still great sprinters but their health is compromised due to a variety of reasons though they don’t “do that crazy chronic cardio” because it will make them skinny and slow. They’re brainwashed. There are also long distance athletes who are relatively muscular for their sport, despite their heavy endurance training load, just look at some great 1500m and 3000m endurance athletes who have phenomenal physiques. Oh yeah, those distances aren’t really endurance – or are they?

Strength or Endurance, or Both?

1500m elite athletes

1500m elite athletes – notice the differences in body types.

So who do you want to be – the skinny guy or the buff one? Be whoever you want to be as long as you remain healthy and you’re achieving (or making progress on) your athletic goal. You can become a great long distance runner and definitely not look like the anti-aerobic poster boy. But if you want to be a great long distance runner then some sacrifices will be made. You will lose some strength. You will lose some power. There is a price to being competitive. Nobody cares how many burpees or pull-ups you can do at the end of your race. (Well, the guy who you beat cares.) If you don’t want to be competitive and are exercising because you enjoy it and want to reap the health and fitness benefits, then find the balance between strength, power, and endurance that you are comfortable with. You shouldn’t give a shit what anyone else thinks as long as it’s working for you.

Pick Your Poison: CrossFit or Marathons

Problem is, fitness programs are not working for most. There are as many people who should not be running long distance as there are those who should not be doing CrossFit. They’re equal-opportunity injury and illness programs for the general masses when you don’t balance health and fitness. And it’s the craze right now – not just CrossFit and marathons, but paleo workouts, half marathons, ultras, and numerous obstacle-mud races. If you’re reading a site by some strength-only guru who says you can get all your aerobic benefits from lifting weights a bit faster than when you lift them slowly then good luck with that. If you believe it fully then you shouldn’t be on Sock Doc because here we care more about just getting by with minimal fitness and looking buff with no concern for overall health. Last I checked running is a natural, and actually vital, human movement. You might not like to run, but you should be able to run.

fat powerlifter

Ouch. That’s a harsh caption. Is it true? 9 out of 10 endurance athletes say so. And yes I made that up.

Yeah, excessive high intensity “aerobic” (I put that in quotes because it really isn’t aerobic when it’s called high intensity in such a way), increases insulin, free radical damage, stress hormones particularly cortisol, and of course increases your chance of injury along with a slew of other health problems. You risk dying from it too if you’re not careful; plenty of people have proven this to be true. But proper aerobic activity can not only reverse all this but also take your health and fitness to the next level. Where is the ceiling for endurance training? Nobody knows – because YOU were not in the study. It’s one hundred percent individualized.

Train Smart. Train Hard. Stay Healthy.

Remember: Always health first, fitness second. So train smart and train hard when you can and you’re ready to do so. Training hard is good for you, but do not do such extreme training too often. I love training hard, but I am intentional about it and only when my health is optimal and my movement is efficient, (or of course when I’m training with someone who is whining). If you haven’t realized yet – Sock Doc isn’t some ‘train this way’ or ‘always train slow and easy’ site. It’s a ‘figure out how you should be training’ site based upon your health, fitness, life, and goals – not the most recent news report, research study, or commercial.

Now go run, walk, or lift. Or incorporate them together in a strength and conditioning workout as I describe and show is this MovNat Endurance Workout. Or don’t do anything if that’s what you’re up for.

Follow up article here: Heart Damage: Five Ways to Prevent a Heart Injury and Reduce Your Chances of Dropping Dead


Sock Doc Newsletter


  1. James says

    “Training hard is good for you, but do not do such extreme training too often. ”

    -Many endurance athletes will do 1-2 “hard” or anaerobic training sessions a week. Is this “too often”?

    Or is it a percentage of time spent in the anaerobic zone? A lot different for a 100 mile week runner to run 15 miles anaerobically a week than a 30 miles runner doing the same.


    • says

      It depends on where you are in your training and if you’re healthy enough to do it. I’ve done 3-4 a week at various times. But you don’t want to be doing even 1-2 for weeks and months, that’s too much too long. Check out the SD Training Principles for more on this.

