Nearly 40,000 runners began the trek Sunday morning to complete the New York City Marathon, but it was Brit Paula Radcliffe and Kenyan Martin Lel, who ran across the finish line first.
And while there were no early reports of major injuries during or after the race, the unexpected death, on Saturday, of 28-year-old marathon champion runner Ryan Shay, loomed, as Radcliffe and Lel, ran away with the victories and the $130,000 prize.
Shay's death, which occurred after he collapsed five miles into a race at the Olympic trials in New York, highlighted just how dangerous the sport can be — even for the most fit athletes. He will undergo an autopsy to reveal exactly what happened to him.
In fact, hundreds of marathoners are taken to the hospital every year for various injuries, and as the sport's popularity has increased, so have the injuries.
Even for the fittest athlete, the running distance of 26.2 miles is a brutal undertaking.
The marathon has its roots in ancient Greece, when an Athenian soldier ran that distance to deliver a message. He then died on arrival.
"As far back as the original marathon, the 'no pain, no gain' seems to be the motto of the runner to make it to the finish line," said Dr. Ronald Grelsamer, orthopedic surgeon at New York's Mount Sinai School of Medicine. "But for the everyday runner, it may not be worth the sacrifice."
Yet, each year, a growing number of novice runners lace up their sneakers and hit the pavement, following in the footsteps of more experienced runners.
During the last 20 years, the number of people entering marathons has doubled in the United States.
First-time runner Luis Corona is one of the 40,000 runners who participated in this weekend's marathon.
"I'm nervous, I don't know what to expect," he said. "I'm just looking to have fun, but I am concerned what happens if I do get injured."
And while the sight of the marathoners in Central Park may be enough to inspire the less active to get up and go, not everyone is fit enough to do so.
"They open themselves up to the risks of cardiac injury, ankle, knee, hip and back pain," Grelsamer said. "I'm a big believer in listen to your body principle. If you feel something abnormal in your chest, in your joints, that's your body telling you to back off."
It could be a sign of dehydration or overhydration, or something more serious. It also could cause serious trouble as when, during this year's sweltering Chicago Marathon, 95 runners were taken to the hospital for heat-related injuries, and one died of heart problems.
But many marathoners still believe the thrill of completing the race is worth the risk.
"There's always fear at the beginning," said veteran marathoner Martin Harper. "There's aches and pains at the end. But all along, you're driven by the fact that you want to succeed, and you're not going to let yourself stop. It's worth all the pain."