Marathon training injuries: When to Pause and When to Stop

Training for and running a marathon can put a great deal of strain on your body. It’s a rare soul who can do either without picking up at least one injury. But running is so beneficial for mind and body that it would be a shame to avoid it just because you might hurt yourself. Instead, try and safeguard yourself as much as possible from injury and know when to stop and recover.

Let’s look at some of the most common running injuries, the warning signs and the indicators of when to stop training and when to seek help. Almost half of all those who train for a marathon will suffer from an associated injury so you’re not alone!


Most of us will have had a blister, whether from running or not. They can be so painful as your sock and shoe constantly rub against the raw skin, and wet feet can exacerbate the problem.

Run or stop: run.

Treatment: use a sterile pin to pierce the blister and drain the fluid. When you need to wear socks or shoes, cover the blister with gauze and then a plaster, or use one of the gel-filled plasters which act like a second skin. Be careful not to stick a plaster directly onto the blister as you will hurt it more trying to peel the plaster off later. If you are prone to blisters while running, take some plasters of choice with you.

Prevent: well fitting socks and shoes won’t rub or cause aggravation. If your feet get hot, apply powder first and try socks with good wicking properties.

Runner’s Knee

There are lots of different knee injuries with all kinds of causes. Runner’s knee is a complaint where the knee cap shifts during running, irritating the cartilage beneath. It’s often caused by weak quads or taking strides that are too long.

Run or stop: depends on the degree of pain. Certainly don’t ignore it and always listen to your body.

Treatment: if you’re really not sure what type of knee pain you have, come and see us. We’d also recommend using a foam roller on your quads. Reducing mileage is a good idea as is cross-training, or opting for a non-weight-bearing exercise, such as swimming. Ice can help too.

Prevent: make sure your shoes fit well and are the correct type for your gait. Have your gait analysed if you’re not sure – we can do this. Strengthening exercises are always a good idea. Check your stride length too to make sure you’re not taking overly long steps – 170 – 180 per minute is the ideal.

Shin splints

This covers pain experienced anywhere along the front or sides of your shin. It is injury to the muscle, tendon or bone tissue of the shin and you’ll know if you have shin splints – it hurts a lot when you’re running and sometimes when you’re not. It’s one of the most unpleasant running injuries and one which can lead to more serious pain.

Run or stop: at first, you may find the pain eases during exercise. However, don’t try and run through the pain as it will make the injury worse. So, stop.

Treatment: rest and ice. Try cross training, such as deep water running and swimming. Then return to running gradually, but only once pain free. It can be frustrating but it’s worth waiting!

Prevent: shin splints are sometimes caused by piling on too much mileage too quickly so avoid doing that. A good rule of thumb is to add no more than 10% each week. A tried and tested training plan will help you plan your mileage.

Achilles tendonitis

Your Achilles is a tendon that comes under an enormous amount of pressure. It connects your calf muscle with your heel and is in use every time you walk, run, jump or rise onto the balls of your feet. Intense, repetitive activity can cause it to inflame, which is Achilles tendonitis.

Run or stop: run, but at a reduced volume. Your Achilles needs to strengthen which it won’t do if resting.

Treatment: gentle running if manageable. Calf stretches work too. If the pain continues to get worse, come and see one of our Osteopaths so you don’t tear the tendon.

Prevent: Work on building strong calf muscles and warming up before running – don’t start running if your legs haven’t warmed up properly. Adding on too much mileage too quickly can cause Achilles tendonitis too, so only increase gradually.

Hamstring strain and pain

Your hamstrings are a collection of three muscles that run from the base of your glute, down behind the knee to the top of your calf.  They are used whenever the knee is bent and are often tight in runners. There is a huge difference between a strain and a pain: a strain is severe, sometimes preceded by a ‘pop’, and will make you stop in your tracks; a pain is more of a hurt or ache.

Run or stop: strain = stop, pain = run

Treatment: RICE (Rest, Ice, Compression, Elevation) treatment for a strain, with stretching exercises when the pain recedes. Then take a very gradual return to running. Hamstring pain can be treated with stretches but don’t ignore the pain so much that it becomes a strain.

Prevent: a quality warm up with dynamic stretches. Include focused hamstring stretches too as part of your conditioning regime.

Plantar fasciitis

A common foot complaint amongst runners! The plantar fasciitis, which runs along the bottom of your foot, becomes inflamed and can be painful to walk on, especially after a night’s rest. You may be more susceptible to this injury if you have high arches or flat feet so worth getting them checked if you‘re not sure.

Run or stop: Stop. There is some discussion as to continuing to run at a moderate pace, or walk/run until it starts hurting, but it depends on the severity of pain you’re in.

Treatment: stretch your foot frequently and try rolling it over a frozen bottle of water a few times a day.

Prevent: wear the right shoes for your feet, do lots of strength and conditioning exercises for your calves, Achilles and feet.

There are other complaints and injuries you may suffer along the way – or perhaps you are so careful with your strength and conditioning exercises that you sail through, injury-free! Whatever happens, listen to your body and don’t be afraid to put your training on hold for a little while.

For the sake of a couple of weeks you could be safeguarding yourself against months out of running action! And if you‘re ever in doubt about pain or injury, come and see one of our Osteopaths and we’ll be able to advise what you should do next – whether finding out what’s causing the pain, giving you strengthening exercises,  or helping you with another aspect of your injury and training. 

You can book an initial appointment online here

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