  2. Greg Slatner says

    I am not sure if the problem is so much the research as the the reason why the research is being done. The “average” person out there can not handle the Gangemi paradigm. The average person would not read the headline Research confirms Train Smart. Train Hard. Stay Healthy. No offense Doc but 95% of people cannot handle that as reality. You are fighting an uphill battle.

    The fact of the matter is that the research is done because people want to hear it is ok not to run and it is ok to drink read wine because really it is good for you. It is sad to say but the studies will support what ever they set out to prove and as Maffetone points out frequently where the money comes from will also dictate the outcome of study.

    I am the only one in my family that takes NO drugs of any kind, eats no processed food, and the only one with any level of fitness yet I am considered the weird one with fringy beliefs. So no mattter how true “our side” is we will never get the coverage of the other side because almost no one what’s to hear it.

      • Greg Slatner says

        That’s why I read your stuff. You stand for something. Not only that you walk your talk. Very rare keep it up! Thank you

  3. Vlad says

    Doc, great article as always. The sprinter in the photo is Dwain Chambers of the UK. He was actually busted for PEDs and given a lifetime ban which was recently lifted. You were spot on.

  4. Nadia Morales says

    Well said (written) Doc.

    Besides the media, I hear this at work too: “you look too skinny,” “you should eat more tacos,” “you’re gonna disappear if you keep running.” I’m 124 lbs and gave up CrossFit (I weighed 130 then) to train for a marathon (I cannot do both; not that “gifted”). Even though I don’t take their words seriously because all of them seem overweight, it does get to my nerves that they don’t mind their own sh*t.

      • John R says

        It’s a sad state of affairs that being overweight is now almost the norm. 25 years ago today’s ‘skinny’ people were the norm.

    • says

      Gets on my nerves too that some of my trainer friends with their NSCA strength and conditioning certs call me skinny fat because I don’t have ripped abs and gigantic muscles like the figure chics they admire who are on every anabolic steroid and expensive supplement on the market. These guys are 30-50 pounds overweight (seriously fat for trainers) and couldn’t even keep up with me on a moderate 8-10 mile hike up a mountain. I also gave up super heavy lifting a while back (mostly do bodyweight circuits, walking, hiking, dance, and yoga) and the benefit of that is my endurance and my flexibility for dance (which I actually love) is back to what it was when I was 18 (I’m 42 now). I also weigh 8 lb less and am no longer bulky which is great when you’re flying around on a single point trapeze. If being 113 lb 19% bodyfat and fitter than most people my age and some younger qualifies as skinny fat then I’ll take that label any day! Great article Sock Doc and so agree with you on this “It’s a ‘figure out how you should be training’ site based upon your health, fitness, life, and goals – not the most recent news report, research study, or commercial.” Yes!!!

  5. Jonas says

    You did it again Doc,
    everytime I read your articles I end up with a good feeling and a big smile on my face!
    Spot on as always.

  6. Sean says

    Sock Doc, I was forwarded this article by a fellow endurance trainee.

    While the truth about most of the “studies” is that they are bound by some scientific code set to define an experiment and collect data about about a theory. Therein lies the rub. Theories are often “agendized”. Additionally, the parameters of an experiment are often very stringent so that the data that is to be collected can be collected with the least amount of variables (things that would influence the data being collected). This is problematic as each individual will have their predefined genetic and trained for parameters (i.e., Anaerobic threshold, metabolic, cardiovascular, etc). Maybe with the exception of any over doers, the fact that most theories/studies/experiments do not comprehensively and systemically examine the subject matter, endurance training, creates doubt about the relevance of how it applies to any endurance trainee.

  7. Noah says

    Sock Doc,

    Just read your newest article, and loved it. As a student, I’m a bit neurotic when it comes to school, and don’t exercise/train as much as I should, and did during undergrad.

