Marathon running is impressive, whether you’re a seasoned runner or a first-timer. But like all sports, in particular running, there are risks of injury. Here at CBR Clinics we see plenty of training and race-related injuries, as 30% of those who start a marathon will finish with an injury. Understanding where they are, why they happen, and how to prevent them can make all the difference. In this article, let’s dive into the world of marathon runners injuries, and how to keep you on the road for your next race!
Injury Prevalence: Knee vs Ankle
It’s simple, your knees and ankles are the usual suspects. Among marathon runners (those racing up to 26.2 miles), the most frequent injuries happen around the knee. The top offenders? Patellofemoral pain syndrome and Iliotibial band syndrome. And for the ankle, Achilles tendinopathy.
However, things get interesting when we look at ultramarathoners (those brave souls taking on distances over 26.2 miles). For them, the ankle becomes the most injured site. The extended distances and the stress from running multiple days in a row tend to put extra strain on those lower limbs which often result in more tendinopathies and direct traumas such as inversion injuries.
The Risk Factors: Who’s More Likely?
Not everyone is equally likely to be injured. Here are some of the main risk factors:
- Previous Injuries: If you’ve been injured before, you’re more likely to get injured again.
- Training Factors: Runners with lower weekly mileage, shorter long runs, and fewer training days are at higher risk.
- Sudden Changes: Unprepared jumps in training intensity or volume can overload tendons leading to tendinopathies.
- Gender and Experience: Women have a slightly higher injury rate than men, and new runners are more at risk than seasoned marathoners.
Top 5 Injuries to Watch Out For
For non-ultramarathoners, the top injuries include:
- Achilles tendinopathy – Pain and inflammation of the Achilles tendon, often caused by overuse or sudden changes in repetition or load.
- Medial tibial stress syndrome (shin splints) – Inflammation to the periosteum or microdamage to the tibia bone.
- Patellofemoral pain syndrome – This is a broad term that can have several different causes; patella/quadraceps tendinopathies, fat pad inflammation, articular irritation (degeneration or arthritic changes).
- Plantar fasciitis – Pain in the bottom of the foot, often towards the heel, where the fascia is inflamed.
- Iliotibial band syndrome – Lateral knee pain, normally associated with tension and weakness in the TFL and gluteus muscles.
In the world of ultramarathons, injuries like anterior tibial stress syndrome (the anterior version of MTSS), patellofemoral pain syndrome, and Achilles tendinopathy rule.
How to Prevent Injuries
Thankfully, many injuries are preventable with the right approach:
- Solid Training Programme: Using a formal, structured plan is key. Gradual progression of your mileage, aiming for 23 miles per week for half-marathons and 40 miles per week for a full marathon. This should involve faster short runs, slower long runs and recovery runs.
- Take It Slow: Newbies, we’re talking to you! Don’t do too much, too soon. The slower the progression, the less risk you’ll have of injury.
- Strengthen and Stretch: To prevent injury, it is essential to balance your running with strengthening and mobility exercises, especially for the hips, knees and ankles.
- Learn To Recognise Pain: Listen to your body! If something doesn’t feel right, don’t hesitate to seek advice from a physio. It may also be a sign to spend more time on your recovery.
- Diversify: Use low-impact activities like swimming or cycling to assist recovery or continue to improve overall cardiovascular fitness without overloading with running.
Summary
Marathons, let alone ultra-marathons, are challenging, but they don’t have to leave you riddled with injuries. By following a well-planned training programme, listening to your body, and employing preventative exercises, you can cross the finish line without a trip to the physio or doctor.
But do not fret, if you do get injured while running, you can see why! You won’t be the first and you won’t be the last! Our physios at CBR clinics are here to help diagnose you with the use of special tests and biomechanic assessments (including running assessments) and treat you so you can get back to the miles tarmac ahead.
Sources
- Kakouris, N., Yener, N., & Fong, D. T. P. (2021). A systematic review of running-related musculoskeletal injuries. PubMed.
- Mohseni, M. M., et al. (2019). Factors Associated with Half- and Full-Marathon Race-Related Injuries. PubMed.
- Fredericson, M., & Misra, A. K. (2020). Epidemiology and Aetiology of Marathon Running Injuries. Springer.
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Author Charlie Briers – Chartered Senior Physiotherapist, Clinical Administrator and Instructor.
