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Study: blood flow restriction may reduce marathon-related tissue damage

New research says this specific type of preconditioning may help, no running required

Photo by: RunCalgary

When it comes to heart and overall health, some researchers are still debating whether running a marathon is too much of a good thing. There is evidence to suggest that this type of prolonged, strenuous exercise increases cardiac biomarkers that reflect the stress on the heart, and it’s known to increase biomarkers of liver injury as well. Studies show these changes are temporary, and biomarkers begin to fall in the hours and days following a race, but is it possible to protect against this stress from the start?

Researchers at Gdansk University in Poland, Charles University in the Czech Republic and elsewhere designed a study, published in Frontiers in Physiology, to determine whether a procedure called remote ischemic preconditioning (RIPC) can reduce markers of heart and liver damage, as well as oxidative stress in recreational runners after a marathon.

RIPC involves repeatedly inflating a blood pressure cuff around a limb to restrict blood flow for a few minutes at a time, then deflating the cuff to allow blood flow to return to normal, which has been shown to reduce certain cardiac and liver biomarkers after valve replacement surgery and liver transplant. It’s also been shown to benefit exercise performance.

Participants in this study were amateur runners who had run at least five marathons, with finish times between 2:50 and 3:20; they were training for the 46th Dębno Marathon in Poland. Runners were randomly assigned to the RIPC group or a control group.

126th Boston Marathon, April 18, 2022. Photo: Kevin Morris

Over 10 consecutive days, participants went to training sessions where they lay down with a blood pressure cuff wrapped around each thigh. For those in the RIPC group, the cuff was inflated so it was tight enough to restrict blood flow to the leg for five minutes, then deflated to allow blood to start flowing again for five minutes. This cycle was repeated four times. In the control group, the cuff was barely inflated at all, so that it never stopped blood flow.

After 10 days of training with the blood pressure cuff, participants ran the Polish marathon. The researchers used blood samples taken from participants before and after the blood pressure cuff training, as well as before and after the race, to measure markers of heart and liver damage.

Georgina Marathon, Oct. 17, 2021. Photo: Edison Yao

After the race, all the runners showed an increase in these markers (including creatine kinase, cardiac troponin level, total bilirubin, ALT and others), but the increase was much smaller in the group that did the RIPC training.

The results suggest that this type of blood flow restriction training can have a protective effect against liver and heart damage associated with running a marathon.

More research is needed to fully understand the potential benefits of this type of preconditioning, but it could be a simple way to manage the toll a marathon takes on runner’s bodies.

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