    This trimester I’ve been trying to increase my overall health, so I’ve been running typically 3x a week using my HR monitor for 45-60 minutes. My pace isn’t great, but I have definitely decreased it from what I started at.

    I’ve dropped some weight (180–>169, close to what I started school at). If I want to put back on some of the muscle I’ve lost what is your honest opinion on cross fit? In your article it seemed like you weren’t against it, as long as it wasn’t all you did since it’s not aerobic at all?

    For the spring I was thinking about running 2x/week, and then doing cross fit 3x.

    If I’m getting in approximately 5 workouts in a week, what would you recommend? 2 days running? 3?
    2/3x /wk working out with weights on my own, cross fit, or?

    • says

      Hey Noah – My stance on CrossFit is basically this: Most people shouldn’t be doing it – they have no foundation and their form sucks. If I was a CrossFit owner, I’d make it mandatory for trainees to take 6 weeks of aerobic-building and technique classes before doing any WOD. Any good CrossFit owner, and there are some, would hopefully agree with this and some have certain variations of this.

      Personally I don’t take CrossFit because I don’t have the time, or interest. I like MovNat a lot better – it’s more real-life natural movements; but that’s just me.

      As I mention in this article, it’s up to you how you want to tailor your workouts. Running 2X a week isn’t much in my opinion – even if they are one hour each. I’d rather see you do 4 runs a week (or some form of “cardio” conditioning) at 30-35 min each, unless you’re training for a long distance race; but it doesn’t look like you are.

      • Kevin Flowers says


        I usually agree with your positions, but to say that “most” people should not do CrossFit is just a bit of an overstatement, don’t you think? CrossFit is about training with constantly varied functional movements performed with intensity. Which part of that should “most people” not do? I agree that most people who start CrossFit lack foundation and/or proper form (just as most beginning runners lack foundation and/or proper running form). But any decent CrossFit coach introduces new members (particularly those without much, if any, prior athletic-training experience) to the movements (particularly the Olympic lifts) slowly, using low weights and focusing almost exclusively on form. This results in massive improvements in power and mobility, while minimizing injuries. For example, in the last few years of doing CrossFit at two local boxes, I’ve only seen one CrossFit-induced injury that kept the person out of regular training for more than a week (and that was in a highly-trained, highly-skilled athlete, who injured his wrist trying to set a PR on a clean & jerk), whereas in any given year, we see a fairly large proportion of runners (both beginners and experienced runners) suffer such injuries. It’s fairly obvious to anyone (such as you) who pays attention to such things that a large proportion of runners regularly suffer such injuries because of bad form and/or too much intensity. Yet you would not say that “most” people should therefore not take up running, would you? I don’t want to convert this thread into a “CrossFit is the [greatest/worst] thing ever” discussion, but I’m surprised that you would state such an over-generalization about it, given how moderate and non-hyperbolic you seem to try to be about most other things.

        • says

          Hi Kevin, I appreciate your comment and I hear what you’re saying. Maybe “most” isn’t the best choice of words, but if most means 51% of 100% then yes I’ll use that word. I think you and I are saying/thinking the same thing – most who do CrossFit have no foundation and they lack form. For most, CrossFit is all they do and I’ve heard way too often from these people that “aerobic will ruin their CrossFit gains.” Yes, there are exceptions, and there are decent CF coaches so by no means am I bashing CF. I actually think it’s great for those who are fit, healthy, and able. But yes, I stand by what I say – “most are not”. This is also true for running. I think most people shouldn’t be doing even half-marathons. I think most people should be walking and NOT running until they build a base (by walking).

          So yes, most should not take up running at first – but they should build up to it, and I would say the same for CF. Also, I see a lot of people injured at CF, and of course a lot of injured runners too as you note. By injuries I’m not necessarily talking a connective tissue tear or sudden injury like the guy you mention, but a “bad shoulder” or a knee that needs to be wrapped, for example, would be in my list there.

          I hope that helps and makes sense. What it comes down to is that everybody wants to “play with the big guys” – they want to run far, run fast, lift heavy, lift often – and they’re not ready. So walk before you run, and lift properly before you lift heavy.

