Former Division I Athlete Dies of Rare Muscle Condition After NYC Marathon Collapse

Rachel Apa died on Sunday afternoon after collapsing near the 24th mile of the New York City Marathon. The 24-year-old former Division I field hockey player was transported to Mount Sinai Hospital in critical condition and passed away hours later. Doctors attributed her death to rhabdomyolysis, a rare condition involving severe muscle breakdown.

Steve Apa, Rachel’s father, monitored her progress from Lewisberry, Pennsylvania, using a tracking app while she ran her first marathon. Her mother, Michelle Apa, and two friends traveled to New York to support her in person. The family had planned the run as a learning experience, with Rachel expressing excitement during a pre-race phone call.

Text messages exchanged between father and daughter during the race documented a gradual decline in Rachel’s condition. At the 9-mile mark, around 11:30 a.m., she texted "Hey, go," a reference to her father’s football career at Lehigh University. She reported feeling amazing, crediting pre-race carbohydrate intake. Steve advised caution, reminding her to treat the race as a learning run.

As the distance increased, Rachel’s updates became shorter and more distressed. After passing the 14th mile, she sent a single word, "Ugh." By the 20th mile, she texted "Ow, ow" twice. Steve checked in at miles 21, 22, and 23, instructing her to focus on finishing rather than maintaining speed. His last message was sent near 1:30 p.m. as she approached the 24th mile.

The tracking app showed Rachel’s location stopping abruptly. Michelle Apa and two friends waiting near the 25th mile also observed the halt. Michelle called Steve, who instructed her to find their daughter. When Michelle reached the 24th mile marker, an EMS worker informed her that an ambulance had taken Rachel to the hospital. The worker then transported Michelle to Mount Sinai in a second ambulance.

New York Road Runners, the event organizer, stated that a bystander performed CPR before medical staff arrived. Paramedics then used a defibrillator on the runner. The Cleveland Clinic defines rhabdomyolysis as muscle breakdown caused by overexertion, which allows toxic components from muscle fibers to enter the bloodstream and kidneys. Doctors described the condition as extremely rare.

Rachel was a lifelong athlete who played field hockey at Bucknell University and maintained an active routine after graduation. She had recently moved to Charleston, South Carolina, to pursue an MBA while working remotely. She ran the marathon with the Parkinson’s Foundation to honor her grandfather, who died from the disease. In a LinkedIn post, she described him as a role model who encouraged her to push her limits.

The Apa family has returned to Pennsylvania. Rachel’s two brothers are processing the loss. Steve Apa confirmed the details of the incident and the medical findings to NBC News.