23 year old runner dies at 2XU Compression Run

A 23 year old man had died during the 2XU Compression Run that was held on Sunday. Investigations are currently ongoing so there is not much details about the case. Nonetheless, here are some things to consider when participating in long distance races.

Keep your ego in check

Everybody knows that they need to be adequate prepared before running a longer distance. It could be a full marathon or even a 5km run. You need to be prepared and I think everybody knows that. You don’t need a chiropractor to tell you that.

The problem is not in the knowledge. The problem is in the choice of behaviour or action when you realised that you are not adequate prepared. What do you do?

I am not insinuating that the young man who passed away was inadequate prepared. However, I do see many people going for running races and events despite having full knowledge that they are not ready or not in a good state to race.

In my opinion, this is very poor decision making.

Listen to your professional advice

A staggering number of people have approached us to ask if we can help them prepare for an upcoming race or event. They would start sharing about having certain injuries or having certain pains. If you are coming to me 6 weeks or three months before, sure that makes sense.

Quite often, these athletes are checking in two or even one week before their race! While I may claim be good at my job, I certainly am no miracle worker.

For such cases, our advice is always to go for the race but take it super easy. That is to don’t push yourself and to take it extremely conservatively. Unfortunately, most of these athletes still go with the intention to PB … despite having full awareness that they are not at 100%.

I do commend the effort to seek professional but I guess what will make even more sense is to follow professional advice that comes.

On top of keeping your ego in check, the ability to practise restrain is equally important.

No pain doesn’t mean all is well

I strongly exert that listening to your body is bad advice. This advice suggests that if you feel okay, it means you are okay to keep going. This is 100% not true.

No pain doesn’t mean no injury. More mind boggling, pain also does not mean injury. This is why listening to your body is a slippery slope.

There are many, many people whom I have met that are super cautious in their workouts but still get injured anyways. It’s usually because they have no initial symptoms and they assume that means everything is working well. Some conditions (e.g., tendinopathy, runner’s knee) takes prolonged periods of repetitive strain before the affected tissue becomes symptomatic.

With this in mind, it’s always better to err on the side of caution. If you are not feeling well that day, skip your race. If you have not adequately trained for the race, skip it. Sure, you can still go and take it super easy. But that’s if you have enough self-control to stick to your plan.

If not, avoid in its entirety.

Asymptomatic or “silent” coronary disease

Research estimates that between 2 to 4% of middle-aged men have silent coronary disease. In other words, they have an existing heart condition with zero symptoms. Unless you have done some thorough cardiac tests in the past, it could potentially go completely undetected.

Such is the case for 22-year-old Malcolm Sng Wei Ren. In 2011, Malcolm, the then Singapore Management University business  undergraduate died after completing a half-marathon. In the coroner’s report, he died of acute coronary insufficiency. Malcolm had an abnormal coronary artery that was previously undetected.

To an extremely large extent, it’s better to be safe than be sorry. Always err on the side of caution!

What are the signs that you should stop running?

If you are experiencing chest pain, extreme shortness of breath, lightheadedness, faintness, and/or chest palpitations during a long run, you should definitely pause to evaluate what is going on.

It is always a good idea to call for help (e.g., emergency services) especially if your symptoms do not seem to reduce with rest. For heat stress or headstroke, hydration can be helpful.

Do not resume running!

Is it safe to run a marathon?

If you are healthy and well-trained, yes it is extremely safe to run a marathon. The most serious adverse event associated with marathons or other long distances is cardiac events. In absolute terms, prevalence of cardiac death with marathons is very rare at 0.002%. The risk of dying from running a marathon is estimated to be 1 death per 149 968 participants.

However, when comparing to the risk of general life, the annual risk of premature death from running one marathon is 120 times higher. The risk of sudden cardiac death is also 2.5 times higher among young athletes between 12 and 35 years old than non athletes.

In other words, even though marathons are considered safe, there are still risks involved in running a marathon.

Avoid marathons that are known to be poorly organised

When news broke that a 23-year old man had died during the 2XU Compression Run 2025, many race participants took to social media to share their negative experience. One of the complaints was that there were limited water points so hydration was a bit of an issue. Furthermore, even when there were water points, the small setup resulted in bottlenecks.

There were many recounts of people who saw runners who collapsed and requiring medical assistance.

“Hydration: At one point, the main water booth ran out of water to provide (not sure if it was temporary or they had backup supplies). Had to approach the next water booth which apparently was a game booth which participants must play a game to win a bottle. Literally had to beg the staff to give us a cup of water.”

If you think this year was an isolated incident, it is not. A reddit user shared that the main water booth ran out of water in 2XU 2024 and they had to beg a staff member to give a cup of water.

In the 2023 edition, 2XU Compression Run had the same overcrowding at water points. Pris Chew shared that she had to stop in order to get a cup of water or Pocari Sweat cos she was blocked. So, if you didn’t want to stop, you could potentially end up missing on hydration.

Based on these, it may be reasonable to conclude that 2xu Compression Run may not be the best event in Singapore’s running race calendar?

Crowd control is always challenging for major running events. Nonetheless, organisers can (and have the onus) to plan accordingly. For example, the Standard Chartered Singapore Marathon this year will take place over two days to accommodate the increase in runners.