Rachel Apa, a 24-year-old former collegiate athlete from Lewisberry, Pennsylvania, died after collapsing near mile 24 of the New York City Marathon on Sunday, Nov. 1. Her father, Steve Apa, said doctors informed the family she died from rhabdomyolysis, a rare condition in which muscle tissue breaks down from extreme exertion, while the New York City medical examiner’s office conducts its official investigation.
Race organizers and officials told CBS New York that Apa collapsed around 1:30 p.m. near 85th Street in Central Park, roughly two miles from the finish line of her first marathon. She was running in bib number 29977 to raise money for Parkinson’s disease in memory of her grandfather, who died of the condition in 2022.
Her mother, Michelle Apa, filmed her smiling and high-fiving along the course at mile 14. According to her family’s account to The New York Times, Apa texted her father “Ow” at mile 18 and “Ow ow” at mile 19 before collapsing shortly after passing mile 23.
Spectator Michaela Nicholas, a hospital social worker, found that Apa had no pulse. Bystanders, including two people in the crowd who said they were doctors, performed CPR before New York Road Runners medical staff used a defibrillator and paramedics took her by ambulance to Mount Sinai Medical Center. Doctors worked for about six hours to save her before she was pronounced dead at 9:40 p.m.
What doctors say about rhabdomyolysis in marathon runners
When skeletal muscle breaks down rapidly during extreme physical exertion, it releases harmful substances into the bloodstream that can overwhelm the kidneys and lead to acute kidney failure, cardiac arrest and organ failure. Steve Apa told The New York Times that doctors at Mount Sinai attributed his daughter’s death to the condition, adding that her loss felt unfathomable because she was 24 years old and in top physical health and shape.
Dr. Mohamed Somad, a nephrologist at WellSpan Health, told WGAL that while regular exercise can cause minor muscle soreness or injury, severe cases in healthy athletes are uncommon.
“It’s not rare to have some muscle injury, but it is rare to have the extent of muscle damage that can lead to organ failure and death, especially in an otherwise healthy person.”
Somad noted that muscle breakdown severe enough to trigger kidney failure, organ failure or death is “extremely rare.” Endurance runners and athletes preparing for long-distance races should talk to a doctor before changing their training regimen or treatment plan, and seek immediate medical care if severe muscle pain, weakness or dark urine develops during or after intense exercise.
Tributes for Rachel Apa and marathon background
Apa grew up in Lewisberry Borough and graduated from Red Land High School in 2020 before attending Bucknell University, where she played Division I field hockey and scored 17 goals during her collegiate career. She graduated magna cum laude from Bucknell in May 2024 with a Bachelor of Science in Business Administration, worked full-time as a product and project manager at TE Connectivity, and had recently started an MBA program at Charleston Southern University.
Bucknell University released a statement mourning its former student-athlete: “The Bucknell community mourns her loss and extends its heartfelt condolences to all who knew and loved her.” The West Shore School District also honored her in a statement, saying its community was deeply saddened by the passing of the 2020 Red Land High School graduate and noting that she made a lasting impact on the school and district through her accomplishments as a student-athlete and in the years after graduation.
As of Tuesday, Nov. 3, Apa’s fundraising page with the Parkinson’s Champions team had raised more than $8,000, doubling her original $4,000 goal, PhillyVoice reported. Sunday’s 26.2-mile race was the 55th New York City Marathon and set a world record as the largest marathon in history for the third consecutive year, with more than 61,000 finishers.
New York Road Runners expressed condolences to Apa’s family, friends and the running community, and noted that the previous runner death following a medical incident at the New York City Marathon occurred in 2024. The New York City medical examiner’s office is investigating to determine an official cause of death.