Common Marathon-Related Injuries and Expert Tips to Prevent the Pain

Training for a marathon is no walk in the park — pun intended. That's because prepping your body to run or walk 26.2 miles requires dedication, skill, serious willpower, and months of focused training.

While crossing the finish line and fulfilling a personal goal makes it all worth it, the rigorous nature of the race does open up the potential of running-related injuries.

Here, we spoke with sports medicine and physical therapy professionals about a few of the most common issues, plus tips on what you can do to prevent any injuries from ruining your run.

Runner's Knee

Dr. Leda Ghannad, MD, assistant professor of orthopedic surgery and physical medicine and rehabilitation at Rush University Medical Center, says this issue is properly known as patellofemoral pain syndrome. It consists of front knee pain from the kneecap not tracking properly and "can be caused by a combination of factors, including improper running shoes, lack of proper cross training, or running mechanics."

Runner's knee is associated with another injury called iliotibial band friction syndrome, which Dr. Ghannad says is a tight ligament on the outside of the knee that causes lateral (or outside) knee pain.

To help prevent runner's knee issues, Dr. Dan Giordano, PT, DPT, CSCS of Bespoke Treatments in New York City, suggests working in strengthening exercises, as well as increasing your mobility by foam rolling, followed by dynamic stretching prior to your run.

Foam Rolling Calves, hamstrings, quads, and glutes for 15-30 seconds.

Dynamic Stretching
Dr. Giordano says five reps of the following exercises each side for each stretch will help increase range of motion.
Glute Table Tops
Quadricep Pulls
Hamstring Scoops

On your strengthening days, Dr. Giordano suggests three sets of 15-25 reps. Or, before your run and after your mobility workout, one set of each.
Lateral Stepping: Hinge at the hips and keep your stability leg as still as possible. You should feel this in your stable leg glute. If you feel it in your quad, you may be in too much of a squat instead of a hinge.
Single Leg Bend and Reach
Step Down

Stress Fractures

"A stress fracture is a hairline crack in the bone that is caused by submaximal, cyclical overuse, Dr. Brad Whitley, PT, DPT of Bespoke Treatments in Seattle, explains. At the worst, a stress fracture can actually turn into a complete fracture of the bone.

While Dr. Whitley says there's no way to 100 percent prevent stress fractures, you can reduce your chances by gradually building up your weekly mileage when training, adding no more than 10 percent of mileage from the previous week, and changing up the surfaces you run on. "Trail running makes the body accommodate to uneven surfaces and improves bone strength," he adds.

Another tip? Don't make running your only workout. "By doing other movements than just running, your musculoskeletal system must accommodate to the different directional stressors, thus making your bones stronger. Supplementing with other multidirectional sporting activities like soccer, basketball, or tennis are examples."

Calf and Hamstring Strains

"Muscle strains occur when the muscle exceeds its capacity to contract and tears," Dr. Whitley says.
To prevent strains, Dr. Whitley urges runners to do a general warmup that increases the core body temperature, "as well as some submaximal strengthening exercises for the muscles in question," like calf raises or hamstring bridges.

"During the race, making sure that you're staying in tune with your body as needed. If you're feeling abnormal muscle guarding or twinging, slowing your pace or altering your stride frequency are good strategies to combat strains during the race," he adds.

Injury Prevention Tips to Keep in Mind

In addition to properly stretching and training, there's a few other pro tips to take into consideration.

  • Replace your sneakers regularly — Dr. Ghannad recommends approximately every 200-500 miles. This ensures that your shoes maintain shape and offer your foot the proper support.However, you should never wear brand new shoes to a race either, as you should be comfortable in how your shoe performs.
  • Don't discount your easy workout days. "Run your hard days hard and take your easy days easy," Dr. Whitley says. "The human body is incredibly resilient and can adapt to training stressors daily and weekly. Using slower running days as strict recovery training can improve performance in the long run and reduce the chance of central fatigue, burnout, and injury."
  • Listen to your body and don't try to push through pain. "Pain is often your body's signal that something is not right and might need medical attention,"Dr. Ghannad says.