Common Injuries When Training for a Marathon

Patients often come in with increased lower extremity related running injuries to see our physical therapists here at Pro+Kinetix. The reason for this is that many many of our patients run long distances or are training for marathons. 

Let’s talk about some of the more frequent running injuries we see as patient mileage increases. Everyone who is training may sustain an injury as a result of the increased number of repeated motions placed on the lower extremities. That aspect alone can lead to a slew of problems. When you combine this with ineffective cross training and little rest, the results can be excruciating. Here are a handful of the most common injuries that runners have when training.

The most common ailment I’ve seen is a hip flexor strain, which is followed by ITB syndrome, sometimes known as runners knee. Anterior and posterior shin splints are two more ailments that might occur. Plantar fasciitis is another very common injury we see at our physical therapy office. Training properly is one of the simplest methods to avoid all of these ailments. How many times a week do you run? This is one of the first questions we ask my patients. If the answer is more than 3-4 times a week, I will tell the patient that they are overdoing it. I normally recommend running 3-4 times per week.

One day should be a “regular” run of 4-5 miles at a moderate pace. Another day should be a hill day, with a large amount of inclines and declines in your jogging path. That running day should be roughly 4-6 miles long and include a variety of speeds and paces. Finally, as you progress week-over-week, there should be a day of the week 3 months out from your marathon where you get your long miles in, which are usually 12-19 miles, until the final month before your marathon.  You should start tapering these lengthy runs down til the week before the marathon at that point.

If you feel you need to run four days a week, make the fourth run short and easy, and always take a day off after the long run, which we call a stretch day. Cross exercise during the week, such as yoga or pilates, as well as modest weight training, is beneficial. I’d like to offer you an idea of how these ailments present themselves so that you can correctly identify them and know how to stretch or strengthen the affected areas.

  1. Typical Hip Flexor Strain

The runner will experience pain in the anterior region of the hip due to a hip flexor strain. Walking/running during the swing portion of the gait cycle frequently worsens symptoms. 

  1. ITB Syndrome (Runner’s Knee)

ITB syndrome, sometimes known as runners knee, is the next injury to be discussed. This injury can cause pain in the lateral hip and gluteal area, which can then spread to the lateral thigh and knee. Pain can be severe, especially if there is a deficit in hip abduction. In addition to foam rolling, it is beneficial to stretch the ITB and hip flexor on a daily basis to avoid these two injuries.

  1. Shin Splints

Shin splints, both posterior and anterior, are two other typical problems that might develop in a runner preparing for a Marathon. Both of these injuries can occur on the outside or inside of your shin. When you move your ankle during the swing portion of the gait cycle when jogging or walking, the pain might be acute and intensify.

  1. Plantar Fasciitis

Plantar fasciitis is the final acquired injury during marathon preparation. Sharp stabbing pain in the bottom of the foot and heel area is a symptom. Runners with this injury may also have excessively tight calf muscles and a reduced range of motion in their ankles. When they stand, walk, or run, they experience discomfort. They also have a tendency to have more discomfort when they first get out of bed in the morning. This is due to the fact that their calf and plantar fasciitis have been in a shortened or relaxed position for the whole night, and the initial shock of placing the foot on the floor can be extremely painful. The best technique to deal with this ailment is to do some substantial calf stretching and regular trigger point massage on the plantar fascia. Wearing a plantar fascia night splint and self-massaging with a trigger point ball are two things we strongly advise our patients to do.

If you are experiencing any of these injuries or pain while training long distances of running, feel free to make an appointment to see one of our Pro+Kinetix physical therapists by visiting

Oakland, CA Pain Management Clinic

Dr. Ben Bagge

Pro+Kinetix Physical Therapy & Performance

"We Help Active Adults & Athletes Get Back To Workouts and Sports They Enjoy without surgery, stopping activities they love, or relying on pain medicine."
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