Today's question for Lindsey comes in from Graham. He says he started the 2014 Comrades Marathon, but collapsed from dehydration with just under 3km’s to go. He was taken to hospital unconscious. He was there for 3 hours, he says it was unlikely that he would have finished with about 15 minutes to go when he did collapse.

He says as far as training goes he did about 1050km from January to Comrades Marathon race day. He is 41years old. He says he seems to have made a full recovery; he waited just over 3 weeks after the Comrades Marathon until he ran again. He did run a 5km very slowly –which felt very strange, but it is understandable he supposes.

He has also cycled twice but with no problem and not on consecutive days. He says he set out to do a 10k on the 30^th June, but only managed about 7km because it felt like it was a bit too much. He says it feels like he’s not done any running, like he is starting out again and the day after the 7km his legs felt so stiff he felt like a beginner. What’s the story, what is going on with his body?

Brad Brown: Today's question for Lindsey comes in from Graham. He says he started the 2014 Comrades Marathon, but collapsed from dehydration with just under 3km’s to go. He was taken to hospital unconscious. He was there for 3 hours, he says it was unlikely that he would have finished with about 15 minutes to go when he did collapse.

He says as far as training goes he did about 1050km from January to Comrades Marathon race day. He is 41years old. He says he seems to have made a full recovery; he waited just over 3 weeks after the Comrades Marathon until he ran again. He did run a 5km very slowly –which felt very strange, but it is understandable he supposes.

He has also cycled twice but with no problem and not on consecutive days. He says he set out to do a 10k on the 30^th June, but only managed about 7km because it felt like it was a bit too much. He says it feels like he’s not done any running, like he is starting out again and the day after the 7km his legs felt so stiff he felt like a beginner. What’s the story, what is going on with his body?

What caused this Comrades Marathon failure?

Lindsey Parry: Unfortunately there is a lot of things that could be wrong with his body, so it is difficult to nail it down. In terms of his actual training for this year’s Comrades Marathon, just over 1000k’s should still be enough to finish the Comrades Marathon.

Something else has happened on race day, and the fact that he passed out – that could be related to heat stress I suppose, but even though it was a warm day it is unlikely. It could well related to something like hyponatremia or water intoxication.

It could be related to some underlying condition. It could be related to running with an illness – particularly if he got sick in the days after the race. So he would have started the race not knowing that he was carrying some sort of viral infection.

All of those things would lead to the situation he finds himself in now. If he had an acute virus which led to him passing out, then chances are that by that stage his immune system was weakened to the point where all the cells, the muscles and even potentially the heart could have been infected by that virus.

The comeback from illness at the Comrades Marathon

If that is the case, then it is a really long, laborious process to recover. Clues to that would be: if he starts exercising and his heart rate goes really really high, perhaps even slightly irregular, and that it takes quite a long time to come down. Dizziness, shortness of breath when exercising, and the stiffness of the muscles is a potential clue to that as well BUT it could also fall into any of the other scenarios which are far less serious.

Once we completely annihilate ourselves and push ourselves way past the point of no return, to where our body actually needs to shut down to the extent of passing out to prevent us from doing any more damage, to recover from that is a long process.

Someone that has had to go to hospital and have surgery will tell you that it takes a LONG time for their body to recover from the anaesthetic and the operation and this, while not quite as serious as an operation, is not totally different to that. So my advice to him would be to start out as a beginner, and if starting out as a beginner is still causing him distress and issues particularly around high heart rate, then I would get myself off to a doctor and get checked out.

But the stiffness is not unusual in somebody who has pushed themselves past the point of no return. It will take him a few weeks and he needs to really build up like he is a beginner to give himself a chance of doing this without too much discomfort.