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Triathlon Tragedy

In the most recent New York City triathlon, two competitors died as a result of injuries incurred during the swimming event.  While this should not discourage triathlon participation, it is a reason for caution.

 Triathlon competitions are a combination of swimming, cycling and running in a single event.  The most well-known event is held each year in Hawaii and consists of a 2.4 mile swim, 112 mile bike ride and a 26.2 mile run.

 These events are more popular when the distances are shortened.  The New York event is made up of a 0.9 mile swim, 24.8 mile bike and 6.2 mile run.  These shorter distances allow for broader participation in regard to age and ability.

 Recent studies show that the death rate for triathletes is twice that of marathon participants.  In a 2010 study published in the medical journal, JAMA, where 14 deaths from triathlons were analyzed, 13 of these occurred during the swim portion of the event while the other resulted from a bike accident.

 Autopsies revealed the majority of those who died had cardiac abnormalities. Autopsy reports are unavailable for the two most recent triathlon deaths although the cause of death is presumed cardiac in origin.

 While the number of deaths in triathlon is relatively small (15 deaths per million participants) efforts should be taken to make these events safer. Physical examination of each athlete before an event is not practical but all participants should be examined annually by their personal physician to determine if it is safe to participate in extreme events like triathlons.

 The mass start of the swim event makes collisions inevitable and impedes the ability to reach an injured athlete. Staggered starts should be considered.

 Triathlons are a great way to cross train and remain physically fit. Adequate preparation must include a thorough medical evaluation at any age.    

 Anthony G. Alessi, MD, is Stroke Center Medical Director at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at www.backushospital.org.