What Is Rhabdomyolysis? NYC Marathon Runner Rachel Apa, 24, Dies Just Two Miles From Finish Line

Rachel Apa, a 24-year-old runner from Lewisberry, Pennsylvania, died after collapsing just two miles from the finish line of the New York City Marathon on Sunday, 1 November 2026. Her father, Steve Apa, told The New York Times that she died from rhabdomyolysis, a potentially life-threatening condition involving muscle breakdown.

However, New York City's medical examiner said on 3 November that her official cause of death had not been determined. 'It's unfathomable,' her father said. 'Perfect health, perfect shape, 24 years old.'

Rachel Apa's Final Texts Before NYC Marathon Collapse

Apa, a former Bucknell University field hockey player, was running her first marathon. Her mother, Michelle, filmed her smiling at mile 14, while her father tracked her progress from Pennsylvania. During the run, Apa texted her father 'Ow' at mile 18. A mile later, she sent another message: 'Ow, Ow.'

When Steve saw she had reached mile 23, he texted that she was in the 'final stretch'. She never replied. Apa collapsed near mile 24 in Central Park at approximately 1.30 pm. A spectator began CPR before race medical personnel took over, according to New York Road Runners.

She was transported to Mount Sinai Medical Center, where doctors attempted to save her life for more than six hours. She was pronounced dead at 9.40 pm.

What Is Rhabdomyolysis and Why Can It Be Deadly?

According to WebMD, rhabdomyolysis, commonly called 'rhabdo', occurs when damaged muscle fibres break down and release their contents into the bloodstream. These substances can damage the kidneys, potentially causing kidney failure.

Severe cases may also trigger dangerous electrolyte imbalances, irregular heartbeats and cardiac arrest. Although potentially fatal, early treatment can significantly improve recovery.

What Causes Rhabdomyolysis in Marathon Runners?

WebMD identifies extreme physical exertion as a possible trigger, particularly during prolonged or unusually intense exercise. Marathon runners and other endurance athletes may be at risk, especially when dehydration or high temperatures increase physical strain.

Other causes include crush injuries, certain medications, infections and heatstroke. However, investigators have not confirmed whether rhabdomyolysis caused Apa's death.

Apa was running with the Parkinson's Foundation Champions team in honour of her grandfather, who died in 2022. 'My grandfather was my role model growing up,' she wrote, crediting him with inspiring her love of sports and movement.

Her death highlights the importance of recognising potentially serious exercise-related symptoms while authorities continue investigating its cause.