A 24-year-old Pennsylvania woman who had spent months preparing for her first New York City Marathon collapsed just over two miles from the finish line and later died. Her family says doctors identified a rare and potentially life-threatening condition called rhabdomyolysis as the cause.

Rachel Apa, a former college field hockey player and lifelong athlete, was running the November 1 race to raise money for the Parkinson’s Foundation in honor of her grandfather. What began as a personal challenge and tribute ended in a medical emergency that has left her family, friends and the running community devastated.

Her father, Steve Apa, described his daughter as healthy, active and full of energy. He said the family had been told that she suffered from rhabdomyolysis, a condition in which damaged muscle cells release substances into the bloodstream that can cause serious complications.

However, New York City’s Office of the Chief Medical Examiner said it was investigating her death and had not yet issued a final determination on the cause.

COLLAPSED JUST TWO MILES FROM THE FINISH LINE
Rachel was approaching mile 24 of the 26.2-mile New York City Marathon when she experienced a medical emergency in Central Park on Sunday afternoon.

According to the New York Police Department, officers observed the 24-year-old experiencing a medical episode near the mile marker at approximately 1:40 p.m. Emergency medical personnel transported her to Mount Sinai Hospital in critical condition.

Race organizer New York Road Runners said a bystander began performing CPR before event medical personnel took over. Medical staff continued resuscitation efforts and used a defibrillator before paramedics transported Rachel to the hospital.

Despite the efforts to save her, she died later that evening.

Her father told reporters that doctors worked for several hours in an attempt to save her. The family was ultimately informed that she had not survived.

Rachel’s mother, Michelle, had been following the race in person alongside two of her daughter’s friends. Her father remained at home in Lewisberry, Pennsylvania, monitoring her progress through the marathon tracking application and exchanging text messages with her.

When Rachel’s location stopped moving near mile 24, the family realized something was wrong.

Her mother rushed toward the area where Rachel had last been seen. An emergency worker told her that her daughter had already been taken to the hospital.

HER FINAL MESSAGES TO HER FATHER
In the hours before the emergency, Rachel had been communicating with her father as she made her way through the race.

At approximately mile nine, she sent him an encouraging message and told him she felt amazing. She also wrote that she had never felt so good, according to her father’s account.

Steve reminded her not to push too hard, emphasizing that this was her first marathon and that finishing safely mattered more than speed.

As the race continued, however, her messages began to change.

Around mile 18, she sent a brief message expressing discomfort. Later, she sent messages saying, “Ow, ow,” as she continued running.

Her father encouraged her to slow down and take it easy. By mile 23, he sent another reminder that reaching the finish line mattered more than maintaining her pace.

He continued trying to contact her around mile 24, but she stopped responding.

Her location on the tracking application also stopped advancing.

For the family, those final messages have become a painful reminder of how quickly an ordinary race day turned into an unimaginable tragedy.

WHAT IS RHABDOMYOLYSIS?
Rhabdomyolysis, often called rhabdo, is a serious medical condition that occurs when muscle tissue breaks down and releases its contents into the bloodstream.

Damaged muscle cells can release myoglobin, a protein that can harm the kidneys, as well as potassium and other substances that can disrupt the body’s normal chemical balance.

In severe cases, complications may include acute kidney injury, dangerous heart rhythm abnormalities and other life-threatening problems.

The condition can develop following extreme physical exertion, particularly when someone pushes their body beyond its ability to recover. Heat exposure, dehydration, illness and certain medications or substances can also increase the risk.

Importantly, rhabdomyolysis is not limited to people who are physically unfit. Athletes and people who exercise regularly can also develop the condition.

According to medical information cited by CBS News, approximately 26,000 cases are diagnosed in the United States each year.

WARNING SIGNS THAT CAN BE EASY TO OVERLOOK
Symptoms of rhabdomyolysis can vary, and they may initially resemble ordinary soreness or exhaustion after strenuous exercise.

Common warning signs include:

Severe or unusual muscle pain.
Muscle weakness or swelling.
Dark-colored urine that may resemble tea or cola.
Unusual fatigue or difficulty completing physical activity.
Nausea or feeling generally unwell.
Symptoms can develop over hours or several days after muscle damage occurs.

Medical professionals emphasize that suspected rhabdomyolysis requires urgent evaluation. Blood tests, including measurements of creatine kinase, can help identify muscle damage. Treatment often involves intravenous fluids, monitoring kidney function and managing electrolyte imbalances.

Severe cases may require intensive hospital treatment, and some patients with serious kidney complications may need dialysis.

The condition can be life-threatening, but early recognition and treatment can make a significant difference.

A LIFETIME OF SPORTS AND ACHIEVEMENT
Rachel was not new to athletics.

She played field hockey for nine years with Central Penn Field Hockey Club before continuing her career at Bucknell University in Pennsylvania.

During her four years with the university’s Division I field hockey program, she scored 17 goals and earned Academic All-Patriot League honors.

She graduated in 2024 with a degree in markets, innovation and design.

Her former teammates remembered her as competitive, committed and someone who gave her full effort while maintaining a smile.

After college, Rachel continued to stay active while building her professional career. She worked as a product manager for TE Connectivity and had recently moved to Charleston, South Carolina, to pursue a master’s degree in business administration.

Her father described her as someone who was constantly moving, whether she was focused on work, school or sports.

SHE RAN TO HONOR HER GRANDFATHER
Rachel’s participation in the New York City Marathon was about more than completing a major athletic challenge.

She joined the Parkinson’s Champions fundraising team to raise money for the Parkinson’s Foundation in memory of her grandfather, who died in 2022 after living with the disease.

In her fundraising message, Rachel explained that her grandfather had been one of her role models growing up. He encouraged her to stay active, push her limits and embrace challenges.

Watching Parkinson’s gradually affect his ability to move had left a lasting impression on her.

She wanted her marathon effort to help support people and families affected by the condition.

Rachel had set a fundraising goal of $4,000. Following news of her death, donations surged past that target, eventually exceeding $20,000.

The response reflected the impact of her effort and the number of people who wanted to honor the cause she had chosen.

FAMILY AND RUNNING COMMUNITY MOURN HER LOSS
Bucknell University released a statement expressing condolences to Rachel’s family and friends, remembering her as an important member of its field hockey program.

Her former club also paid tribute to her commitment, competitive spirit and the joy she brought to the sport.

TE Connectivity and the broader athletic community expressed sympathy following the news.

One spectator who witnessed Rachel collapse also described trying to comfort her while others performed CPR. Michaela Nicholas, a hospital social worker, said she held Rachel’s hand and spoke to her, telling her that she was not alone and that she was loved.

It was a small act of compassion during an extremely distressing moment.

QUESTIONS REMAIN ABOUT THE MEDICAL EMERGENCY
Rachel’s death has drawn attention to the risks associated with extreme physical exertion, including a condition that many people may not recognize.

Her father said she had been in excellent health and had trained for months before attempting the marathon. Her experience is a reminder that physical fitness does not eliminate every medical risk associated with endurance events.

At the same time, officials have not publicly established the complete medical circumstances surrounding her collapse. The New York City medical examiner’s investigation remains important in determining the final cause of death.

For Rachel’s family, the loss is especially difficult because she was so close to completing the race she had worked toward for months.

She was running in honor of someone who had inspired her to embrace movement and physical challenges. Her fundraising effort has continued to grow even after her passing.

Rachel Apa was 24 years old. She never reached the finish line, but the cause she ran for and the memories she left behind have reached far beyond the marathon course.