NFL, Gatorade and bananas

It must have been the bananas

Superbowl Sunday has come and gone, and New York Giants played the part of giant slayers by upsetting the New England Patriots, a team that steam-rolled the competition during the regular season, and even when against the ropes always seemed to be able to pull out a win from somewhere. Not in Superbowl XLII however, and Manning (the younger one, amazingly) led the Giants to two fourth quarter scores to win the title.

There are plenty of talking heads and pundits on the web, television, and in print to provide you all the detailed analysis of the game you need. Neither of us have tremendous insight into the game of football, and so we will leave the breakdown to the other guys. However, there is one story that emerged from the Superbowl that does fall within our "playbook", so we thought we'd spend some time on that instead!

New York coach Tom Coughlin does not read The Science of Sport

Back in October of 2007 we did a series on muscle cramps. In it we looked at the different theories of cramps, looked at the prevailing and perhaps dogmatic theory, presented a novel theory to explain cramps, and finally used the debate around cramps to demonstrate how science and knowledge evolve as new evidence comes to light.

The gist of this debate is that for years cramps have been attributed to dehydration and electrolyte imbalances and deficiencies. We suspect many of you who played youth sports were told, when playing in hot weather, to eat lots of bananas. The hypothesis there is that potassium depletion causes muscle cramps, and it is commonly accepted that bananas are a food stuff that is rich in potassium. So, quite simply, to stave off cramps one must just eat plenty of bananas - elementary school knowledge (or so we thought), and it turns out that even in the Superbowl, they adhere to that same dogma!

So in the big game, late in the first half, the crack Fox TV broadcast team crossed to their onfield reporter, who informed the watching nation that as a result of the high humidity in the stadium (the roof was closed), the Giants players were having problems with cramps, and that the coaches, sharp as they are, immediately had boxes of bananas brought to the sidelines. Sure enough, a couple of minutes later the cameras spotted it---a pile of bananas on the Giants sideline!

The first important (though tongue-in-cheek) point here is that Tom Coughlin and his coaching staff clearly do not subscribe to The Science of Sport. . .or perhaps they do, but they missed our series on muscle cramps? The second interesting point is in spite of all of the technology the NFL teams and coaches have at their disposal, all the high-tech strategies they employ, their wealth of human resources---19 coaches for the Giants and 14 for the Patriots---they rely on techniques that are entirely unproven and which no scientific evidence supports.

And then thirdly, and perhaps most thought provoking, is that Gatorade are the Official sports drink of the NFL, and copious amounts of it are available on the side of the field. Yet for some reason, the Giants were not told this - they chose the banana instead of the Gatorade! So calling for the banana backup is an indication that...the Gatorade wasn't working...? That wasn't an ad you saw in the Superbowl! Imagine the tagline..."Gatorade appears NOT to prevent cramps. Try bananas instead..."

No, science does not always have the answer

Admittedly, science does not always have the answers. Human performance even in individual events is incredibly complex. One only has to look at our previous post for some insight into will power and motivation to understand that many factors, perhaps too many and too complicated to measure, predict performance.

But it is still fascinating that at what many consider the pinnacle of professional sports---the NFL---the coaching staff turns to bananas during a game to alleviate muscle cramps. This is a sport in which assistant coaches, perched high above, take moving and still pictures, analyze them, and relay information about their opponents down to the coach on the sidelines. It is a sport that makes exstensive use of video analysis as players watch hours of game film of opposing teams to "get to know" them and their offensive and defensivee formations. They appear to be on the edge of technology. . . or are they? The bananas suggest otherwise, and give hope that maybe there is room for basic science.

In any case, it was a cracker of a game, and in our honest opinion the better team on the day won the match. Somehow the Patriots never really looked like the team that dismantled their opponents 18 games in a row. The Giants found a way to get to them, and came out ahead as a result of their efforts.

Be sure to come back later this week as we move on to Part III of our series on exercise in the cold.

Marathon survival: Courage and physiology

Marathon survivorship – physiology of some courageous marathon finishes

Last week, we featured the debut marathon of Kayoko Fukushi of Japan. As the fastest Japenese woman ever over the HALF MARATHON, much was expected of Fukushi’s debut marathon in Osaka, but in the end, she left the world with memories of a different kind – 15 minutes to cover the final 2km, three falls in the final 300m in the finishing stadium, and testament to the challenges posed by the marathon distance.