  8. says

    Nothing more to say but THANK YOU! I completely agree. I listen to all the Paleo/Fitness/Health Podcast and of course each of them think there way is the ONLY way… when it really comes down to EVERYONE IS DIFFERENT. I would love to be Dean Karnazes and be able to run 200 miles a week but guess what I tried to hit 80 and my body said NO!… I could lift weights and do crossfit all week and NEVER look like those fitness models, my body is not built like that, I’m built like a runner… DIFFERENT STROKES for DIFFERENT FOLKS… people need to stop trying to fit one mold, it would be a pretty boring world if we all did the same exercise and ate the exact same way!

  9. Joe Bowman says

    I love your attitude and what you stand for. Still working my way through your site. I studied all of Maffetone’s books, and really enjoy building the aerobic system. I came from a lifting background and had that picture perfect body but not much stamina.. now only been building aerobic base for a while, mixed with some anaerobic after plateaus. It amazes me that when I started, i couldn’t run in my heart rate zone, but now down to 10min mile pace, very fast on the bike, and can swim well. I still have a somewhat bulky muscular build, and would like to maintain that to a point but also get my pace down to 7min mile pace. I feel so much better this way, and get frustrated with my clients because no one wants to spend time (3 months +) to build their aerobic base before adding lifting back to their program. Where can I find more information like books to read about aerobic building etc. I have read all maffetone, a lot of arthur lydiard, but can’t find much else though their are tons of books on muscles building. I think health first, and then fitness and agree with you 100% (though I think your cursing is a little excessive, but just my opinion) and your articles are amazing. I wish their were more like you around.

    • says

      Thanks Joe. Regarding the cursing – I believe this is the first time I used the “F” word in an article, as using it usually looks very unprofessional. Though I felt it necessary this one time, and if I wrote it f*cking as many people would, that would have been spineless on my part. I think if you mean it you should say it.

  10. bill says

    I am a parent of an extreme athlete who follows you and others defending this “sport”. I simply want to first state that having lived with an extremist in sport, I and her mother can unequivocally state that extreme exercise and sport is EXTREMELY HARMFUL to your body and your mind. They have completely absorbed my child into your cult of extreme sports at the expense of all else. She constantly uses people like you and your “ilk” to defend her “healthy” lifestyle. I find it offensive. You are a “chiropractic physician”. You are NOT an MD qualified in physical research. Mr. Hutchinson is a qualified PHYSICIST….also not an MD qualified in physical research. It is laughable that I have taken my daughter to Mayo Rochester for physical examination by the top doctors (MD) in the world, and yes many parts of her body are in excellent condition but the hematologist, a “Doctor/Teacher of the year” at Mayo said she was physiologically anorexic!! Explained as basically starving the rest of her body to exercise. The physical evidence is overwhelming in a 5’4” frame weighing 95 pounds or less, and mental illness is also evident to anyone living it with her. She defies the validity of Mayo and defends the likes of you and “adrenal” gland fanatics, and “gastro parasite” fanatics to maintain her indefensible positions. So as far as we, her parents, and I’m certain thousands and thousands of other parents around the country are concerned, I wish you would take your “interpetations” of “others” research and keep it to yourself. You are doing more harm than good. No degree is necessary in any occupation to know that EXTREME anything is not good for ones body or mind. I will be most interested to see if you post this to your followers as a counter weight to your defense of extreme athletics.

    • says

      Oh of course I’ll post this Bill. Great comment. Thanks for the website bashing. You’re the first to call my site one that promotes EXTREME SPORTS. Can you tell me exactly what that is? I didn’t know I was promoting a sport and leading a cult. How is promoting health, proper training using your body as a guide (not some book), healthy sleep and eating, a balanced lifestyle, and natural ways to help assess, treat, and prevent injuries an EXTREME SPORT and EXTREMELY HARMFUL as you say? How much have you read of this site? How much do you know of studies – which in the case of this article you’re commenting on, are being questioned by more than me? I also find it comical when I get “readers” such as yourself on my site who think just because I don’t have a MD after my name then I’m not qualified to discuss health; only MD/PhD combo docs are qualified to discuss research.

