Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.
It's not simply endurance athletes though. It was 2x ultra-marathons >26 miles, or at least 5 marathons completed.
We're not really optimized for this sort of extreme endurance and long-term development of serious pathologies is unsuprising.