In the aftermath of the race (you can watch the final 400m, as well as our analysis of the race at our previous post), Fukushi’s final 400m was a hot topic on discussion boards and running websites. So in this follow up post, we thought we’d look back on other famous marathon finishers. We tip our hats, and our physiological paintbrush, at the following three famous “Marathon survivors”.

Gabrielle Andersen-Scheiss

In 1984, for the first time, women were allowed to run the marathon at the Olympic Games. The race was won by Joan Benoit, in a remarkable time of 2:24:52, beating off a stellar field including Weitz, Kristiansen, and Rosa Mota. The time was remarkable for a number of reasons. Not least of all, conditions in LA were hot and heavy – ahead of the Games, there was a great deal of anxiety over potential problems caused by the pollution – much as there are around the Beijing Olympic Games this year.

But in the end, the heat caused the problems, and the biggest problems of all were encountered by Gabriela Andersen-Scheiss, of Switzerland.

Andersen-Scheiss entered Olympic Games AND Physiology folklore thanks to her performance over the final 400m of the race. This video, shown below, is often shown at physiological conferences as a demonstration of what happens to the physiology when the body temperatures rises to reach a ‘critical threshold’.

What you will see in the video below (apologies for the poor quality – if anyone has a better version, let us know!), is that Andersen Scheiss enters the stadium clearly in distress, and over the next 400m, staggers around the track, taking an incredible 5 minutes to cover the final lap! The video edits out much of this last lap (again, let us know if you know where a better version exists), but you can get a good idea of just what is wrong – it seems as though the left side of her body is dragging the “paralysed” right hand side behind it. And this is typical of what happens when the core body temperature rises to above 40 degrees Celsius.

The role of the brain

We’ve brought this up before, but it bears repeating – until the mid to late-1980’s, the theory for exercise in the heat was that you fatigued because the body was unable to provide sufficient blood to the skin for cooling AND the muscles for exercise. In this theory, dehydration was a problem because it meant less blood, which only worsened the problem. But in 1979, Ethan Nadel found the first evidence that the blood flow was not the problem. This finding was repeated in numerous studies, where they found that the body was perfectly capable of getting enough blood to muscle and to skin.

However, the body temperature can still rise (this is a function of exercise intensity and the environment), and when it happens, the evidence began to suggest that the brain was involved. Why? Because scientists started to observe that when people in LABORATORIES hit a body temperature of 40 degrees, they started to display symptoms of neurological problems. Which is exactly what you see in Andersen-Scheiss – “paralysis” of one half of her body, inability to control the limbs, and so forth. This classic symptom was strongly suggestive of the neural contribution to fatigue.

It was later found that when the brain gets too hot, it actually recruits less muscle (Nybo and Nielsen, 2001). Of course, when you exercise in the heat, it’s not quite as simple as a brain the stops activating muscle when you get too hot – I (Ross) did a study in 2004 that found that the activation of muscle actually goes down BEFORE you get too hot. In other words, the brain slows you down by activating less muscle IN ADVANCE of hyperthermia, specifically so that you don’t reach this point of complete exhaustion and ‘paralysis’.

However, as the video above testifies, it happens, with dramatic consequences. Andersen-Scheiss, for her part, became something of an Olympic legend as a result of her courage. She ended up finishing in 37^th place, some 20 minutes after Benoit. She was treated and released within 2 hours, showing how even the most intense effort is probably still within the reserve capacity for the body.

Jim Peters – the Vancouver 1954 marathon

Jim Peters of England was the Paula Radcliffe of his generation - he had broken the world record four times and was the first man to run under the 2:20 barrier, taking the record down by an astonishing eight minutes to 2:17:39!

So when he lined up in the 1954 Vancouver Empire State Games (today called the Commonwealth Games), he was the overwhelming favourite. This was the same Games, incidentally, that Roger Bannister and John Landy raced in what would later be called “the mile of the century”, with Bannister outkicking Landy to win. That race actually happed while this marathon was being run, and so Bannister actually sat in the stadium waiting for the men to finish.

Anyway, the marathon that day was particularly hot, and Jim Peters staggered into the stadium in first place, but was looking like he'd had too much to drink. He was swaying from side to side, and it looked as though one half of his body had been paralysed – much in the same way as Andersen-Scheiss would look 30 years later.