      Actually if you read more than a few paragraphs of this site you’d know that it’s people like your daughter, who clearly has some major health issues, are exactly what I am NOT promoting. And I do so by discussing how it affects their “adrenal” glands (which I guess you don’t think exist), and other aspects of well-being. So if she read this site, any more than you, then she would be learning how to train properly and listen to her body. And if you knew even 1% of that, you would have never written this comment because I clearly say often, including this article, that those who participate in such sports should not be doing so (and that it very well may kill them).

      • bill says

        It is enough as a parent to know that if your triathathlete daughter (Iron Man etc) uses your site to defend her extreme exercise to compete such insanity then that is enough for me. She is all over all these sites that defend running, including extreme running, as healthy when it is not. Running is healthy. In the general population running over 26 miles is not. Regardless of your qualifications they in no way should represent anything superior to the Mayo Clinic in Rochester. Whether she mis-interpets your words or “research” I don’t know and seriously would not devote the hours necessary to pry from the BS the facts of your logic medically, physically, or philosophically. As I point out it is a parental response to an actual situation not a broad swipe of all excercize….it is the extreme, which you defended against the articles in NY Times and WSJ that put you in that category not me.

        • says

          This comment is more comical than your first. I defend extreme running? No Bill, I say to those to stop doing that and pay attention to your health. You’re making derogatory comments on a very site that is saying what your daughter is doing is wrong. It’s not my fault she’s not getting the point of my site any less than you.

          Don’t comment here and call me a cult leader when you haven’t read past one article where I discuss bad research interpretation due to missing data & statistical manipulation.

          • bill says

            “I’m referring to the current round of news reports, websites, and “research” that have once again concluded that so-called aerobic and endurance training will, to some extent, harm your health if not outright kill you. I was going to let it go since these news reports state nothing new, but after many questions and concerns I’ve decided to address it again”
            After which you and Alex attack the research as slanted blah blah blah…..all YOUR opinion.
            You are comical in your defense of yourself denying that you are not supporting extreme athletics when you just did exactly that in print

          • bill says

            Please don’t respond as I have just completed lunch and your hypocrisy is making me ill. Certainly anyone who follow or listens to anyone who calls himself “SOCK DOC” it goes without saying is not playing with a full deck….or in your case has a shoestring lose.
            Count your toes and go to sleep now.
            night night little boy

          • James says

            What’s interesting is, I read this articile and was immediately concerned I was doing doing too much stressful exercise and wanted to re-think things. My guess is that the daughter is not understanding this site and the father, Bill, is taking her word for it without reading much.

        • Justin Doran says

          seriously sir, it wouldn’t take much “prying” to realize that Dr. Gangemi is not in favor of “extreme training”, quite the opposite actually. I’d recommend that you read his previous blogs and maybe you could use them to help your daughter along towards recovery. Lastly, although this is clearly a touchy subject for you, try to remember that the public domain is not the best place to get emotional.

        • Chris says

          Holy wow! Someone is looking for anyone to blame for the poor job they did raising their daughter to make informed and intelligent decisions. It sounds like both parent and daughter need some counseling. (From a PhD of course!)

  11. says

    No need for me to respond further to this guy. He thinks extreme sports is running aerobically in 60 minutes; and not even those studies say they are such.. Ill end it with his immature comment.

  12. Lynn Novak says

    It really wouldn’t matter what rebutle you use for this person. He obviously used his “extreme” beliefs raising his daughter. In my humble opinion – it sounds as if she has an addictive personality and if exercise wasn’t her “drug” of choice the result would have already been catastrophic. He, as with other enablers, are trying to point the finger at someone else than dealing with the reality of the situation. Very unfair he chose you Dr. Gangemi, for his scape goat. I believe in you as do ALL your fellow cult followers…carry on chosen one, carry on!!!

