How to Avoid Injuries when Training for the Marathon

Without fail, every February and March we see a spike in patients who come in presenting injuries from training for the London Marathon. Aside from the unlucky few who suffer a fall or other acute trauma, the vast majority of these injuries will be avoidable.

While newspapers, running magazines and websites share tips on stretching, running technique and how to buy the best pair of running shoes, these factors are massively overstated compared to load management – which is by far the most important discipline to learn for safe and successful marathon training.

Why do people injure themselves during marathon training?

Most of the injuries we treat in people training for a marathon are a result of overloading. In other words, demanding more from your body than it is capable of.

During training, your heart and lungs become more efficient at delivering oxygen and your muscles more efficient at utilising it. This adaptation occurs quite rapidly – with some variance depending on your age and general fitness – allowing you make significant gains in your running distance and speed each time you train.

People who start running for the first time are often taken by surprise by how quickly their progress seems to be advancing, which can be very motivating and exciting for beginners.

But under the surface things don’t look quite so optimistic. Some tissues, such bones and tendons, adapt far more slowly to increased load.

So while you may be thrilled by being able to double your progress each week, your ankles, knees and hips will start to suffer, until you wake up one morning in agony or collapse during your run when something gives out.

It’s a situation we encounter in our patients time and time again, year after year. Such injuries are easily avoidable if you learn to manage your load.

How can you manage load during marathon training?

For novice runners, I follow a simple rule: avoid increasing your load by more than 10% per week. This is a handy rule to remember across all your exercise and activities. For running, you can measure your load through your distance.

10% is about as much as you can expect the load bearing capability of your tendons and others connective tissues to improve per week. By limiting your training to how much they can adapt, you significantly reduce your risk of injury.

Following the 10% per week rule, it would take you around 40 weeks of training to be able to run a marathon distance if you are an absolute beginner, or 23 weeks if you can currently complete a 5k run comfortably.

The 10% rule is very broad and there will always be individual variance, particularly if you have an injury history. Even when following the 10% rule, make sure to continue to listen to your body – don’t try and power through pain.

While muscle soreness is expected after training, you should not feel pain in your tendons, joints or bones. If you feel such pains, reduce your load until they subside or, if they are persistent, book an appointment with your physiotherapist.

Why do marathon training injuries spike early in the year?

If overloading can happen at any point during training, why is there a spike in injuries during February and March?

From what I’ve gathered from our patients, there are two factors at play:

1. People realising they are behind on their training and trying to catch up in the weeks before the marathon.
2. People taking a break from exercise through a cold winter and failing to account for their drop in fitness.

My general advice for avoiding injury after taking a break from your usual exercise or training routine for one or two weeks is to decrease your load by 30%, then ramp back up to your pre-break load over two weeks.

If you know you are going to be taking breaks from your routine it is very important that you take this re-conditioning time into account in your schedule, otherwise you risk undoing months of hard work with an injury.

Is it too late to start marathon training now?

If you’re reading this in February and you want to take part in this year’s marathon, I’m sorry to tell you that you’ve left it far too late to start training.

Around 30% of people who sign up to the London Marathon don’t make it to the start line due to sustaining training related injuries. Even if you are generally fit or genetically gifted, I can almost guarantee you will be one of them if you start training now.

This is, however, the ideal time to start training for next year’s. Even if you are a complete beginner, there’s enough time to be able to safely complete your training if you start now.

The best way to kick off your training on the right foot is to come and see us for a general fitness check up and overview of your strength, weaknesses and injuries. The more you know about your body, the more likely you will be to make it through the finish line.

To book your appointment, email info@coventgardenphysio.com, call 0207 497 8974, or book online.

Cameron Tudor

B.PHYSIOTHERAPY PG CERT INDEPENDENT PRESCRIBING, MCSP, MHCPC