The conditions in Vancouver were pretty warm with starting temperatures in the shade in the high 20's Celsius. Reports were that the sun was so warm that the tar melted during the race! The temperatures may not jump out as being exceptionally high for those in the hotter parts of the world right now, but given that most of the athletes were not adapted to the heat, it was a tough day in the marathon. The conditions were so severe that out of 16 starters, only 6 finished the race.

Jim Peters was not one of them. After entering the stadium, with only 385 yards to run, Peters fell SIX TIMES within the first 200 yards. He took 11 minutes to cover that distance (making Fukushi look like a greyhound in her race!), before eventually collapsing for the final time – 200 yards SHORT of the finish line! He was taken to hospital, where he spent 7 hours being treated intensively before being released.

Incidentally, the athlete who was in second position with about two miles to run, Stan Cox, had also collapsed and ended up in hospital. At the 25 mile mark, he was so disoriented that he ran into a lamp-post, collapsing again. Eventually, police helped him to an ambulance, and he was taken to the hospital, where he’d later be joined by Peters.

And then finally, the eventual winner was a Scot, Joe McGee, who had actually collapsed five times on the course as well! But he heard that the two men who had been in front of him failed to finish, he picked himself up and went on to win! An attritional race if ever there was one!

The IronMan duel – Sian Welch and Wendy Ingram

And finally, for perhaps the most dramatic video we know of, we go to the IronMan Hawaii Triathlon of 1997, where Sian Welch and Wendy Ingram “race” over the final few hundred meters for fourth and fifth place.

This video, shown below, is difficult to watch, for the sheer agony that I’m sure most of you can relate to in some manner. It’s absolutely remarkable because it shows two elite athletes, both struggling with a combination of fatigue, muscle cramp and in the case of Welch in particular, hypoglycaemia. It’s quite clear that she’s in a disoriented state, and struggles to balance, find direction and stay co-ordinated.

Wendy Ingram, for her part, is cramping quite severely, and modifies her running style drastically in the final straight before the finish line.

What is most amazing, from a physiological point of view, is that the women move through different stages of what I would call “muscle activation patterns”. It’s as though there is a Plan A, which is to run absolutely normally, finishing strong (like some of the men who are finishing at around the same time as these two, you’ll see them in the background).

But given the difficulties both are experiencing, the brain quickly switches over the Plan B, which is this “modified running technique” – anything to keep going forward. Ingram’s “spider walk” is amazing, she’s clearly putting everything she has into what looks an incredibly uncomfortable running style!

Welch is unable to do even this – her muscles have simply been “switched off” and she has nothing left, mostly as a result of the low energy she has available and her fatigue – tired muscles with little fuel, and the brain says “No chance you’re running any more!” She’s unbalanced, uncoordinated and out of control. Eventually she staggers and walks to within meters of the finish line – she is on Plan C. But then she falls, taking Ingram down as well. And you’ll see in the video, the eventual winner between the two of them is the one who first realises the need for Plan D – Crawl!

So it’s an astonishing video, and you’ll hear reference to Julie Moss, a link you’ll find in the comments section of our Fukushi post from last week.

But this finish, and these two women, must surely go down as one of the bravest and most courageous, dramatic finishers in history!

Can you ever overcome the body’s limit through sheer willpower?

One question that is often asked when this whole area of “limits to performance” is discussed is this whole issue of “mind over matter”. What we are saying is that brain decides when “enough is enough”, and reduces the activation of muscle fibers BEFORE you even get near the dangerous levels of body temperature or fuel depletion, for example.

The logical question, however, is “Can an athlete, through sheer willpower, find that little bit extra, over-ride the brain’s protective reduction in muscle activation, and allow the athlete to go that little bit faster?” Professor Tim Noakes, who is one of the primary drivers of the theory of the brain protecting the body, often talks about the psychology and willpower aspects. And while they are relevant, I feel it’s not quite correct – it’s not simply a case that the guy who wants it most will win, which is unfortunately the spin that is often put on it.

So the answer is complex. Certainly, willpower and psychology play a role, and different people will tolerate different levels of discomfort. But I think that what these videos and stories show is that eventually, physiology wins the day. Peters, Welch, Andersen-Scheiss, and Ingram are all examples of athletes who have dug deep, found EVERYTHING their physiology has to offer, and quite literally run to the “edge of the limit”, but eventually, their physiology shuts down so completely that they simply could not run anymore. And yes, they survived. So in that sense, the brain did its job of protecting them, because all made recoveries, none “exercised themselves to death” (this happens, but it requires some special circumstances, we’ll discuss that in a future post).

