The Most Common Marathon Training Injuries (& How to Avoid Them)

Marathon training injuries often stem from the high mileage and repetitive stress associated with preparing for a 26.2-mile race. Common injuries include runner’s knee (patellofemoral pain syndrome), shin splints, Achilles tendinitis, plantar fasciitis, IT band syndrome, and stress fractures.

Injuries can occur whether you are training for your first marathon or have done a dozen. You can avoid common running injuries if you correctly craft your training plan.

You can also do many injury prevention things to prevent overuse injuries.

How Many People Get Injured Training for a Marathon?

According to research, 82% of runners will experience some running-related injury over the course of their running career. A sports medicine doctor who writes for the New York Times reported that 30% of people training for a marathon will have injuries ranging from shin splints to stress fractures to knee pain. 

You should know that there are ways to prevent this from happening.

7 Most Common Types of Injuries Marathon Runners Face During Training

1. Achilles Tendonitis: Achilles tendinopathy is a common injury when runners increase their mileage too quickly.
2. Hamstring Injuries: Pain in your hamstrings can be anything from a strain to a tear. If your hamstrings are tight or weak, you are more prone to injuring them.
3. IT Band Syndrome: Pain outside the knee is sometimes IT band syndrome. Common in runners and cyclists, it is inflammation of the iliotibial band. The iliotibial band stretches from the hip to the top of the knee, offering an athlete’s knee stability.
4. Plantar Fasciitis: Plantar fasciitis or plantar heel pain is when the fascia on the bottom of the foot becomes sore and inflamed. This pain is typically worse first thing in the morning.
5. Runner’s Knee: Patellofemoral syndrome, more commonly called runner’s knee, is a dull pain around the front of the kneecap.
6. Shin Splints: Shin splints are characterized by pain along the inside edge of the shinbone. The pain is due to tissue inflammation in the area between the middle of the lower leg and the ankle, also called medial tibial stress syndrome.
7. Stress Fracture: A tiny fracture in the bone that causes pain is a stress fracture. Stress fractures are caused by repetitive motion impact exercises such as running.

Coping with Marathon Injuries

There are many things you can do if you find yourself injured. If your body tells you to take a few days off, rest is the best thing. Some injuries do well with ice, whereas others respond best to heat. Be certain to investigate which to use for your situation.

Did the discomfort come as you increased mileage? Try decreasing your training volume slightly and see if that results.

Is it time to see a doctor? Choosing a sports medicine physician will likely get you back in the game faster than if you see a general practitioner. Physical therapists can often give you stretches and strengthening exercises to help you come back from injury.

If your shoes seem worn down, a new pair of kicks might solve the problem. Sometimes, a sports massage helps ease discomfort.

8 Ways to prevent Marathon Running Injuries

There are some things you can do to help you get to the starting line on race day injury-free.

• Build Up Carefully: Runners should not increase their weekly mileage by more than 10-15% each week. Be very intentional about this process. Most training programs incorporate this type of mileage increase, especially for beginners. Don’t be tempted to jump mileage too quickly.
• Core Work: Besides other strength training, don’t forget to work on your core. The core of your body is crucial to preventing muscle imbalances.
• Cross Training: Even though you might be tempted to run daily, don’t do it. Take one full rest day each week and one or two non-impact cross-training days (depending on how many days each week you plan to run).
• Flexibility: Remember what we said about tight muscles leading to injury? Work on your flexibility with yoga or intentional stretching once your muscles are warm.
• Fuel & Hydration: Fueling your body properly and using enough fluids are excellent ways to keep your body in tip-top shape during marathon training.
• Perfect Form: Have you worked with a coach to ensure your running form does not make you vulnerable to injuries? Having the proper biomechanics can go a long way to helping you run better, more efficiently, and experience fewer injuries.
• Shoes: Make certain your running shoes fit your needs as a runner and are not worn out. When your shoes start to break down it is time for a new pair. Shoes are not something to skimp on!
• Strength Training: Incorporating some strength training into your workout regimen is a great way to prevent injuries. Don’t feel like you have to be lifting heavy weights. You can do many exercises using your body weight for resistance.

What Type of Injuries Can You Still Run With?

As a distance runner, know you can expect twinges, aches, and pains. You need to learn the difference between the discomfort you can run through and the pain that tells you to stop.

Long-distance running is a delicate balance between staying committed to your training and not flirting with crazy when an injury occurs.

1. Mild Muscle Strains

• Characteristics: Slight discomfort that improves with a proper warm-up.
• Management: Reduce mileage and intensity. Focus on gentle stretching, strengthening exercises, and possibly alter your running form as advised.

2. Runner’s Knee (Patellofemoral Pain Syndrome)

• Characteristics: Pain around the kneecap that typically worsens with downhill running or after sitting for long periods.
• Management: Adjust your running surface, avoiding downhill routes. Strengthening exercises for the quadriceps, hamstrings, and hips can help. Sometimes, modifying stride length and improving cadence can reduce stress on the knee.

3. Shin Splints

• Characteristics: Tenderness, soreness, or pain along the inner side of your shinbone.
• Management: Consider running on softer surfaces, reduce mileage, and address potential issues with running mechanics. Strengthening and flexibility exercises focusing on the calves and possibly using orthotics can also help.

4. Plantar Fasciitis

• Characteristics: Sharp heel pain that usually feels worse in the morning.
• Management: Use supportive footwear, possibly with custom orthotics. Stretching the calves and the plantar fascia, along with strengthening the foot muscles, can aid in recovery. Running might be more comfortable after the plantar fascia has been properly warmed up.

5. Achilles Tendinitis

• Characteristics: Pain and stiffness along the Achilles tendon, particularly during the morning or after long periods of rest.
• Management: Reduce running intensity and volume. Eccentric heel drops and exercises to strengthen the calf muscles can be beneficial. Pay attention to footwear and consider heel lifts temporarily.

6. IT Band Syndrome

• Characteristics: Pain on the outside of the knee, often worsening with activity.
• Management: Reduce mileage and avoid aggravating activities. Stretching and strengthening the hips and glutes can help. Cross-training activities like cycling or swimming may be less irritating.