What are the typical marathon training injuries and how do I prevent them?

The first few months of the year signal the start of marathon training. Most UK marathons are scheduled for spring, so January to April see our streets increasingly populated with runners of all ages and ability.

For some it will be their first marathon training experience while others will be seasoned pros. If you fit into either of these categories, or somewhere in between, you need to be aware that injuries can happen to any runner regardless of their experience.

But what are the warning signs and can you prevent injury knocking you completely off course?

1. Runner’s Knee

Yes, it really is a recognised running injury. Officially called Patellofemoral Pain Syndrome, or PFPS, runner’s knee is a side effect of overuse of the knee and is the most common running ailment. It occurs as a result of your kneecap misaligning and irritating the groove of your thighbone on which it rests.

Why your kneecap is misaligned, however, isn’t that simple, and could be attributed to a number of reasons. It could be due to overuse, common amongst those who go from zero or little running to many miles of pounding the pavements.

It could be down to a glut imbalance glut imbalance. If this is the case core and glut strengthening is helpful as part of your rehab.

Or it could be down to the arches of your feet being too high or too flat, imbalanced quads, a knock or fall to the knee area or that the bones in your knee and thigh are actually out of alignment – which you probably wouldn’t have noticed until you started a repetitive weight bearing exercise.

Fear not, runner’s knee is treatable without surgery. But you do need to be sensible if pain strikes and not try to run through the pain. A common symptom to look out for is pain in or around your knee, particularly brought on when bending it, such as going up or down stairs. Your knee might be swollen too.

The first thing to do is to follow the R.I.C.E. procedure – rest, ice, compression and elevation. Anti-inflammatories, such as ibuprofen, will help reduce any swelling but shouldn’t be taken too often. Strapping can also help, using elastic bandage or special patella straps. Seek out some stretches to help strengthen the knee area and make sure you do them! Orthotics in your shoes may be necessary if your knee pain stems from over or under pronating feet, but seek medical advice first.

2. Achilles Tendonitis

Your Achilles is a small tendon in the back of the leg, connecting the heel with the calf, but it is one of the thickest and strongest tendons in your body. It has a lot of weight and pressure to manage, particularly when you run, as it provides the force you use to push off the ground. The faster you run, the more pressure it bears.

Achilles problems are signalled by a dull ache in the area which eases off as you run but is exacerbated by uphill running, fast running or wearing shoes with little heel. You can continue to train with Achilles pain but definitely don’t ignore it – it may get to the point where you can’t bear to run at all and then the recovery period is much lengthier.

Achilles tendonitis can be caused by tight or weak calf muscles, poor range of movement in the ankle or excessive pronation. It might be tempting, therefore, to stretch the calf muscles more to ease the tightness. However, due to the construction of your Achilles tendon, standard calf stretches can do more harm than good. Instead, try an eccentric heel drop, where you use a step to allow your heel to drop lower. It’s a fabulous stretch for both the Achilles and the calf and will stretch your calf without damaging your Achilles.

You can also try warming up the area before your run, applying ice after your run, gently foam rollering the area (check out some foam rolling techniques first) or using heel lifts in your running shoes – but only until the pain subsides. Improving the foot’s range of movement will also be beneficial as will ankle strengthening exercises.

3. Hamstring Strain and Pain

Many runners suffer from hamstring pain of one kind or another. Your hamstrings are a group of three muscles at the back of your leg that reach from your sit bones down to your knee. You use them constantly for walking and running to flex your knees and extend your hips. Because many of us sit for long periods of time, hamstrings tighten up and become stiff, which causes pain. And the repetitive action of running puts strain on the muscle group too.

Sore hamstrings are usually not severe enough to force a rest from running but, like all injuries, shouldn’t be ignored! They may feel less sore while running or moving around because of increased blood flow to the area. The best course of action is regular stretching, before and after running, but always avoid stretching cold muscles as this can aggravate the pain. Stretching while lying down is a much gentler option.

Tight hamstrings are generally linked to weak or tight hips or glutes, meaning the hamstrings have to work harder. Any imbalance like this will inevitably lead to pain! Definitely incorporate some glute stretches, hip flexor and hip opening exercises in to your regular routine – lunges and squats are both good examples.

4. Plantar Fasciitis

Difficult to pronounce, horrible to have. Plantar fasciitis is a debilitating injury for runners because it more or less does prevent you from running. It is pain in the bottom of the foot, either felt in the heel or along the sole and can be a dull ache or a sharp pain. It may be worse when you first get out of bed.

Taking a break from running will speed up the healing process and there are several other ways you can help. Strengthening your foot is key so try pulling a towel along the floor using your toes; ‘writing’ with your foot helps and moves your ankle around too.

Calf stretches are beneficial, as is keeping your trainers on –walking around barefoot is not recommended. There are some devices you can use, such as a strassburg sock at night (not pretty but practical), or orthotics in your shoes as well as ice applied to the area. Plantar fasciitis also responds well to rolling the sole of your foot over a myofascial ball.

Catch plantar fasciitis early and you should be back to running relatively quickly. Don’t over do it on your return, ease in very gently and only when you don’t experience any pain during your foot strike.

Of course, there are other injuries that be experienced but hopefully you won’t be one of the afflicted and can enjoy a pain free running career. Allowing each muscle group to be strong and balanced undoubtedly helps prevent injury and it is essential to listen to your body if anything starts to hurt. It can be very frustrating to stop or rein in your running, but preventative action is much better than having to stop all together.

If you feel you’re suffering with any of these injuries, or are experiencing any pain from running, give us a call on 020 8316 5316, or book online and make an appointment with one of our Osteopaths. We’ll find out what’s causing the pain, and we’ll work through a treatment plan together to help it get better, and get your training back on track.

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