So, to use a morbid analogy – no matter how badly you want to go, you cannot commit suicide by holding your breath – physiology wins. And similarly, during exercise, your willpower can take you that little bit closer to the limit. In fact, training takes you nearer that limit, since you learn what is tolerable and what is not. Motivation is of course important here too – given the right motivation, you might be prepared to tolerate a lot more than usual! But as you approach that “limit”, your body begins to progressively throw barrier after barrier in front of you. It becomes more and more difficult to hold the pace. Your brain is not activating muscle at the same level, and your perception of effort rises and rises. And eventually, physiology wins the day, and you stop, either voluntarily or because your legs fail to hold you up any more. This is human performance at the very extremes, but it’s still physiology!

Join us for exercise in the cold next post!

Ross

Exercise in the Cold: Part II

A physiological trip through cold water exposure

While we are all still thinking about the incredible video of Kayoko Fukushi's marathon finish, we thought we would carry on with our series on exercise in the cold. Most of us are still firmly in the depths of the northern-hemisphere winter, and so we hope you found Part I of this series relevant---it was meant to introduce some basics of heat loss and temperature regulation, and also look at some of extreme stories such as the runner who "won" an ultra-marathon by being the only one to complete the race in below-freezing temps. The price of victory? Losing two toes!

Water vs. air exposure

In tackling this series on exercise in the cold, we differentiate between cold AIR and cold WATER exposure - the key difference is that the heat LOSSES in water are so much greater than on land, that you're far less likely to develop any kind of hypothermia (low body temperature) on land. In fact, water conducts heat about 25 times better than air. So when water moves across your skin you will lose heat more quickly compared to air simply because of its physical properties.

As as we said in Part I, the key to managing exercise on land is simply through appropriate clothing. But the introduction of some water to the mix ('Just add water') makes the situation far more complex and challenging and that's what we'll tackle today!

Too much heat to cool down - why hypothermia is the least of your worries

Perhaps the first, and maybe the most surprising fact about cold water physiology, is that your body has too much heat to become hypothermic within about 30 minutes, no matter how cold the water is! In other words, it is not possible to get so cold that you're in danger unless you are in the water for more than about 30 minutes. The graph below shows this:


So from this graph, you can see that even at water temperatures of 0 degrees celsius, 30 minutes falls within the marginal zone, not the lethal zone. Many would probably survive for close to an hour - this is demonstrated by shipwreck victims, who have survived freezing water for this long.

The implication of this is that if someone is immersed in cold water, and dies, the cause of death is unlikely to be hypothermia unless that person has been exposed for a long time! Hypothermia is often wrongly blamed for death in people exposed to cold water - getting too cold is actually the least of your worries! We'll take a look at the main challenges a little later, but first, a key discussion about body composition and its effect on your ability in the cold.

Lessons from English Channel swimming

Perhaps the best forum in which to examine the physiology of cold-water swimming and immersion is English Channel swimming. The great British Exercise Physiologist Lawrence Griffiths Pugh performed a series studies in this area on the channel swimmer Jason Zirganos. Zirganos died from exposure to cold water while attempting to cross the Irish Channel, but his legacy was to leave behind a solid understanding of cold-water physiology.

The importance of body fat - 'fatter = warmer'!

The first important point about cold-water exposure is that body composition has a profound effect on core temperature during immersion. Pugh demonstrated this when he compared himself---the scrawny scientist type---to Zirganos, the chubby cold-water swimmer type. When just sitting in 16 C water the rectal temperature of both men fell, but after approximately 80 min Zirganos was sitting a full one degree higher than Pugh. The more dramatic difference was when swimming in the same water, though. Zirganos was able to maintain his temperature at around 38 C for nearly two hours while Pugh's temperature began to plummet after just 30 min until he exited the water after about 70 min, when his temperature was less than 34 C.

This early research from the 1950's pioneered this area of physiology, and today we have a substantial body of evidence that demonstrates both the effects of cold-water immersion and how we adapt to this stress.

