MARATHON TRAINING & INJURY MANAGEMENT
Marathon training season is upon us and anybody working to a three or six-month training schedule will be out running a few times a week and gradually build up their long runs.
Because of the high training mileage involved in marathon training it is not unusual to pick up niggles and injuries during training. These can range from simple aches and pains that might limit your training ability for a few days to more worrying injuries that can disrupt training programs and perhaps even place competing at jeopardy.
Below are some typical running injuries and information about services that we offer to help our marathon runners cope with their training mileage, minimize injuries and compete successfully.
5 Common Running Injuries:
Patellofemoral pain syndrome
This presents as pain at the front of the knee or around the kneecap. It is typically worse going downstairs, running downhill or during squatting and lunging. It tends to come on gradually during running and if left untreated can result in prolonged periods of inactivity. The pain can be from a variety of sources, but is often from irritation of the cartilage on the underside of the kneecap and/or the tendon that attaches the thigh muscle to the lower leg. This can be caused by several things such as hip weakness, quads weakness, altered biomechanics, muscle tightness, sub-optimal running technique and very likely a combination of these factors.
Achilles Tendinitis
This is a soft tissue disorder that affects the Achilles tendon, which attaches your calf muscles to your heel bone. Pain can be felt either in the tendon itself or directly on the back of the heel bone. This happens because of repetitive rapid loading of the tendon beyond its capacity which leads to microtrauma. The symptoms typically are a combination of pain, localised swelling, weakness of the muscle and stiffness, which is worse in the morning. Pain is normally worse at the start of activity, eases during activity and then is worse that evening or the morning after. Common causes are weakness and tightness of the calf and gluteal muscles, and poor running style in addition to various lifestyle factors.
Plantar Fasciitis
This problem is called many things including ‘Policeman’s Heel’ and is often poorly diagnosed leading to poor management. True plantar fasciitis affects the thick, soft tissue located on the sole of the foot and presents with intense arch pain near the heel. This is often worse first thing in the morning, worsens when standing after prolonged sitting and with walking or running. Recent research has shown that this condition presents very similarly to Achilles Tendinitis and is normally treated with gradual loading exercises and a graduated return to running. Tight and weak calf muscles are typical underlying problems, foot posture and running technique can play a major role.
Shin Splints
Shin splints is again one of those terms that is used for different problems affecting the front of the lower leg. Different diagnoses include Medial Tibial Stress Syndrome (MTSS), Compartment Syndrome and Tenosynovitis of the long toe tendons. Therefore, getting the diagnosis right for ‘Shin Splints’ is important because the management of each problem can vary. Shin splints generally occur with excessive mileage increases. Underlying factors generally include tight, weak calf muscles, poor control around the hips and/or poor running biomechanics. Left untreated shin splints can be lengthy injuries, so getting diagnosed and treated early is highly recommended.
Stress Fractures
Stress fractures can also be a source of pain for runners. These occur when excessive repeated load is placed on a bone, this can first lead to swelling inside the bone (stress response) and then if not managed properly to a crack in the bone (stress fracture). These can occur in the pelvis, thigh, lower leg, or foot. Symptoms include a very specific point of pain along the bone which is worse on impact and can continue despite stopping running. Stress fractures in the running population are most common along the shin bone and in the foot. Initial rest to calm the bone allowing for healing to occur with a subsequent graded return to strengthening and running is the usual treatment. Rest during marathon training can be devastating this is a problem to get diagnosed and treated early.
Our top tips for Marathon Training and Preventing Injury
- Screening and prevention.
One of the best ways to avoid injury that is often overlooked. Ideally all runners should be fully screened for potential problems including footwear and gait analysis at the start of their marathon training journey. Dealing with injuries when they occur is understandable, but often these injuries could be avoided with a more individualised approach to training and exercise. In most cases preventing injury is better than a reacting to an injury so book in if want to improve your training.
- Structure your training.
Basic training guides can be found on the London Marathon website and in magazines such as Runners World. A suggested increase in mileage of about 10-20% per week with a reduced week every fourth week is common. Keeping a diary or using apps such as Strava can help keep a close eye on total weekly mileage and avoid over-training. Many runners are not realistic in setting out their regimes and become disheartened when unable to complete the schedule due to other life commitments. Others don’t plan at all and then start upping their mileage in a panic going too far too soon and picking up injuries.
- Goal setting.
This really helps keep motivation high even when the main event is months away. If you are a novice, then be realistic and aim to gradually increase your running distance. Why not start with a 5k, moving up to 10k and then half marathon events spread out through your training plan. Running an actual event is a great eye opener to novice runners and gets you well prepared for the big day.
- Strength training.
A common mistake by runners is that running will make you stronger. In essence, running will make you better at running, however, it is important to be strong enough to run. Each step applies upwards of 5x bodyweight through your body as you run, which over time can lead to injury. Therefore, you need at least one dedicated strength session per week with prescribed exercises based on your individual requirements, to help prevent possible injuries.
- Nutrition & Recovery.
Allowing the body sufficient time to recover and adapt will help to avoid over-training issues, illness, and injury. Sleep is an important factor in this and therefore planning your schedule and commitments to allow for a good regular night sleep is imperative.
Staying hydrated and giving the body the right balance of foods to perform and recover is also vital. Runners need the right balance of carbohydrate, protein and fat in their diets and should try to vary calorific intake day to day depending on the training load. Due to the training you would be undertaking it is not a good idea to also be in a calorie deficit as this will not give your body enough resources to recover well. If in doubt speak to a member of staff which can help guide you through your nutrition.
Performance Packages and Injury Management
Our performance packages have been created specially to help in these situations.
Combining injury prevention screening with an individualised exercise program, running analysis and sports massage therapy sessions, these packages can provide invaluable information and treatment to incorporate into your marathon training program.
Our physiotherapists are experts in sports injuries and can design structured strength plans individual to your needs. They can also help with running technique, training programs and of course, if needed, injury management and treatment.
Our sports massage therapists are invaluable during marathon training. It will be a very rare person that does not get tight or pick up a little niggle and our sports massage therapists can help during training, just before events and for recovery, plus provide further advice about training programs, nutrition, and injury prevention.
