It has long been known that physical exertion, as in long-distance running, can cause medical problems. Think of Pheidippides, a Greek soldier who died after a long run to Athens bringing news of the Athenian victory in the Battle of Marathon in 490 bc. He found the major officials waiting anxiously for news. After gasping “Joy, we win,”1 he died. The current marathon distance of 26 miles 385 yards is roughly the distance from Marathon to Athens.
Burgdorf WHC, Hoenig LJ. A Championship Quiz on Sports-Related Dermatoses. JAMA Dermatol. 2015;151(1):107. doi:10.1001/jamadermatol.2014.1157