The cold-shock response - the biggest challenge to survival in the cold

One of the first things you experience when submerging yourself in cold water is something called the "cold-shock response." This is characterized by an uncontrollable gasp for air, followed by a prolonged period of hyperventilation - more rapid breathing. In fact, this response is one of the most likely causes of death in most cold-water immersions such as when one falls out of a boat into icy water. It's not difficult to see that if the timing of that "gasp" is slightly wrong, you'll take in a huge lungful of air, and one or two gasps while underwater is all it takes to drown.

The other big 'killer' is a heart attack, which can result when the temperature of the blood returning to the heart is suddenly cooled - this can affect the electrical conduction within the heart, causing fibrillation. So it is these two possibilities - drowning and cardiac arrest that are most likely the cause of death. However, as we said, most times, people blame hypothermia for death, when in fact the body temperature does not need to fall for an unlucky 'swimmer' to perish in the cold.

Swimming in the cold - a problem of breathing and muscle weakness

Once you've overcome that problem, however, the next thing to worry about is swimming. And again, the hyperventilation that happens in the cold has a profound effect on the ability to swim in an efficient manner. The graph below, from a paper published by Eglin and Tipton in 2005 (EJAP) shows the breathing response of a swimmer exposed to cold water. It shows the BREATHING RATE in breaths per minute against time in a person who stands in a cold shower at 10 C.


So the rate of breathing goes up from about 16 breaths per minute to 75 breaths per minute, within the first 20 seconds. It then stays up at 40 breaths per minute for the next few minutes. It is not difficult to see how that would affect your ability to swim, because your stroke rate would have to change substantially to allow you just to breathe!

Next problem - the "DiCaprio" problem - a cold muscle, and cold skin, equal a weak muscle

The next problem is equally significant - when the muscle and the skin are cooled, the muscle becomes weaker! So the cold water on the skin will make a powerful swimmer incapable of swimming, simply because his skin is cooled. There is evidence from studies that shows that the ability of the muscle to produce force is as much as 25% lower immediately after exposure to water at 10 degrees celsius - this would only drop in even colder water. Then we add to that the fact that as you get cold, your body's natural response is to shiver. But when you shiver, your co-ordination is affected, making it even more difficult to swim!

This obviously has profound implications on ability to swim. And for all those who watched in despair as the character played by Leonardo DiCaprio could not swim to safety in the movie Titanic, you now have a physiological explanation - he simply could not swim, because his skin and muscles were too cold to contract normally! (Far be it for us to suggest that Hollywood portrayed that accurately!). The principle remains, however - a good swimmer in warm water will be an average swimmer in the cold. And a weak swimmer in the warm...well, that's a recipe for trouble.

The good news - adapting the cold shock response

So that is the bad news. . .but the good news is that humans are adaptable organisms, and just like we make adaptations to things like marathon training, we also make adaptations to stressors such as cold-water immersion. The data show that exposures to cold water as short as three minutes in a 10 C shower will attenuate the cold-shock response by as much as 20-30%. In the graph below, you can see the same data we showed above (Eglin and Tipton, 2005, EJAP), but this time, we've added in a comparison with the breathing rate AFTER six 3-minute long exposures to the cold water.

So you can see that only six exposures is enough to reduce the cold shock response by 20%. If you have even longer exposures, you can bring it down by 50%. That is obviously a significant reduction, and the implication is that swimming will be far easier if you are simply adapted to the cold.

The second important adaptation has to do with blood flow and heat loss. When at rest your muscle tissue actually acts as in insulator. This changes when you exercise because now you are pumping lots of blood to the working muscles, and it is the blood that transports heat around the body. Therefore when you start to swim in cold water you send more blood to the muscles, and all this does is increase your heat losses as now the blood----and the heat it contains----it close to the surface of the body and the cold-water. Since water conducts heat very well, the heat from your body readily moves to the water. . .and the consequence of this is a decrease in core temperature even though you are producing some heat with your muscle contractions.

Decreases in sh-sh-sh-shivering

Another big change that occurs with repeated cold-water exposures is that we lower our "shivering threshold," or the temperature at which we begin to shiver. The bonus of with shivering is that we produce heat as our muscles are contracting, although involuntarily. The bad news is that when trying to perform a complex movement such as swimming (or any dynamic activity), shivering can really foul things up. So we adapt by lowering the temperature at which we begin to shiver, and the result is that you can swim for longer before being hampered by shaking limbs and uncontrolled movements.

Evidence for non-shivering thermogenesis?