    • bill says

      Dear Lynn you ingnorant moron……it is qutie the reverse. I’ve spent 10’s of thousands of dollars in nutritionists, psychologist, psychiatrists….weeks coaching the reverse response to her issues including staying near her first college for weeks to provide support to get her to reverse these trends. In addition for the last 8 years my wife and I repeatedly cajol and encourage and chastise her over this behavior……enabler??? That’s absurd! The fact that I confront one of HER ENABLERS in “SOCK DOC(?)” is further proof of the reverse….It is him and his ilk that are the enablers.
      Guess you don’t have a child….too much exercise?????????????????//

  13. barefootcourier says

    Thanks for cutting to the chase! I struggle to find WHAT information to believe. Between poorly done research studies (often questionably funded by far from impartial parties) to newspapers more concerned with sales than facts, its pretty hard to find quality information to digest

  14. Bill P says

    Great articel Doc!!!!!! Notice the initial after my first name, Im NOT the same Bill from a few posts ago……I appreciate you coming out “guns blazing” on this article. Im glad you cleared the air and spoke some truth on this subject. Thanks for all of your free information!

    • Joe W says

      I couldn’t agree more. My wife and I both cheered when we read this article. We loved the thoughtful, thought-provoking analysis here. Glad to see you sticking to your guns! And for providing more information on a topic that has been of great interest to us lately.

  15. StevenB says

    Heading to the cardiologist on Monday because my Dr. did an EKG and found I might have LVH (Left Ventricular Hyperthrophy). I’m 48 and have been experiencing dizziness and heart flutters more frequently recently during training runs and races. I run 40-70 miles a week, have run many road races, and just finished my 20th ultra which includes three 100 milers. I’m spooked! What is usually the outcome for folks with LVH? I hope I can get this corrected with rest, adjustments to my training, and possibly medication. Running is my passion but I don’t want it to kill me.

  16. Julia Moffitt says

    Dear Soc Doc,

    Well done. I too am tired of this gloom and doom scenario being painted for runners. I am a PhD level cardiovascular physiologist who teaches cardiovascular physiology to medical students. I get only ONE lecture to deliver exercise physiology content. You are right they are in no way educated to the point of being able to offer advice on such matters. Second point you made is regarding intensity – right on, where are they measuring the intensity of these runners? Final point that I would like to make, and you may want to think about this to include in future discussions is the comparative risk. Paffenberger found in one of his very large scale studies that the risk of CVD in men who expend less than 2,000 kcal/wk in exercise is 64%! Although the reverse wide scale epidemiological evidence is lacking in runners who train intensely most studies find only a 10-20% risk of some forms of cardiovascular pathology (scarring, atrial fib. etc.) and that is only in relation to those athletes studied and not the population at large! So here’s the choice the media will not tell folks – do nothing and you have a 64% risk of CVD, or do something and you may, if you run really far and very intensely have only a 10-20% risk of some forms of CVD. I know which option I’m taking!

    Thank you,
    Julia Moffitt, PhD
    Des Moines University College of Osteopathic Medicine

  17. PeeWee says

    It seems like you are needlessly criticizing and harping on Mark Sission’s “chronic cardio” Idea. His idea is more focused on the context of weight loss and how running a lot (with a deranged metabolism) is a bad way to achieve that. You have taken that to mean that healthy people like yourself are going to die mid stride.

    The ability to run when you need or want to is an indicator of health not a cause of health,The way strengthening skeletal muscles(to adequate not superhuman levels) seems to have a cause relationship with health and aging.

    Sprinter vs Jogger / Genetics vs Epigenetic

    Yes our muscles look the way they look and there are limits to muscularity but what about the tangible differences in training effect between sprinting and jogging.

    Are you going to look like Ronnie Coleman Just because you lift heavy weight’s?

    You’re not , you don’t have his genetics or his drugs that doesn’t mean the training effect you get is any less beneficial.

