Family of marathon runner who died urges awareness of exercise-induced rhabdomyolysis
Rachel Apa, a 24-year-old former Division I athlete, collapsed near the finish of the New York City Marathon and died from complications of exercise-induced rhabdomyolysis, prompting her family to campaign for greater medical preparedness at endurance events.
A 24-year-old former Division I athlete from central Pennsylvania died after collapsing near the finish line of the New York City Marathon, officials said the cause was exercise-induced rhabdomyolysis, a condition in which severe muscle breakdown releases harmful substances into the bloodstream.
Apa, a Bucknell University field-hockey player, had texted her father during the race, initially feeling "amazing" at mile 9, but later reported pain at miles 18 and 19 before collapsing at mile 24. Spectators performed CPR until a race medical crew arrived with a defibrillator ten minutes later, but doctors pronounced her dead at a hospital.
Dr. Carl Covey, a sports-medicine physician, explained that rhabdomyolysis can cause electrolyte imbalances, particularly elevated potassium, which may trigger life-threatening cardiac arrhythmias. He noted that while the condition is not rare, fatalities are extremely uncommon, especially among athletes. Diagnosis requires a blood test for creatine kinase, and treatment ranges from oral hydration for mild cases to intravenous fluids and cardiac monitoring for severe cases.
A study of the 2022 New York City Marathon found 24 runners treated for rhabdomyolysis, up from 15 across the previous five races, a rise attributed to unusually high temperature and humidity that day. This year’s race saw cooler temperatures, but experts caution that sudden spikes in training intensity or unaccustomed exertion remain key risk factors.
Apa’s family has launched a GoFundMe campaign that has raised over $109,000 to establish the Rachel Apa Foundation, which aims to educate runners about rhabdomyolysis and advocate for rapid on-course medical response at endurance events. A memorial walk is planned at her high school, Red Land, on Sunday.
Medical officials continue to investigate Apa’s death, reviewing her training history, possible prior episodes of rhabdomyolysis, medication use, and whether heat-related illness contributed. The New York City Medical Examiner’s Office has not yet issued a final determination of cause and manner of death.