Finally, there is evidence that humans actually increase their core temperature either acutely or chronically in response to repeated cold-water exposures. The net effect of this response is that they can then remain in a cold environment for much longer before suffering any detrimental effects of the exposure, such as decreased nerve conduction velocity and then shivering (and a loss of coordination as a result of that shivering). Simply put, they have more heat in their bodies, and together with the other adaptations we mentioned above it means they reach a critically low temperature much later than someone who is not adapted to the cold.

So the take-home message here is that cold-water exposure is just like any other "stressor" or training stimulus. Our physiological response to these stimuli is to make adaptations that allow us to cope better with the , which in this case is cold-water immersion.

That wraps up Part II of this series, but stay tuned for Part III, when we will examine how the cold actually affects exercise performance!

Amazing marathon video

Kayoko Fukushi's debut - an amazing video of what happens when the marathon goes wrong

In our most recent post, we looked at some really interesting stories from the indoor athletics and tennis worlds.

But here's one that I felt should be added to this, and it includes a video which I found through the Let's Run website (great source of news).

The story, and the video, come from the Osaka Marathon over the past weekend. The full story of the race can be read here.

But the real story, from our point of view, anyway, was that of a Japanese runner, Kayoko Fukushi, making her debut in the marathon event.

Fukushi is Japan's national record holder over 3000m, 5000m and the half-marathon. Considering how many brilliant female athletes Japan has produced in the marathon, when one of their runners with such speed over the shorter distances steps up to the marathon, it is bound to cause a stir.

And so, at the Osaka Marathon, Fukushi lined up for her first marathon knowing that no Japanese woman had ever run faster than her over the half-marathon - a great source of confidence, no doubt.

But too fast too soon, and the price is paid

Perhaps a little too much confidence, in hindsight, because Fukushi set out at a pace of sub-2:20, leaving the entire field behind from the very first kilometer! According to reports, she ran about 3:20/km for the first 25km - just about on pace for 2:20. But by 32km, she had slowed substantially, run 3:42 for that kilometer. The rest of the field caught and passed her at about the 35km mark - she lost a lead of about 4 minutes within about 5 km! So the wheels had really come off.

Just how much did they come off? Well, take a look at this video (available also on YouTube), and you'll see her final kilometer, complete with frantic and excitable Japanese commentary, and a very enthusiastic crowd - it's quite an entertaining package and a courageous run, which we describe a little more below. The video is just under four minutes long.

Fukushi enters the stadium, falls flat on her face, stands up and soldiers bravely on. I timed her final 300m at 2 minutes and 21 seconds - a pace of 7:50/km! That includes two falls in the final 200m.

For more insight into this pacing strategy, the graph below shows the pace per 5km interval during her race. The blue line represents her pace (in min/km), and the maroon blocks are added to give an indication of the pace - they project a 10km time based on each 5km interval.


What is interesting as an observation is that she's not showing any mental symptoms like confusion (though she is smiling, which some would possibly say is a mental sign considering her physical state!). One of the main symptoms of hypoglycemia (running out of glycogen and hence your blood sugar levels fall) is deliriousness and confusion. Fukushi is running in a straight line (albeit slowly), at least. It's quite apparent that her physiology has basically shut down - she could not pick up the pace even if she wanted to. It would be really interesting to speculate just what percentage of her total muscle she's actually using. Is she using ALL the muscle? It hardly seems like. Rather, it looks as though something has put a brake on her running speed. This "central fatigue", characterised by poor co-ordination (she falls over repeatedly) and often, confusion (not apparent here) was recognised by scientists as a key indication that the fatigue was NOT simply in the muscles, but also in the brain.

It's also an illustration of just how badly things can go wrong if the early pace is too ambitious. Having reached half-way in 1:10.32, Fukushi covered the second half in 1:30.32! That's still a pretty respectable half-marathon time for many people, no doubt! It's all relative of course...

But then Fukushi's final 7.2km took her 40:25 (pace of 5:37/km), and her final 2.2 km was run at an average of 7:06/km, and includes that section from the video above! A courageous run by Fukushi, no doubt. One really interesting thing to debate is whether this is an "intelligent" act to continue. Just how much do the final 10km take out of her? Is there a chance that this effort will affect her future marathon running performances? Of course, it's just as easy to argue that she'll be stronger for it, and back for that 2:20 some day! Again, time will tell...

The moral of the story - patience, aim rather run a negative split, especially in your first marathon, and remember, you might pay heavily for a fast early pace!

Cheers
Ross