    Are you going to look like an emaciated Pro endurance athlete running or cycling a few hundred miles a week?

    You’re not, you don’t have his genetics or his drugs that doesn’t mean the same health eroding mechanisms aren’t being activated in your body.

    This doesn’t make the analogy wrong, it simply provides a visual for a hard to visualize metabolic environment.

    Can we conclusively say that Janne Holmen wouldn’t look more muscular and be in much better shape had he taken up sprinting instead of Distance ? we don’t know , if yes , no he probably wouldn’t have been a champion at sprinting with his genetics.

    All training is “bad” for you and the body deals with it by getting stronger,faster,leaner,bigger or dying.

    All that being said , death is a really bad metric because everyone dies. If they could redo the study to show quality of life instead of just when it ended that would help a lot.

    • says

      I didn’t realize Mark Sisson coined the term “chronic cardio”. Actually I share very similar views and thoughts on health and fitness as he does so I’m not sure why you see it that way – especially to the point of me criticizing him; that’s a figment of your imagination.

      Anyway – pretty much the rest of what you’re saying here is what I address in the article, for the most part.

  18. says

    I’m participating in Ultrarunners Longitudinal TRAcking (ULTRA) Study https://stanfordmedicine.qualtrics.com/SE/?SID=SV_aY1e47DdzVRjHKI led by Dr. Marty Hoffman (VA Northern California Health Care System) and Dr. Eswar Krishnan (Stanford University). At some point after reading one of those articles claiming that ultra-runners run to their infarcts, I asked those researchers for their opinions. I wrote,


    I’m really sorry for misusing your email addresses which you provided for ULTRA study.
    But in chance you could find a couple of minutes to spare, as a long-distance runner I would really appreciate your opinion on a sharply negative view on long-distance running health influence by Dr. Mercola in his “One of the Worst Forms of Exercise There Is” http://goo.gl/IDTCl article.

    On one hand, it’s interesting to read and there are links to studies and should be valid points too. On the other, I can’t abstract myself from the fact that Dr. Mercola is trying to promote his own “PeakFitness” system… To me, what he suggests looks like a common sense and is very similar to other fitness systems, for example P90X, which I enjoy.

    Thank you and sorry again for bothering you,”

    Dr. Marty Hoffman was so kind to answer me. He wrote,

    “Hi Vladimir. Thanks for participating in the ULTRA Study.

    As for your questions about this article of Dr. Mercola, I would also be skeptical of stuff you find on the internet with associated products for sale. As far as I can tell, he is not a scientist, and has not published any scientific papers in this area.

    That said, there are indeed a couple studies I’m aware of now that have suggested some temporary right ventricle dysfunction after a marathon or ultramarathon (our study on this is attached). At least in our work, I understand that baseline (pre-race) findings were normal, suggesting that the post-race changes are temporary. As is the case with skeletal muscle after fatiguing exercise, some temporary dysfunction in the heart should not be surprising. The question is whether this fully recovers or causes some scarring that might lead to electrical conduction problems as has been pondered. I don’t think we have enough information to say one way or the other at this point.

    Personally, in terms of potential cardiac injury, I would be more concerned about high intensity exercise (like that promoted by Dr. Mercola) than the prolonged lower-intensity stuff that ultramarathoners typically do. On the other hand, I think that if you want to optimize performance in ultramarathon running, some high intensity (interval type work) is necessary.

    Hope that helps, and that you keep enjoying exercise!


    • says

      Thanks for sharing that Vlad. I have studies of the true dangers of prolonged endurance in Part V of the Training Principles (http://sock-doc.com/sock-doc-training-marathons/). And yeah, Mercola reads a study and talks about what he thinks it means. Unfortunately many believe him to be some nutrition and fitness God. Far from it. If all you’re doing (or even the majority of your workouts) are those quick interval bursts with little warm-up and cool-down then you’re pretty much guaranteeing yourself an injury and you’ll never develop much fitness (and almost no aerobic fitness).


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